2709例泌尿生殖道支原体培养及耐药性分析

目的对门诊2 709例病例的支原体培养标本进行泌尿生殖道解脲脲原体(Ureaplasma urealyticum,Uu)与人型支原体(Mycoplasma hominis,Mh)感染情况及耐药性的分析,为临床的诊断及治疗提供参考依据。方法采用商品化试剂盒对2 709例标本进行Uu、Mh半定量培养及药物敏感试验。结果 2 709例标本中总阳性率为56.15%,其中Uu占比39.87%、Mh占比8.08%、Uu和Mh共同阳性者占比8.19%,男性标本阳性率为47.78%、女性标本阳性率为66.26%。药敏结果显示,单独Uu感染者对喹诺酮类(5.00%~34.40%)、红霉素(42.80%)敏感率较低,而对四环素类(88.90%~95.00%)、交沙霉素(97.30%)敏感率较高。单独Mh感染者与Uu和Mh混合感染者耐药情况均较为严重,除四环素、强力霉素、交沙霉素、美满霉素敏感率在50%以上,对其余药物的敏感率均在50%以下。结论泌尿生殖道支原体感染以Uu感染为主,其中女性感染率高于男性;药敏结果显示感染者对四环素、强力霉素、交沙霉素、美满霉素敏感率较高,单独Mh感染者与Uu和Mh混合感染者耐药情况更为严重。     

女性泌尿生殖道支原体感染及耐药性观察

目的了解女性泌尿生殖道感染患者解脲支原体(Uu)和人支原体(Mh)感染及耐药情况,指导临床合理应用抗菌药物。方法采用法国梅里埃公司生产的IST2支原体培养及药敏试剂盒,对932例女性泌尿生殖道感染患者进行培养及药敏试验。结果 932例患者中支原体阳性426例,总检出率45.7%,其中Uu阳性354例(37.9%),Mh阳性14例(1.5%),Uu+Mh阳性58例(6.2%);药敏结果表明,Uu与Mh对多西环素、交沙霉素、四环素较为敏感,Uu对环丙沙星、氧氟沙星耐药率较高,而Mh对克拉霉素、红霉素、阿奇霉素耐药率较高。结论女性泌尿生殖道支原体检出率较高,主要以Uu为主,Uu和Mh对多种抗菌药物耐药,应引起临床重视。     

长沙地区1409例泌尿生殖道支原体感染者的感染状况及药敏分析

目的了解长沙地区普通人群泌尿生殖道支原体感染的现状及药敏情况,为临床合理用药提供依据。方法收集并回顾性分析湖南省人民医院1 409例门诊泌尿生殖道感染者的支原体培养鉴定结果及其药物敏感试验结果。结果 1 409例门诊样本中,支原体总阳性率为15.3%(215/1409);其中,解脲脲原体(Uu)和人型支原体(Mh)阳性率为11.5%和6.2%,单独感染Uu、单独感染Mh和混合感染Uu+Mh阳性率分别为9.1%、3.8%和2.4%;女性支原体阳性率为22.3%,明显高于男性的3.3%(χ~2=92.378,P0.01);药物敏感性较高的为强力霉素、美满霉素和交沙霉素,耐药性较高的有喹诺酮类和罗红霉素;女性感染者对交沙霉素和壮观霉素的敏感性高于男性,对其他药物的敏感性则明显低于男性。单独Uu感染者对各抗菌药物(环丙沙星和壮观霉素除外)的敏感性均高于单独Mh感染者,而混合Uu+Mh感染者则为药物敏感性最低的一组(对大部分药物的敏感性低于40%)。结论长沙地区普通人群泌尿生殖道支原体感染的阳性率总体较低,但耐药问题依然突出,临床用药时可把四环素类药物和交沙霉素纳入首选,同时依据感染者的性别、感染类型等选择适宜药物进行治疗。     

女性泌尿生殖道支原体感染及耐药性分析

目的通过分析深圳市人民医院2009年9月至2010年4月女性泌尿生殖道支原体感染状况及耐药性变迁,指导临床合理用药。方法采用法国生物梅里埃公司MyeoplasmaIST2支原体鉴定及药敏试剂盒,进行支原体检测及药敏分析。结果2135例患者总检出率为54．6％（1166／2135）,其中解脲脲支原体（Uu）阳性1017例（47．6％）;人型支原体（Mh）阳性32例（1．5％）;Uu＋Mh阳性117例（5．5％）。1166例患者支原体对9种抗生素够感性依次为原始霉素（99．8％）、交沙霉素（99．6％）、强力霉素（96．3％）、四环素（94．4％）、克拉霉素（85．6％）、阿奇霉素（77．6％）、红霉素（75．6％）、氧氟沙星（28．4％）和环丙沙星（22．8％）。结论支原体（尤其是Uu）感染已成为女性泌尿生殖系统炎症的主要病原体之一,治疗支原体感染应选择原始霉素、交沙霉素、强力霉素等敏感率高的药物及药敏试验显示敏感的药物,喹诺酮类药物耐药率较高,应引起临床重视。     

