绍兴地区泌尿生殖道支原体属感染和耐药情况及耐药机制研究  

Study of resistance and mechanism of mycoplasma causing urogenital tract infections in Shaoxing

作　　者：金秀萍 寿叶女 陈文虎[2] 刘小香[2] 孙爱华[2] 

机构地区：[1]浙江省绍兴市柯桥区中医医院检验科,312030 [2]浙江医学高等专科学校基础医学部,杭州市310053

出　　处：《中华全科医学》2015年第12期2020-2022,共3页Chinese Journal of General Practice

基　　金：浙江医学高等专科学校持续建设计划项目(2013-XKCX03);浙江省卫生高层次创新人才工程项目

摘　　要：目的分析绍兴地区泌尿生殖道支原体属感染、耐药情况以及解脲脲原体(Ureaplasma urealyticum,Uu)对喹诺酮类药物的耐药机制。方法对713例泌尿生殖道炎症患者进行支原体培养及药敏试验,随机抽取40株Uu临床分离株PCR扩增gyr A和par C基因喹诺酮耐药决定区并测序,对结果进行统计分析。结果支原体总检出率为45.0%。女性检出率60.0%明显高于男性21.1%(P<0.05)。Uu单独感染率(31.8%)明显高于人型支原体(Mycoplama hominics,Mh)单独感染率(1.8%)、也高于Uu和Mh混合感染率(11.4%),P<0.01。支原体对美满霉素和强力霉素的敏感率分别为94.7%和86.0%,对3种喹诺酮类药物敏感率均小于30.0%。Mh对交沙霉素和美满霉素100%敏感,敏感率明显高于Uu、Uu和Mh混合感染(P<0.01);其余7种抗菌药物对Uu的敏感性高于Mh、Uu和Mh混合感染。喹诺酮中介耐药株Gyr A中D112E突变率(70%)与耐药株(75%)均高且二者间差异有统计学意义(P>0.05),而耐药株Par C中S83L突变率(65%)明显高于中介耐药株(15%,P<0.01)。结论泌尿生殖道感染以Uu为主,女性感染率明显高于男性。支原体属对各种抗菌药物已产生一定程度的耐药,S83L和D112E突变与喹诺酮类药物耐药性密切相关,且S83L突变可提高耐药程度。Objective To analyze the prevalence and drug resistance of Mycoplasma in Shaoxing area,and the mechanism of resistance to quinolones in Ureaplasma urealyticum（ Uu）. Methods The results of mycoplasma culture and drug sensitivity test were analyzed by using the mycoplasma detection kits in 713 patients with urogenital tract infection. PCR and DNA sequencing were conducted to analyze QRDR associated genes mutation of gyr A and par C in 40 Uu isolates. The results were statistical analyzed. Results Forty-five percent of the patients were with positive for mycoplasma,and the infection rate in feminine（ 60. 0%） was obviously higher than that in masculine（ 21. 1%）,P〈0. 01. Among them,31. 8%were infected with Uu,1. 8% with Mycoplama hominics（ Mh）,and 11. 4% with Uu and Mh mixed infection,the Uu infection rate was much higher than that of Mh infection,Uu and Mh mixed infection（ P〈0. 05）. The results of drug sensitivity test showed Mycoplasma was with a higher sensitivity to minocycline and doxycycline（ 94. 7% and 86. 0%,respectively）.The sensitive rate to three kinds of quinolones was all less than 30%. The susceptibility rate of Mh to minocycline and josamycin were all 100%,its sensitive rate was significantly higher than Uu,Uu and Mh（ P〈0. 01）; and sensitive rate of Uu infection to the other seven kinds of drug were significantly higher than Mh infection,Uu and Mh mixed infection（ P〈0. 01）. The mutation rate of D112 E in Gyr A in the plasmid-mediated quinolone resistance strains and drug resistant strains was 70% and 75%,respectively,the difference was not significant（ P〉0. 05）,but S83 L mutation in Par C in the resistant isolates was significantly higher than in the plasmid-mediated quinolone resistance strains（ P〈0. 01）. Conclusion The infection of Uu is common in the patients with urogenital tract infection and the infection rate in feminine is higher than that in masculine. Mycoplasma has produced drug resistance to antibacterial agents in a certain degree.D112 E a

关 键 词：泌尿生殖道 支原体属 药敏试验 突变 耐药性 

分 类 号：R691.3[医药卫生—泌尿科学] R375[医药卫生—外科学]