深圳市女性不孕症相关因素及病因分析

目的分析深圳市女性不孕症相关因素及病因状况,为防治提供依据。方法对2009年7月～2010年12月在我院生殖中心就诊的731例女性不孕病例的病史和诊治资料进行回顾性分析。结果宫颈UU/MH感染、盆腔炎、输卵管病变及排卵障碍是导致的女性不孕主要危险因素;原发性不孕的主要病因是排卵障碍、内分泌因素及宫颈UU/MH感染,继发性不孕主要病因是宫颈UU/MH感染、输卵管病变及盆腔炎;盆腔炎、输卵管病变、排卵障碍三大因素占UU/MH感染总数83.24%;相关因素中,性和生殖健康知识缺乏、吸烟及常喝酒占比例小于5%。结论加强宫颈UU/MH感染、输卵管病变、盆腔炎及排卵障碍疾病的预防是降低女性不孕的重要措施。     

泌尿生殖系统支原体感染及耐药性研究

目的分析湖北省黄石市中医医院2009年1月至2010年6月间泌尿生殖道支原体感染状况及其药物敏感情况,并进一步探讨其耐药性变化,为临床合理用药提供参考。方法采用珠海银科医学工程有限公司提供的支原体培养试剂盒进行检测。回顾性统计分析本院送检的女性及男性泌尿生殖道感染患者的尿道/宫颈分泌物支原体鉴定及药物敏感情况。结果送检的1080例标本中共检出支原体440例,总检出率为40.7%,其中解脲支原体(Uu)356例(80.9%),解脲支原体合并人型支原体(Uu+Mh)46例(10.4%),人型支原体(Mh)38例(8.6%)。药敏结果表明,强力霉素、交沙霉素、美满霉素敏感率较高,其次为克拉霉素、阿奇霉素。氧氟沙星、司帕沙星、罗红霉素的敏感性较低。结论本院支原体感染以解脲支原体为主,强力霉素和交沙霉素可作为目前治疗泌尿生殖道Uu和Mh感染的首选药物,临床治疗前应尽可能进行支原体培养及药敏试验,合理规范用药。     

上饶地区NGU患者支原体与沙眼衣原体感染状况及支原体耐药性分析

目的了解江西上饶地区非淋菌性尿道炎(NGU)患者解脲脲原体(Uu)、人型支原体(Mh)与沙眼衣原体(Ct)感染状况,分析支原体的耐药性,指导本地区临床合理用药。方法 采用支原体的分离鉴定与药敏试剂盒检测拟诊为NGU患者Uu与Mh,同时用实时荧光定量PCR(FQ-PCR)检测Ct,分析NGU病原体的构成比与支原体的耐药性。结果 886例标本中,Uu、Mh与Ct的检出率分别为41.4%、7.7%和14.4%,男性感染率明显低于女性。药敏试验结果显示,Uu、Mh和Uu+Mh对药物的敏感性最高者为交沙霉素和多西环素,Uu对罗红霉素、氧氟沙星和司帕沙星耐药性高,Mh及Uu+Mh则对罗红霉素、阿奇霉素和克拉霉素耐药性高。结论本地区NGU病原体构成主要为Uu,治疗本地区泌尿生殖道支原体感染可首选交沙霉素与多西环素。     

解脲脲原体生物被膜形成与耐药性的相关性研究

目的 研究解脲脲原体(Ureaplasma urealyticum,Uu)标准株及临床分离株体外形成生物被膜的能力及游离状态与形成生物被膜后药物敏感性的差异.方法 对Uu标准株3、8血清型(Uu3、Uu8)及从女性患者宫颈中分离鉴定的21株Uu临床株进行体外培养后,扫描电镜、激光共聚焦显微镜鉴定生物被膜形成,并在生物被膜形成前后进行约敏测定(四环素、红霉素、环丙沙星).配对秩和检验及x2检验分别比较Uu游离状态及形成生物被膜后最低抑菌浓度间及耐药率间的差异.结果 Uu3、Uu8及21株Uu临床株均具有体外形成生物被膜的能力.Uu形成牛物被膜后对四环素、红霉素及环丙沙星的最低抑菌浓度较游离状态明显增高(P<0.001).Uu形成生物被膜后对红霉素及环丙沙星的耐药率增高具有统计学意义(P值分别为<0.001及0.035),但对四环素的耐药率增高无统计学意义(P=0.293).结论 Uu标准株及临床株均具有体外形成生物被膜的能力,Uu形成生物被膜后对抗菌素的抵抗力增加,出现了多重耐药现象.

