抗菌药物对泌尿生殖道沙眼衣原体临床株培养的影响

【摘要】 目的 探讨抗菌药物对泌尿生殖道沙眼衣原体感染者衣原体培养结果的影响，并分析药敏变化。 方法 取临床经直接免疫荧光检测确定为衣原体感染者的尿道或宫颈拭子进行传代培养，碘染后发现包涵体者为培养阳性。分析患者临床用药与培养阳性及阳性代数之间的关系，并对阳性菌株进行体外药敏测试。结果 2010—2012年，共培养临床标本285份，阳性39份；未用药即培养的标本61份，阳性17份（27.87%）；用药后培养224份，阳性22份（9.82%），两组阳性率比较，χ2 = 13.22，P ＜ 0.05。未用药组阳性的17例中，1代阳性4例，2代5例，3代5例，4代2例，5代1例；用药后组阳性的22例中，2代2例，3代3例，4代9例，5代6例，6代2例，未用药与用药后培养标本首次出现沙眼衣原体包涵体的代数经秩和检验，差异有统计学意义（P ＜ 0.05），未用药标本出现阳性代数早于用药后的标本。对培养阳性的39份的标本进行体外药敏检测，结果发现，未用药患者的MIC值低于用药患者。 结论 与未用药患者的标本相比，用抗菌药物患者的标本在应用细胞培养法检测衣原体时阳性率低，出现阳性者需增加传代才能检出。 【关键词】 衣原体, 沙眼； 治疗结果； 培养技术； 微生物敏感性试验

Effect of orally administered antimicrobial agents on the cultivation of urogenital Chlamydia trachomatis

CHEN Li-xin *, WANG Rui, YOU Cong, LIU Zhi-chao, WANG Jing, LI Zhuo-ran, LIU Yuan-jun, LIU Quan-zhong. *Department of Dermatology, General Hospital, Tianjin Medical University, Tianjin 300052, ChinaCorresponding author: LIU Quan-zhong, Email: liuquanzhong@medmail.com.cn 【Abstract】 Objective To investigate the effect of orally administered antimicrobial agents on the cultivation and antimicrobial susceptibility of urogenital Chlamydia trachomatis （CT）. Methods Totally, 285 patients with urogenital CT infection diagnosed by direct immunofluorescence from 2010 to 2012 were recruited in this study. Of them, 61 patients were untreated, and 224 had received a course of regular antimicrobial treatment 5 weeks before the recruitment. Urethral or cervical swab specimens were collected from all of these patients and subjected to CT culture. The relationship of antimicrobial treatment with the culture-positive rate and the minimum number of passages required for the detection of CT inclusion bodies was assessed. In vitro susceptibility test was performed on the clinical CT isolates. Results Of the 285 clinical specimens, 39 were positive for CT by cell culture. The CT culture-positive rate was 27.87% （17/61） in untreated patients and 9.82% （22/224） in treated patients （χ2 = 13.22, P < 0.05）. Of the 17 positive specimens from untreated patients, 4 were identified as positive after 1 passage of culture, 5 after 2 passages, 5 after 3 passages, 2 after 4 passages, and 1 after 5 passages. Meanwhile, among the 22 positive specimens from treated patients, 2 were identified as positive after 2 passages, 3 after 3 passages, 9 after 4 passages, 6 after 5 passages, 2 after 6 passages. Rank sum test showed that the minimum number of passages required for the detection of CT inclusion bodies was statistically lower in the specimens from untreated patients than those from treated patients （P < 0.05）. The CT isolates from untreated patients showed a reduced antimicrobial sensitivity compared with those from treated patients. Conclusions Compared with the specimens taken from untreated patients, those from treated patients exhibit a lower CT culture-positive rate but an increased minimum number of passages required for the detection of CT inclusion bodies. 【Key words】 Chlamydia trachomatis ; Treatment outcomes; Culture techniques; Microbial sensitivity tests