1180例孕妇性传播疾病检查结果分析

目的：了解性传播疾病在孕妇中的流行情况。方法：对1180例入院我院待产的孕妇，取阴道分泌物革兰氏染色找念珠菌、滴虫；取宫颈分泌物作沙眼前原体抗原检测及淋球菌、支原体培养。结果：1180例孕妇标本病原体检出率为17．5％，检出率依次为淋球菌0．34％，滴虫0．68％，念珠菌3．22％，沙眼衣原体5．76％，支原体7．46％。结论：由衣原体、支原体感染引起的非淋菌性宫颈炎是孕妇最常见的性传播疾病。     

标本涂片与培养对淋病的诊断意义

我们对新研制的淋球菌培养基（WuhanGonococ－calMedium，WGC）进行临床试用时做涂片和培养进行比较，男性尿道分泌物涂片淋球菌阳性与培养阳性的符合率为94．8％；女性宫颈标本涂片阳性者为培养阳性的43．5％，与书刊报道近似，报告如下。对象与方法一、对象对903例有婚外性交     

85例泌尿生殖道支原体、衣原体检测情况报告

为了解泌尿生殖道感染患者衣原体及支原体的感染情况 ,我们对本院性病门诊的 85例非淋菌性尿道 (宫颈 )炎及淋病患者作沙眼衣原体、解脲支原体检测。1　资料和方法1 1　ＮＧＵ组　 5 2例患者均按非淋菌性尿道 (宫颈 )炎的诊断标准〔1〕,其中男 35例 ,女 17例 ,年龄 18～ 5 0岁。全部病例分泌物涂片及培养都未检出淋球菌。1 2　淋病组　 33例患者分泌物涂片及培养均检出淋球菌 ,其中男 2 2例 ,女 11例。1 3　取材　男性用无菌拭子插入尿道口内 2ｃｍ～ 3ｃｍ ,停留5秒种转动取出拭子。女性扩阴后 ,用棉签揩去宫颈外口分泌物 ,再用拭子插入宫…     

278份宫颈分泌物真菌检测结果分析

近年来 ,真菌致病菌群在不断变迁 ,条件致病真菌致病逐渐增多 ,妇女阴道真菌感染呈明显上升趋势[1] 。 1997年 1月～ 1999年 1月 ,我们对 2 78例有女性阴道感染症状而淋球菌、沙眼衣原体、解脲支原体检测阴性的患者宫颈分泌物进行了真菌检测 ,结果报告如下。　[作者单位 ] 1湖北医科大学附属第二医院皮肤科 ,湖北武汉　430 0 71 ;2湖北医科大学附属第二医院检验科资料与方法标本来源　 2 78份标本均为我科门诊就诊女患者的宫颈分泌物 ,患者均有不同程度女阴阴道感染症状 ,如外阴瘙痒、白带增多、分泌物有异味等。作淋球菌培养、沙眼衣原体和…     

新生儿淋菌性眼炎1例

患儿，男，4天，因双眼红肿，有脓性分泌物。不能睁眼，于1999年2月1日来我站门诊部就诊。患者系第3胎，第3产，足月顺产，查体：T36.8CP100次/分、R28次／分。一般情况尚可，系统检查无异常。皮肤科情况：双眼微闭，眼脸红肿，表面粘有脓性结痴，睁眼困难，分开眼险有脓液流出，结膜红肿充血。余部位未见异常。实验室检查取限内脓液革兰氏染色镜检可见大量细胞内革兰氏阴性双球菌，取患儿父亲尿道分泌物作培养，淋球菌阳性，患儿母亲宫颈分泌物作培养，淋球菌亦阳性。治疗经过（1）局部治疗：用3％硼酸溶液冲洗双眼，每隔2小时1次，冲洗…     

氟啶酸和头孢三嗪噻肟治疗无并发症淋病的多中心研究

氟啶酸(enoxacin)是一种新合成的喹诺酮类广谱抗生素,在体外有很好的抗淋球菌活性。对90％PPNG和非PPNG菌株的MIC均<0.06μg/ml。本文报告用氟啶酸和头孢三嗪噻肟治疗无并发症淋病的多中心随机对照研究。受试者均为16岁以上在美国3个州的SID门诊就诊的成年病人,共152例,男119例,女33例。男性作尿道分泌物涂片,找到细胞内革兰阴性双球菌;女性作宫颈粘膜涂片找到细胞内革兰阴性双球菌,并于最近有淋球菌培养阳性而未经治疗或最近(14天内)与已确诊为淋球菌感染的性侣有性交史。病史提示有性接触史者加作直肠和咽部标本培养,同时作淋球菌药物敏感试验和衣原体培养。疗     

