泌尿生殖道支原体属感染特点及耐药性分析

目的探讨泌尿生殖道支原体属感染状况及对抗菌药物的耐药情况，指导临床合理用药。方法采用支原体培养药敏试验试剂盒，对临床收集的1852例泌尿生殖道感染患者标本进行支原体属培养及10种抗菌药物的体外药敏试验。结果在1852例受检患者标本中检出支原体阳性782例，总阳性率为42．2％。其中解脲脲原体（Uu）单一感染617例，占78．9％；人型支原体（Mh）单一感染28例，占3．6％；Uu和Mh混合感染137例，占17．5％。21～30岁年龄段患者支原体培养阳性率为42．9％，明显高于其他年龄段。药敏试验结果显示，Uu阳性者对交沙霉素、多西环素、米诺环素、克拉霉素较敏感，敏感率分别为95．7％、92．9％、92．8％和91．6％，而耐药率在70．0％以上的有大观霉素、阿奇霉素、环丙沙星、罗红霉素。结论治疗泌尿生殖道支原体属感染应首选交沙霉素和多西环素等敏感性高的药物，避免使用大观霉素、阿奇霉素等耐药性高的药物。临床上对疑似泌尿生殖道感染的患者进行支原体属的培养和药敏试验，对支原体属感染的抗菌治疗有重要的临床意义。

Clinical features and antibiotic resistance of genitourinary tract infections caused by Mycoplasma

Objective To investigate the clinical features and antibiotic resistance of genitourinary tract infections due to Myco-plasma and Ureaplasma pathogens. Methods A total of 1 852 genitourinary tract specimens were collected from the outpatients with potential genitourinary tract infection. The specimens were cultured for isolation of Mycoplasma and Ureaplasma and sub-sequent susceptibility testing. Results The prevalence of Mycoplasma was 42.2% （782/1 852） in these genitourinary samples, including 617 （78.9%） patients infected with Ureaplasma urealyticum （Uu） and 28 （3.6%） patients with Mycoplasma homi-nis （Mh）. Uu plus Mh mixed infection was found in 137 （17.5 %） patients. The prevalence of genitourinary Mycoplasma was the highest （42.9%） in the age group of 21-30 years, significantly higher than that of other age groups. Susceptibility testing showed that majority of Uu strains were susceptible to j osamycin （95.7 %）, doxycycline （92.9 % ）, minocycline （92.8 % ） and clarithromycin （91.6 %）. More than 70.00% of the Mycoplasma isolates were resistant to spectinomycin, azithromycin, cipro-floxacin and roxithromycin. Conclusions Uu is highly susceptible to josamycin and doxycycline but highly resistant to spectino-mycin and azithromycin. For suspectd genitourinary tract infections, it is necessary to perform Mycoplasma culture and suscep- tibility testing for optimal management of such infections.