Abstract：

Objective To study the ability of standard strain and clinical isolates of Ureaplasma spp. to form biofilms in vitro and to compare the antibiotic susceptibility of sessile cells and their planktonic counterparts. Methods A total of 21 Ureaplasma wealyticum(Uu) isolates recovered from female patients diagnosed with cervicitis and Uu serovar 3 and Uu serovar 8( Uu3, Uu8) were included. Scanning electron microscope and confocal scanning laser microscopy were used to identify biofilm formation. Conventional antibiotic susceptibility tests and biofilm susceptibility assays for tetracycline, erythromycin and ciprofloxacin were carried out. The paired rank sum test and was applied to analyze the statistical differences between the MIC and the minimal biofilm inhibitory concentration. The x2 test was applied to analyze the statistical differences of global resistance percentages between planktonic cells and sessile cells. Results Uu3, Uu8 and 21 Uu isolates all can form biofilms in vitro. Minimal inhibitory concentration of sessile cells compared with planktonic cells were obviously higher for tetracycline, erythromycin and ciprofloxacin (P <0.001). Global resistance percentages between planktonic cells and sessile cells were different for erythromycin (9.52% vs 61.90% , P < 0. 001), ciprofloxacin ( 80. 95% vs 100% , P = 0. 035 ) and tetracycline (4. 76% vs 14.29% , P =0.293). Conclusion Uu isolates and Uu1, Uu8 all can form biofilms in vitro, and biofilm formation can strengthen resistance of Uu to antibiotics, even multidrug resistance was observed.     

反复性自然流产患者细菌性阴道病及解脲支原体感染状况118例分析

目的了解反复性自然流产患者下生殖道细菌性阴道病及解脲支原体感染情况。方法对118例反复性自然流产患者作为实验组及109例有正常妊娠史的健康体检者作为对照组,进行下生殖道细菌性阴道病及解脲支原体感染检测。结果实验组细菌性阴道病感染28例(23.7%),解脲支原体感染49例(41.5%),二者双重感染25例(21.2%);对照组细菌性阴道病感染13例(11.0%),解脲支原体感染22例(20.2%),二者双重感染9例(8.3%),实验组与对照组比较有统计学意义(P<0.05)。自然流产2次患者细菌性阴道病感染16例(21.0%),解脲支原体感染28例(36.8%),二者双重感染15例(19.7%)。自然流产≥3次患者细菌性阴道病感染13例(28.6%),解脲支原体感染21例(50.0%),二者双重感染10例(23.8%)。随着流产次数的增加解脲支原体感染率上升(P<0.05),细菌性阴道病及二者双重感染率也呈上升趋势,但无统计学意义(P>0.05)。结论下生殖道细菌性阴道病及解脲支原体感染与反复性自然流产之间存在一定相关性,孕前检查要重视筛查细菌性阴道病及解脲支原体感染情况。     

The association between respiratory tract Ureaplasma urealyticum colonization and severe retinopathy of prematurity in preterm infants ≤1250 g

Aim

To evaluate the association between respiratory tract Ureaplasma urealyticum (Uu) colonization and development of retinopathy of prematurity (ROP) requiring treatment.

Methods

The infants with birthweight (BW) ≤1250 g born in a third-level neonatal intensive care unit between March 2009 and May 2010 were prospectively identified. Nasopharyngeal swabs for Uu colonization were taken in postnatal first 3 days. Culture-positive patients were reevaluated on the twelfth day by nasopharyngeal swabs for Uu. The primary outcome was to define whether there was an association between respiratory tract Uu colonization and severe ROP requiring treatment. Independent sample''s t-test or Mann–Whitney U-test was used to compare continuous variables and Chi-square test or Fisher''s exact test for categorical variables. Multivariate (backward) logistic regression analysis was performed to simultaneously measure the influence of the independent variables with ROP as the dependent variable.