沙黄单染色法快速检查淋球菌与培养法的对比观察

分泌物涂片染色检查淋球菌 ,是诊断淋病的基本方法。传统的革兰染色法比较费时。笔者用沙黄单染色法[1] 快速检查与淋球菌培养法对 182例标本进行了对比观察 ,报告如下。临床资料　 182例均为我院妇科和外科门诊患者。方法　按操作常规 ,无菌棉签采取宫颈、阴道或尿道等处分泌物 ,立即接种于Ｔ -Ｍ培养基上 ,置 3 6.5℃ ,70 %湿度 ,7%ＣＯ2 温箱培养 2 4～ 48ｈ后鉴定。根据菌落形态特征、氧化酶阳性、革兰染色阴性的肾形双球菌者为淋球菌分离培养阳性。在接种培养的同时 ,制涂片 1张 ,待干后用沙黄单染色液染色 3 0ｓ～ 1ｍｉｎ ,水洗待干…     

女性宫颈淋球菌3种检测方法比较

淋病是由淋球菌引起的泌尿生殖道的化脓性感染，女性淋球菌感染常仅表现为宫颈脓性分泌物或无症状，因此，选择一种特异、敏感的检测方法对诊断女性淋球菌感染有着重要的意义。本文采用淋球菌培养、聚合酶链反应(PCR)、连接酶链反应(LCR)3种检测方法检测宫颈淋球菌，并比较3种方法检测淋球菌的特异性及敏感性。     

三种方法分离女性生殖道解脲支原体结果分析

对２１例受检者采用无菌棉拭子取阴道分泌物、宫颈粘液及无菌液体阴道冲洗三种方法进行解脲支原体分离，结果示宫颈粘液ＵＵ阳性１８例（８５．７％）；冲洗液ＵＵ阳性１６例（７６．２％）；阴道分泌物ＵＵ阳性１５例（７１．４％）。经统计学处理三种取材方法ＵＵ检出率无显著性差异，只有宫颈粘液ＵＵ检出率略高于其余两法。     

女性尿道和宫颈两处取材平行淋球菌培养及意义探讨

淋球菌培养是女性淋病诊断的金标准[1],故目前国内多采用培养法,但样本均取自宫颈内。我们于1997年6月～1998年2月,对我科性病门诊,临床疑为淋病的92例女性患者,同时取宫颈和尿道标本进行培养,共培养阳性病例69例,现报告如下。材料和方法一般资料　69例淋球菌培养阳性患者,年龄18～50岁,其中无症状者34例;白带增多,外阴痒26例;伴有尿痛、尿道不适7例;合并前庭大腺脓肿,下腹、肛门坠胀不适2例,以上患者均有性乱或配偶、亲属有性病感染史。取材方法　在排尿2～3ｈ后,先用干棉拭子擦去尿道口周围的分泌物,将灭菌白金耳环伸入尿道1ｃｍ,轻轻转动…     

Presence of two strains of Neisseria gonorrhoeae in both the cervix and pharynx of a patient with disseminated infection caused by a single strain

Neisseria gonorrhoeae was cultured from the cervix, pharynx and blood stream of an 18-year-old woman who had a disseminated gonococcal infection. Two different phenotypes of N. gonorrhoeae, distinguished on the basis of their protein I serovar, whole-cell protein profile, lectin-type and antibiotic susceptibility, were isolated from both the cervix and pharynx, whereas only one of these phenotypes was isolated from the blood. This finding stresses the importance of blood cultures as a prelude to determining appropriate antimicrobial therapy in cases of disseminated gonococcal infection.     

Characterisation of Neisseria gonorrhoeae from women with simultaneous infections at two sites.

Infection with two strains of Neisseria gonorrhoeae was found in paired cultures from 8.7% (6/69) of women who had infections of the cervix, rectum, or urethra. Paired gonococcal cultures from each patient were characterised by auxotyping, susceptibility to four antibiotics, and acrylamide gel electrophoresis patterns of the gonococcal cell proteins.     

Ciprofloxacin treatment of chlamydial infections of urogenital tracts of women.

Ciprofloxacin was evaluated in chlamydial infections of the urogenital tracts of women treated with a dosage regimen of 500 mg orally twice a day for seven days. Of the 40 women evaluated, 30 were infected with Chlamydia trachomatis only, two were infected with Neisseria gonorrhoeae only, and a further eight had combined gonococcal and chlamydial infections. Ten were found to be harbouring Chlamydia trachomatis in the urethra as well as the cervix. Neisseria gonorrhoeae was eradicated from all patients with or without concomitant chlamydial infection. The overall chlamydial reisolation rates were 14% (5/35) four weeks after treatment and 23% (6/26) 11 weeks after treatment. The organism was not reisolated from the urethra of any of the patients after treatment. Ciprofloxacin was effective against Mycoplasma hominis, but almost completely ineffective against Ureaplasma urealyticum.     

