中文摘要：

目的：检测近4年来天津地区泌尿生殖道沙眼衣原体对阿奇霉素、米诺环素、莫西沙星3种临床常用抗生素体外药物敏感性，并评价药敏结果与临床疗效的关系。方法：将采集到的符合要求的299例临床标本及E型标准株破壁、离心后接种于细胞培养板的McCoy细胞，培养60～72h后碘染观察衣原体包涵体。原代培养阴性或阳性的标本均进行传代培养。阴性标本均传代培养至第5代，阳性标本传代培养至感染率达90％以上，收集标本进行3种常用抗生素的药敏试验。结果：共培养出沙眼衣原体阳性株104株，阳性率为34．78％。其中McCoy细胞感染率达90％以上的菌株共94株，药敏（最低抑菌浓度，MIC）结果分别为阿奇霉素（0．063～1．000mg／L），米诺环素0．004～0．128mg／L，莫西沙星0．030～0．240mg／L。应用阿奇霉素、莫西沙星、米诺环素治疗后的沙眼衣原体总体阴转率分别为44．44％、63．46％、88．89％。结论：随着时间的推移和抗生素的广泛应用．抗生素的敏感性呈不同程度的下降，米诺环素抗衣原体活性相对较强。整体评价临床各类药物治疗效果与时间变化趋势分析，药敏结果与临床疗效之间明显相关。

英文摘要：

Objective： To test in vitro drug susceptibility of recent clinical isolates from patients with urogenital chlamydial infection to azithromycin, minocyline and moxifloxacin in last 4 years in Tianjin, and explore the relationship between suscep- tibility testing and therapeutic effects. Methods： Laboratory reference strains of C. trachomatis（E serovar） and 299 clinical isolates of Chlamydia trachomatis were inoculated on McCoy cells, and cultured for 48-72 hours. The presence of the inclusion of Chlamydia trachomatis was identified by Lugol＇s iodine solution The culture-negative samples were cultured for another five passages. The culture-positive samples were cuhured until more than 90% McCoy cells being infected, then the cells were collected for susceptibility testing to 3 antimicrobials. Results： Out of 299 clinical isolates 104 strains were positive for C.trachomatis, the positive rate was 34.78%. Among them,the positivestrains with an infection rate greater than 90% of McCoy cells accounted for 94 strains The MIC of azithromycin, minocyline and moxifloxacin against these isolates were 0.063-1.000 mg/L, 0.004-0.128 mg/L and 0.030-0.240mg/L respectively. In the treatment of chlamydial infection with azithromyein, moxifloxacin, or minocycline, the overall clearance rates of C.trachomatis were 44.44%, 63.46% and 88.89% respectively. Conclusions： With the lapse of time and the wide spread use of antibiotics, the antibiotic sensitivity of Chlamydia trachomatis is gradually reduced indifferent levels Minocycline exhibited a markedly better action against Chlamydia trachomatis in-vitro. In overall evaluation of the therapeutic effects of above drugs, susceptibility testing was significantly correlated to the therapeutic efficacy.