沙眼衣原体、支原体属感染及药物敏感度分析

目的了解女性非淋菌性宫颈炎患者沙眼衣原体（CT）、支原体感染及药敏情况。方法采集342例女性非淋菌性宫颈炎患者的宫颈分泌物进行CT抗原检测、支原体培养及药敏试验。结果CT和支原体感染共249例（72．8％），其中解脲脲原体（Uu）129例（37．7％），显著高于人型支原体（Mh）15例（4．4％）。Uu＋Mh混合感染60例（17．5％）及Uu＋Mh＋CT混合感染45例（13．2％）（P〈0．005）。246株支原体对环丙沙星、红霉素、氧氟沙星、克拉霉素、阿奇霉素、四环素、原始霉素、交沙霉素和多西环素的耐药率分别为76．5％、45．9％、43．5％、35．3％、29．40／40、10．6％、3．5％、2．40／40和2．40／40。结论CT和支原体是引起非淋菌性宫颈炎主要病原体，支原体的耐药性监测对指导临床治疗具有重要意义。     

中西医结合与阿奇霉素治疗沙眼衣原体感染性尿道炎的疗效比较

目的　探讨中西医结合治疗衣原体感染性尿道炎之疗效。方法　选择单一衣原体感染性尿道炎随机分成中西医结合治疗组与阿奇霉素治疗组 ,采用追踪观察方式 ,中西医结合组口服土霉素片 (OxytetracyclinTablets) 0 .5gqid(首剂加倍 ) ,共 14d ;同时自拟中药方剂 ,1剂 /d ,煎服 ,亦服 14d。阿奇霉素组口服阿奇霉素片 (AzithromycinTablets)第 1天 1.0g顿服 ,第 2日起每日 0 .5g ,顿服 ,共 7d。结果　中西医结合组治愈率为 87.9% (5 1/ 5 8) ;阿奇霉素组治愈率 85 .5 % (4 7/ 5 5 )。结论　中西医结合与阿奇霉素治疗衣原体感染性尿道炎 ,治愈率相比无统计学差异(P >0 .0 5 ) ,但中西医结合疗法更经济更实惠     

临床分离的解脲脲原体耐药性的变迁

目的了解本院2007～2009年临床分离的解脲脲原体耐药性的变迁,更好地指导临床合理用药。方法对2007～2009年就诊的可疑非淋菌性尿道炎(宫颈炎)患者进行支原体的培养及药物敏感检测。结果交沙霉素和强力霉素3年中耐药性均小于10%;大环内酯类红霉素和罗红霉素的耐药性均较高;喹诺酮类药物环丙沙星、氧氟沙星和司巴沙星的耐药性呈较高水平。结论 解脲脲原体的药物敏感性随时间的变化而变化,定期监测解脲脲支原体的耐药性十分必要。     

重庆地区性传播疾病患者387例支原体培养及药敏试验结果分析

目的了解重庆地区性传播疾病(sexually transmitted disease,STD)患者支原体感染情况及其药物敏感试验结果.方法对387例支原体培养阳性的STD患者的支原体培养及药敏试验结果进行回顾性分析.结果在支原体感染患者中,以20～40岁患者为主要感染人群,男女比例无明显差别;解脲支原体(ureaplasma urealyticum,Uu)为主要病原体;在对9种药物进行的药敏试验结果中,交沙霉素、美满霉素及强力霉素敏感率较高,依次为94.06%、88.89%、86.82%,对克林霉素、阿齐霉素及罗红霉素的耐药率较高.结论对于Uu和人型支原体(Mycoplasma hominis,Mh)感染,临床医生应当结合药敏试验合理应用抗生素.目前重庆地区Uu和Mh感染的治疗可以首选交沙霉素及半合成四环素类抗生素进行治疗.     

Ciprofloxacin-Releasing ROS-Sensitive Nanoparticles Composed of Poly(Ethylene Glycol)/Poly(D,L-lactide-co-glycolide) for Antibacterial Treatment

