支原体及衣原体感染对慢性盆腔炎患者阴道微生态和抗菌药物耐药性的影响分析  

Effects of mycoplasma and chlamydia infection on vaginal microecology and antimicrobial resistance in patients with chronic pelvic inflammatory disease

作　　者：余婵娟 徐秀兰 利园梦 洪琴 YU Chanjuan;XU Xiulan;LI Yuanmeng;HONG Qin(Jiujiang Economic and Technological Development Zone People′s Hospital,Jiujiang,Jiangxi 332000,China)

机构地区：[1]九江经济技术开发区人民医院,江西九江332000

出　　处：《现代医药卫生》2025年第2期371-376,共6页Journal of Modern Medicine & Health

摘　　要：目的探讨解脲支原体(UU)、人型支原体(Mh)、沙眼衣原体(CT)对慢性盆腔炎患者阴道微生态和抗菌药物耐药性的影响。方法选取2020年1月至2023年12月于该院就诊的慢性盆腔炎患者95例作为研究组,同期体检的健康女性40例作为对照组。对比分析2组患者支原体和衣原体感染情况、阴道微生态情况及感染患者药敏试验结果。结果研究组中,39例(41.05%)UU感染,29例(30.53%)Mh感染,12例(12.63%)CT感染,7例(7.37%)混合感染,8例(8.42%)患者未发现相关感染。对照组中,6例(15.00%)UU感染,5例(12.50%)Mh感染,2例(5.00%)CT感染,2例(5.00%)混合感染,25例(62.50%)未发现相关感染。UU、Mh及未发现感染的例数之间,差异有统计学意义(P<0.05);研究组阴道菌群密度Ⅰ级+Ⅳ级、菌群多样性Ⅰ级+Ⅳ级及优势菌异常比例均高于对照组,差异有统计学意义(P<0.05)。药敏试验结果显示,UU感染患者对阿奇霉素的敏感性最高(71.79%),其次是强力霉素(66.67%)、交沙霉素(51.28%)和左氧氟沙星(51.28%);Mh感染患者对强力霉素和克拉霉素的敏感性最高(68.97%),其次是四环素(55.14%);CT感染患者对左氧氟沙星的敏感性最高(83.33%),其次是美满霉素(66.67%);混合感染的患者对强力霉素敏感性最高(71.43%)。UU感染与阴道菌群密集度之间存在相关性(P<0.05),而与菌群多样性和优势菌的异常比较,差异无统计学意义(P>0.05);Mh感染、CT感染与阴道菌群密集度和菌群多样性、优势菌比较,差异均无统计学意义(P>0.05),混合感染与优势菌之间存在相关性(P<0.05),而与阴道菌群密集度和菌群多样性比较,差异无统计学意义(P>0.05)。结论UU感染可能对阴道菌群密集度构成影响,混合感染可能对优势菌构成产生影响。药敏试验结果提示,支原体患者可考虑使用阿奇霉素、强力霉素进行治疗,衣原体感染者可考虑使用左氧氟沙星进行治疗,混合感染者可考虑使用强力霉素进行治�Objective To investigate the effects of ureaplasma Urealyticum(UU),mycoplasma hominis(Mh)and Chlamydia trachomatis(CT)on vaginal microecology and antimicrobial resistance in patients with chronic pelvic inflammatory disease.Methods A total of 95 patients with chronic pelvic inflammatory disease from January 2020 to December 2023 were selected as the study group,and 40 healthy women who underwent physical examination during the same period were selected as the control group.The infection of mycoplasma and chlamydia,vaginal microecology and drug sensitivity test results of infected patients were compared and analyzed.Results In the study group,39 patients(41.05%)were infected with UU,29 patients(30.53%)were infected with Mh,12 patients(12.63%)were infected with CT,7 patients(7.67%)were co-infected,and 8 patients(8.42%)had no associated infections.In the control group,6 cases(15.00%)of UU infection,5 cases(12.50%)of Mh infection,2 cases(5.00%)of CT infection,2 cases(5.00%)of mixed infection,25 cases(62.50%)of no associated infection was found.There was statistical significance in the number of UU,Mh and CT infection cases and no infection cases(P<0.05).The density of vaginal floraⅠ+Ⅳ,the diversity of bacterial floraⅠ+Ⅳand the abnormal proportion of dominant bacteria in the study group were higher than those in the control group,the difference was statistically significant(P<0.05).The results of drug sensitivity test showed that UU infected patients had the highest sensitivity to azithromycin(71.79%),followed by doxycycline(66.67%),lucamycin(51.28%)and levofloxacin(51.28%).Mh infected patients had the highest sensitivity to doxycycline and clarithromycin(68.97%),followed by tetracycline(55.14%),CT infected patients had the highest sensitivity to levofloxacin(83.33%),followed by melomycin(66.67%).Patients with mixed infection had the highest sensitivity to doxycycline(71.73%).There was a correlation between UU infection and the concentration of vaginal flora(P<0.05),but there was a statistical significance bet

关 键 词：慢性盆腔炎感染 支原体 衣原体 阴道微生态 耐药性 

分 类 号：R711.33[医药卫生—妇产科学]