摘要
目的:分析自体精液保存患者支原体感染现状及其药敏试验,为临床合理用药提供参考。方法:采用横断面调查研究,分析自2013年11月至2020年3月期间于四川大学华西第二医院人类精子库进行自体精液保存的850例患者的临床资料,分析其支原体感染情况及药敏试验。据患者年龄将患者分为13~20岁、21~30岁、31~40岁、41~50岁和>50岁5个年龄段,比较其支原体感染情况;据患者婚姻状况将患者分为已婚及未婚,比较其支原体感染情况。结果:①自体精液保存患者支原体感染例数为167例,阳性率19.65%。各年龄段支原体阳性率差异有显著统计学意义( P<0.001),其中以>50岁阳性率最高[35.29%(6/17)],其次为31~40岁年龄段[26.23%(80/307)],支原体感染率最低的年龄段为13~20岁[2.86%(2/70)];已婚人群的支原体感染率[23.51%(91/387)]明显高于未婚人群[16.41%(76/463)]( P=0.009)。②167名支原体阳性患者药敏试验结果显示,对交沙霉素敏感性最高,其次为罗红霉素、阿奇霉素、强力霉素及克拉霉素;对环丙沙星耐药性最高,其次为司帕沙星、左氧氟沙星及氧氟沙星。支原体药敏试验结果提示,对喹诺酮类抗菌药耐药性最强,且不同年份间喹诺酮类抗菌药耐药性差异有统计学意义( P=0.001)。 结论:自体精液保存患者支原体感染率较高,已婚患者及育龄期患者支原体感染率较高 。建议支原体感染阳性患者进行自体精液保存前应治疗,转阴后再进行精子冻存,临床治疗时应根据药敏试验选择相应的抗生素,避免产生耐药反应。
Objective:To analyze the mycoplasma and ureaplasma infection and drug sensitivity analysis on sperm cryopreservation patients in Sichuan area, in order to provide reference for clinical rational use of the drug.Methods:A cross-sectional study was conducted from November 2013 to March 2020, 850 patients who came to human sperm bank of West China Second University Hospital, Sichuan University for sperm cryopreservation participated in this study. Sensitivity analysis of the mycoplasma and ureaplasma were performed. All the patients were classified into 5 groups to compare the mycoplasma and ureaplasma statues according to the age: 13-20 years old, 21-30 years old, 31-40 years old, 41-50 years old, >50 years old;according to the marital status of the patients, the patients were divided into married and unmarried to compare the mycoplasma and ureaplasma infection.Results:① There were 167 cases of the mycoplasma and ureaplasma infection in sperm cryopreservation patients, the positive rate was 19.65%. The positive rate of mycoplasma and ureaplasma infection in all age groups had a significant difference ( P<0.001), among which the group of >50 years old had the highest positive rate [35.29% (6/17)], followed by 31-40 years old group [26.23% (80/307)], and the 13-20 years old group had the lowest positive rate of mycoplasma and ureaplasma infection [2.86% (2/70)]. The mycoplasma and ureaplasma infection rate of married people [23.51% (91/387)] was significantly higher than that of unmarried people [16.41% (76/463)] ( P=0.009). ② The antimicrobial susceptibility test (AST) in 167 mycoplasma and ureaplasma-positive patients showed that the most sensitive drugs for mycoplasma and ureaplasma were josamycin, followed by roxithromycin, azithromycin, doxycycline and clarithromycin;the most resistance drugs for mycoplasma and ureaplasma were ciprofloxacin, followed by sparfloxacin, levofloxacin and oxygen ofloxacin. AST showed that the most resistance drugs for mycoplasma and ureaplasma were quinolone antimicrobials, and there was significant differences in the resistance of quinolone antimicrobials in different years ( P=0.001). Conclusion:The mycoplasma and ureaplasma infection rate of sperm cryopreservation patient was at a high level, married patients and reproductive-age patients had a higher rate of mycoplasma and ureaplasma infection. It is recommended that patients with positive mycoplasma and ureaplasma infection should be treated before self-sperm preservation, and the semen should be frozen after mycoplasma and ureaplasma infection become negative. During clinical treatment, antibiotics should be selected according to drug sensitivity experiments to avoid drug resistance.
作者
鲜泱
刘博
柳莎莎
赵文瑞
周斌
刘晓
蒋敏
李福平
Xian Yang;Liu Bo;Liu Shasha;Zhao Wenrui;Zhou Bin;Liu Xiao;Jiang Min;Li Fuping(Human Sperm Bank,Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,China; Laboratory of Molecular Translational Medicine,Center for Translational Medicine,Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Clinical Research Center for Birth Defects of Sichuan Province,West China Second University Hospital,Sichuan University,Chengdu 610041,China)
出处
《中华生殖与避孕杂志》
CSCD
北大核心
2021年第6期551-556,共6页
Chinese Journal of Reproduction and Contraception
基金
四川省科技计划资助(2020ZYD007)。
关键词
支原体感染
药敏分析
自体精液保存
Mycoplasma and ureaplasma infections
Antimicrobial susceptibility test
Sperm cryopreservation
