泌尿生殖道感染解脲支原体培养和药敏分析及临床治疗(1)

    【关键词】  解脲支原体；药敏；临床治疗

     Separation of Ureaplasma urealyticum with urinogenital duct infection and antibiotic susceptibility test and chemotherapy

      【Abstract】  Objective  To investigate the infection of Ureaplasma urealyticum(Uu) among patients from this region and to apply in reason common antibiotics. Methods  Urinogenital specimen of 726 cases were collected and cultured for isolation identification of Uu.Antibiotic susceptibilitive test were performed with microdilution plates.106 patients of positive of Uu were carried through routine chemotherapy with one of Minocycline,Josamycin,deoxycycline and clarithromycin. Results  For the 726 patients,positive rates for Uu were 45.45%(330/726).The drugs of susceptive rate over 90% were minocycline,josamycin,deoxycycline and clarithromycin in turn.Rate of darkening of patients for Uu was 73.58% (78/106) for one period of treatment,86.79% (92/106) for two period of treatment. Conclusion  The patients with Uu from this region were more susceptibilitive to those 4 antibiotics,were more tolerance to quinolone and they would be cured with sensitive drugs in routine.It was necessary to perform drug sensitivity test before chemotherapy.

    【Key words】  Ureaplasma urealyticum;drug sensitivity test; clinical therapy

    为了了解本地区泌尿生殖道解脲支原体感染及耐药情况，采用解脲支原体药敏试剂盒对726例临床标本进行培养、鉴定、药敏观察，现报告如下。

    1  资料与方法

    1.1  病例资料  全部标本均来自于本院2005年12月～2006年8月男性门诊和妇科门诊患者，共726例，男606例，女120例，年龄19～62岁，平均28.5岁。

    1.2  标本采集  男性无菌取精液或前列腺液,女性采用无菌拭子取宫颈阴道后穹隆分泌物,置无菌试管内立即送检。

    1.3  试剂  试剂盒采用珠海丽拓发展有限公司支原体分离、鉴定、药敏检测试剂盒。测定药物包括：四环素、氧氟沙星、红霉素、强力霉素、交沙霉素、司帕沙星、罗红霉素、美满霉素、左氟沙星、克拉霉素、阿奇霉素、诺氟沙星共12种抗生素。

    1.4  方法  严格按说明书进行操作和结果观察。

    1.5  治疗病例资料  共106例，男80例，女26例，年龄19～55岁（平均30岁）。纳入排除标准：（1）所有患者经检查    均无细菌、淋菌、衣原体、滴虫感染。（2）在被纳入实验前1   周无服用抗生素史。（3）治疗期间采取防护措施防止交叉感染。治疗方法：首选美满霉素、交沙霉素、强    力霉素、克拉霉素其中敏感的药物一种，按常规剂量口服用药治疗，疗程3周。停药1周后进行支原体培养，未转阴者改服上述四种抗生素中的另外一类敏感药物进行治疗。

    2  结果

    2.1  不同来源标本培养结果分析  726例患者中精液检出阳性率42.72%(188/440),前列腺液检出阳性率44.57%(74/116)，阴道分泌物中检出阳性率56.7%(68/120)。总检出阳性率45.54%(330/726),见表1。表1  726例不同来源标本培养结果

    2.2  支原体培养及药敏结果  见表2。表2  250株解脲支原体药敏试验结果

    2.3  敏感药物治疗结果分析  106例中1个疗程治疗后78例转阴,12例未转阴自行停止治疗,16例换用另外一类敏感药物治疗第2个疗程,其中14例转阴,2例未转阴自行停止治疗。见表3。表3  敏感药物治疗结果分析

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