生殖支原体、解脲脲原体对12种抗生素的药物敏感性分析

目的提高非淋菌性尿道炎（NGU）临床合理用药率。方法对61株生殖支原体（Mg）、252株解脲脲原体（Uu）行12种抗生素的药物敏感性试验。结果 Mg对阿奇霉素、美满霉素、克拉霉素、强力霉素、罗红霉素、交沙霉素的敏感性较高。Uu对强力霉素、美满霉素、克拉霉素、交沙霉素、四环素、阿奇霉素的敏感性较高。Mg、Uu对喹诺酮类药物均不敏感。结论对NGU患者不宜采用喹诺酮类药物作为经验治疗;宜根据药物敏感性结果足量足疗程使用抗菌药物,无药物敏感试验参考时,可使用美满霉素、克拉霉素、强力霉素、交沙霉素、阿奇霉素治疗。     

解脲支原体与人型支原体体外耐药性探讨

目的 探讨解脲支原体(UU)和人型支原体(Mh)的耐药性，指导临床合理用药。方法 采用体外培养的方法，对244例UU阳性、86例Mh阳性的泌尿生殖道感染患者，做药物敏感试验，检测UU与Mh对抗生素的耐药性。结果 对UU、Mh敏感的药物分别是普那霉素(90．91％)、交沙霉素(86．06％)、强力霉素(72．73％)。对红霉素、氧氟沙星、四环素的耐药率分别为52．42％、48．79％和45．15％。结论 对泌尿生殖道支原体(UU与Mh)感染可首选普那霉素、交沙霉素和强力霉素，不宜选用红霉素、氧氟沙星和四环素治疗。     

解脲脲原体对四环素类药物的耐药性及tet M耐药基因研究

目的探讨目前解脲脲原体对四环素类药物的耐药性及其与tetM耐药基因的关系。方法对分离自临床妇产科和性病门诊患者的解脲脲原体株,经鉴定确认后,采用微量肉汤稀释法检测其四环素和米诺环素的最小抑菌浓度(MIC),根据药敏结果分层随机抽取部分菌株,采用PCR技术扩增四环素耐药基因tetM。结果解脲脲原体的米诺环素和四环素MIC50(50%菌株被抑制所需抗生素浓度)分别为<0.062 5 mg/L和<0.125 mg/L;MIC90(90%菌株被抑制所需抗生素浓度)分别为0.125 mg/L和1 mg/L;在34株非四环素耐药的解脲脲原体菌株中,有7株检测到tetM基因。tetM基因阳性组的四环素和米诺环素的MIC水平比tetM阴性组高,且差异有统计学意义(四环素:t=4.34,P=0.000 1;米诺环素:t=5.90,P<0.000 1)。结论在江苏部分地区四环素类药物可以重新作为治疗解脲脲原体感染的一线药物,尤其是米诺环素的抗菌效果较好;在非四环素耐药的解脲脲原体菌株中也存在tetM基因的携带,且影响其MIC的提高。     

2009～2011年我院泌尿生殖道支原体感染与药敏结果回顾性分析

目的了解泌尿生殖道支原体感染及对不同抗生素的药敏情况。方法采用支原体培养鉴定药敏一体化试剂盒对26 060例疑为泌尿生殖道感染患者的泌尿生殖道分泌物进行检测。结果检出支原体感染10481例,阳性率为40.22%。其中溶脲脲原体(Uu)感染9 366例(89.36%),人型支原体(Mh)感染109例(1.04%),溶脲脲原体、人型支原体(Uu+Mh)合并感染1006例(9.60%)。药敏结果显示,Uu单独感染及Uu+Mh合并感染对交沙霉素、强力霉素、美满霉素敏感,喹诺酮类与大环内酯类药物耐药率下降。Uu+Mh合并感染呈耐药谱广、耐药率高特点。结论 Uu是引起泌尿生殖道感染的主要支原体,Uu+Mh合并感染耐药性增加,交沙霉素、强力霉素和美满霉素可作为治疗支原体感染的首选药物。     

