大观霉素等对泌尿生殖道支原体的药敏试验及其临床疗效的观察

Antimicrobial Susceptibility of Mycoplasma and Clinical Response to Antimicrobial Agents(Spectinomycin etc.)in Genitourinary Mycoplasma Infection

目的观察大观霉素、米诺环素、阿奇霉素和司氟沙星对解脲脲原体(Uu)和人型支原体(Mh)的药敏情况及国产大观霉素治疗泌尿生殖道支原体感染的临床疗效.方法①药敏试验:支原体培养基设大观霉素、米诺环素、阿奇霉素和司氟沙星1μg/mL(敏感质量浓度)和4μg/mL(耐药质量浓度)2个质量浓度.②治疗方法:国产大观霉素2.0 g肌内注射,每日1次,共7～10 d,治疗7 d后复查,观察近期疗效.治疗结束后2～4周复查1次,观察远期疗效.结果①药敏试验:1 658例分泌物标本中Uu阳性519例和Mh阳性61例.Uu对米诺环素的耐药率为7.7%,阿奇霉素为13.9%,司氟沙星为21.4%,大观霉素为7.3%:Mh的耐药率分别为18.0%,54.1%,45.9%和29.5%.②国产大观霉素对Uu的MIC为0.01～0.3μg/mL,Mh的MIC为0.02～0.6μg/mL.③临床疗效:43例泌尿生殖道支原体感染患者经肌内注射大观霉素治疗后痊愈37例(86.0%),显效4例(9.3%),无效2例(4.7%),总有效率为95.3%.支原体清除率为95.3%.其中24例患者于治疗后2周复查未复发.结论支原体对大观霉素的耐药率比米诺环素、阿奇霉素和司氟沙星的耐药率低,临床应用国产大观霉素治疗泌尿生殖道支原体感染取得满意疗效.

Objective To investigate the antimicrobial susceptibility of spectinomycin?minocycline?azithromycin and sparfloxacin to mycoplasma(Uu and Mh)and therapeutic effect of spectinomycin to my-coplasma infection in genitourinary tract.Methods①The susceptibility test:each of the4drugs was divided into two concentrations.One was at1μg/mL(sensitive concentration)and the other was at4μg/mL(resistant concentration).If mycoplasma does not grow in both concentrations,it means the drug tested is sensitive.If it grows in both concentrations,the drug tested is resistant.If mycoplasma grows in lower concentration and does not in higher concentration,it means moderate sensitive.②Treatment regimen:Spectinomycin was injected,2g/d IM,for7-10days as a course of treatmeant.Patients were followed-up7days later and2~4weeks after treatment.Results①Among1658specimens,519were found Uu positive,and61Mh positive.The resis-tance rates of Uu to4different drugs were:7.7%for minocycline,21.4%for sparfloxacin,13.9%for azithromycin and7.3%for spectinomycin.Whereas,those of Mh were:18.0%,45.9%,54.1%,and29.5%re-spectively.②The clinical effect of spectinomycin was:out of43treated patients,37(86.0%)cured,4(9.3%)markedly improved,2(4.7%)failed.Total effective rate was95.3%and so was the elimination rate of my-coplasma.Conclusion The resistant rate of mycoplasma to spectinomycin is lower than that to minocycline?azithromycin and sparfloxacin,and the former is widely used in the treatment of mycoplasma(especially Uu)infection,with a satisfactory clinical effect.