十堰地区女性泌尿生殖道支原体感染状况及其对四环素类抗生素耐药机制研究  

Detection and Evaluation of Antibiotic Susceptibility of Ureaplasma Urealyticum and Mycoplasma Hominis in Shiyan Area and Associated Mechanisms of Drug Resistance to Tetracycline

作　　者：李咏梅[1] 余光清[2] 李莉[3] 蒋诗琴[4] 

机构地区：[1]郧阳医学院附属人民医院妇产科,湖北十堰442000 [2]深圳市宝安区疾病预防控制中心,广东深圳518101 [3]郧阳医学院附属太和医院妇产科,湖北十堰442000 [4]郧阳医学院药理学教研室,湖北十堰442000

出　　处：《郧阳医学院学报》2008年第3期233-236,共4页Journal of Yunyang Medical College

摘　　要：目的:了解十堰地区女性泌尿生殖道感染患者支原体感染状况及其对药物敏感性的变化情况,并探讨其对四环素类抗生素可能的耐药机制。方法:1568例女性泌尿生殖道感染患者,取宫颈分泌物进行解脲支原体(Uu)和人型支原体(Mh)培养鉴定及药敏检测,根据药敏结果随机抽取部分菌株,采用PCR技术扩增四环素类抗生素耐药基因tetM。结果:支原体总感染率为43.5%(682/1568);Uu对多西环素、交沙霉素及米诺环素敏感率较高(85.4%、79.8%和78.3%);阿奇霉素及氧氟沙星的耐药率较高,其敏感率仅为30.8%、25.8%;对米诺环素耐药的支原体耐药株可检出tetM基因。结论:十堰地区支原体的混合感染、耐药性上升趋势十分严重,四环素类药物可以重新作为治疗解脲支原体感染的一线药物。Objective To investigate the infectious status in urogenital tract and changing trend of drug susceptibility of mycoplasma in Shiyan area and associated mechanisms of drug resistance to tetracycline. Methods U. urealyticum （Uu） and M. hominis （Mh） were detected in 1 568 cases with urogenital tract infection, and the susceptibility of clinical strains to antibiotics were determined using Mycoplasma IST kit and based on the susceptibility tested, the resistance gene tetM from strains of urealyticus were amplified by PCR. Results The total positive rate of mycoplasma infection in female was 43.5%, 447 cases were infected by U. urealyticum,and 88 cases by M. hominis and 147 cases were positive with both species. Doxymycin ,Josamycin and Minomycin were the most effective agents against Uu strains. The azitromycin and ofloxacin showed a high resistance rate. The resistance strains of U. urealyticum to tetracycline possessed the resistance gene tetM. Conclusion Mixed infection and increasing resistance of mycoplasmas is serious. Multiple resistance to two or more antibiotics are common. Mycoplasma is a predominant pathogen in female genitourinary tract infection, and it is sensitive to Doxymycin, Josamycin and Minomycin. This findings also indicate that resistance monitoring of mycoplasma periodically has important significance in clinical practices.

关 键 词：支原体 抗生素 药物敏感性 

分 类 号：R518.9[医药卫生—内科学]