667例非淋菌性尿道炎患者支原体感染率检测与耐药性分析

目的检测非淋菌性尿道炎患者的支原体感染率及对9种抗生素的耐药性为临床用药提供指导。方法对667例疑似支原体感染非淋菌性尿道炎患者进行了支原体培养及药敏试验,并对结果进行统计分析。结果支原体总检出率为47.2%(315/667),女性检出率56.3%(213/378)明显高于男性35.3%(102/289)(P<0.05)。解脲支原体(Uu)阳性率37.6%(251/667)明显高于人型支原体(Mh)1.9%(13/667)及Uu+Mh混合感染阳性率7.6%(51/667)(P<0.05)。药敏试验结果:支原体对交沙霉素、原始霉素和强力霉素均较为敏感(敏感率≥96.2%)。对环丙沙星耐药率最高(91.1%),对氧氟沙星、红霉素以及四环素耐药率均≥65.7%。克拉霉素和阿奇霉素对Uu较敏感(敏感率分别为71.7%和64.9%),对Mh和Uu+Mh混合感染则耐药性较高(耐药率≥69.2%),Mh是否参与感染与克拉霉素及阿奇霉素耐药程度相关。结论非淋菌性尿道炎患者支原体感染Uu比较常见,且女性检出率显著高于男性。临床分离支原体大多具有多重耐药性和高耐药性,临床治疗需根据药敏结果加以选择。

Prevalence and Drug Resistance of Mycoplasma in 667 Patients with Non-gonococcal Urethritis

Objective To evaluate the occurrence of ureaplasma urealyticum(Uu),and mycoplasma hominis(Mh) in non-gonococcal urethritis(NGU) and to determine the bacterial resistance to nine antibiotics in order to determine the most suitable treatment strategy.Methods The results of mycoplasma culture and drug sensitivity test were analyzed by using the mycoplasma detection kits in 667 patients with NGU from 2009 to 2010.Results A total of 315(47.2%) cases were mycoplasma positive in the 667 NGU patients,and the infection rate in feminine(56.3%)was obviously higher than that in masculine(35.3%)(P<0.05).Among them,251(37.6%) were infected with Uu,13(1.9%) with Mh,and 51(7.6%) with both Uu and Mh,and the Uu infection rate was much higher than that of Mh and mixed infection(P<0.05).The results of drug sensitivity test showed a higher sensitivity to josamycin,pristinamycin and doxycycline(96.2%,98.4% and 97.5% respectively).The highest rate of resistance was to ciprofloxacin(91.1%).The resistant rates to ofloxacin,erythromycin and tetracycline were all higher than 65.7%.The Uu sensitivity rates to clarithromycin and azythromycin were higher than those of Mh and mixed infection(P<0.05).Conclusion The infection of Uu is common in the patients of NGU and the infection rate in feminine is higher than that in masculine.Because of their high and multi-drug resistance,antibiotics should be chosen according to drug sensitivity test results.