广州地区解脲脲原体对7种药物体外敏感性研究

目的测定7种抗菌药物对50株解脲脲原体体外抗菌作用效果。方法采用液体倍比稀释法测相应抗生素的最低抑菌浓度(MIC)。结果红霉素、交沙霉素、阿奇霉素的MIC50分别为0.50、0.25、0.50mg/L,MIC90分别为4.00、4.00、4.00mg/L;加替沙星、左氧氟沙星、司帕沙星的MIC50分别为0.25、4.00、0.50mg/L,MIC90分别为2.00、64.00、2.00mg/L;四环素的MIC50为0.50mg/L,MIC90为32.00mg/L。结论大环内酯类药物中交沙霉素敏感性最高,喹诺酮类药物加替沙星、司帕沙星对解脲脲原体有较高敏感性,四环素的敏感性较低。     

167株男性解脲脲原体耐药性分析

目的监测山西省大同市第四人民医院检验科皮肤性病门诊男性患者尿道分泌物中分离的解脲脲原体（Ureaplasma urealyticum,Uu）对常见抗菌药物的耐药性和耐药变迁,为泌尿生殖道解脲脲原体感染者提供参考依据,更好地指导临床合理用药。方法对2010年1月～2012年12月皮肤性病门诊男性患者尿道分泌物中分离的167株解脲脲原体的红霉素、左氧氟沙星、洛美沙星、氧氟沙星、克拉霉素、罗红霉素、阿奇霉素、交沙霉素、司帕沙星、美满霉素、强力霉素、甲砜霉素12种抗菌药物耐药检测结果进行分析。结果 167株解脲脲原体耐药率为94.60%,其中耐3种药最高（22.20%）,耐9种药、耐11种药和耐12种药最低（均为1.20%）,耐药率由高到低依次是红霉素81.40%、左氧氟沙星55.10%、洛美沙星46.10%、氧氟沙星44.30%、克拉霉素34.10%、罗红霉素31.70%、阿奇霉素30.50%、交沙霉素28.10%、司帕沙星27.50%、美满霉素16.80%、强力霉素16.80%、甲砜霉素15.60%,除美满霉素外,解脲脲原体对上述抗生素耐药率,均有逐年升高趋势。结论解脲脲原体的耐药率较高,并有逐年升高的趋势,临床医生应根据药敏试验结果合理应用抗生素,对降低耐药率,有效控制疾病具有重要的意义。     

尿道宫颈炎支原体检测情况及药敏分析

目的对2641株培养阳性支原体的药敏结果进行统计分析,以便为临床支原体感染者的药物治疗提供有价值的参考信息,并提高临床疗效。方法采用支原体培养、鉴定、药敏一体化试剂盒(14Drugs),对4714例泌尿生殖道感染患者进行支原体培养鉴定,对2641株支原体进行14种抗生素体外药敏试验。结果4803例患者标本中,支原体培养阳性者2641例,阳性率为54.99%。2641例支原体阳性者中,单纯解脲脲原体(Uu)感染1811例,占68.57%;单纯人型支原体(Mh)感染63例,占2.39%;Uu+Mh混合感染767例,占29.04%。男女患者支原体感染阳性率差异有统计学意义(χ2=152.409,P<0.001)。检出的2641株支原体中,44株全耐药株均为Uu+Mh混合感染,且其检出率逐年上升。耐药现象尤以环丙沙星与红霉素最为严重。单纯Uu感染其敏感性最高的为交沙霉素(99.75%),其次为克拉霉素(97.85%);耐药率最高的为环丙沙星(66.81%)。单纯Mh感染其敏感性最高的为强力霉素(96.83%),其次为交沙霉素(93.65%);耐药率最高的为红霉素(88.89%)。Uu和Mh混合感染的患者,敏感性最高的...     

运用PCR方法检测解脲脲原体生物群在临床实际应用的探讨

目的探讨用聚合酶链反应（PCR）检测解脲脲原体（Uu）生物群，在临床实际运用的可行性与必要性。方法采用微量肉汤稀释法测定uu体外抗菌药物敏感性，并以多条带抗原（MB—Ag）基因为靶位，设计分群引物，对uu菌株进行生物分群检测。结果124株uu临床菌株中，男性parvo生物群占36-84％（14／38），T960生物群占63．16％（24／38），未检测到两群混合的情况；女性parvo生物群占74．41％（64／86），T960生物群占23．26％（20／86），两群都检测到的占1．62％（2／86）。Uu两大生物群对四环素、多西环素、洛美沙星的耐药率无显著性差异（P值分别为0．1558、1．0000、0．3801），但对红霉素，阿齐霉素耐药率存在显著性差异（P值分别为0．0008和〈0．0001）。结论建议临床工作中运用PCR方法检测Uu生物群，便于指导临床治疗。     