1796例泌尿生殖道支原体培养及药敏结果分析

目的分析新乡地区1796例泌尿生殖道标本的支原体培养及抗生素药物敏感试验,指导临床合理使用抗生素。方法支原体培养鉴定、药敏试剂盒购自贝瑞特公司。同时检测解脲支原体和人型支原体,并进行10种抗生素的药敏试验。数据统计采用χ^2检验。结果支原体培养1596例标本中,541例解脲脲原体（Uu）阳性,阳性率为33.9%;39例人型支原体（Mh）阳性,阳性率为2.4%;解脲脲原体、人型支原体均阳性76例,阳性率为4.8%。200例正常对照组27例阳性,阳性率为13.5%。药敏结果显示,强力霉素、克拉霉素和美满霉素的抗菌活性较强。结论支原体感染以Uu为主,Uu＋Mh次之,正常人泌尿生殖道支原体阳性率为13.5%。只有某些血清型感染且在达到一定浓度以上同时宿主处于多种病原体感染或免疫机制紊乱时,Uu才能致病。避免滥用抗生素引起生殖道菌群失调。临床上治疗Uu感染、Mh感染或Uu＋Mh混合感染时,建议选用强力霉素、克拉霉素和美满霉素。     

4103例泌尿生殖道支原体感染及药敏分析

目的通过分析泌尿生殖道支原体感染及药敏情况,为临床提供用药指导。方法采用支原体检测试剂盒进行支原体属培养和药敏试验。结果4103例患者标本中,检出支原体属1336株,总阳性率为32．56％;其中单一解脲脲原体（Uu）感染1227例,阳性率为91．84％;单纯人型支原体（Mh）感染15例,阳性率为1．12％;Uu＋Mh混合合感染94例,阳性率为7．04％。解脲脲原体对阿奇霉素、红霉素、交沙霉素、罗红霉素、米诺环素、强力霉素敏感性高;单纯人型支原体对交沙霉素、米诺环素、强力霉素敏感。结论泌尿生殖道支原体感染以Uu为主。支原体大多具有多重耐药性,临床治疗需根据药敏结果选药物。     

316例输卵管性不孕患者生殖道Ct、Uu及Mh的检测及耐药性分析

目的通过对316例输卵管性不孕患者生殖道沙眼衣原体、解脲支原体、人型支原体感染以及耐药情况进行检测分析,研究其与不孕症的关系,并探讨用药合理性。方法收集316例2013年2月至2016年9月至我院进行诊治的输卵管性不孕患者作为研究组,并选取同期297例来进行检查的健康人作为对照组。对两组人员生殖道分泌物进行沙眼衣原体(Chlamydia trachomatis,Ct)、解脲支原体(Ureaplasma urealyticum,Uu)、人型支原体(Mycoplasma hominis,Mh)检测,并进行药敏试验。结果研究组患者Ct、Uu、Mh、Ct+Uu、Uu+Mh感染率以及总感染率均明显高于对照组,差异均具有统计学意义(Ps0.05)。Uu对原始霉素、四环素、强力霉素、交沙霉素、阿奇霉素、克拉霉素、红霉素敏感性较高(90%以上),对氧氟沙星、环丙沙星耐药性较高。Mh对原始霉素、四环素、强力霉素、交沙霉素敏感性较高(90%以上),对氧氟沙星、环丙沙星、阿奇霉素、克拉霉素耐药性较高。Uu+Mh对原始霉素、四环素、交沙霉素敏感性较高(90%以上),对阿奇霉素、氧氟沙星、环丙沙星耐药性较高。结论对输卵管性不孕患者,应进行生殖道分泌物Ct、Uu、Mh的检测,判断是否发生感染或混合感染,并根据药敏结果选择合适的抗生素进行治疗,以提高治疗效果。     

3类抗菌药物体外抗解脲脲原体和人型支原体的作用

目的比较四环素类、大环内酯类和喹诺酮类3类抗菌药物,对临床分离株解脲脲原体(Uu)和人型支原体(Mh)的抗菌作用,为临床用药提供参考依据.方法采用直接肉汤药盘法测定了临床标本中,195株Uu和1218株Mh对3类抗菌药物中的8种抗生素的敏感性.结果 195株Uu对四环素、多西环素、米诺环素、罗红霉素、阿齐霉素、交沙霉素、氧氟沙星和司帕沙星的敏感率,分别为21.0%、48.2%、39.5%、79.0%、88.7%、74.9%、28.2%和64.6%.118株Mh对四环素、多西环素、米诺环素、罗红霉素、阿齐霉素、交沙霉素、氧氟沙星、司帕沙星的敏感率分别为5.1%、33.9%、26.3%、0.0%、0.0%、89.8%、70.3%和64.4%.960例混合感染的Uu Mh,对交沙霉素最敏感(79.2%).结论泌尿生殖道支原体的药敏监测对指导临床治疗具有重要意义.     