Since urinary tract infections (UTIs) are closely associated with oxidative stress, we developed ROS-sensitive nanoparticles for ciprofloxacin (CIP) delivery for inhibition of UTI. Poly(D,L-lactide-co-glycolide) (PLGA)- selenocystamine (PLGA-selenocystamine) conjugates were attached to methoxypoly(ethylene glycol) (PEG) tetraacid (TA) (TA-PEG) conjugates to produce a copolymer (abbreviated as LGseseTAPEG). Selenocystamine linkages were introduced between PLGA and TA to endow reactive oxygen species (ROS) sensitivity to nanoparticles. CIP-incorporated nanoparticles of LGseseTAPEG copolymer were fabricated by W/O/W/W emulsion method. CIP-incorporated nanoparticles responded to H₂O₂ and then their morphologies were disintegrated by incubation with H₂O₂. Furthermore, particle size distribution of nanoparticles was changed from mono-modal distribution pattern to multi-modal distribution pattern by addition of H₂O₂. CIP release from nanoparticles of LGseseTAPEG copolymer was faster in the presence of H₂O₂ than in the absence of it. In antibacterial study using Escherichia coli (E. coli), free CIP and free CIP plus empty nanoparticles showed dose-dependent inhibitory effect against growth of bacteria while CIP-incorporated nanoparticles have less antibacterial activity compared to free CIP. These results were due to that CIP-incorporated nanoparticles have sustained release properties. When free CIP or CIP-incorporated nanoparticles were introduced into dialysis membrane to mimic in vivo situation, CIP-incorporated nanoparticles showed superior antibacterial activity compared to free CIP. At cell viability assay, nanoparticles of LGseseTAPEG copolymer have no acute cytotoxicity against L929 mouse fibroblast cells and CCD986sk human skin fibroblast cells. We suggest LGseseTAPEG nanoparticles are a promising candidate for CIP delivery.     

UAA-AAUS guideline for M. genitalium and non-chlamydial non-gonococcal urethritis

Non-chlamydial non-gonococcal urethritis (NCNGU) is defined as urethritis with neither Neisseria gonorrhoeae nor Chlamydia trachomatis. Possible causative agents of NCNGU include Mycoplasma genitalium, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Trichomonas vaginalis, and so on. Among these microorganisms, the pathogenicity of M. genitalium and T. vaginalis to the male urethra has been confirmed so far.The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) belonging to the Urological Association of Asia (UAA) had developed the guidelines regarding NCNGU and the present guidelines were updated from previous edition. Relevant references were meticulously reviewed again and latest studies were collected. In addition to the levels of evidence, the recommendation grades were defined using the modified GRADE methodology. Herein, we present the new edition of the UAA-AAUS guidelines for M. genitalium and non-chlamydial non-gonococcal urethritis.     

重庆地区4414例泌尿生殖道支原体检测及药敏分析

目的 研究解脲支原体(Uu)和人型支原体(Mh)在非淋球菌性尿道炎(NGU)疑似感染者中的感染率和药敏情况.方法 使用安图生物支原体培养鉴定计数药敏试剂盒检测4 414份疑似泌尿生殖道感染者临床标本.结果 4 414份标本中,检出支原体阳性感染者2 295例,阳性率51.99％,其中Uu和Mh的单一感染阳性率分别为40.69％和2.08％,两者共同感染阳性率9.22％.交沙霉素(JOS)、多西环素(DOX)、克拉霉素(CLA)、加替沙星(GAT)和红霉素(ERY)敏感率分别为96.03％、95.51％、78.69％、77.21％和72.55％.罗红霉素(RXT)、甲砜霉素(THI)、克林霉素(CLI)和克拉霉素(CLA)的耐药率分别为16.91％、22.27％、41.96％和17.60％.结论 Uu是NGU感染中的主要病原体,临床推荐使用DOX、JOS、GAT和ERY作为一线药物,而不适宜使用耐药率高的RXT、THI、CLI和CLA.     

非淋球菌性尿道炎中生殖支原体的检测

为了探讨生殖支原体（Ｍｇ）与非淋球菌性尿道炎（ＮＧＵ）的关系,我们建立了套式ＰＣＲ法对２１６例ＮＧＵ病人尿道（阴道）分泌物标本做了Ｍｇ检测。分别扩增得到２９６ｂｐ和３７１ｂｐ片段。套式ＰＣＲ扩增片段经Ｅ．ｃｏＲＩ酶切和与γ３２Ｐ－ＡＴＰ标记的ＭＧＳ－Ｉ探针做斑点杂交,均证明扩增片段为Ｍｇ－Ｐａ。此方法灵敏度为１０３ｃｆｕ／ｍｌ。用此引物对其它８种支原体扩增均为阴性,具有高度的特异性。实验结果表明,ＮＧＵ患者Ｍｇ－ＰａＤＮＡ总阳性率为７．８％（１７／２１６）正常人群阳性率１．２％（１／８１）,两组有显著性差异（ｘ２＝３．９８５,Ｐ＜０．００５）。从不同性别比较,男性ＮＧＵＭｇ－ＤＮＡ检测阳性率１０．２％（７／６８）,女性６．７％（１０／１４８）,男性略高于女性。成人与儿童比较,成人ＮＧＵＭｇ－ＤＮＡ检测阳性率１０．３％（１１／１０６）儿童检测阳性率５．４％（６／１１０）,成人略高于儿童,统计学亦无显著性差异。结果提示Ｍｇ是ＮＧＵ病原体之一,在正常人群中也检测出阳性,说明它有正确寄居的可能性。