1244例慢性前列腺炎患者病原微生物检测及耐药性分析.docVIP

1244例慢性前列腺炎患者病原微生物检测及耐药性分析 作者：徐亚丽 王崇义 葛宏兵 【摘要】 目的 探讨慢性前列腺炎患者前列腺中病原微生物及其耐药性。 方法 取前段尿（VB1）及前列腺液，进行常规外观、显微镜镜检、分离培养（细菌、真菌、支原体）及衣原体检测，采用API与ATB系统鉴定细菌；K-B纸片法测定细菌的耐药性；PCR法测定葡萄球菌的MceA 基因；表型确证试验检测大肠埃希菌与克雷伯菌的超广谱β-内酰胺酶（ESBL），Mycoplasma IST2试剂检测支原体及对9种抗生素的耐药性；采用chemtrueTMchlamydia 抗原检测法检测衣原体。结果 1244例前列腺液中702份标本中检出病原微生物786株，最常见的病原微生物为细菌356株（45.3%）、支原体306株（38.9%）和衣原体119株（15.1%）。葡萄球菌是引起慢性细菌性前列腺炎的最主要的病原菌，203株中126株为耐甲氧西林葡萄球菌（MRS），其对除万古霉素外的其他12种抗生素均有较高的耐药率；306株支原体对9种抗生素的耐药率分别为氧氟沙星(68.3%)、环丙沙星(80.4%)、红霉素(62.7%)、阿奇霉素(58.2%)、克拉霉素（51.6%）、四环素（21.2%）、强力霉素（12.7%）、交沙霉素（12.1%）、原始霉素（5.6%）；31株大肠埃希菌和克雷伯菌中，ESBL阳性12株，阳性率38.7%；38株肠球菌中，链霉素高度耐药17株，庆大霉素高度耐药15株，链霉素+庆大霉素均高度耐药12株，耐万古霉素肠环球菌（VRE）2株。结论 慢性前列腺炎病因复杂，病原微生物种类较多，多重耐药菌感染常见，加强病原微生物及耐药性检测 ，对于慢性前列腺炎的诊断与 治疗 具有十分重要的意义。 【关键词】 慢性前列腺炎 病原菌 耐药性 葡萄球菌 支原体 衣原体 　　【Abstract】 Objective To study the pathogen and its drug-resistance in expressed prostatic secretion(EPS) of 1244 prostatitis patients. Methods The first-voded of urine(VB1) and EPS were collected for microscopic examine、fractional culture(bacteril,fungus,mycoplasma)and chlamdiae test, the bacterias were confirmed with API and ATB systerm its drug-resistance were examined by using K-B test; The Meca gene of Staphylococcus was examined by polymerase chain reaction(PCR);the extended spectrum beta-lactamase(ESBL) was detected by phenotypic confirmatory;nine drug-resistance of mycomplasma were confirmed by mycoplasma IST2; the chlamydia was confirmed by chemtrueTMchlamydia. Results 778 strains pathogenic bacteria were detected in 702 sample of 1244 patients,the main pathogens were bacteria(347,44.6%)、mycoplasma(306,39.3%) and chlamydia (119,15.3%).Staphylococcus was the main pathogenic bacteria for the cause of chronic bacterial prostatitis ,126 strains were meticillin-resistant staphylococcus(MRS) in 203 strains,they had higher drug-resistant against 12 antibiotics except vancomycin ; 306 strains mycoplasma had high drug-resistance against antibiotics ,they were OFX(68.3%)、CIP(80.4%)、ERY(62.7%)、AZI(58