不孕不育患者支原体感染情况和耐药率分析

目的探讨本地区不孕不育患者解脲支原体(Ureaplasma urealyticum,UU)和人型支原体(Mycoplasma hominis,MH)感染率和耐药率,以期了解支原体在该人群流行情况和耐药率变化情况,为治疗选择合适的抗菌药物。方法对2012年1月-2013年11月期间济宁市第一人民医院生殖科门诊4 266例不孕不育患者培养法检测UU和MH,并对1 557例阳性标本行体外药敏实验,分析其耐药现状。结果不孕不育患者支原体总感染率为36.5%,UU感染率显著高于MH感染率(P0.01)。男性和女性生殖道支原体感染率分别为31.8%、45.4%,女性支原体感染率显著高于男性(P0.01)。生殖道支原体对喹诺酮类抗菌药物耐药率相对较高,对大环内酯类和四环素类耐药率较低。2013年支原体对12种抗菌药物的耐药率同比多数降低。MH对多数抗菌药物耐药率均较高,对美满霉素、强力霉素药物高度敏感。结论不孕不育患者具有较高的UU和MH感染率,支原体对常用抗菌药物有一定耐药性,临床应根据药敏结果有选择性地使用抗菌药物。

Analysis on Mycoplasma infection and antimicrobial resistance in patients with infertility

Objective To study the infection rate and drug resistance rate of Ureaplasma urealyticum（ U. urealyticum） and Mycoplasma hominis（ M. hominis） in patients with infertility in this area so as to select the appropriate antibiotics for the treatment. Methods From January,2012 to November,2013,4,266 specimens from infertility patients in the Fertility Clinic,the First People＇s Hospital of Jining City were cultured for U. urealyticum and M. hominis,and drug sensitivity test was performed in1,557 positive samples to know the drug resistance rate. Results The total infection rate of Mycoplasma in the infertility patients was 36. 5%. The infection rate of U. urealyticum was significantly higher than that of M. hominis（ P〈0. 01）. The infection rate of genital tract Mycoplasma was significantly higher in women than in men（ 45. 4% vs 31. 8%,P〈0. 01）. The results of drug sensitivity test showed that genital tract Mycoplasma was relatively high-resistant to quinolone antibiotics,but more sensitive to macrolide antibiotics and tetracycline-class antibiotics. The resistance rates of Mycoplasma to 12 kinds of antibiotics in 2013 declined mostly as compared with those in 2012. The resistance rates of M. hominis to most antibiotics were high in the study except minocycline and doxycycline. Conclusions The infertility patients had high infection rates of U. urealyticum and M.hominis; moreover,Mycolasma showed a definite resistance to commonly used antibiotics. Clinicians should use antibiotics based on the results of drug sensitivity test.