泌尿生殖道炎症病人支原体感染现况及耐药性分析

Prevalence and Drug Tolerance of Mycoplasma in Patients with Urogenital Inflammation

目的 :了解泌尿生殖道炎症病人支原体感染现况及耐药性情况。 方法 :统计 1999～ 2 0 0 3年门诊诊断为非淋菌性尿道炎 (NGU)、慢性前列腺炎及盆腔炎等泌尿生殖道疾病病人 30 5 5例 ,分析其支原体培养及药物敏感试验结果。 结果 :30 5 5例病人共检出支原体感染 992例 ( 32 .5 % ) ,5年间差异无显著性 (P <0 .0 5 )。其中单纯溶脲脲原体 (Uu)感染 70 1例 ( 70 .7% ) ,单纯人型支原体 (Mh)感染 4 4例 ( 4 .4 % ) ,Uu和Mh混合感染 2 4 7例 ( 2 4 .9% ) ,单纯Uu感染远高于混合感染和单纯Mh感染 (P <0 .0 1)。单纯Uu感染计数≥ 10 4cfu/ml占 76 .7% ,而单纯Mh感染者≥10 4cfu仅占 18.2 %。对强力霉素、原始霉素、交沙霉素和四环素敏感性较高 ,分别为 94 .3%、96 .6 %、86 .5 %和97.4 % ,对红霉素和氧氟沙星敏感性仅 5 4 .8%和 2 9.4 %。 结论 :在对病人进行支原体检测时 ,应同时进行Uu和Mh的检测 ,并做支原体药物敏感试验 ,以合理选择抗生素。

Objective: To observe the prevalence and drug tolerance of mycoplasma( Ureaplasma urealyticum and Mycoplasma hominis ) in patients with urogenital inflammation. Methods: Three thousand and fifty five patients with urogenital inflammation such as non gonococcal urethritis(NGU), chronic prostatitis or pelvic inflammation from 1999 to 2003 were included. The results of mycoplasma culture and drug sensitivity test were analyzed. Results: A total of 992( 32.5 %) cases were mycoplasma positive in the 3 055 patients, and there was no significant difference in the yearly positive percentage in the 5 years ( P < 0.05 ). Among them, 701( 70.7 %) were infected with Ureaplasma urealyticum , 44( 4.4 %) with Mycoplasma hominis , and 247( 24.9 %) with both Ureaplasma urealyticum and Mycoplasma hominis , the Ureaplasma urealyticum infection rate being much higher than that of Mycoplasma hominis and mixed infection ( P < 0.01 ). The high colony counting(≥10 4 cfu/ml) in Ureaplasma urealyticum infection patients accounted for 76.7 %, while Mycoplasma hominis infection represented only 18.2 %. The results of drug tolerance test showed a higher sensitivity to doxycycline, pristinamycin, jiaomycin and testracycline ( 94.3 %, 96.6 %, 86.5 % and 97.4 % respectively), and a lower sensitivity to erythromycin and ofloxacin ( 54.8 % and 29.4 % respectively). Conclusions: Ureaplasma urealyticum and Mycoplasma hominis should be detected simultaneously and the drug tolerance test is needed for the selection of appropriate antibiotics.