男性不育症患者精液标本的病原学调查

目的了解我院近三年来男性不育症患者精液标本的细菌菌谱分布及衣原体、支原体的感染情况,为临床治疗用药提供依据。方法对2004年～2006年间来我院生殖中心就诊的不同病因的3533例男性不育症患者的精液标本病原体培养的结果进行统计分析,分析其致病菌的分布及耐药情况。结果 2004、2005、2006年的413、1303、1817份男性不育症患者的精液标本中分别有195、650、795份病原体培养阳性。检到细菌分别为145、498、639株,以革兰阳性菌为主,2004、2005、2006年分别占89.7%(130/145)、89.6%(446/498)、93.1%(595/639)。革兰阳性菌中又以表皮葡萄球菌为主,近三年分别占43.1%(56/130)、37.8%(170/450)、31.1%(185/595);分离到的表皮葡萄球菌对万古霉素全部敏感;对苯唑西林耐药率最高。近三年分别有18、124、66份精液标本衣原体金标试验阳性;分别有119、304、408份精液标本检到支原体,检到的支原体以解脲支原体(UU)为主,解脲支原体对氧氟沙星耐药率最高、交沙霉素耐药率最低。结论我院近三年男性不育症患者的精液标本很大部分可分离到细菌及支原体和衣原体,表明感染是引起男性不育的一个重要因素。病原菌主要以革兰阳性菌、解脲支原体为主;致病菌多样化,使得对不育症患者的治疗复杂化。对男性不育症患者的治疗需加强病原菌的检测和其耐药性的分析,进行合理用药,提高不育症患者的生育率。

Investigation of pathogens about semen of infertile men

Objective：To investigate the distribution and the antimicrobial resistance of the bacteria,mycoplasma and Chlamydia isolated from the semen of infertile men in our hospital last three years,and to provide clinicians with grounds for choosing antibiotic agents.Methods：The data of semen＇s microbes culture from 3533 infertile men with variable reasons 2004 ～ 2006 and their sensitivity to antibiotics were statistically analyzed.Results：There were 195,650 and 795 positive samples respectively in 413 samples of 2004,1303 of 2005 and 1817 of 2006.Respectively 145,498 and 639 strains were cultured;Gram-positive bacteria accounted for 89.7%,89.6% and 93.1%.Staphylococcus epidermidis was the major one and accounted for 43.1%,37.8% and 31.1% last three years.As for the isolated Staphylococcus epidermidis,their antimicrobial resistance was the lowest against vancomycin（0.0%）,but the highest against oxacillin.Respectively 18,124 and 66 samples were detected Chlamydia last three years;119,304 and 408 samples were detected urealyticum and ureaplasma urealyticum was the most.For the ureaplasma urealyticum,it was the highest against ofloxacin,and the lowest against josamycin.Conclusions：Bacteria,mycoplasma and Chlamydia are the possible etiological factors of male infertility.The main pathogens about semen of infertile men were Staphylococcus epidermidis and ureaplasma urealyticum last three years.Varieties of pathogens about semen of infertile men diversified and their therapy were complex.It is important to keep on detecting pathogens about semen of infertile men and their sensitivity to antibiotics and using them properly so as to increase their procreation rate.