王晋蜀 黄梦雅 赵明丹 周汛

摘   要：目的  探究泌尿生殖道支原體感染情况及对常用抗菌药物的耐药情况，为指导临床合理应用抗菌药物提供科学依据。方法  本研究使用支原体培养、鉴定及药敏检测试剂盒（液基型），对临床收集的489例疑似泌尿生殖道感染患者的标本进行支原体培养、鉴定及药敏检测。结果  发现在489例标本中，支原体阳性有202例，阳性率为41.30%，人型支原体单一阳性有24例，占11.88%，解脲支原体单一阳性有171例，占84.65%，混合感染有7例，占3.47%。女性、男性支原体检出率分别为52.36%、17.44%，女性明显高于男性。阳性患者以20～35岁为主，占66.83%。支原体对交沙霉素、强力霉素和美满霉素敏感性最高，敏感率分别为89.60%、88.12%和84.65%，对红霉素、司巴沙星、环丙沙星、氧氟沙星和左氧氟沙星敏感性较低，敏感率分别为18.81%、10.40%、1.49%、6.44%和5.94%。结论  本研究证实支原体感染中主要由解脲支原体感染为主。临床应参考药敏结果合理用药，经验用药时交沙霉素、强力霉素和美满霉素最好，应避免使用司巴沙星、环丙沙星、氧氟沙星和左氧氟沙星。

关键词：泌尿生殖道感染;解脲支原体;人型支原体;药物敏感试验;抗生素

中图分类号：R69;R446.5                             文献标识码：A                              DOI：10.3969/j.issn.1006-1959.2018.16.029

文章编号：1006-1959（2018）16-0098-03

Detection，Identification and Drug Resistance Analysis of Urogenital Mycoplasma Infection

WANG Jin-shu，HUANG Meng-ya，ZHAO Ming-dan，ZHOU Xun

（Chongqing Hospital of Traditional Chinese Medicine/Department of Skin and Beauty，Chongqing Academy of Traditional Chinese Medicine，Chongqing 400021，China）

Abstract：Objective  To investigate the infection of urogenital mycoplasma and the resistance to common antibiotics，and to provide scientific basis for guiding the rational application of antibiotics.Methods  Mycoplasma culture，identification and drug sensitivity test kits（liquid-based）were used to culture，identify and detect drug susceptibility in 489 patients with suspected genitourinary tract infections.Results  The results showed that among 489 specimens，202 were positive for mycoplasma， the positive rate was 41.30%，24 were positive for human mycoplasma，accounting for 11.88%，there were 171 cases of ureaplasma urealyticum single，accounting for 84.65%，and 7 cases of mixed infection，accounting for 3.47%.The detection rates of female and male mycoplasma were 52.36% and 17.44%，respectively，and women were significantly higher than men.Positive patients were mainly 20 to 35 years old，accounting for 66.83%.Mycoplasma is most sensitive to josamycin，doxycycline and minocycline，with sensitivity rates of 89.60%，88.12% and 84.65%， respectively，sensitivity to erythromycin，sirfloxacin，ciprofloxacin，ofloxacin and levofloxacin was low，with sensitivity rates of 18.81%， 10.40%，1.49%，6.44% and 5.94%，respectively.Conclusion  This study confirmed that mycoplasma infection is mainly caused by ureaplasma urealyticum infection.Clinical reference should be made to the rational use of drug susceptibility results.It is best to use josamycin，doxycycline and minocycline when using drugs.Sparfloxacin，ciprofloxacin，ofloxacin and levofloxacin should be avoided.

Key words：Urogenital infection;Ureaplasma urealyticum;Human mycoplasma;Drug sensitivity test;Antibiotic

支原体（mycoplasma）是一类缺乏细胞壁、形态上呈高度多变性，能通过除菌器，在无生命培养基中能生长繁殖的最小原核细胞型生物，能形成有分支的长丝。支原体中的解脲支原体（ureaplasma urealyticum，UU）和人型支原体（mycoplasma hominis，Mh）可寄居于人的泌尿生殖道，并在一定的条件下引起非淋病性尿道炎（nongonococcal urethritis，NGU），主要通过性途径传播，其中有30%的NGU是由UU所致[1]。……