慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中的细菌16SrRNA基因检测

目的:探讨细菌在慢性非细菌性前列腺炎病因中的作用,评估细菌16S核糖体核糖核酸(16SrRNA)基因在前列腺液标本和前列腺组织标本中检出的差异.方法:应用PCR方法检测38例慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中细菌16SrRNA基因,同时对照检测尿道拭子和直肠拭子以及穿刺枪头拭子的细菌16SrRNA基因.结果:细菌16SrRNA基因的检出率在前列腺液中和前列腺组织中分别为 78.9%和81.5%(P＞ 0.05).细菌基因信号在前列腺液标本中和尿道拭子中各有30例( 78.9%)和4例( 10.5%)呈阳性(P＜ 0.01);在前列腺组织中和直肠拭子中各有31例( 81.5%)和6例( 15.8%)呈阳性(P＜ 0.01),无一例穿刺枪头拭子阳性.结论:慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中均有细菌16SrRNA基因的检出,其病因可能与细菌感染有关. 细菌16SrRNA基因的检出在前列腺液标本和前列腺组织标本中差异无统计学意义.     

119例非淋菌性泌尿生殖道感染支原体培养及药敏分析

目的:了解非淋菌性泌尿生殖道感染患者中解脲支原体(UU)和人型支原体(MH)感染情况及对9种常用抗生素的敏感性.方法:男性患者刮取尿道分泌物或取前列腺液;女性患者取宫颈分泌物送检.并采用Mycoplasma IES支原体分离、鉴定、药敏成套试剂盒检验.结果:119例患者中,支原体检出阳性者36例( 30.2%),其中UU单独感染者32例( 88.9%),另4例为MH、UU混合感染( 11.1%).男性支原体培养阳性者32例( 28.6%,32/112);女性支原体培养阳性者4例( 57.1%,4/7).结论:进行支原体感染进行药敏检测,对指导临床用药有重要意义.     

男性尿道细胞学对性传染性疾病的检查

宫颈阴道涂片检查性传染性疾病已有许多报道,但男性尿道细胞学尚未被开发,作者对此加以研究,探讨宫颈阴道涂片中所看到的特异性改变是否也能在男性尿道涂片中被发现。材料和方法妇女生殖道感染的配偶以及人类免疫缺陷病毒血清检查阳性患者所提供的男性尿道细胞学检查共270例。方法是用特制微型拭子取样,将拭子轻轻扭动着插入尿道、至距尿道口2—4厘米时抽出拭子,制备涂片五张,湿片一张,其余     

男性泌尿生殖系统淋巴瘤临床病理分析

目的:探讨男性泌尿生殖系统淋巴瘤的临床病理特征和免疫表型。方法:回顾性分析35例男性泌尿生殖系统淋巴瘤的病理形态学和免疫组化标记,结合文献对其临床病理特点进行分析。结果:35例淋巴瘤患者的年龄4～83岁,平均年龄56.5岁,≥50岁者28例(80%)。发生于睾丸者最多,28例(80%),其次是前列腺3例(8.6%),精索、精囊、阴茎和附睾各1例(各2.9%)。组织学类型包括:弥漫性大B细胞淋巴瘤(DLBCL)22例(62.9%)、粘膜相关淋巴组织(MALT)淋巴瘤6例(17.1%)、Burkitt淋巴瘤4例(11.4%)、外周T细胞淋巴瘤2例(5.7%)和浆细胞瘤1例(2.9%)。结论:男性泌尿生殖系统淋巴瘤少见,多发生于中老年人,大多是B细胞淋巴瘤,以DLBCL最常见,其次是MALT淋巴瘤、Burkitt淋巴瘤,T细胞淋巴瘤和浆细胞瘤罕见,男性泌尿生殖系统淋巴瘤的确诊依赖组织病理学,免疫组化标记对明确诊断、分型和鉴别诊断具有肯定价值。     