解脲支原体耐药性与tetM基因关系的研究

目的 从流行病学角度进一步探讨解脲支原体(Uu)耐药性与其tetM基因之间的关系。方法 对177株Uu临床菌株采用微量肉汤稀释法检测其对四环素和强力霉素的敏感性,用聚合酶链反应(PCR)法检测其tetM基因携带情况,并用R×C表γ~2检验分析Uu对四环素族药物的耐药性与tetM基因之间的关系。结果 (1)Uu对四环素和强力霉素的耐药性与tetM基因关系密切(P<0.05);(2)PCR法检测Uu临床菌株tetM基因的结果与微量肉汤稀释法检测Uu对四环素族药物耐药性的结果并不完全一致;(3)Uu1～14血清型标准菌株中仅Uu9型对四环素和强力霉素表现出较高的耐药性,且检测到了terM基因,而其余13个血清型对这两种抗生素均较敏感,也未检测到tetM基因。结论 (1)Uu对四环素族药物的耐药性与tetM基因关系密切,tetM基因可同时诱导Uu对四环素和强力霉素产生耐药性;(2)PCR法检测tetM基因对于判断Uu对四环素族药物的耐药性具有重要参考价值,但并不能完全替代传统的微量肉汤稀释法用于临床检测Uu对四环素族药物的耐药性。     

非淋病性尿道炎患者解脲脲原体耐药性分析

目的：通过调查非淋病性尿道炎患者解脲脲原体（Uu）感染现状及耐药性,为临床医师合理使用抗菌药物提供实验依据。方法：采用法国生物梅里埃公司Mycoplasma IST2支原体试剂盒对1897例非淋病性尿道炎患者进行支原体培养和药敏试验。结果：Uu阳性检出率为43.2%（819/1897）。Uu对喹诺酮类抗菌药物环丙沙星、氧氟沙星敏感率最低,分别为14.8%、24.7%;对原始霉素、强力霉素、交沙霉素敏感率较高,分别为100%、100%、97.4%;对红霉素、四环素敏感率分别为62.5%、91.4%;对阿奇霉素、克拉霉素敏感率均为75.9%。结论：Uu为非淋病性尿道炎的重要病原体,必须加强耐药性检测,以有效控制Uu感染。     

解脲支原体对8种抗菌药物的敏感性研究

目的 了解解脲支原体(Uu)体外药物敏感性状况.方法 以微量肉汤稀释法对Uu作8种抗菌药物的敏感性测定.结果 304株Uu对抗菌药物的高度敏感率依次为罗红霉素(63.2%)、阿奇霉素(48.7%)、红霉素(47.4%)、多西霉素(28.3%)、交沙霉素(8.2%)、米诺环素(4.6%)、环丙沙星(36%)、氧氟沙星(3.3%).发现1株(0.3%)对该8种药物均耐药.结论 加强Uu的药敏检测,监测耐药情况的变化,对指导临床用药,防止Uu耐药性产生具有重要的意义.     

深圳市泌尿生殖道解脲支原体和人型支原体感染状况及药物敏感性分析

目的 了解深圳市泌尿生殖道支原体感染状况及耐药性变化趋势，指导临床合理用药。方法 用Mycoplasma IST试剂盒对深圳市2002年8460例泌尿生殖道感染患者，取尿道(宫颈)分泌物进行了解脲支原体(UU)和人型支原体(Mh)的培养鉴定及药敏检测。结果 UU单独感染2067例，Mh单独感染54例，UU和Mh混合感染678例。男性感染率为27．2％，女性感染率为40．2％。药敏试验显示：UU对氧氟沙星的敏感性下降至36．1％，Mh对红霉素和四环素的敏感性分别降至9．3％和48．1％，原始霉素、交沙霉素对两种支原体都保持稳定的高敏感性。结论 支原体的混合感染、耐药性上升趋势十分严重，交沙霉素应作为目前治疗泌尿生殖道UU和Mh感染的首选，支原体耐药性的长期监测是指导临床治疗的重要依据。     

Septic arthritis and bacteremia due to Mycoplasma resistant to antimicrobial therapy in a patient with systemic lupus erythematosus.

