非妇科患者泌尿生殖道支原体感染特征与耐药分析

Characteristics and Drug Resistance Analysis of Urogenital Mycoplasma Infections in Patient Specimens From Non-Gynecologic Departments

摘要

目的 分析四川大学华西医院2020-2024年非妇科患者泌尿生殖道支原体感染的流行病学特征及耐药情况。方法 本研究对2020-2024年间本院泌尿外科、皮肤性病科等相关科室（不含妇科）送检的856例支原体培养标本进行了回顾性分析。采用法国生物梅里埃比色法试剂盒进行支原体培养、鉴定及药敏试验。分析支原体检出率、种属分布、人群特征及耐药谱。结果 总体阳性率14.02%（120/856），以尿道分泌物为主（48.33%）。单纯脲原体属感染占89.17%（107/120），单纯人型支原体感染占4.17%（5/120），混合感染占6.66%（8/120）。非妇科泌尿生殖道支原体感染患者中，女性患者阳性率（24.67%）高于男性（8.27%）（P<0.05），感染风险为男性的2.98倍（风险比 = 2.98， 95% CI：2.12～4.19）；高发年龄为30～39岁（50.00%）。喹诺酮类普遍耐药（氧氟沙星和环丙沙星耐药率>80%）；大环内酯类的交沙霉素敏感率最高（93.33%）；四环素类的多西环素敏感率为100%。结论 泌尿生殖道支原体感染以单纯脲原体属为主，女性及30～39岁人群高发。在临床指征明确时，治疗可优先考虑四环素类药物如多西环素，并需特别关注人型支原体及混合感染对大环内酯类的高耐药问题。

Abstract

Objective To analyze the epidemiological characteristics and drug resistance patterns of urogenital mycoplasma infections in patient specimens from non-gynecologic departments at West China Hospital, Sichuan University between 2020 and 2024, and to provide evidence for clinical diagnosis, treatment, and antimicrobial stewardship of mycoplasma infections in non-gynecologic patients. Methods A total of 856 Mycoplasma culture specimens were retrospectively analyzed in the study. All specimens were submitted for lab analysis by urology, dermatovenereology, and other relevant departments (excluding gynecology) of our hospital between 2020 and 2024. Mycoplasma culture, identification, and antimicrobial susceptibility testing were performed using the bioMérieux colorimetric kit (France). The detection rate, species distribution, demographic characteristics, and antimicrobial resistance profiles of mycoplasma infections were analyzed accordingly. Results The overall positivity rate was 14.02% (120/856), with urethral secretions constituting the predominant specimen type (48.33%). Ureaplasma spp. infections accounted for 89.17% (107/120), Mycoplasma hominis infections for 4.17% (5/120), and co-infections for 6.66% (8/120). Among patients with non-gynecologic urogenital mycoplasma infections, the positive rate in women (24.67%) was higher than that in men (8.27%) (P < 0.05), with women exhibiting a 2.98-fold higher risk of infection (risk ratio [RR] = 2.98, 95% CI: 2.12-4.19) compared to men. The peak incidence occurred in the 30-39 age group (50.00%). High resistance to quinolones was prevalent, with resistance rates exceeding 80% for both ofloxacin and ciprofloxacin. Among macrolides, josamycin exhibited the highest susceptibility rate (93.33%). Among tetracycline-class antibiotics, all isolates were 100% susceptible to doxycycline. Conclusion Urogenital mycoplasma infections are predominantly caused by Ureaplasma spp. infection, with higher incidence among women and individuals aged 30-39 years. When clear clinical indications are present, tetracycline-class antibiotics, such as doxycycline, should be considered preferential therapeutic options. Special attention should also be given to the high rates of macrolide resistance of Mycoplasma hominis infections and co-infections.

关键词

支原体属 / 微生物耐药性 / 泌尿生殖系统感染

Key words

Mycoplasma / Drug resistance, Microbial / Urogenital system infections

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