不育男性支原体检测及药敏试验的样本选择

<正>生殖道感染是危害男性生殖健康的重要原因之一,大约15%的男性不育与此有关。用于支原体检测及药敏试验的样本有所不同,可以是精液、尿道分泌物或前列腺液。经尿道留取样本进行支原体检测,会造成尿道损伤而引起患者排尿疼痛、不适,从而使复查时取材依从性下降,为此,我们对220例不育男性患者的两种样本(精液、射精后尿道残留物)进行了研究,并对二者的阳性一致性及药物     

配偶宫颈HPV感染男性外生殖器HPV感染状况研究

目的:人类乳头瘤病毒(HPV)是女性发生宫颈癌的必要病因,也与男性阴茎癌、口咽癌、肛门癌等密切相关,但是目前对男性HPV的研究较少。本文研究配偶宫颈HPV感染男性外生殖器HPV感染状况,为临床制定HPV相关性疾病的防治措施提供科学依据。方法:收集2016年8~12月因配偶宫颈HPV感染阳性,南京医科大学附属妇产医院泌尿男科门诊就诊男性的相关资料。尼龙棉签拭子在阴茎头、冠状沟、包皮内板、阴茎体等处取样,运用凯普生物HPV分型检测试剂盒,采用PCR和膜杂交的方法,检测不同型别HPV感染情况。结果:去除不合格病例,共纳入139例患者信息。139例配偶宫颈HPV感染男性外生殖器HPV感染率为83.5%。HPV感染类型以6,16,39,18,58,52型为主,分别占43.2%(60/139)、19.4%(27/139)、10.1%(14/139)、9.4%(13/139)、9.4%(13/139)、9.4%(13/139)。在配偶宫颈HPV感染阳性的男性中,包皮过长比率高达75.5%,但包皮正常和包皮过长男性HPV感染率没有显著差异(P0.05)。结论:配偶宫颈HPV感染阳性的男性是HPV感染的高危人群,有必要对此类人群进行筛查和治疗,以降低男女双方的HPV感染。     

高通量二代测序技术在泌尿生殖道无乳链球菌筛查中的应用

目的探讨高通量二代测序技术(NGS)在泌尿生殖道无乳链球菌(GBS)筛查中的应用价值。方法运用高通量二代测序技术检测58份男性尿道分泌物、30份处女和20份孕妇阴道分泌物中的微生物,同时进行GBS荧光定量聚合酶链反应(FQ-PCR)和传统细菌培养鉴定。结果GBS在NGS中的检出率为18.5%(20/108),在FQ-PCR中的检出率为20.4%(22/108),在传统细菌培养鉴定中检出率为4.6%(5/108)。NGS与FQ-PCR两种分子生物学方法在男性尿道分泌物、处女和孕妇阴道分泌物GBS筛查鉴定中符合率为100%、30%和0%。男性尿道分泌物中的菌群数量最多,孕妇阴道分泌物中的菌群数量最少。男女泌尿生殖道均有瑞士乳酸杆菌、惰性乳酸杆菌、copri普雷沃菌、无乳链球菌、婴儿链球菌等相同菌群存在。结论高通量二代测序技术具有高通量、高准确度和高灵敏度的特点,适合微生物菌群及物种的筛选,男、女泌尿生殖道均有无乳链球菌定植,且菌群结构部分相同。     

江苏部分农村男性生殖道人乳头瘤病毒感染状况及危险因素调查

目的:调查江苏部分农村男性生殖道人乳头瘤病毒(HPV)的感染状况及感染危险因素。方法:选取前期进行宫颈细胞学检查的农村妇女的配偶为研究对象,根据女方宫颈细胞学检查结果分别选取正常组104例,宫颈上皮内瘤变(CIN)Ⅰ组100例,CINⅡ组95例,CINⅢ组99例。检查研究对象生殖器外观有无湿疣等病变,并用棉拭子采集研究对象生殖道脱落细胞进行HPV分型检测。采用调查问卷收集研究对象基本特征信息。结果:398例研究对象生殖器未见明显病变。HPV总检出率为11. 31%,高危型阳性率为8. 54%。Logistic回归分析显示每天清洗生殖器可显著减少男性生殖道HPV感染风险(OR=3. 030,P=0. 003)。结论:江苏部分农村"健康"男性中,有着相对较高的HPV隐性感染,每天清洗可能是HPV感染的一个保护因素。     