Cell-mediated immune response in gonococcal infections.

Peripheral blood lymphocyte (PBL) transformation stimulated by gonococcal and meningococcal antigens was studied in 29 men and 21 women with uncomplicated gonorrhoea. The blastogenic responses of PBLs from these men and women were substantially higher than from normal controls. Cross-reactivity between Neisseria gonorrhoeae and Neisseria meningitidis was manifested by the PBL transformation responses in patients with gonorrhoea to non-purified meningococcal antigen (MGC-I). In both male and female patients the PBLs were stimulated by non-purified gonococcal antigen (GC-I) and by non-purified meningococcal antigen. The extent of the blastogenic response in women was much greater than in men. Partial purification of these antigens by gel chromatography resulted in reduced cross-reactive responses to the semi-purified meningococcal antigen (MGC-II). Female patients demonstrated marked stimulation with the semi-purified gonococcal antigen (GC-II), while male patients showed slight stimulation with GC-II. It is possible that cell-mediated immunity may act to limit the spread of gonococcal infection beyond the genital mucous membranes.     

Cell-mediated immune response in gonococcal infections.

Peripheral blood lymphocyte (PBL) transformation stimulated by gonococcal and meningococcal antigens was studied in 29 men and 21 women with uncomplicated gonorrhoea. The blastogenic responses of PBLs from these men and women were substantially higher than from normal controls. Cross-reactivity between Neisseria gonorrhoeae and Neisseria meningitidis was manifested by the PBL transformation responses in patients with gonorrhoea to non-purified meningococcal antigen (MGC-I). In both male and female patients the PBLs were stimulated by non-purified gonococcal antigen (GC-I) and by non-purified meningococcal antigen. The extent of the blastogenic response in women was much greater than in men. Partial purification of these antigens by gel chromatography resulted in reduced cross-reactive responses to the semi-purified meningococcal antigen (MGC-II). Female patients demonstrated marked stimulation with the semi-purified gonococcal antigen (GC-II), while male patients showed slight stimulation with GC-II. It is possible that cell-mediated immunity may act to limit the spread of gonococcal infection beyond the genital mucous membranes.     

Prevalence, incidence, and risk of acquiring urogenital gonococcal or chlamydial infection in prostitutes working in brothels.

At two week intervals specimens were taken from 24 prostitutes working in two brothels and cultured for urogenital infection with Chlamydia trachomatis and Neisseria gonorrhoeae. Demographic and clinical data were also collected. C trachomatis was found initially in four and N gonorrhoeae in two of the 20 women at risk of infection. During the study period three new chlamydial and gonococcal infections were diagnosed, resulting from 949 unprotected contacts. Eight women (33%) had developed salpingitis, in contrast to 15% in the general female population. An attempt was made to estimate the infectivity of C trachomatis for the prostitutes. The epidemiological importance of the chlamydial and gonococcal reservoir in the prostitutes was also considered.     

Should screening of genital infections be part of antenatal care in areas of high HIV prevalence? A prospective cohort study from Kigali,Rwanda, 1992-1993. The Pregnancy and HIV (EGE) Group.

OBJECTIVE--To study the prevalence and incidence of genital infections and their association with HIV-1 infection among pregnant women in Kigali, Rwanda. SUBJECTS AND METHODS--HIV+ and HIV- pregnant women were followed prospectively during the last three months of pregnancy. At enrolment, syphilis test (RPR) on blood sample, Chlamydiae trachomatis ELISA test on cervical smear, laboratory gonococcal culture, trichomonas and candida direct examination, CD4 lymphocyte count were performed. At each monthly follow-up clinic visit until delivery, genital infections were screened in the presence of clinical signs and symptoms. RESULTS--The HIV seroprevalence rate was 34.4% (N = 1233), 384 HIV+ women and 381 HIV- women of same parity and age were enrolled. Prevalence of genital infections at enrolment was generally higher in HIV+ women than in HIV- women: syphilis, 6.3% versus 3.7% (p = 0.13); Neisseria gonorrhoea, 7.0% versus 2.4% (p = 0.005); Trichomonas vaginalis, 20.2% versus 10.9% (p = 0.0007); Chlamydia trachomatis, 3.4% versus 5.5% (p = 0.21); Candida vaginalis, 22.3% versus 20.1% (p = 0.49). Until delivery, the relative risk of acquiring genital infections was also higher in HIV+ women than in HIV- women: 1.0 for syphilis (95% CI: 0.5-2.2), 3.7 for Neisseria gonorrhoea (1.0-13.3), 2.6 for Trichomonas vaginalis (1.5-4.6) and 1.6 for Candida vaginalis (1.1-2.4). CONCLUSION--In the context of high HIV-1 seroprevalence among pregnant women, prenatal care should include at least once screening for genital infections by clinical examination with speculum and a syphilis testing in Africa.     

