泌尿生殖道感染支原体分布和耐药性分析

Analysis of distribution and drug resistance of Mycoplasma in genitourinary tract infection

目的了解北京丰台医院泌尿生殖道感染支原体分布及耐药性,为临床合理用药提供依据。方法选取2019年1月至2022年8月北京丰台医院疑似泌尿生殖道感染并送检支原体培养的患者标本1654份,统计支原体分布情况,行药敏试验统计耐药性。结果1654份标本中检出阳性标本733份,检出率为44.3%;解脲脲原体(Uu)感染占比最高(33.2%),其次为Uu+人型支原体(Mh)感染(7.6%)、Mh感染(3.5%);女性阳性标本检出率为50.7%,高于男性的30.4%,差异具有统计学意义(P<0.01)。1654份标本中,21~30岁标本最多,其次为31~40岁、≥41岁;≤20岁阳性标本检出率最高,其次为21~30岁、31~40岁。Uu感染时,敏感率超过90.0%的抗菌药物有强力霉素、美满霉素、克拉霉素和交沙霉素,耐药率较高的有司帕沙星、阿奇霉素;Mh感染时,强力霉素、美满霉素、交沙霉素的敏感率均达到了100.0%,耐药率超过50.0%的有环丙沙星、罗红霉素、克拉霉素;Uu+Mh感染时,强力霉素、美满霉素和交沙霉素的敏感率均超过85.0%,罗红霉素、克拉霉素的耐药率超过85.0%。结论我院泌尿生殖道感染支原体以Uu为主,女性检出率明显高于男性。感染人数以21~30岁最多,≤20岁阳性标本检出率最高。体外药敏试验表明,强力霉素、美满霉素和交沙霉素对各种类型的生殖道支原体感染都有较高的敏感率,在紧急情况下,临床医生可以经验性使用这三种药物治疗生殖道支原体感染患者。

Objective To investigate the distribution and drug resistance of Mycoplasma in genitourinary tract infection in Beijing Fengtai Hospital,and to provide evidences for clinical rational drug use.Methods From January 2019 to August 2022,1654 specimens from patients suspected genitourinary tract infection and submitted for Mycoplasma culture at Beijing Fengtai Hospital were selected,and the distribution of Mycoplasma was analyzed.Drug sensitivity test were conducted to measure drug resistance.Results Among 1654 specimens,733 were positive,with a detection rate of 44.3%;Ureaplasma urealyticum(Uu)infection accounted for the highest proportion(33.2%),followed by Uu+Mycoplasma hominis(Mh)infection(7.6%)and Mh infection(3.5%);the detection rate of positive specimens in women was 50.7%,which was higher than 30.4%in men,and the difference was statistically significant(P<0.01).Among 1654 specimens,21-30 years old specimens were the most,followed by 31-40 years old and≥41 years old;the detection rate of positive specimens≤20 years old was the highest,followed by 21-30 years old and 31-40 years old.When Uu was infected,the antibiotics with a sensitivity rate over 90.0%include doxycycline,minocycline,clarithromycin and josamycin,the antibiotics with higher drug resistance rate were sparfloxacin and azithromycin;when Mh was infected,the sensitivity rate of doxycycline,minocycline and josamycin reached 100.0%,and the drug resistance rate of ciprofloxacin,roxithromycin and clarithromycin exceeded 50.0%;when Uu+Mh was infected,the sensitivity rate of doxycycline,minocycline and josamycin were over 85.0%,while the drug resistance rate of roxithromycin and clarithromycin were over 85.0%.Conclusion Uu was the main Mycoplasma in genitourinary tract infection in our hospital,and the detection rate in women is higher than that in men.The number of infected people was the highest in 21-30 years old,and the detection rate of positive specimens was the highest in≤20 years old.In vitro drug sensitivity test showed that doxycycline,minocycline and josamycin are highly sensitive to various types of genital tract Mycoplasma infection.In emergency cases,clinical doctors can empirically use these three drugs to treat patients with genital tract Mycoplasma infection.