上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (5): 646-.doi: 10.3969/j.issn.1674-8115.2012.05.025

• 论著（临床研究） • 上一篇    下一篇

泌尿道解脲脲原体感染及药敏情况分析

严富洪, 陈 楠   

  1. 上海交通大学 医学院附属瑞金医院肾脏科, 上海 200025
  • 出版日期:2012-05-28 发布日期:2012-06-01
  • 通讯作者: 陈 楠, 电子信箱: chennan@medmail.com.cn。
  • 作者简介:严富洪(1972—), 男, 主治医师, 硕士；电子信箱: fuhong0036@163.com。

Analysis of Ureaplasma urealyticum infection |and drug sensitivity in urinary tract

YAN Fu-hong, CHEN Nan   

  1. Renal Devision, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2012-05-28 Published:2012-06-01

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摘要：

目的 分析解脲脲原体（Uu）在泌尿生殖道和中段尿中的检出率及其药敏情况。方法 收集泌尿生殖道（3 326例）和中段尿（701例）送检标本，进行支原体（Uu+人型支原体）培养和药敏试验，将支原体数量≥104 CFU作为阳性判断标准。结果 701例中段尿标本中，共检出Uu阳性130例（18.5%），人型支原体均为阴性；其中女性Uu阳性检出率为19.1%（124/650），男性Uu阳性检出率为11.8%（6/51）。3 326例生殖道标本中，共检出Uu阳性851例（25.6%），其中3例人型支原体为阳性；女性Uu阳性检出率为28.1%（783/2 790），男性Uu阳性检出率为12.5%（67/536）。中段尿Uu的药敏试验结果显示，敏感率较高的药物依次为交沙霉素（98.5%）、盐酸多西环素(强力霉素)（97.9%）和原始霉素（97.7%）。中段尿Uu感染对于交沙霉素、强力霉素、原始霉素的敏感率高于生殖道分泌物，耐药率则低于生殖道分泌物，差异均有统计学意义（P<0.05）。Uu对阿奇霉素的敏感率在尿路感染中仅为70.2%、而在生殖道感染中为77.7%，远低于交沙霉素的98.5%。结论 在尿路感染的初次筛查中，Uu感染的阳性检出率较高。不同部位Uu感染对抗生素的敏感性和耐药性可能不同。交沙霉素和强力霉素可考虑可以作为治疗泌尿道Uu感染的首选药物。

关键词: 解脲脲原体, 泌尿道感染, 药敏试验

Abstract:

Objective To investigate the incidence of Ureaplasma urealyticum (Uu) infection in genitourinary tract and mid-stream urine, and analyse its sensitivity to drugs. Methods Three thousand three hundred and twenty-six urine samples of genitourinary tract and 701 mid-stream urine samples were collected. Culture of mycoplasma (Uu+Mycoplasma humenis) and drug sensitivity tests were performed, and quantity of mycoplasma ≥104 CFU was regarded as positive. Results Among the 701 mid-stream urine samples, 130 （18.5%）samples were positive for Uu, including 124 females (124/650, 19.1%) and 6 males (6/51, 11.8%), and all were negative for Mycoplasma humenis. Among the 3 326 urine samples of genitourinary tract, 851 （25.6%）samples were positive for Uu, including 783 females (783/2 790, 28.1%) and 67 males (67/536, 12.5%), and 3 samples were positive for Mycoplasma humenis. Drug sensitivity tests of Uu in mid-stream urine revealed that drugs with highest sensitivity were josamycin (98.5%), doxycycline (97.9%) and pristinamycin (97.7%). Uu infection in midstream urine was more sensitive to josamycin, doxycycline and pristinamycin with lower resistance than genital secretion (P<0.05). The sensitivity of Un to azithromycin was only 70.2% in urinary tract infection, and that was 77.7% in genital tract infection, which was significantly lower than that to josamycin (98.5%). Conclusion The positive detection rate of Uu infection is relatively higher in initial screening of urinary infection. The sensitivity and resistance to antibiotics may be different in different sites of Uu infection. Josamycin and doxycycline may serve as the first-line therapy for urinary Uu infection.

Key words: Ureaplasma urealyticum, urinary tract infection, drug sensitivity test