Rapid assessment of sexually transmitted diseases in a sentinel population in Thailand: prevalence of chlamydial infection, gonorrhoea, and syphilis among pregnant women--1996

OBJECTIVE: To determine the prevalence of sexually transmitted diseases (STDs) among pregnant women in Thailand, where case reporting suggests a marked decrease in STDs following a campaign promoting condom use during commercial sex. DESIGN: Cross sectional study of women at their first visit to the study hospitals' antenatal clinics in Chiang Rai (n = 500) and Bangkok (n = 521). METHODS: First catch urine specimens were tested for Chlamydia trachomatis and Neisseria gonorrhoeae using the Amplicor CT/NG polymerase chain reaction assay. Syphilis and HIV serological testing were performed in the study hospitals' laboratories. RESULTS: The prevalence of chlamydial infection was 5.7%, gonorrhoea 0.2%, and syphilis 0.5% (all VDRL or RPR titres were < or = 1:4). The prevalence of HIV infection was 7.1% in Chiang Rai and 2.9% in Bangkok. In a multivariate logistic regression analysis, chlamydial infection was associated with younger age and with higher gestational age at first antenatal clinic visit, but was not associated with marital status, gravidity, city of enrollment, or HIV infection status. CONCLUSIONS: There was a low prevalence of gonorrhoea and syphilis among these pregnant women in Thailand. Chlamydial infection was detected at a higher prevalence, especially among younger women and women registering later for antenatal care. Testing of pregnant women using easily collected urine specimens and a sensitive nucleic acid amplification assay is a feasible method of rapidly assessing chlamydial and gonococcal prevalence.


     

Spectinomycin resistant gonococcal infections in West Germany. Detection in 7 patients and occurrence of post-gonorrheal epididymitis caused by the spectinomycin-resistant PPNG strain

Seven patients (four men, three women) with gonococcal urethritis resistant to spectinomycin treatment were seen in May and June 1989 in the Department of Dermatology in Berlin (West), and strains of Neisseria gonorrhoeae (NG) resistant to spectinomycin were detected, cultured in vitro from these individuals. In five of the seven patients penicillin-resistant strains were found, including a penicillinase-producing strain in one case; the other two patients had penicillin-sensitive strains. In all cases the NG-populations detected were sensitive to cephalosporin and cipro(oxo)floxacin. In a 17-year-old young man with the PPNG strain severe gonococcal epididymitis developed after repeated infection that had been inadequately treated with spectinomycin. All seven patients mentioned sexual contact with individuals who lived in Southeast Asia or had their origins there; in at least four cases the contact persons came from Thailand. This is the first report on spectinomycin-resistant Neisseria gonorrhoeae infections (PPNG and non-PPNG) in the Federal Republic of Germany. The necessity for monitoring the results of penicillin and/or spectinomycin treatment of gonorrhoea are underlined for the dermatovenereologist, and some guidelines for therapy are given.     

Bacterial vaginosis (BV) and the risk of incident gonococcal or chlamydial genital infection in a predominantly black population

OBJECTIVE: The objective of this study was to assess in prospective data whether bacterial vaginosis (BV) is associated with gonococcal/chlamydial cervicitis. STUDY: A total of 1179 women at high risk for sexually transmitted infections was followed for a median of 3 years. Every 6 to 12 months, vaginal swabs were obtained for Gram stain, culture of microflora, and Neisseria gonorrhoeae and Chlamydia trachomatis. A Gram stain score of 7 to 10 based on the Nugent criteria categorized BV. RESULTS: Baseline BV was associated with concurrent gonococcal/chlamydial infection (adjusted odds ratio, 2.83; 95% confidence interval [CI], 1.81-4.42). However, the association between BV and subsequent, incident gonococcal/chlamydial genital infection was not significant (adjusted relative risk [RR], 1.52; 95% CI, 0.74-3.13). Dense growth of pigmented, anaerobic Gram-negative rods (adjusted RR, 1.93; 95% CI, 0.97-3.83) appeared to elevate the risk for newly acquired gonococcal/chlamydial genital infection. CONCLUSIONS: BV was common among a predominantly black group of women with concurrent gonococcal/chlamydial infection but did not elevate the risk for incident infection.