盆腔炎患者解脲支原体和沙眼衣原体感染菌群分布及优势菌药物敏感性

Distribution of Ureaplasma urealyticum and Chlamydia trachomatis among patients with pelvic inflammation and antimicrobial susceptibility testing for dominant strains

目的 探讨盆腔炎患者解脲支原体、沙眼衣原体感染与分泌物菌群分布的关系及优势菌药敏试验结果。方法 选取2020年1月-2022年6月无锡市人民医院收治的108例盆腔炎患者为盆腔炎组,同期体检的120名健康女性为对照组。比较两组解脲支原体、沙眼衣原体感染及阴道分泌物菌群分布情况,不同严重程度盆腔炎患者解脲支原体、沙眼衣原体感染及分泌物菌群分布情况,采用Spearman相关性分析盆腔炎患者解脲支原体、沙眼衣原体感染与分泌物菌群分布的相关性,分析优势菌药敏试验结果。结果 盆腔炎组解脲支原体、沙眼衣原体感染、菌群多样性Ⅰ+Ⅳ级、菌群密度Ⅰ+Ⅳ级及微生态异常的患者占比均高于对照组(P<0.05);重度盆腔炎组解脲支原体、沙眼衣原体感染的患者占比高于轻度盆腔炎组、中度盆腔炎组,重度盆腔炎组及中度盆腔炎组阴道菌群多样性Ⅰ+Ⅳ级、菌群密度Ⅰ+Ⅳ级及微生态异常的患者占比高于轻度盆腔炎组(P<0.05);盆腔炎患者解脲支原体感染和沙眼衣原体感染均与阴道菌群多样性Ⅰ+Ⅳ级、菌群密度Ⅰ+Ⅳ级及微生态异常呈正相关(P<0.05);盆腔炎患者对环丙沙星及左氧氟沙星的耐药性较高,而对强力霉素、克拉霉素的敏感性较高。结论 解脲支原体、沙眼衣原体感染及盆腔分泌物菌群分布与盆腔炎的发生、发展具有密切关系,且解脲支原体、沙眼衣原体感染与盆腔分泌物菌群分布相关,而盆腔炎患者对强力霉素、克拉霉素的耐药率较低,临床可据此给予有效的治疗措施。

OBJECTIVE To explore the relationship between the Ureaplasma urealyticum, Chlamydia trachomatis infection and the distribution of secretion flora in patients with pelvic inflammation and the results of drug sensitivity test of dominant bacteria. METHODS 108 patients with pelvic inflammation admitted to the Wuxi People′s Hospital from Jan 2020 to Jun 2022 were selected as the pelvic inflammation group, while 120 healthy women who underwent physical examinations during the same period were selected as the control group. The distribution of U. urealyticum, C. trachomatis infection and distribution of secretion flora in the two groups, and the distribution of U.urealyticum, C.trachomatis infection and distribution of secretion flora in patients with pelvic inflammatory disease of different severity were compared. The correlation between U.urealyticum, C.trachomatis infection and secretion flora distribution in patients with pelvic inflammatory disease were analyzed by spearman correlation, the drug sensitivity test results of dominant bacteria was analyzed. RESULTS The proportion of patients with U.urealyticum, C.trachomatis infection, flora diversity Ⅰ+Ⅳ, flora density Ⅰ+Ⅳ and microecological abnormalities in the pelvic inflammation group were higher than the control group(P<0.05). The proportion of patients with U.urealyticum and C.trachomatis infection in the severe pelvic inflammation group was higher than that in the mild pelvic inflammation group and moderate pelvic inflammation group. The proportion of patients with vaginal flora diversity Ⅰ+Ⅳ, flora density Ⅰ+Ⅳ, and abnormal microecology in the severe and moderate pelvic inflammation groups were higher than that in the mild pelvic inflammation group(P<0.05). U.urealyticum infection and C.trachomatis infection in patients with pelvic inflammatory disease were positively correlated with vaginal flora diversity grade Ⅰ+Ⅳ, flora density grade Ⅰ+Ⅳ and microecological abnormalities(P<0.05). Patients with pelvic inflammation had high resistance to ciprofloxacin and levofloxacin. They had high sensitivity to doxycycline and clarithromycin. CONCLUSION U.urealyticum, C.trachomatis infection and pelvic secretion flora distribution were closely related to the occurrence and development of pelvic inflammation, and U.urealyticum, C.trachomatis infection and pelvic secretion flora distribution were significantly related, while the resistance rate of pelvic inflammation patients to doxycycline and clarithromycin was low, so clinical treatment measures could be taken accordingly.