【2016年】十堰地区女性泌尿生殖道支原体感染状况及其对四环素类抗生素耐药机制研究【临床医学论文】.docVIP

临床医学论文-十堰地区女性泌尿生殖道支原体感染状况及其对四环素类抗生素耐药机制研究 ??? ???????? 作者：李咏梅, 余光清 李莉 蒋诗琴 【摘要】? 目的：了解十堰地区女性泌尿生殖道感染患者支原体感染状况及其对药物敏感性的变化情况，并探讨其对四环素类抗生素可能的耐药机制。方法：1 568例女性泌尿生殖道感染患者，取宫颈分泌物进行解脲支原体(Uu)和人型支原体(Mh)培养鉴定及药敏检测，根据药敏结果随机抽取部分菌株，采用PCR技术扩增四环素类抗生素耐药基因tetM。结果：支原体总感染率为43.5%(682/1 568)；Uu对多西环素、交沙霉素及米诺环素敏感率较高（85.4%、79.8%和78.3%）；阿奇霉素及氧氟沙星的耐药率较高，其敏感率仅为30.8%、25.8%；对米诺环素耐药的支原体耐药株可检出tetM基因。结论：十堰地区支原体的混合感染、耐药性上升趋势十分严重，四环素类药物可以重新作为治疗解脲支原体感染的一线药物。 【关键词】? 支原体;抗生素;药物敏感性 ??? Abstract:Objective To investigate the infectious? status in urogenital tract and changing trend of drug susceptibility of mycoplasma in Shiyan area and associated mechanisms of drug resistance to tetracycline.Methods U.urealyticum(Uu) and M.hominis(Mh) were detected in 1 568 cases with urogenital tract infection,and the susceptibility of clinical strains to antibiotics were determined using Mycoplasma IST kit and based on the susceptibility tested，the resistance gene tetM from strains of urealyticus were amplified by PCR.Results The total positive rate of mycoplasma infection in female was 43.5%, 447 cases were infected by U.urealyticum,and 88 cases by M.hominis and 147 cases were positive with both species.Doxymycin,Josamycin and Minomycin were the most effective agents against Uu strains.The azitromycin and ofloxacin showed a high resistance rate.The resistance strains of U.urealyticum to tetracycline possessed the resistance gene tetM.Conclusion Mixed infection and increasing resistance of mycoplasmas is serious.Multiple resistance to two or more antibiotics are common.Mycoplasma is a predominant pathogen in female genitourinary tract infection,and it is sensitive to Doxymycin,Josamycin and Minomycin.This findings also indicate that resistance monitoring of mycoplasma periodically has important significance in clinical practices. ??? Key words:Mycoplasma;Antibiotic;Drug susceptibility assay ???? 四环素类、大环内酯类及喹诺酮类是既往治疗支原体感染的常用药物，但因抗菌药滥用，使得支原体对四环素产生了较强的耐药性。支原体对四环素的耐药与携带tetM基因密切相关[1-2]。为更好地指导临床合理用药，对我院妇科门诊女性泌尿生殖道感染患者支原体感染情况及其耐药