我院227例输卵管性不孕患者生殖道支原体感染及药敏结果分析
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摘要
目的:研究输卵管性不孕患者生殖道支原体感染现状及耐药情况。方法:将我院2015年1月至2017年6月227例输卵管性不孕患者纳入不孕组,选取同期在我院进行孕前检查的100例健康女性志愿者为对照组,采集宫颈分泌物进行支原体培养、鉴定与药敏试验。结果:227例输卵管性不孕患者共检出129例生殖道支原体感染,包括66例解脲支原体感染、38例人型支原体感染、25例解脲支原体+人型支原体感染。不孕组生殖道支原体总感染率为56.8%显著高于对照组的14.0%(χ2=51.746,P=0.000)。解脲支原体对强力霉素与美满霉素最敏感,敏感率均为93.9%;对克拉霉素耐药性最高,耐药率为56.1%。人型支原体对四环素与强力霉素最敏感,敏感率均为94.7%;对罗红霉素耐药性最高,耐药率为68.4%。解脲支原体+人型支原体对强力霉素最敏感,敏感率为88.0%;对阿奇霉素耐药性最高,耐药率为92.0%。不孕组解脲支原体、人型支原体、解脲支原体+人型支原体感染率及生殖道支原体总感染率显著高于对照组(P<0.05)。结论:生殖道支原体感染以解脲支原体感染为主,呈多重耐药性,临床治疗应在药敏试验结果指导下进行。
Objective:To study the current status and drug resistance of genital tract mycoplasma infections in patients with tubal infertility.Methods:227 patients with tubal infertility who were admitted to the hospital from January 2015 to June 2017 were included in the infertility group.100 healthy female volunteers were selected as the control group at the same time.The cervical secretions were collected for mycoplasma culture,identification and drug sensitivity test.Results:A total of 129 cases with genital tract mycoplasma infection were detected in 227 patients with tubal infertility,including 66 cases with Ureaplasma urealyticum infection,38 cases with Mycoplasma hominis infection and 25 cases with Ureaplasma urealyticum and Mycoplasma hominis infections.The total genital tract mycoplasma infection rate in the infertility group was significantly higher than that in the control group(56.8% vs 14.0%)(χ2= 51.746,P = 0.000).Ureaplasma urealyticum was most sensitive to doxycycline and mycophencin,and the sensitivity rate was 93.9%.The drug resistance to clarithromycin was the highest,and the drug resistance rate was 56.1%.Mycoplasma hominis was most sensitive to tetracycline and doxycycline,and the sensitivity rate was 94.7%.The drug resistance to roxithromycin was the highest,and the resistance rate was 68.4%.Ureaplasma urealyticum and Mycoplasma hominis were most sensitive to doxycycline,and the sensitivity rate was 88.0%,.The drug resistance to azithromycin was the highest,and the resistance rate was 92.0%.Conclusion:.Ureaplasma urealyticum infection is the main part of genital tract mycoplasma infection,showing multi-drug resistance.The clinical treatment should be guided by results of drug sensitivity test.
Objective:To study the current status and drug resistance of genital tract mycoplasma infections in patients with tubal infertility.Methods:227 patients with tubal infertility who were admitted to the hospital from January 2015 to June 2017 were included in the infertility group.100 healthy female volunteers were selected as the control group at the same time.The cervical secretions were collected for mycoplasma culture,identification and drug sensitivity test.Results:A total of 129 cases with genital tract mycoplasma infection were detected in 227 patients with tubal infertility,including 66 cases with Ureaplasma urealyticum infection,38 cases with Mycoplasma hominis infection and 25 cases with Ureaplasma urealyticum and Mycoplasma hominis infections.The total genital tract mycoplasma infection rate in the infertility group was significantly higher than that in the control group(56.8% vs 14.0%)(χ2= 51.746,P = 0.000).Ureaplasma urealyticum was most sensitive to doxycycline and mycophencin,and the sensitivity rate was 93.9%.The drug resistance to clarithromycin was the highest,and the drug resistance rate was 56.1%.Mycoplasma hominis was most sensitive to tetracycline and doxycycline,and the sensitivity rate was 94.7%.The drug resistance to roxithromycin was the highest,and the resistance rate was 68.4%.Ureaplasma urealyticum and Mycoplasma hominis were most sensitive to doxycycline,and the sensitivity rate was 88.0%,.The drug resistance to azithromycin was the highest,and the resistance rate was 92.0%.Conclusion:.Ureaplasma urealyticum infection is the main part of genital tract mycoplasma infection,showing multi-drug resistance.The clinical treatment should be guided by results of drug sensitivity test.
引文
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[2]刘习明,宁联芳,尹立,等.中西医结合治疗4983例不孕不育症患者临床妊娠病案分析[J].湖南师范大学学报(医学版),2015,12(6):69~72.
[3]王冬莲,陈亮香,廖湘玲,等.生殖道支原体致不孕患者输卵管Toll样受体表达及意义[J].中国现代医学杂志,2015,25(10):24~27.
[4]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2013.359~370.
[5]李会阳,韩姹,王辰,等.生殖支原体与生殖健康关系的研究进展[J].中华妇产科杂志,2016,51(10):795~797.
[6]李美红,王峰,吕婉飞,等.国内某地区妊娠妇女生殖道支原体感染现状调查[J].中国消毒学杂志,2016,33(4):343~345.
[7]王琦,张红云,陈蔚清,等.继发性不孕不育女性生殖道支原体与沙眼衣原体的感染分析[J].中华医院感染学杂志,2016,26(10):2348~2350.
[8]陈芳芬,杨泽妹,许爱玲,吴海莉.生殖道支原体属及衣原体属感染对女性不孕及性功能的影响分析[J].中国性科学,2018,27(1):130~133.
[9]胡云岚,杨崇勤,杜永政.女性泌尿生殖道支原体感染及药敏状况分析[J].现代预防医学,2017,44(5):477~478.
[10]潘长清,王丹,齐成秋,等.不孕妇女支原体感染调查与药物敏感性研究[J].中华医院感染学杂志,2017,27(11):2583~2586.