887例宫颈分泌物支原体培养及耐药性分析

目的 了解女性泌尿生殖道感染患者支原体感染及耐药情况.方法 采用生物梅里埃IST2试剂盒,对887例宫颈分泌物进行培养及药敏试验.结果 887例标本中检出Uu阳性401例(45.2％),Mh阳性4例(0.5％),Uu+Mh阳性137例(15.4％),共检出542例(61.1％).药敏结果表明,Uu与Mh对原始霉素、交沙霉素、强力霉素、四环素较为敏感,对环丙沙星耐药率最高.结论 女性泌尿生殖道Uu和Mh感染率很高,主要以Uu为主,Uu和Mh对多种抗菌药物耐药,其中以环丙沙星为最高,单纯Uu、Mh和Uu+ Mh的耐药率存在一定差异,治疗支原体感染首选交沙霉素、四环素.     

2006～2010年泌尿生殖道炎症患者支原体感染率检测与耐药性分析

目的 了解杭州市萧山区2006～ 2010年泌尿生殖道炎症患者支原体感染及耐药情况.方法 对4 023例泌尿生殖道炎症患者用支原体鉴定及药敏试剂盒进行支原体培养及药敏试验.结果 支原体总检出率为48.1％,女性检出率51.2％明显高于男性41.8％ (P ＜0.05).支原体培养阳性患者中Uu单独感染1701例(88.0％),Mh单独感染57例(2.9％),Uu+ Mh混合感染176例(9.1％),Uu单独感染明显高于Mh单独感染和Uu+ Mh混合感染(P＜0.05).5年间支原体阳性检出率从2006年的39.4％到2010年的58.1％逐年增高,感染模式观察期内无明显变化.支原体对交沙霉素、原始霉素和强力霉素均敏感(敏感率≥91.4％),对四环素、红霉素、氧氟沙星和环丙沙星的耐药率高,均大于50％.比较2006年至2010年各种支原体对9种药物的耐药率,除四环素外耐药率呈不同程度上升,四环素耐药率2007年和2008年较高,后逐年下降,2010年为53.5％.混合感染总体耐药率比Uu或Mh单独感染耐药率高.结论 泌尿生殖道炎症患者支原体感染Uu比较常见,且女性检出率显著高于男性.临床分离支原体大多具有多重耐药性,临床治疗需根据药敏结果加以选择.     

Prevalence of Chlamydia trachomatis and genital mycoplasmas in asymptomatic women.

To establish the prevalence of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum in women attending a family planning and a prenatal clinic in Halifax, cervical swabs were obtained at the time of the first visit from 491 women who had no symptoms of genital infection. Among the women attending the family planning clinic M. hominis occurred in combination with C. trachomatis more frequently than expected (p less than 0.05). It occurred in the absence of U. urealyticum in only a few cases (13% of the occurrences in the family planning clinic and 6% of those in the prenatal clinic). C. trachomatis was significantly more prevalent in women under 25 years of age (p less than 0.04). However, mycoplasmas were as prevalent in women over 30 years as in those under 30. There were no significant differences in the infection rates of the organisms by trimester among pregnant women. More research is necessary for a proper understanding of the role of M. hominis and U. urealyticum in genitourinary infections and pregnancy outcomes.     

泌尿生殖系统感染支原体培养及药敏结果分析

目的 :了解解脲支原体和人型支原体在泌尿生殖系统感染中的致病作用和对抗生素的药敏情况。方法 :对 5 87例泌尿系感染患者进行支原体培养 ,并对阳性标本行 12种抗生素药敏试验。采用支原体培养、鉴定、药敏一体化试剂盒进行检测。结果 :5 87例患者中支原体阳性 16 4例 ,感染率为 2 7 9% ,解脲支原体 (Uu)、人型支原体 (Mh)及Uu +Mh混合感染的阳性率分别为 2 1 3%、1 5 %和 5 1%。女性感染率显著高于男性 (P <0 0 1)。支原体对 12种抗生素敏感性最高的是交沙毒素 (92 7% ) ,其次为可乐必妥(85 4 % )、司帕沙星 (84 8% )。结论 :泌尿生殖系统感染者支原体感染率为 2 7 9% ,主要由解脲支原体引起 (占 76 2 % ,12 5 / 16 4 ) ,泌尿生殖系感染支原体患者应首选交沙霉素治疗。     

女性生殖道支原体检测及药敏结果分析

采用支原体培养、鉴定、药敏为一体的试剂对294例女性患者进行培养及药敏实验结果,强力霉素和交沙霉素的敏感率较高,分别为92.9%和88.2%,其次为美满霉素87.6%、阿齐霉素84.7%和罗红霉素73.5%,解脲支原体感染率明显高于人型支原体感染率(p＜0.05)有统计学意义.     

