生殖医学科女性患者支原体感染状况及耐药性变迁

Mycoplasma infection status and drug resistance changes in patients from Department of Reproductive Medicine

目的探讨生殖医学科女性患者支原体感染状况及耐药性变迁,为生殖道支原体感染预防和临床合理使用抗菌药物提供科学依据。方法回顾性分析2010年1月-2018年12月生殖医学科进行解脲支原体(UU)、人型支原体(MH)培养与药物敏感性试验检测的6 661例女性患者病例资料,年龄17~61岁。结果支原体总感染率为48.64%(3 240/6 661),UU、MH及UU+MH感染3组的阳性率分别为42.26%(2 815/6 661)、0.62%(41/6 661)、5.76%(384/6 661)。支原体总感染率及UU感染率呈逐年下降趋势,差异有统计学意义(均P<0.05)。≤20岁的人群具有最高的感染率(70.97%,44/62),支原体的感染率随着年龄增长呈显著下降趋势,差异有统计学意义(χ2=23.87,P<0.001)。UU对环丙沙星的耐药率最高,呈逐年上升趋势,差异有统计学意义(χ2=112.39,P<0.001),其次是氧氟沙星,但呈现下降的耐药趋势,差异有统计学意义(χ2=238.95,P<0.001)。MH、UU+MH对红霉素、环丙沙星、阿奇霉素、克拉霉素、罗红霉素的耐药性较高且稳定,UU+MH对氧氟沙星、异帕沙星的耐药率总体呈下降趋势,差异有统计学意义(均P<0.01)。结论生殖医学科女性患者支原体感染率较高,UU为主要感染类型,支原体感染率呈逐年下降的趋势,≤20岁女性支原体感染率最高。对于支原体感染的患者要依据药敏结果选择合适的抗生素,切实达到及时、有效的治疗结果。

Objective To explore mycoplasma infection status and drug resistance changes in patients from Department of Reproductive Medicine,provide a scientific basis for prevention of mycoplasma infection in genital tract and rational use of antibacterial agents.Methods From January 2010 to December 2018,6 661 female patients aged 17-61 years old underwent Ureaplasma urealyticum (UU),Mycoplasma hominis (MH) culture and drug sensitivity test in Department of Reproductive Medicine,then the clinical data were retrospectively analyzed. Results The total infection rate of mycoplasma was 48. 64% (3 240/6 661). The positive rates of UU infection,MH infection,and UU+MH infection were 42. 26% (2 815/6 661),0. 62% (41/6 661),and 5. 76% (384/6 661),respectively. The total infection rate of mycoplasma and UU infection rate decreased year by year (P<0. 05). The infection rate among the women aged 20 years old or under 20 years old was the highest (70. 97%,44/62). The infection rate of mycoplasma decreased significantly with age (χ~2= 23. 87,P<0. 001). The drug resistance rate of UU to ciprofloxacin was the highest,showing an increasing trend year by year (χ~2= 112. 39,P <0. 001),followed by ofloxacin,which showed a decreasing trend (χ~2= 238. 95,P<0. 001). The drug resistance rates of MH and UU+MH to erythrocin,ciprofloxacin,azithromycin,clarithromycin,and roxithromycin were high and stable. The drug resistance rates of UU+MH to ofloxacin and isepamicin showed a decreasing trend (P<0. 01). Conclusion The infection rate of mycoplasma among female patients in Department of Reproductive Medicine is high,UU is the main type of infection. The infection rate of mycoplasma shows a decreasing trend year by year,which is the highest among the women aged 20 years old or under 20 years old. For the patients with mycoplasma infection,antibiotics should be selected according to drug sensitivity test to achieve timely and effective treatment.