大连地区沙眼衣原体泌尿生殖道感染及耐药性检测分析  

Chlamydia Trachomatis Infection of Genitourinary Tract and Drug Resistance in Dalian Area

作　　者：李爱莉[1] 朱辉[2] 孙杰[1] 张振国[1] 袁阳[1] 王去非[1] 王稳[1] 宋仁广 占城[1] 

机构地区：[1]大连市皮肤病医院,辽宁大连116021 [2]天津医科大学总医院,天津300052

出　　处：《中国皮肤性病学杂志》2016年第2期154-156,共3页The Chinese Journal of Dermatovenereology

基　　金：大连市政府科技基金资助

摘　　要：目的对大连地区沙眼衣原体泌尿生殖道感染患者进行流行病学调查;比较观察不同药物不同疗程治疗沙眼衣原体泌尿生殖道感染的疗效;通过检测基因23S rRNA的突变情况探讨沙眼衣原体对大环内酯类药物的分子耐药机制。方法对2013年1月-2013年12月本院皮肤性病科门诊诊治的126例沙眼衣原体感染的尿道炎患者进行流行病学调查;统计分析不同方法的治疗结果;同时筛选出6例沙眼衣原体对大环内酯类药物耐药株,进行耐药基因23S rRNA突变的检测。结果男女患者沙眼衣原体阳性率差异无统计学意义(P>0.05);阿奇霉素长疗程治疗方案与其他三组治疗方案对沙眼衣原体感染患者的治愈率差异有统计学意义(P<0.05);其他三组治疗方案之间的治愈率差异无统计学意义(P>0.05);扩增23S rRNA的基因,PCR产物中耐药株测序结果中有1株A2059G突变,有3株A2057G突变,1株A2093T突变,5株有T2611C突变。结论男女沙眼衣原体感染的患病率无差别;阿奇霉素长疗程治疗方案对沙眼衣原体感染的患者治愈率较高;大连地区沙眼衣原体对大环内酯类药物的耐药分子基础是23S rRNA基因的点突变。Objective Epidemiological survey of chlamydial genitourinary patients in Dalian. To compare the curative effect of genitourinary tract ehlamydial infection with different drugs and different period of treatment. To study macrolide resistance and determine molecular mechanisms in Chlamydia trachomatis（CT） by detecting the mutation of 23S rRNA. Methods To collect the epidemiologieal investigation on the 126 patients with suspected Chlamydia trachomatis infection of genitourinary tract in our hospital ,from January 2013 to December 2013. Statistically analyze the overall cure rate of different treatments of CT infection of NGU. The sequences of 23S rRNAs were investigated in the mutants and parental strains. Results No obvious difference was found between male and female patients with CT positive rate. There was significant difference of the long course of treatment of azithromycin. An investigation into the sequences of 23S rRNAs in the mutant and parental strains revealed individual changes of A2057G,A2059G, G2093T and T2611C （Escherichia coli numbering） in the mutants. Three, one, one and five of the six passage-derived strains in our study contain mutations. Conclusion No obvious difference was found between male and female patients with CT positive rate. There was significant difference of the long course of treatment of azithronlycin. The molecular mechanism macrolide resistance in Chlamydia trachomatisis is point mutation in 23S rRNA.

关 键 词：沙眼衣原体 大环内酯类 耐药性 流行病学 

分 类 号：R374.1[医药卫生—病原生物学]