泌尿生殖道支原体检测在临床抗菌治疗中的应用

The Application of Mycoplasma Detection in the Urogenital Tract in Clinical Antibacterial Therapy

摘要: 目的：调查分析2021~2023年泌尿生殖道支原体的感染情况，并探讨三年间的耐药率变迁，为临床合理使用抗菌药物提供科学参考。方法：选取2021年1月~2023年12月就诊于广西中医药大学附属瑞康医院妇科、男性科的首诊患者作研究对象，收集支原体的检测结果进行回顾性分析，比较不同性别、不同年龄段的支原体感染情况，同时分析不同年份耐药率的变迁。结果：共纳入11,103例病例，阳性结果4771例，总阳性率为42.97% (4771/11,103例)，其中34.9%为单独解脲支原体感染，共计3871阳性例数，其次为UU + MH混合感染，7.2% (802/11,103例)，以及单独人型支原体的0.9%感染率(98/11,103例)，三种类型的感染率存在显著差异(P < 0.05)。同时，在不同年龄阶段，男性感染阳性率均明显低于女性患者，P < 0.05。不同年份间感染率无差异(P > 0.05)，但耐药率有差异，其中，单独UU感染时，甲砜霉素、克林霉素及司帕沙星耐药率逐年增长，差异均有统计学意义(P < 0.05)；单独MH感染时，强力霉素、交沙霉素为全敏感；而UU + MH混合感染者对四种大环内酯类抗菌药物耐药率皆超过90%，且克林霉素、司帕沙星及加替沙星耐药率有增长趋势(P < 0.05)。结论：泌尿生殖道支原体最常见为解脲支原体感染，且女性感染率显著高于男性。在抗菌药物的使用中，甲砜霉素、克林霉素、司帕沙星等均有增长趋势，需提高临床监控，进一步加强抗菌药物的合理使用。

Abstract: Objective: To investigate and analyze the infection status of Mycoplasma in the urogenital tract from 2021 to 2023, and to explore the changes in drug resistance rates over the three years, providing a scientific reference for the rational clinical use of antibacterial drugs. Methods: First-visit patients who visited the Gynecology and Andrology Departments of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from January 2021 to December 2023 were selected as the research subjects. The test results of mycoplasma were collected for retrospective analysis. The mycoplasma infection situations of different genders and age groups were compared, and the changes in drug resistance rates in different years were analyzed simultaneously. Result: A total of 11,103 cases were included, with 4771 positive results, and the total positive rate was 42.97% (4771/11,103 cases). Among them, 34.9% were isolated Ureaplasma urealyticum infections, with a total of 3871 positive cases. The second was mixed UU + MH infections, with 7.2% (802/11,103 cases). And the 0.9% infection rate of Mycoplasma hominis alone (98/11,103 cases), there were significant differences in the infection rates among the three types (P < 0.05). Meanwhile, at different age stages, the positive rate of infection in males was significantly lower than that in female patients, P < 0.05. There was no difference in the infection rate among different years (P > 0.05), but there were differences in the drug resistance rate. Among them, when UU was infected alone, the drug resistance rates of thiamphenicol, clindamycin and spafloxacin increased year by year, and the differences were statistically significant (P < 0.05). When infected with MH alone, doxycycline and jiaoxamycin are fully sensitive. The resistance rates of the mixed infections of UU + MH to the four macrolide antibacterial drugs all exceeded 90%, and the resistance rates of clindamycin, spafloxacin and gatifloxacin showed an increasing trend (P < 0.05). Conclusion: The most common mycoplasma in the urogenital tract is Ureaplasma urealyticum infection, and the infection rate in females is significantly higher than that in males. In the use of antibacterial drugs, thiamphenicol, clindamycin, spasfloxacin, etc. all show an increasing trend. It is necessary to improve clinical monitoring and further strengthen the rational use of antibacterial drugs.