گزارش تازه‌ترین دستاورد تشخیص مولکولی و بررسی مقاومت آنتی‌بیوتیکی اوره‌آ پلاسما اوره ‌آلیتیکوم و نیسریا گونوره‌آی جدا شده از ترشحات سرویکس زنان نابارور مراجعه کننده به درمانگاه زنان مرکز آموزشی- درمانی شهدای تجریش تهران

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه میکروب‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار باکتری‌شناسی پزشکی، مرکز تحقیقات سلامت مردان و بهداشت باروری، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه زنان و مامایی، مرکز تحقیقات سلامت مردان و بهداشت باروری، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 دانشیار گروه آمار زیستی، مرکز تحقیقات فیزیوتراپی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: نیسریاها و اوره‌آ پلاسماها، از مهم‌ترین باکتری‌های عامل عفونت ژنیتال و ناباروری محسوب می­ شوند. مطالعه حاضر با هدف جستجوی این دو پاتوژن در ترشحات سرویکس زنان نابارور با تأکید بر روش‌های مولکولی و تعیین ژن­ های مقاومت دارویی مرتبط با آزیترومایسین و سیپروفلوکساسین انجام شد.
روش‌کار: در این مطالعه توصیفی، نمونه ­های اندوسرویکال حاصل از ترشحات سرویکس 135 زن نابارور و 135 زن سالم مراجعه کننده به بیمارستان شهدای تجریش از مهر 1397 لغایت شهریور 1398 مورد بررسی قرار گرفت. تجزیه و تحلیل داده ­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) انجام شد. جهت بررسی رابطه بین عفونت و ناباروری در افراد از آزمون کای دو استفاده شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: میزان شیوع نیسریا گونوره‌آ و اوره‌آپلاسما اوره آلیتیکوم در گروه مورد در مقایسه با گروه کنترل قابل توجه و معنی‌دار بود (05/0≥p). بر اساس آزمون کای دو، بین عفونت و ناباروری در افراد ارتباط معنی‌داری مشاهده شد (05/0≥p). شیوع مقاومت به آزیترومایسین اوره‌آ پلاسما اوره آلیتیکوم و نیسریا گونوره آ به‌ترتیب 35 مورد (6/48%) و 7 مورد (3/58%) بود. مقاومت در برابر سیپروفلوکساسین در نیسریا گونوره آ 3 مورد (25%) و در اوره آپلاسما اوره آلیتیکوم 64 مورد (8/68%) گزارش شد. بالاترین میزان شیوع ژن‌های مقاومت در هر دو باکتری مربوط به mtrR و gyrA بود.
نتیجه ­گیری: مقاومت آنتی‌بیوتیکی در باکتری‌های مورد مطالعه نشان‌دهنده مصرف بی‌رویه آنتی‌بیوتیک‌ها، گسترش ساختارهای ژنی مقاومت به آنتی‌بیوتیک و انتقال ژنتیکی در بین جمعیت‌ها است. جهت درمان قطعی و عدم بروز مقاومت در سویه‌های پاتوژن، تعیین الگوی مقاومت باکتری‌ها جهت پیگیری روند مقاومت ضروری است.

کلیدواژه‌ها

عنوان مقاله [English]

The report of the latest achievement of molecular diagnosis and investigation of antibiotic resistance of Ureaplasma urealyticum and Neisseria gonorrhoeae isolated from cervical secretions of infertile women referring to the women's clinic of Shohadaye-Tajrish Educational-Treatment Center, Tehran

نویسندگان [English]

  • Mehdi Goudarzi 1
  • Masoumeh Navidinia 2
  • Maryam Afrakhteh 3
  • Ahmad Reza Baghestani 4
1 Associate Professor, Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Medical Bacteriology, Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Obstetrics and Gynecology, Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Associate Professor, Department of Biostatistics, Physiotherapy Research Center, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Neisseria and ureaplasma are considered to be the most important bacteria causing genital infection and infertility. The present study was conducted with the aim of searching for these two pathogens in the cervical secretions of infertile women, emphasizing molecular methods and determining drug resistance genes related to azithromycin and ciprofloxacin.
Methods: In this descriptive study, endocervical samples obtained from cervical secretions of 135 infertile women and 135 healthy women referred to Shohada Tajrish Hospital from October 2018 to September 2019 were examined. Data were analyzed by SPSS statistical software (version 21). Chi-square test was used to investigate the relationship between infection and infertility in individuals. P<0.05 was considered statistically significant.
Results: The prevalence of Neisseria gonorrhoea and Ureaplasma urealyticum was significant in the case group compared to the control group (P≤0.05). According to chi-square test, a significant relationship was observed between infection and infertility (P≤0.05). The prevalence of azithromycin resistance in Ureplasma urealyticum and Neisseria gonorrhoeae was 35 cases (48.6%) and 7 cases (58.3%), respectively. Ciprofloxacin resistance was reported in 3 cases (25%) of Neisseria gonorrhoeae and 64 cases (68.8%) of Ureaplasma urealyticum. The highest prevalence of resistance genes in both bacteria was related to mtrR and gyrA.
Conclusion: Antibiotic resistance in the studied bacteria indicates the indiscriminate use of antibiotics, the spread of antibiotic resistance gene structures, and genetic transmission among populations. In order to definitively treat and prevent the occurrence of resistance in pathogen strains, it is necessary to determine the resistance pattern to follow the resistance trend.

کلیدواژه‌ها [English]

  • Antibiotic Resistance Genes
  • Infertile women
  • Infertility factors
  • Neisseria gonorrhoeae
  • Ureaplasma urealyticum

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 12
اسفند 1401
صفحه 1-13

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