299例泌尿生殖道沙眼衣原体的检测及药物敏感性分析  

The detection and the susceptibility analysis to antimicrobial agents in 299 cases of urogenital chlamydial trachomatis infection

作　　者：邵丽丽[1] 江勇[1] 杨丽娜[1] 杨晓静[1] 刘原君[1] 刘全忠[1] 

机构地区：[1]天津医科大学总医院皮肤科、天津性传播疾病研究所,天津300052

出　　处：《临床皮肤科杂志》2010年第3期141-143,共3页Journal of Clinical Dermatology

基　　金：国家自然科学基金(30872285)资助项目

摘　　要：目的:检测近4年来天津地区泌尿生殖道沙眼衣原体对阿奇霉素、米诺环素、莫西沙星3种临床常用抗生素体外药物敏感性,并评价药敏结果与临床疗效的关系。方法:将采集到的符合要求的299例临床标本及E型标准株破壁、离心后接种于细胞培养板的McCoy细胞,培养60～72 h后碘染观察衣原体包涵体。原代培养阴性或阳性的标本均进行传代培养。阴性标本均传代培养至第5代,阳性标本传代培养至感染率达90%以上,收集标本进行3种常用抗生素的药敏试验。结果:共培养出沙眼衣原体阳性株104株,阳性率为34.78%。其中McCoy细胞感染率达90%以上的菌株共94株,药敏(最低抑菌浓度,MIC)结果分别为阿奇霉素(0.063～1.000mg/L),米诺环素0.004～0.128mg/L,莫西沙星0.030～0.240mg/L。应用阿奇霉素、莫西沙星、米诺环素治疗后的沙眼衣原体总体阴转率分别为44.44%、63.46%、88.89%。结论:随着时间的推移和抗生素的广泛应用,抗生素的敏感性呈不同程度的下降,米诺环素抗衣原体活性相对较强。整体评价临床各类药物治疗效果与时间变化趋势分析,药敏结果与临床疗效之间明显相关。Objective： To test in vitro drug susceptibility of recent clinical isolates from patients with urogenital chlamydial infection to azithromycin, minocyline and moxifloxacin in last 4 years in Tianjin, and explore the relationship between suscep- tibility testing and therapeutic effects. Methods： Laboratory reference strains of C. trachomatis（E serovar） and 299 clinical isolates of Chlamydia trachomatis were inoculated on McCoy cells, and cultured for 48-72 hours. The presence of the inclusion of Chlamydia trachomatis was identified by Lugol＇s iodine solution The culture-negative samples were cultured for another five passages. The culture-positive samples were cuhured until more than 90% McCoy cells being infected, then the cells were collected for susceptibility testing to 3 antimicrobials. Results： Out of 299 clinical isolates 104 strains were positive for C.trachomatis, the positive rate was 34.78%. Among them,the positivestrains with an infection rate greater than 90% of McCoy cells accounted for 94 strains The MIC of azithromycin, minocyline and moxifloxacin against these isolates were 0.063-1.000 mg/L, 0.004-0.128 mg/L and 0.030-0.240mg/L respectively. In the treatment of chlamydial infection with azithromyein, moxifloxacin, or minocycline, the overall clearance rates of C.trachomatis were 44.44%, 63.46% and 88.89% respectively. Conclusions： With the lapse of time and the wide spread use of antibiotics, the antibiotic sensitivity of Chlamydia trachomatis is gradually reduced indifferent levels Minocycline exhibited a markedly better action against Chlamydia trachomatis in-vitro. In overall evaluation of the therapeutic effects of above drugs, susceptibility testing was significantly correlated to the therapeutic efficacy.

关 键 词：衣原体 沙眼 抗生素 药物敏感性 

分 类 号：R691.3[医药卫生—泌尿科学]