基层中医院735例女性宫颈分泌物支原体检测及药敏分析

目的了解生殖道支原体感染与年龄、白带清洁度的关系及对抗生素的敏感性,为临床用药提供依据。方法对735例疑似生殖道感染标本采用珠海迪尔生物有限公司生产的试剂盒进行支原体培养和药敏试验,取阴道分泌物作清洁度检查。结果735例标本中检出支原体阳性402例,阳性率为54．7％,解脲脲原体（Uu）、Uu＋Mh混合感染及人型支原体（Mh）分别占75．1％、20．9％、4．0％。Uu、Uu＋Mh阳性患者好发于18～40岁。白带清洁度异常者的Uu、Uu＋Mh、Mh阳性率明显高于白带清洁度正常者。药敏结果显示,支原体对强力霉素、美满霉素敏感性较高,敏感率为85．7％～100．0％。结论白带清洁度异常者为支原体感染的高危人群,诊治时应常规做支原体检测,支原体感染的治疗应根据感染病原体的类型和药敏结果合理应用抗生素。     

Microbial causative agents of male urethritis.

The incidence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Neisseria gonorrhoeae and Trichomonas vaginalis was studied in men with urethritis. Out of 150 examined men 48.7% had the positive isolation of U. urealyticum, 26.0% C. trachomatis, 22.7% N. gonorrhoeae, 18.7% M. hominis and in one (0.7%) patient T. vaginalis was found. None of the above mentioned microorganisms was detected in 24.7% of examined men. In 43.3% cases only one agent was isolated. In 23.3% of the men the combination of two agents, in 8.0% the combination of three and in 0.7% even the combination of four studied microorganisms was observed. C. trachomatis was most frequently observed in combination with N. gonorrhoeae (15 cases) and U. urealyticum (14 cases). M. hominis and U. urealyticum occurred simultaneously in 22 examined men.N.gonorrhoeae was most frequently found together with U. urealyticum (16 cases). Concerning the occurrence of other bacteria and yeasts, no significant difference was found between the groups positive and negative for the above mentioned microorganisms.     

Impact of Mycoplasma hominis and Ureaplasma urealyticum on the concentration of proinflammatory cytokines in vaginal fluid

The main aim of this study was to determine impact of Mycoplasma hominis and Ureaplasma urealyticum on the concentrations of selected proinflammatory cytokines in vaginal fluid in pregnant women. The samples were obtained from 120 pregnant women at 22 to 36 weeks gestation. Vaginal fluid were analyzed for the concentrations of IL-1 alpha, IL-1 beta, IL-6 and IL-8 using standard enzyme-linked immunosorbent assay technique (ELISA), and cervical fluid for prevalence of Mycoplasma hominis and Ureaplasma urealyticum. Genital mycoplasmas were diagnosed in 36 of 120 pregnant women (30%), (in 17 of 36 women (47.2%) both M. hominis and U. urealyticum, in 14 women (38.9%) only U. urealyticum, and in 5 cases (13.8%) only M. hominis were diagnosed). Vaginal levels of IL-8 was statistically higher among women with genital mycoplasmas infection, as compared to group without these bacteria (p=0.033), while there was no correlation between IL-1 alpha, IL-1 beta and IL-6 concentrations and genital mycoplasmas infection. Future studies should concentrate on evaluation the impact of other lower genital tract bacteria on concentration of IL-8 and other proinflammatory cytokines.     

Comparison of polymerase chain reaction assay and Mycoplasma IST 2 test with culture for detection of infections caused by Ureaplasma urealyticum and Mycoplasma hominis

The polymerase chain reaction (PCR) technique and commercial Mycoplasma IST 2 test were compared with culture for the detection of U. urealyticum and M. hominis in 173 clinical samples obtained from patients without clinical symptoms from genito-urinary tract. The presence of U. urealyticum was diagnosed by culture in 24 samples, by PCR in 33 samples and by Mycoplasma IST 2 test in 39 samples. The presence of M. hominis was diagnosed in 26 samples only by Mycoplasma IST 2 test--culture and PCR were negative. The study showed the excellent sensitivity (100%) and good specificity (appropriately 94.0% and 90.0%) for U. urealyticum in PCR and Mycoplasma IST 2 test. The discrepancy of results obtained in Mycoplasma IST 2 test and culture as well as in PCR may suggest the over sensitivity of the commercial test for detection of M. hominis.