260例女性生殖道解脲支原体、沙眼衣原体耐药情况分析  

Drug resistance of Ureaplasma urealyticum and Chlamydia trachomatis infection in 260 female reproductive tracts

作　　者：曾芍 张先平 ZENG Shao;ZHANG Xianping(Loudi Vocational and Technical College,Loudi 417000,Hunan,China;Loudi Hospital Affiliated to University of South China)

机构地区：[1]娄底职业技术学院护理学院,湖南娄底417000 [2]南华大学附属娄底医院

出　　处：《中国病原生物学杂志》2023年第6期721-724,733,共5页Journal of Pathogen Biology

基　　金：湖南省自然科学基金(No.2021JJ70034)。

摘　　要：目的了解解脲支原体(UU)、沙眼衣原体(CT)感染后患者血常规特点,并检测其药物敏感性,为临床治疗提供依据。方法分析UU、CT单一病原体感染者的临床资料;运用RT-PCR技术对UU和CT进行测定;采用倍比稀释法测定UU和CT对临床常用抗生素耐药情况;运用PCR技术对UU喹诺酮类药物耐药(决定)区进行扩增并测序。结果206例患者中,UU感染207例,年龄18~69(39.15±12.30)岁,BMI平均(23.52±1.49)kg/m^(2),18~、20~、30~、40~、50~和≥60岁患者分别为5、59、54、50、25和14例。CT感染53例,年龄18~65(38.47±12.52)岁,BMI平均(24.09±1.58)kg/m^(2),各年龄组患者分别为2、14、17、10、5和5例。UU感染者与CT感染者WBC、HB、LYM、BAS、EOS、PLT和SIgA值差异有统计学意义(均P<0.05)。药敏结果显示,UU对交沙霉素、美满霉素、四环素、罗红霉素、阿奇霉素、左氧氟沙星、环丙沙星和司帕沙星耐药率分别为1.93%、1.45%、8.21%、7.73%、8.70%、54.11%、56.52%和57.49%,CT耐药率分别为11.32%、7.55%、16.98%、30.19%、26.42%、26.42%、32.08%和9.43%。检测的20株UU中,gyrA发生8处碱基突变,其中7处为无义突变,1处错义突变为碱基C336A;13株UU中检出D112E突变,检出率65.00%。parC发生6处碱基突变,其中3处为无义突变。3处错义突变分别为碱基C248T、G370T和T372C,对应氨基酸突变为S83L(TCA→TTA)和G124C(GGT→TGC)。结论女性感染患者在20~40岁处于高发人群。UU对喹诺酮类药物耐药程度较高,可能与氨基酸突变有关。Objective To study the clinical characteristics of Ureaplasma urealyticum and Chlamydia trachomatis infection,and detect their drug sensitivity,so as to provide basis for clinical treatment.Methods The data of patients only infected with U.urealyticum or C.trachomatis were selected for study.U.urealyticum and C.trachomatis were determined by RT-PCR.The drug resistance of U.urealyticum or C.trachomatis to commonly used antibiotics in clinical practice were determined by coubling dilution method.The U.urealyticum quinolone resistant(determining)region were amplified by QRDR,and then the product were sequenced.Results Among 206 patients,207 were infected with UU,aged 18-69(39.15±12.30)years old,with an average BMI of(23.52±1.49)kg/m^(2).There were 5,59,54,50,25,and 14 patients aged 18-,20-,30-,40-,50-,and≥60 years old,respectively.There were 53 cases of C.trachomatis infection,aged 18-65(38.47±12.52)years old,with an average BMI of(24.09±1.58)kg/m^(2).There were 2,14,17,10,5,and 5 patients in each age group,respectively.There were significant differences in WBC,HB,LYM,BAS,EOS,PLT and SIgA values between U.urealyticum and C.trachomatis(all P<0.05).The drug sensitivity test showed that the drug resistance rates of U.urealyticum to josamycin,minocycline,tetracycline,roxithromycin,azithromycin,levofloxacin,ciprofloxacin and sparfloxacin were 1.93%,1.45%,8.21%,7.73%,8.70%,54.11%,56.52%and 57.49%respectively.The drug resistance rates of C.trachomatis were 11.32%,7.55%,16.98%,30.19%,26.42%,26.42%,32.08%and 9.43%respectively.Eight base mutations occurred in 20 strains of U.urealyticum gyrA,seven of which were nonsense mutations.One missense mutation was the base C336A,resulting in the amino acid mutation of D112E(GAC→GAA),and the detection rate of this mutation is 65%.There were six base mutations in parC,three of which were nonsense mutations.The missense mutations were C248T,G370T and T372C,respectively,and the corresponding amino acid mutations were S83L(TCA→TTA)and G124C(GGT→TGC).Conclusion Female patients w

关 键 词：女性生殖道 解脲支原体 沙眼衣原体 耐药性 

分 类 号：R374[医药卫生—病原生物学] R375[医药卫生—基础医学]