13468株泌尿生殖道解脲脲原体临床药敏分析

目的探讨泌尿生殖道解脲脲原体(Ureaplasma urealyticum,Uu)临床株对九种抗生素的耐药变迁和交叉耐药规律。方法回顾分析2013—2019年,13 468株泌尿生殖道解脲脲原体临床株对米诺环素、多西环素、红霉素、阿奇霉素、克拉霉素、罗红霉素、环丙沙星、司帕沙星和左氧氟沙星九种抗生素的年度耐药变迁和交叉药敏结果。结果 2013—2019年期间,中山大学附属第三医院13 468株泌尿生殖道解脲脲原体临床株对9种抗生素的临床药敏结果不一,米诺环素(96.31±0.48)%、多西环素(95.86±0.52)%、克拉霉素(88.22±1.86)%和阿奇霉素(87.15±2.19)%占据敏感率前4位,而环丙沙星的耐药率(83.32±2.78)%尤其突出;Uu对四环素类(米诺环素和多西环素)耐药率和敏感率的年度变迁相对稳定,对大环内酯类(红霉素、阿奇霉素、克拉霉素和罗红霉素)和喹诺酮类(环丙沙星、司帕沙星和左氧氟沙星)耐药率和敏感率的年度变迁存在差异;Uu临床株对不同类别的抗生素之间,存在不同程度的交叉耐药。结论米诺环素、多西环素作为临床一线治疗Uu感染的抗生素,到目前为止仍然保持低耐药率、高敏感率;耐米诺环素和多西环素的解脲脲原体临床株选择抗生素时,阿奇霉素和克拉霉素是理想的替代药物;而对于耐大环内酯类和耐喹诺酮类的解脲脲原体临床株,则推荐米诺环素和多西环素作为首选抗生素。

Analysis of clinical drug sensitivity of 13 468 strains of Ureaplasma urealyticum in urogenital tract

Objective To analyze resistance changes and cross resistance with Ureaplasma urealyticum(Uu)clinical strains to nine antibiotics.Methods The annual changes of resistance and cross resistance with 13 468 clinical strains of Uu to nine antibiotics,minocycline,doxycycline,erythromycin,azithromycin,clarithromycin,roxithromycin,ciprofloxacin,sparfloxacin and levofloxacin were analyzed retrospectively in 2013-2019.Results From 2013 to 2019,13 468 strains of Uu from urogenital tract in The Third Affiliated Hospital,Sun Yat-Sen University showed different clinical drug sensitivity results to nine antibiotics.Minocycline(96.31±0.48)%,doxycycline(95.86±0.52)%,clarithromycin(88.22±1.86)% and azithromycin(87.15±2.19)% were the top four sensitive rates,and ciprofloxacin resistance rate(83.32±2.78)% was particularly prominent.The annual changes of resistance and sensitivity of Uu to tetracyclines(minocycline and doxycycline)were relatively stable,but the annual changes of resistance and sensitivity to macrolides(erythromycin,azithromycin,clarithromycin and roxithromycin)and quinolones(ciprofloxacin,sparfloxacin and levofloxacin)were different;There were different degrees of cross resistance between Uu clinical strains and different types of antibiotics.Conclusions sMinocycline and doxycycline as the first-line clinical treatment of Uu infection antibiotics,so far still maintain a low resistance rate,high sensitivity rate.For clinical strains of Uu resistant to minocycline and doxycycline,azithromycin and clarithromycin are ideal substitutes;for clinical strains of Uu resistant to macrolides and quinolones,minocycline and doxycycline are recommended as the first choice of antibiotics.