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目的:分析不育患者精液中的细菌对精液常规指标的影响及耐药情况,为临床治疗提供依据。方法:对男性不育患者精液通过精液分析仪检测精液常规指标;血液琼脂培养基做细菌培养;经细菌培养将标本分为阳性组和阴性组,统计学分析两组各项常规指标有无差异;根据培养菌种加做药敏试验。结果:84份男性不育患者精液标本细菌培养阳性35份,占41.67%;阴性49份,占58.33%。细菌培养阳性组和阴性组精液常规除液化时间和精子运动分级D级运动有明显差异外(P<0.05),其余指标均无显著性差异。阳性组细菌以金黄色葡萄球菌、表皮葡萄球菌为主,分别占74.2%、17.1%。所选10种抗生素纸片的药敏试验,葡萄球菌对万古霉素敏感率最高,其次为头孢唑林,头孢哌酮、庆大霉素、左氧氟沙星。结论:泌尿生殖道细菌感染主要通过影响液化时间和精子的D级运动而影响生育能力,且细菌感染以G+球菌为主,其中,金黄色葡萄球菌所占的比例最高,在选用的抗生素中,第一、二、三代头孢菌素和喹诺酮类药物可以作为治疗用药。
Objective: To analyze the influence of bacterial in semen of infertile patients on the routine indexes of semen and the drug resistance, so as to provide basis for clinical treatment. Methods: The sperm of male infertility patients were tested for sperm routine indexes by semen analyzer; the blood agar culture medium was used for bacterial culture; the specimens were divided into positive group and negative group by bacterial culture; statistical analysis was made to the difference of each conventional index According to the cultivation of bacteria plus susceptibility testing. Results: Seventy-four male infertile patients were positive for bacterial culture, accounting for 41.67%, negative for 49, accounting for 58.33%. Bacterial culture positive group and negative group semen routine addition to liquefaction time and sperm motility grading D-class movement were significantly different (P <0.05), the remaining indicators were not significantly different. Positive bacteria were Staphylococcus aureus and Staphylococcus epidermidis, accounting for 74.2% and 17.1% respectively. The susceptibility test of the 10 antibiotics disks selected showed that Staphylococcus was the most sensitive to vancomycin, followed by cefazolin, cefoperazone, gentamycin and levofloxacin. Conclusion: Urogenital bacterial infection mainly affects the fertility by influencing the liquefaction time and sperm motility. The most common bacterial infection is Gococcus, of which Staphylococcus aureus has the highest proportion. Among the selected antibiotics, The first, second and third generation cephalosporins and quinolones can be used as therapeutic drugs.