Results

A total of 25 (12.1%) infants developed severe ROP requiring treatment among 206 infants who underwent ROP screening. Mean BW and gestational age of total cohort were 1013±159 g and 27.9±1.6 weeks, respectively. Multivariate analysis demonstrated that BW (OR: 0.64 (95% Cl 0.47–0.88); P=0.006), duration of mechanical ventilation (OR: 1.17 (95% Cl 1.06–1.28); P=0.001), premature rupture of membrane >18 h (OR: 3.83 (95% Cl 1.2–12.2); P=0.02), and Uu positivity in both cultures (OR: 5.02 (95% Cl 1.8–13.9); P=0.002) were independent risk factors for the development of severe ROP requiring treatment.

Conclusions

Respiratory tract colonization with Uu was independently associated with severe ROP requiring treatment.     

衣原体支原体弓形虫和巨细胞病毒感染与自然流产的关系

目的研究衣原体（CT）、支原体（UU）、弓形虫（TOX）、巨细胞病毒（HCMV）对流产的影响。方法应用聚合酶链反应（PCR）技术分别对164例自然流产患者（流产组）和100例人工流产和引产孕妇（对照组）的宫颈分泌物进行CT、UU、TOX、HCMV检测。结果流产组CT、UU、TOX、HCMV的检出阳性率分别为41.46%、34.15%、18.29%、30.39%,与对照组比较,差异有显著意义（P（0.01,P（0.05）。流产次数随UU阳性出率的增高而增多。结论CT、UU、TOX、HCMV是引起自然流产的重要感染源,其中CT、UU是主要病原体。     

不育症男性精液抗精子抗体与支原体感染的相关性分析

目的探讨男性不育患者精液抗精子抗体（AsAb）与支原体感染之间的关系。方法对159例不育男性患者精液进行AsAb和解脲支原体（UU）检测。结果159例男性不育患者中,精液抗精子抗体阳性组支原体阳性检出率为68.97%,精液抗精子抗体阴性组支原体阳性检出率为43.06%,两组之间差异有显著性（P〈0.05）。结论男性免疫性不育AsAb的产生与UU感染有关。     

非淋菌性尿道炎患者支原体属感染及药敏分析

目的通过了解解脲脲支原体(Uu)和人支原体(Mh)的耐药情况,为临床合理用药提供科学的参考依据。方法采用体外培养的方法,对726例可疑性病者的泌尿生殖道分泌物进行Uu和Mh的感染浓度测定及药物敏感试验,并对结果进行分析。结果 726例疑似非淋菌性尿道炎(NGU)患者中387例支原体属培养阳性,阳性率为53.3%,其中解脲脲支原体(Uu)占72.9%;人支原体(Mh)占3.9%;Uu+Mh占23.3%;女性支原体属发病率较男性高,单纯Uu感染显著高于Mh感染和混合感染,差异有统计学意义(P<0.05);药敏结果分析,对多西环素、米诺环素、克拉霉素、交沙霉素敏感率高,而对罗红霉素、左氧氟沙星敏感率较差。结论非淋菌性尿道炎支原体感染主要以Uu发病率最高,应重视培养、鉴定及药敏结果,在临床中对支原体感染治疗应根据药敏结果合理使用抗菌药物,以减少耐药菌株产生。     

阴道假丝酵母菌病患者支原体检测意义

目的：通过对150例阴道假丝酵母菌患者宫颈局部解脲支原体（uu）的检测,了解其混合感染状况,为恰当治疗提供依据。方法：2008年6月-2009年5月,在我院妇产科门诊以外阴瘙痒及白带增多为主诉患者,先取阴道分泌物进行假丝酵母菌检查,同时取宫颈管分泌物进行解脲支原体进行检测。结果：在150例假感染的患者中,uU阳性者116例,占77．33％,较对照组的40．30％明显升高,差异有统计学意义（P〈O．05）丝酵母菌。结论：女性下生殖道假丝酵母菌感染者存在合并UU感染,有必要进行常规的检查,以便正确使用有效药物治疗。