299例泌尿生殖道沙眼衣原体的检测及药物敏感性分析

目的:检测近4年来天津地区泌尿生殖道沙眼衣原体对阿奇霉素、米诺环素、莫西沙星3种临床常用抗生素体外药物敏感性,并评价药敏结果与临床疗效的关系.方法:将采集到的符合要求的299例临床标本及E型标准株破壁、离心后接种于细胞培养板的McCoy细胞,培养60～72 h后碘染观察衣原体包涵体.原代培养阴性或阳性的标本均进行传代培养.阴性标本均传代培养至第5代,阳性标本传代培养至感染率达90%以上,收集标本进行3种常用抗生素的药敏试验.结果:共培养出沙眼衣原体阳性株104株,阳性率为34.78%.其中McCoy细胞感染率达90%以上的菌株共94株,药敏(最低抑菌浓度,MIC)结果分别为阿奇霉素(0.063～1.000 mg/L),米诺环素0.004～0.128 mg/L,莫西沙星0.030～0.240 mg/L.应用阿奇霉素、莫西沙星、米诺环素治疗后的沙眼衣原体总体阴转率分别为44.44%、63.46%、88.89%.结论:随着时间的推移和抗生素的广泛应用,抗生素的敏感性呈不同程度的下降,米诺环素抗衣原体活性相对较强.整体评价临床各类药物治疗效果与时间变化趋势分析,药敏结果与临床疗效之间明显相关.

The detection and the susceptibility analysis to antimicrobial agents in 299 cases of urogenital chlamydial trachomatis infection

Objective: To test in vitro drug susceptibility of recent clinical isolates from patients with urogenital chlamydial infection to azithromycin, minocyline and moxifloxacin in last 4 years in Tianjin, and explore the relationship between suscep-tibility testing and therapeutic effects. Methods: Laboratory reference strains of C. trachomatis (E serovar) and 299 clinical isolates of Chlamydia trachomatis were inoculated on McCoy cells, and cultured for 48-72 hours. The presence of the inclu-sion of Chlamydia trachomatis was identified by Lugol's iodine solution The culture-negative samples were cultured for anoth-er five passages. The culture-positive samples were cultured until more than 90% McCoy cells being infected, then the cells were collected for susceptibility testing to 3 antimicrobials. Results; Out of 299 clinical isolates 104 strains were positive for C.trachomatis, the positive rate was 34.78%. Among them,the positivestrains with an infection rate greater than 90% of McCoy cells accounted for 94 strains. The MIC of azithromycin, minocyline and moxifloxacin against these isolates were 0.063-1.000 mg/L, 0.004-0.128 mg/L and 0.030-0.240mg/L respectively. In the treatment of chlamydial infection with azithromycin, moxifloxacin, or minocycline, the overall clearance rates of C.trachomatis were 44.44%, 63.46% and 88.89% respectively. Conclusions; With the lapse of time and the wide spread use of antibiotics, the antibiotic sensitivity of Chlamydia trachomatis is gradually reduced indifferent levels Minocycline exhibited a markedly better action against Chlamydia trachomatis in-vitro. In overall evaluation of the therapeutic effects of above drugs, susceptibility testing was significantly correlated to the therapeutic efficacy.