中华皮肤科杂志 ›› 2003, Vol. 36 ›› Issue (5): 267-269.

• 论著 • 上一篇    下一篇

大观霉素等对泌尿生殖道支原体的药敏试验及其临床疗效的观察

陈德利1, 叶元康2, 蔡昭惠3, 曹兴午4, 丘惠麟5, 谢崇高6, 沈亮亮1, 陈洁1, 陆震宇2, 涂少华2, 龙绍芬3, 曹有爱4, 金合武4, 柏文质4, 姜梅4, 郭振军4, 姚素红6   

  1. 1. 上海同济大学附属同济医院皮肤性病科, 200065;
    2. 上海同济大学附属同济医院性病实验室, 200065;
    3. 广西北海第二人民医院检验科;
    4. 北京东外医院性生殖专家门诊;
    5. 浙江湖州市妇幼保健医院;
    6. 上海同济大学附属铁路医院皮肤性病科
  • 收稿日期:2002-06-03 出版日期:2003-05-15 发布日期:2003-05-15
  • 基金资助:
    上海市卫生局百人计划(SWB9801);上海市科技发展基金(004119008)

Antimicrobial Susceptibility of Mycoplasma and Clinical Response to Antimicrobial Agents(Spectinomycin etc.)in Genitourinary Mycoplasma Infection

CHEN De-li1, YE Yuan-kang2, CAI Zhao-hui3, CAO Xing-wu4, QIU Hui-lin5, XIE Chong-gao6, SHEN Liang-liang1, CHEN Jie1, LU Zhen-yu2, TU Shao-hua2, LONG Shao-fen3, CAO You-ai4, JIN He-wu4, BAI Wen-zhi4, JIANG Mei4, GUO Zhen-jun4, YAO Su-hong6   

  1. TongJi Hospital Affiliated to TongJi University, Shanghai 200065, China
  • Received:2002-06-03 Online:2003-05-15 Published:2003-05-15

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摘要： 目的 观察大观霉素、米诺环素、阿奇霉素和司氟沙星对解脲脲原体(Uu)和人型支原体(Mh)的药敏情况及国产大观霉素治疗泌尿生殖道支原体感染的临床疗效。方法 ①药敏试验:支原体培养基设大观霉素、米诺环素、阿奇霉素和司氟沙星1μg/mL(敏感质量浓度)和4μg/mL(耐药质量浓度)2个质量浓度。②治疗方法:国产大观霉素2.0g肌内注射,每日1次,共7~10d,治疗7d后复查,观察近期疗效。治疗结束后2~4周复查1次,观察远期疗效。结果 ①药敏试验:1658例分泌物标本中Uu阳性519例和Mh阳性61例。Uu对米诺环素的耐药率为7.7%,阿奇霉素为13.9%,司氟沙星为21.4%,大观霉素为7.3%;Mh的耐药率分别为18.0%,54.1%,45.9%和29.5%。②国产大观霉素对Uu的MIC为0.01~0.3μg/mL,Mh的MIC为0.02~0.6μg/mL。③临床疗效:43例泌尿生殖道支原体感染患者经肌内注射大观霉素治疗后痊愈37例(86.0%),显效4例(9.3%),无效2例(4.7%),总有效率为95.3%。支原体清除率为95.3%。其中24例患者于治疗后2周复查未复发。结论 支原体对大观霉素的耐药率比米诺环素、阿奇霉素和司氟沙星的耐药率低,临床应用国产大观霉素治疗泌尿生殖道支原体感染取得满意疗效。

关键词: 壮观霉素, 尿素支原体,尿素分解, 支原体人型, 微生物敏感性试验

Abstract: Objective To investigate the antimicrobial susceptibility of spectinomycin、minocycline、azithromycin and sparfloxacin to mycoplasma(Uu and Mh)and therapeutic effect of spectinomycin to my-coplasma infection in genitourinary tract.Methods ①The susceptibility test:each of the 4 drugs was divided into two concentrations.One was at 1 μg/mL(sensitive concentration)and the other was at 4 μg/mL(resistant concentration).If mycoplasma does not grow in both concentrations,it means the drug tested is sensitive.If it grows in both concentrations,the drug tested is resistant.If mycoplasma grows in lower concentration and does not in higher concentration,it means moderate sensitive.②Treatment regimen:Spectinomycin was injected,2g/d IM,for 7-10 days as a course of treatmeant.Patients were followed-up 7 days later and 2~4 weeks after treatment.Results ①Among 1658 specimens,519 were found Uu positive,and 61 Mh positive.The resistance rates of Uu to 4 different drugs were:7.7% for minocycline,21.4% for sparfloxacin,13.9% for azit hromycin and 7.3% for spectinomycin.Whereas,those of Mh were:18.0%,45.9%,54.1%,and 29.5% respectively.②The clinical effect of spectinomycin was:out of 43 treated patients,37(86.0%)cured,4(9.3%) markedly improved,2(4.7%)failed.Total effective rate was 95.3% and so was the elimination rate of my-coplasma.Conclusion The resistant rate of mycoplasma to spectinomycin is lower than that to minocycline、azithromycin and sparfloxacin,and the former is widely used in the treatment of mycoplasma(especially Uu)infection,with a satisfactory clinical effect.

Key words: Spectinomycin, Mycoplasma hominis, Ureaplasma urealyticum, Microbial sensitivity tests