2010至2017年长沙地区生殖道支原体感染率及耐药变迁分析  

A retrospective analysis of infection and antimicrobial susceptibility of genital mycoplasma in Changsha from 2010 to 2017

作　　者：刘青林 付瑶阳 胡倩 袁千钦 林慧 蒋传好[1] 唐浩能[1] 唐玲丽[1] Liu Qinglin;Fu Yaoyang;Hu Qian;Yuan Qianqin;Lin Hui;Jiang Chuanhao;Tang Haoneng;Tang Lingli(Department of Clinical Laboratory,Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院检验科,长沙410011

出　　处：《中华检验医学杂志》2019年第11期942-948,共7页Chinese Journal of Laboratory Medicine

基　　金：湖南省自然科学基金(2018JJ2559);中南大学中央高校基本科研业务费专项资金(2017zzts031)。

摘　　要：目的研究长沙地区解脲支原体(Uu)和人型支原体(Mh)的感染和耐药变迁,为临床用药提供实验室依据。方法采用回顾性研究,统计2010至2017年长沙地区湘雅二医院和湖南旺旺医院53006份疑似生殖道支原体感染患者标本,分析Uu和Mh的感染率和耐药率。结果2010至2017年共检测53006份标本,其中Uu感染16830份,感染率为31.75%;Mh感染2471份,感染率4.66%;Uu和Mh混合感染1071例,感染率2.02%。男性Uu感染率为19.48%(5989/30749),低于女性感染率[48.71%(10841/22257)],χ^2=5091,P<0.001;男性Mh感染率为3.16%(973/30749),低于女性感染率[6.73%(1498/22257)],χ^2=369,P<0.001。生殖道支原体感染人群集中在20~40岁,占71.76%(12077/16830)。Uu和Mh的耐药性分析表明,两者对强力霉素、美满霉素耐药率均低于2%,对喹诺酮类抗生素耐药率较高;Uu对大环内酯类抗生素中的环酯红霉素、交沙霉素、克拉霉素耐药率均低于2%,而对阿奇霉素、红霉素耐药率较高,分别为29.74%(5006/16830)和53.74%(9045/16830),Mh对大环内酯类抗生素(交沙霉素除外)耐药率均大于90%。Uu对阿奇霉素的耐药率呈上升趋势,从2010年的3.81%(46/1206)上升至2017年的53.15%(1503/2828),对加替沙星和甲砜霉素的耐药率呈下降趋势,分别从2010年的76.78%(926/1206)和60.28%(727/1206)降至2017年的34.23%(968/2828)和37.87%(1071/2828);Mh对加替沙星、甲砜霉素的耐药率呈下降趋势,分别从2010年的68.93%(122/177)和41.81%(74/177)降至2017年的53.54%(159/297)和21.21%(63/297)。结论强力霉素、美满霉素和交沙霉素对生殖道支原体的敏感率较高,适合于长沙地区临床用药。Uu对阿奇霉素的耐药率呈上升趋势,提示长沙地区存在阿奇霉素的滥用,需加大抗生素用药的监管力度。Objective To study the prevalence and antimicrobial susceptibility of Ureaplasma urealyticum(Uu)and Mycoplasma hominis(Mh)in Changsha,and provide laboratory evidence for clinical drug use.Methods A retrospective study was conducted to analyze 53006 specimens of suspected genital mycoplasma infection in Xiangya Second Hospital of Changsha District and Hunan Wangwang Hospital from 2010 to 2017,and to analyze the infection rate and drug resistance rate of Uu and Mh.Results From 2010 to 2017,a total of 53006 specimens were detected,where there were 16830 cases of Uu infection,the infection rate was 31.75%;2471 cases of Mh infection,the infection rate was 4.66%;and 1071 cases of Uu and Mh mixed infection,the infection rate was 2.02%.Male Uu infection rate was 19.48%(5989/30749),which was lower than the female infection rate 48.71%(10841/22257)(χ^2=5091,P<0.001);male Mh infection rate was 3.16%(973/30749),lower than female infection rate 6.73%(1498/22257)(χ^2=369,P<0.001).The population of genital mycoplasma infection is concentrated between 20 and 40 years old,accounting for 71.76%(12077/16830).The drug resistance rates of Uu and Mh to doxycycline and minocycline were less than 2%,while the drug resistance rate to quinolones was higher;The resistance rate of Uu to macrolide antibiotics such as erythromycin,josamycin and clarithromycin were less than 2%,while the resistance rate to azithromycin,erythromycin and roxithromycin were higher,29.74%(5006/16830)and 53.74%(9045/16830),respectively,and the resistance rate of Mh to macrolide antibiotics(except josamycin)was higher than 90%.Between 2010 and 2017,a gradually increasing resistance of ureaplasmas to azithromycin,from 3.81%(46/1206)in 2010 to 53.15%(1503/2828)in 2017,and decreasing resistance to gatifloxacin and thiamphenicol were observed,from 76.78%(926/1206)and 60.28%(727/1206)in 2010 decreased to 34.23%(968/2828)and 37.87%(1071/2828)in 2017,respectively.The resistance rate of Mh to gatifloxacin and thiamphenicol were decreased,from 68.93%(122/177)and 41.81%(74/

关 键 词：生殖道感染 支原体感染 人型支原体 解脲支原体 抗药性 细菌 

分 类 号：R44[医药卫生—诊断学]