宫颈癌患者生殖道细菌和人乳头瘤病毒感染情况及其耐药性分析

Analysis of bacterial infection and human papillomavirus infection and their drug resistance in patients with cervical cancer

目的了解宫颈癌患者生殖道细菌和人乳头瘤病毒(HPV)感染情况并分析其耐药性。方法2018年1月-2019年10月本院妇科收治的宫颈癌患者112例,检测其生殖道细菌和HPV感染情况及细菌对常用抗菌药物的耐药性,并分析生殖道感染的高危因素,以及生殖道细菌感染与HPV感染的相关性。结果宫颈癌患者生殖道细菌感染率为53.57%(60/112),其中革兰阴性菌感染占76.67%(46/60),以大肠埃希菌为主;革兰阳性菌感染占23.33%(14/60),以金黄色葡萄球菌为主;PCR法检测HPV-DNA阳性68例,阳性率60.71%;宫颈癌患者HPV感染与生殖道细菌感染无显著相关性(χ2=0.350,P>0.05)。药敏试验检测大肠埃希菌、肺炎克雷伯菌对亚胺培南、美罗培南均敏感,耐药率为0;金黄色葡萄球菌对氨苄西林、万古霉素、呋喃妥因、利奈唑胺的耐药率均低于30.00%。经Logistic多因素分析,初次性生活年龄≤20岁、性伴侣数目>1名、妊娠次数≥3次以及未进行工具避孕是宫颈癌生殖道细菌感染的独立危险因素(P<0.05)。结论宫颈癌患者HPV感染率及生殖道细菌感染率均较高,感染病原菌以革兰阴性菌为主,且细菌感染与HPV感染无显著相关性。生殖道细菌感染与多种因素有关,感染菌对多种抗生素耐药,可为该病的预防和治疗提供参考。

Objective To investigate infection of the genital tract by bacteria and human papillomavirus(HPV)in patients with cervical cancer and to analyze the drug resistance of those pathogens.Methods Subjects were 112 patients with cervical cancer who were seen at this Hospital from January 2018 to October 2019.After disinfection with Iodophor,vaginal secretions were collected.The genital tract of patients was analyzed for a bacterial infection and HPV infection.Bacteria were tested forl resistance to commonly used antibiotics.Risk factors for a genital tract infection and their correlation with HPV infection were analyzed.Results The rate of a bacterial infection of the genital tract in patients with cervical cancer was 53.57%(60/112).Ggram-negative bacteria accounted for 76.67%of the bacterial strains isolated(46/60),and Escherichia coli was the main Gram-negative bacterium.Gram-positive bacteria accounted for 23.33%of the bacterial strains isolated(14/60),and Staphylococcus aureus was the main Gram-positive bacterium.Patients tested positive for HPV-DNA at a rate of 60.71%.There was no significant correlation between HPV infection and a bacterial infection of the genital tract in patients with cervical cancer(χ~2=0.350,P>0.05).A drug sensitivity test indicated that E.coli and Klebsiella pneumoniae were sensitive to imipenem and meropenem,and their resistance was 0%.The resistance of S.aureus to ampicillin,vancomycin,nitrofurantoin,and linezolid was lower than 30.00%.Logistic multivariate analysis indicated that having one’s first sexual experience≤20 years of age,>1 sexual partners,≥3 pregnancies,and not using contraceptives were independent risk factors for a bacterial infection of the genital tract in patients with cervical cancer(P<0.05).Conclusion The rate of HPV infection and the rate of a bacterial infection of the genital tract were higher in patients with cervical cancer.Gram-negative bacteria were the main pathogens causing an infection,and there was no significant correlation between a bacterial infection and HPV infection.A bacterial infection of the genital tract is related to many factors.The bacteria causing an infection are resistant to many antibiotics,and the current results may provide a reference for the prevention and treatment of this infection.