程烽 邱华红 陈惠瑜 巫之韵 钟汇

【摘要】 目的：了解胎膜早破孕產妇生殖道支原体感染及药敏情况，为临床治疗提供依据。方法：选择2015年1月-2019年12月福建省妇幼保健院产科病房收治的胎膜早破孕产妇32 620例，采集宫颈分泌物，进行支原体培养和药敏试验。结果：共检出支原体感染4 383例，感染率为13.44%。其中解脲脲原体感染3 205例（占比73.12%），人型支原体感染553例（占比12.62%），两者混合感染625例（占比14.26%）。除红霉素和洛美沙星外，支原体对临床常用大部分抗菌药物敏感性高，耐药性低。解脲脲原体对美满霉素、克拉霉素、交沙霉素、阿奇霉素保持较高的敏感性（分别为95.60%、98.44%、98.76%和94.32%）和较低的耐药性（分别为1.37%、0.84%、0.28%和0.84%）。人型支原体对强力霉素、交沙霉素和阿奇霉素保持较高的敏感性（分别为96.20%、96.75%和89.33%）和较低的耐药性（分别1.08%、1.81%和8.50%）。两种支原体的混合感染，与单一支原体感染相比，对药物的敏感性下降，耐药性上升。结论：胎膜早破孕妇支原体感染以解脲脲原体感染为常见;对胎膜早破的孕妇支原体感染，推荐使用大环内酯类药物，首选为交沙霉素、阿奇霉素。

【关键词】 胎膜早破 解脲脲原体 人型支原体 感染 耐药性

doi：10.14033/j.cnki.cfmr.2020.13.035 文献标识码 B 文章编号 1674-6805（2020）13-00-04

Mycoplasmas Infection and Drug Sensitivity Analysis in Pregnant Women with Premature Rupture of Membranes/CHENG Feng， QIU Huahong， CHEN Huiyu，WU Zhiyun ， ZHONG Hui. //Chinese and Foreign Medical Research， 2020， 18（13）： -88

[Abstract] Objective： To investigate the infection and drug sensitivity of mycoplasmas in genital tract of pregnant women with premature rupture of membranes （PROM）， so as to provide evidence for clinical treatment. Method： A total of 32 620 pregnant women with PROM were included in obstetric unit of Fujian Provincial Maternity and Childrens Hospital from January 2015 to December 2019 Cervical secretions were collected from these patiens for mycoplasma culture and drug sensitivity tests. Result： Totally 4 383 cases of mycoplasma infection were detected， and the overall infection rate was 13.44%. Among them， mono-infection of Ureaplasma urealyticum and Mycoplasma hominis were 3 205 cases （73.12%） and 553 cases （12.62%）， respectively. Co-infection of Ureaplasma urealyticum and Mycoplasma hominis were 625 cases （14.26%）. With the exception of Erythromycin and Lomefloxacin， Mycoplasma displayed high drug sensitivity and low resistance to most of common antibiotics. The sensitivity rates of Ureaplasma urealyticum to Minocycline， Clarithromycin， Josamycin and Azithromycin were relatively high as 95.60%， 98.44%， 98.76% and 94.32% respectively， and the resistance rates were relatively low as 1.37%， 0.84%， 0.28% and 0.84% respectively. The sensitivity rates of Mycoplasma hominis to Doxycycline， Josamycin and Azithromycin were relatively high as 96.20%， 96.75% and 89.33% respectively， and the resistance rates were relatively low as 1.08%， 1.81% and 8.50% respectively. Compared with mono-mycoplasmas infection， co-infection of Ureaplasma urealyticum and Mycoplasma hominis were relatively low sensitivity and high resistance to common antibiotics. Conclusion： Ureaplasma urealyticum is the most common Mycoplasmas of genital tract infection in pregnant women with PROM. For Mycoplasmas infection treatment in pregnant women with PROM， macrolides is recommended， and Josamycin and Azithromycin can be acted as the primary choice.

[Key words] Premature rupture of membranes Ureaplasma urealyticum Mycoplasma hominis Infection Drug resistance

First-authors address： Fujian Childrens Hospital， Fuzhou 350001， China

胎膜早破（prelabor rupture of the membranes，PR0M）指孕产妇临产前发生的胎膜破裂，是妊娠晚期较为严重的一种并发症，是导致早产、绒毛膜羊膜炎、新生儿感染、新生儿窒息等多种围产期并发症的重要因素。目前认为感染是导致胎膜早破的主要因素之一[1]。解脲脲原体（Ureaplasma urealyticum，Uu）和人型支原体（Mycoplasma hominis，Mh）是两种引起生殖道感染的常见病原体，与不良妊娠结局（如流产、胎膜早破）密切相关[2]。……