微量稀释法检测男性不育患者脲原体的耐药性分析

doi:10.3969/j.issn.1673-8640.2018.12.004

摘要/Abstract

摘要：

目的探讨男性不育患者脲原体对大环内酯类、喹诺酮类和四环素类抗菌药物的耐药性,为临床合理用药提供依据。方法采用微量稀释法检测通过固体培养基分离和纯化的分离自男性不育患者精液样本的64株脲原体菌株对12种常用抗菌药物的最低抑菌浓度（MIC）。结果脲原体对12种常用抗菌药物的MIC为0.015~64 μg/mL。脲原体对环丙沙星的MIC₅₀和MIC₉₀最高,分别为16和64 μg/mL;对多西环素的MIC₅₀和MIC₉₀最低,分别为0.25和0.5 μg/mL。按照美国临床实验室标准化协会（CLSI）和相关参考文献折点判断,脲原体耐药率最高的抗菌药物分别为环丙沙星（92.2%）、左氧氟沙星（70.3%）和安妥沙星（64.0%）;耐药率最低的分别为阿奇霉素（0.0%）、交沙霉素（1.6%）和多西环素（3.1%）。结论男性不育患者脲原体菌株对12种常见抗菌药物的MIC分布范围均较广;多西环素对脲原体的抗菌能力最强,环丙沙星的抗菌能力最差。脲原体耐药率最高的是喹诺酮类,阿奇霉素、交沙霉素和多西环素可作为治疗男性不育患者脲原体感染的首选药物。

关键词: 微量稀释法, 脲原体, 男性不育, 耐药性, 最低抑菌浓度

Abstract:

Objective To determine the the drug resistance of Ureaplasma to macrolides,quinolones and tetracyclines in infertile males,to provide a reference for the rational use of antimicrobial agents.Methods Ureaplasma were isolated and purified from semen samples of infertile males by solid culture medium. The minimum inhibitory concentration（MIC） of 12 kinds of antimicrobial agents against 64 isolates of Ureaplasma were determined by microdilution method.Results The MIC of Ureaplasma was 0.015-64.000 μg/mL against the 12 kinds of antimicrobial agents. For Ureaplasma,the MIC₅₀ was 16 μg/mL,and the MIC₉₀ was 64 μg/mL against ciprofloxacin. The MIC₅₀ was 0.25 μg/mL,and the MIC₉₀was 0.5 μg/mL against doxycycline. The drug resistance rates of Ureaplasma to ciprofloxacin,levofloxacin and antofloxacin were 92.2%,70.3% and 64.0%,respectively,according to the Clinical and Laboratory Standards Institute documents and related reference. The drug resistance rates of Ureaplasma to azithromycin,josamycin and doxycycline were 0.0%,1.6% and 3.1%,respectively.Conclusions The MIC of Ureaplasma against the 12 kinds of antimicrobial agents are distributed widely. Ciprofloxacin has low antimicrobial ability,and doxycycline has high antimicrobial ability. Quinolones have high drug resistance to Ureaplasma. Azithromycin,josamycin and doxycycline can be recommended as primary antimicrobial agents for the treatment of Ureaplasma infection in infertile males.

Key words: Microdilution method, Ureaplasma, Male infertility, Drug resistance, Minimum inhibitory concentration

中图分类号:

R446.1

周运恒, 石晓星, 杨阳, 顾伟鸣, 马红霞. 微量稀释法检测男性不育患者脲原体的耐药性分析[J]. 检验医学, 2018, 33(12): 1076-1080.

ZHOU Yunheng, SHI Xiaoxing, YANG Yang, GU Weiming, MA Hongxia. Drug resistance of Ureaplasma isolated from infertile males by microdilution method[J]. Laboratory Medicine, 2018, 33(12): 1076-1080.

图/表 4

参考文献 16

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抗菌药物	S	I	R
左氧氟沙星	≤2	-	≥4
莫西沙星	≤2	-	≥4
四环素	≤1	-	≥2
红霉素	≤8	-	≥16

抗菌药物	S	I	R
左氧氟沙星	≤2	-	≥4
莫西沙星	≤2	-	≥4
四环素	≤1	-	≥2
红霉素	≤8	-	≥16

抗菌药物	测定结果	标准要求
左氧氟沙星	1、2、1	0.5~2
莫西沙星	0.5、0.5、1	0.5~2
四环素	2、0.5、0.5
红霉素	2、2、4	1~8

抗菌药物	测定结果	标准要求
左氧氟沙星	1、2、1	0.5~2
莫西沙星	0.5、0.5、1	0.5~2
四环素	2、0.5、0.5
红霉素	2、2、4	1~8

抗菌药物	S[株（%）]	R[株（%）]	MIC范围（μg/mL）	MIC₅₀（μg/mL）	MIC₉₀（μg/mL）
红霉素	58（90.6）	6（9.4）	0.030~16	4.00	8.00
阿奇霉素	64（100）	0（0）	0.060~8	1.00	2.00
罗红霉素	30（46.9）	24（37.5）	0.060~16	2.00	8.00
克拉霉素	61（93.7）	3（6.3）	0.015~8	0.25	1.00
交沙霉素	63（98.4）	1（1.6）	0.015~8	0.25	1.00
左氧氟沙星	19（29.7）	45（70.3）	0.5~64	8.00	16.00
莫西沙星	51（79.4）	13（20.3）	0.06~16	1.00	4.00
环丙沙星	5（7.8）	59（92.2）	0.5~64	16.00	64.00
安妥沙星	17（26.5）	41（64.0）	1~64	16.00	32.00
四环素	58（90.6）	6（9.4）	0.015~4	0.50	1.00
多西环素	62（96.9）	2（3.1）	0.015~2	0.125	0.50
米诺环素	58（90.6）	3（6.3）	0.015~8	0.50	1.00