慢性宫颈炎解脲脲原体和人型支原体检出状况及其对常用抗菌药物耐药性

Detiction and drug resistance to commonly used antibiotics of Ureaplasma urealyticum and Mycoplasma hominis in chronic cervicitis patients

  • 摘要:
    目的 探讨慢性宫颈炎(CC)解脲脲原体(Uu)和人型支原体(Mh)检出状况及其常用抗菌药物耐药性。
    方法 选取2022年1月-2024年6月宁波大学附属妇女儿童医院妇科收治的91例CC患者为CC组,另选取医院91名同期健康体检女性为对照组。采集所有研究对象生殖道分泌物进行Uu、Mh培育及药敏试验。比较两组生殖道分泌物Uu、Mh及Uu+Mh检出率; 比较不同年龄段CC患者Uu和Mh检出情况; 分析CC患者药敏试验Uu和Mh对强力霉素(DOX)、交沙霉素(JOS)、氧氟沙星(OFL)、克拉霉素(CLA)、红霉素(ERY)、环丙沙星(CIP)、四环素(TET)、阿奇霉素(AZI)和原始霉素(PTN)的耐药性。
    结果 91例CC患者生殖道分泌物标本共检出支原体阳性标本75例(82.41%),其中Uu检出37例,Mh检出25例,Uu+Mh检出13例。CC组Uu、Mh和Uu+Mh检出率分别为40.66%、24.47%和14.29%,均高于对照组的8.79%、4.40%和5.49%(P<0.05);20~40岁年龄段CC患者Uu、Mh和Uu+Mh总检出率高于>40岁年龄段CC患者(P<0.05);CC患者阳性标本中Uu对CLA和DOX敏感性较高,对OFL、CIP和PTN耐药; Mh和Uu+Mh均对JOS和DOX敏感,对OFL和CIP耐药。
    结论 CC患者Uu和Mh检出率较正常人群升高,分离Uu、Mh对喹诺酮类和氨基糖苷类耐药率较高,临床应根据耐药结果结合经验用药选择敏感的抗菌药物进行治疗。

     

    Abstract:
    OBJECTIVE To explore the prevalence of Ureaplasma urealyticum and Mycoplasma hominis among the patients with chronic cervicitis (CC) and observe their drug resistance to commonly used antibiotics.
    METHODS A total of 91 patients with CC who were treated in gynecology department of Women and Children′s Hospital Affiliated to Ningbo University from Jan. 2022 to Jun. 2024 were assigned as the CC group, meanwhile, 91 healthy women who received physical examination were chosen as the control group. The genital tract secretions were collected from all of the research subjects for the culture of U. urealyticum and M.hominis and drug susceptibility testing. The isolation rates of U. urealyticum, M. hominis and U. urealyticum plus M. hominis were compared between the two groups. The isolation rates of U. urealyticum and M.hominis were compared among the different age groups of CC patients. The drug susceptibility testing of U. urealyticum and M.hominis for doxycycline (DOX), josamycin (JOS), ofloxacin (OFL), clarithromycin (CLA), erythromycin (ERY), tetracycline (TET), azithromycin (AZI) and pristinamycin (PTN) were observed.
    RESULTS Totally 75 (82.41%) genital tract secretion samples tested positive for Mycoplasma among the 91 samples, 37 detected with U. urealyticum, 25 were M. hominis, and 13 were U. urealyticum plus M. hominis. The isolation rates of U. urealyticum, M. hominis and U. urealyticum plus M. hominis of the CC group were 40.66%, 24.47% and 14.29%, respectively, higher than 8.79%, 4.40% and 5.49% of the control group (P < 0.05). The total detection rate of U. urealyticum, M. hominis and U. urealyticum plus M. hominis was higher among the CC patients aged between 20 and 40 years old than among the CC patients aged more than 40 years old (P < 0.05). The U. urealyticum strains from the positive specimens of the CC patients were highly sensitive to CLA and DOS but were resistant to OFL, CIP and PTN; the M. hominis and U. urealyticum plus M. hominis strains were sensitive to JOS and DOX but were resistant to OFL and CIP.
    CONCLUSIONS The detection rates of U. urealyticum plus M. hominis are higher among the CC patients than among the normal population. The isolated U. urealyticum and M. hominis strains are highly resistant to quinolones and aminoglycosides. It is necessary for the hospital to empirically choose sensitive antibiotics based on the result of drug susceptibility testing.

     

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