爱媛大学医院孕妇人支原体感染发生率及药敏分析。

Shinobu Murakami, Koichiro Suemori, Yuka Uchikura, Mina Saito, Minami Tamaki, Fumihiro Ochi, Akihiro Tanaka, Hisamichi Tauchi, Takashi Sugiyama, Hitoshi Miyamoto
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引用次数: 0

摘要

目的:人支原体通常定植于下泌尿生殖道,偶而与孕妇盆腔炎、产后发热、早产有关。本研究的目的是调查妊娠女性泌尿生殖道分离的人支原体的发病率和抗菌药物敏感性。方法:采集2014年11月- 2017年12月爱媛大学附属医院妇产科妊娠女性泌尿生殖道标本。采用聚合酶链反应(PCR)方法鉴定了人支原体。采用肉汤微量稀释法测定抗生素的最低抑菌浓度(mic)。结果:1074份标本中人支原体阳性63份(5.9%)。18 ~ 24岁人群人支原体阳性率最高,为21.3%。82例细菌性阴道病患者中人原分枝杆菌阳性21例(25.6%)。42例剖宫产患者中发生宫内感染、盆腔脓肿等感染的17例(40.5%)人支原体阳性。剖宫产前后均给予β-内酰胺类抗生素治疗。所有患者在给予克林霉素(CLDM)后立即恢复。β-内酰胺类抗生素、大环内酯类和磷霉素(FOM)均对人支原体耐药。相比之下,人原分枝杆菌对CLDM、米诺环素和喹诺酮类药物敏感。结论:我们的数据提示,妊娠女性生殖道人支原体感染在年轻、细菌性阴道病和剖宫产术后使用β-内酰胺类抗生素的发生率较高。CLDM, MINO和喹诺酮类药物可能被推荐用于治疗人支原体感染。特别是,由于四环素和喹诺酮类药物在妊娠和哺乳期是不可取的,CLDM可以作为孕妇的适当药物。
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Incidence and Antimicrobial Susceptibilities of Mycoplasma hominis in Pregnant Females, Ehime University Hospital.

Objective: Mycoplasma hominis usually colonizes the lower urogenital tract and has been occasionally associated with pelvic inflammatory disease, postpartum fever, preterm labor in pregnant females. The aim of this study was to investigate the incidence and antimicrobial susceptibilities of M. hominis isolated from the urogenital tracts of pregnant females.

Methods: Specimens were obtained from the urogenital tract of pregnant females at Department of Obstetrics and Gynecology, Ehime University Hospital, between November 2014 and December 2017. The identification of M. hominis was confirmed by the polymerase chain reaction (PCR) methods. The minimum inhibitory concentrations (MICs) of antibiotics were measured using a broth microdilution assay.

Results: Of the 1074 specimens tested, 63 (5.9%) were positive for M. hominis. The M. hominis-positive rate was highest at 21.3% between 18 and 24 years old. The 21 (25.6%) of 82 patients with bacterial vaginosis were positive for M. hominis. The 17 (40.5%) of 42 patients delivered by cesarean section that occurred infections including of intrauterine infection and pelvic abscess were positive for M. hominis. They were all administered β-lactam antibiotics before and after cesarean section. All patients recovered immediately following administration of clindamycin (CLDM). β-lactam antibiotics, macrolides and fosfomycin (FOM) were all resistant against M. hominis strains. In contrast, M. hominis strains were susceptible to CLDM, minocycline (MINO) and quinolones.

Conclusions: Our data suggests that the prevalence of genital M. hominis in pregnant females is high at younger age, bacterial vaginosis and infections after cesarean section with β-lactam antibiotics administration. CLDM, MINO and quinolones may be recommended against M. hominis infection. Especially, CLDM can be used as the adequate agent for pregnant females because tetracycline and quinolones are undesirable during pregnancy and lactation.

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