We report a case of septic arthritis caused by Mycoplasma hominis in a patient with systemic lupus erythematosus. The infection started as monarthritis but spread to at least four joints despite apparently suitable therapy with various antimicrobial agents, including doxycycline, clindamycin, and ciprofloxacin; subsequent bacteremia was documented. Control was ultimately achieved with use of the experimental fluoroquinolone temafloxacin in combination with doxycycline administration, arthroscopic drainage of a persistently infected joint, several intravenous infusions of immunoglobulins (which led to increases in levels of antibodies specific to M. hominis), and discontinuation of corticosteroid therapy. Antimicrobial susceptibility testing of various mycoplasmal isolates showed the presence of the tetM gene, disparity between susceptibility to tetracycline and doxycycline, and increasing resistance to most antimicrobial agents used (including to fluoroquinolones before clinical use), although the patient ultimately had a favorable clinical response to treatment with combined modalities.     

Characterization of an outbreak of tetM-containing Neisseria gonorrhoeae in Argentina.

Phenotypic and molecular characterization of an outbreak of 9 Neisseria gonorrhoeae (NG) isolates exhibiting high-level plasmid mediated resistance to penicillin and tetracycline (PP-TRNG) that took place in Tandil, Argentina between February and April 1995. Comparison with the patterns of the 3 PP-TRNG strains previously isolated were made. We determined the following markers for each strain: antimicrobial susceptibility, serogroup, auxotype, plasmid profile, presence of tetM determinant and restriction pattern of the tetM-containing plasmid. Antimicrobial tests values were: tetracycline disk diameter 12-14 mm, minimum inhibitory concentration (MIC) 32 micrograms/ml; penicillin disk diameter 6 mm, MIC 32 micrograms/ml and sensitive by both methods to spectinomycin, cefuroxime, ceftriaxone and ciprofloxacin. All isolates were of the same serogroup (WI). Ten of the strains, including the 9 from Tandil outbreak, were arginine-requiring, while the other 2 were methionine and arginine-requiring. All of them demonstrate the same plasmid profile (2.6, 3.2, 25.2 MDa). They were positive for the tetM determinant and the restriction analysis identified it is a Dutch-type plasmid. In spite of the temporal and geographical dispersion, PP-TRNG strains in Argentina seem to be highly homogeneous in terms of antimicrobial susceptibility, serogroup, plasmid profiles and even auxotype.     

Increase in minimum inhibitory concentration to quinolones and ceftriaxone in salmonellae causing enteric fever

Multidrug resistance among Salmonella typhi is well known. Reports of treatment failure in enteric fever with Ciprofloxacin made us undertake this study to determine the antibiotic susceptibility pattern of S. typhi and S. paratyphi A isolated from typhoid bacteremia cases, by disc diffusion and MIC by broth dilution method. A total of 50 strains were tested, 48 of Salmonella typhi and 2 of S. paratyphi A. The disc diffusion method was done using ampicillin, chloramphenicol, cotrimoxazole, tetracycline, ciprofloxacin, ofloxacin, cefuroxime and ceftriaxone as antibiotics. The MIC was performed using ciproloxacin, ofloxacin and ceftriaxone based on standard procedure. ACCOT resistance as determined by disc diffusion method was seen in 68% of isolates. All the strains remained susceptible to flouroquinolones cephalosporins and aminoglycosides. The MIC of ciprofloxacin, ofloxacin and ceftriaxone were in the recommended range of susceptibility as given by NCCLS, 14 (28%) strains had MIC of ciprofloxacin greater than 0.5 ug/ml with 4 strains having an MIC of 1.56 ug/ml; 25 (50%) strains had MIC of ofloxacin greater than 0.5 ug/ml and 20 (40%) strains had MIC of ceftriaxone greater than 0.5 ug/ml. The high levels of MIC of ciprofloxacin may account for treatment failure cases. The rising levels of MIC of ofloxacin and ceftriaxone in S. typhi and S. paratyphi is also of concern. We document here the emergence of high levels of MIC not only to ciprofloxacin, but also ofloxacin and ceftriaxone in S. typhi and S. paratyphi A. We recommend that MIC levels of ofloxacin and ceftriaxone should be monitored along with ciprofloxacin in treatment failure cases of enteric fever.