不孕不育女性泌尿生殖道支原体属感染状况及耐药性分析  

Prevalence of mycoplasma causing urogenital tract infections in infertility and sterility female patients in Hangzhou and drug susceptibility analysis

作　　者：卓广超[1] 冯国芳[2] 周红[2] 斯奇[2] 陈露芳[2] 朱立波[2] 

机构地区：[1]浙江省杭州市第一人民医院(南京医科大学附属杭州医院)中心实验室,310006 [2]浙江省杭州市第一人民医院(南京医科大学附属杭州医院)妇产科,310006

出　　处：《中华全科医学》2015年第12期1973-1975,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2012KYB150)

摘　　要：目的 了解杭州地区不孕不育女性泌尿生殖道支原体属感染状况及药敏谱,指导临床合理规范使用抗菌药物。方法 选择2013年1—12月在不孕不育专科门诊就诊的1052例女性患者进行宫颈分泌物支原体培养及药敏试验,并进行统计分析。结果 受检的1052例女性患者中支原体属感染470例,阳性率为44.68%;470例支原体属感染患者中,单独感染解脲支原体（Uu）367例（78.08%）,单独感染人型支原体（Mh）50例（10.64%）,Uu＋Mh两者混合感染53例（11.28%）。药敏试验中,对Uu、Mh、Uu＋Mh混合感染敏感率〉90%的药物有3种,分别为美满霉素、多西环素、交沙霉素;此外克拉霉素、四环素、阿奇霉素仍对单独Uu感染敏感,四环素仍对单独Mh感染敏感。对Uu、Mh、Uu＋Mh混合感染耐药率〉70%的药物有4种,分别为环丙沙星、左氧氟沙星、氧氟沙星、司帕沙星;此外红霉素、罗红霉素、阿奇霉素、克拉霉素仍对单独Mh感染和Uu＋Mh混合感染耐药。支原体属对抗菌药物的多药耐药明显增加,其中Uu单独感染以4~6种抗菌药物多重耐药为主,占66.5%;Mh单独感染以7~9种抗菌药物多重耐药为主,占72.0%;Uu＋Mh两者混合感染以7~9种抗菌药物多重耐药为主,更是达到83.0%。结论 不孕不育女性患者支原体感染率较高,耐药谱比较复杂。多西环素、美满霉素、交沙霉素可作为本地区治疗不孕不育女性患者泌尿生殖道支原体属感染的首选药物,临床治疗上应根据药敏试验的结果,合理规范选用抗菌药物。Objective To investigate the status of Mycoplasma infections in the urogenital tract of the infertility and sterility female patients in Hangzhou and their drug susceptibility so as to guide the reasonable use of antibiotics. Methods The cervical secretions from total 1052 cases of the infertility and sterility female outpatients from 2013 were cultured for Mycoplasma,the drug susceptibility testing was performed,and the statistical analysis was carried out. Results Of 1052 cases of patients investigated,Mycoplasma infections occurred in 470 cases with the positive rate of 44. 68 %,367 cases of patients with Ureaplasma urealyticum（ Un） infections accounted for 78. 08 %,50 cases of patients with Mycoplasma hominis（ Mh） infections accounted for 10. 64 %,and 53 cases of patients with the mixed infections accounted for 11. 28 %.The drug susceptibility rates in Uu,Mh and Uu ＋ Mh to josamycine,doxycycline and minocycline were higher than 90 %.In addition clarithromycin,tetracycline,azithromycin were sensitive to Uu infection,tetracycline was sensitive to Mh infection. The drug resistance rates in Uu,Mh and Uu ＋ Mh to ciprofloxacin,levofloxacin,ofloxacin and sparfloxacin were higher than 70%. On the other hand,Clarithromycin,azithromycin,roxithromycin and erythromycin were resisted to Uu infection and Uu ＋ Mh infection. The drug resistance rate in patients with mixed infections of Uu and Mh was significantly higher than that in patients infected with anyone pathogen alone; the drug resistance rate against 7-9 drugs in the doubly infected patients was up to 83%. the drug resistance rate against 4-6 drugs with mixed infection of Uu was 66. 5%,and that against 7-9 drugs of Mh was 72%. Conclusion The positive rate of mycoplasma infection in urogenital tract of the infertility and sterility women is high. the drug-resistant spectrum is complex. doxycycline,minocycline and josamycine can be used as the first line antibiotics to treat urogenital tract infections in Hangzhou region based on the drug susceptibility

关 键 词：不孕不育 支原体感染 药敏试验 

分 类 号：R711.6[医药卫生—妇产科学] R446.5[医药卫生—临床医学]