实时荧光核酸恒温扩增技术检测泌尿生殖道生殖支原体感染临床观察

目的:了解核酸实时荧光恒温扩增技术(SAT)检测泌尿外科、妇科、性病科门诊就诊患者生殖支原体(MG)感染情况。方法:回顾杭州市第三人民医院、绍兴市人民医院及东部战区总医院2018年1月至2018年12月在泌尿外科、男科、妇科、性病科门诊就诊的疑似泌尿生殖道感染的初诊患者5 711例,年龄16～73(38.77±11.32)岁,其中男性3 425例,女性2 286例;共采集尿液标本3 666例,泌尿生殖道分泌物标本2 095例,其中有50例患者同时采集了尿液及分泌物标本。以SAT检测检测患者MG感染,并同时行解脲脲原体(UU)、沙眼衣原体(CT)、淋病奈瑟菌(NG)检测。结果:5 711例患者中,294例患者MG阳性,阳性率5.15%;其中男性阳性率5.96%(206/3 425),女性阳性率3.85%(88/2 286),男性患者阳性率显著高于女性(P0.05)。50例同时采集了尿液及泌尿生殖道分泌物标本其检测结果一致性为100%。294例MG感染的患者中单纯MG感染患者占比52.04%,206例男性MG感染患者中,单纯MG感染占比63.11%,88例女性MG感染的患者中,单纯MG感染26.13%,男性单纯感染概率明显高于女性(P0.05)。混合感染中,男女均以MG合并UU感染占比最高,且女性MG合并UU感染占比高于男性(P0.05),按年龄分组比较,男女性均为≤20岁组MG阳性率最高,其中男性8.65%(9/104),女性5.13%(4/78),各年龄组MG阳性率有显著性差异(χ~2=32.74,P0.05)。结论:在门诊怀疑泌尿生殖道感染的就诊者中,男性MG感染阳性率高于女性, MG最常见的混合感染是MG合并UU感染,随着年龄增加,MG感染的阳性率逐渐降低;尿液与分泌物作为检测标本来进行SAT检测,其结果一致性较高。     

育龄男性泌尿生殖道解脲支原体和人乳头瘤病毒感染及影响因素分析

目的:了解育龄男性泌尿生殖道解脲支原体(UU)和人乳头瘤病毒(HPV)感染的情况,探讨可能的影响因素,为今后开展生殖道感染的预防提供科学依据。方法:2016年8月至2017年7月,采用分阶段整群抽样的方法,选择上海市松江区的工厂、企事业单位和服务场所的18～50岁的育龄男性,对其进行结构式问卷调查,并采集泌尿生殖道分泌物标本,分别采用培养法和PCR方法进行UU和HPV的检测。结果:本研究共纳入621例育龄男性,泌尿生殖道UU阳性率为44.93%(279/621),HPV感染率为2.90%(18/621),UU和HPV双重感染率为2.42%(15/621)。单因素分析显示吸烟者的UU感染率(50.54%,140/277)高于不吸烟者(40.41%,139/344);高中/技校研究对象HPV感染率(4.84%,12/248)略高于其他文化程度者。二元逐步Logistic回归分析发现:与初中及以下研究对象相比,大专及以上者UU感染的风险较低(OR=0.61,95%CI:0.39～0.96);吸烟者UU阳性的风险高于不吸烟者(OR=1.46,95%CI:1.01～2.01)。结论:上海松江地区育龄男性的UU感染率较高,HPV感染率较低。应加强对文化程度较低(初中及以下)、吸烟育龄男性的UU筛查,以期降低UU的阳性率。     

Diagnosis of bacterial vaginosis during pregnancy

OBJECTIVE.: To evaluate the sensitivity and specificity of the score and each one of the clinical criteria (pH, potassium hydroxide (KOH) test for amines, and clue cells) in relation to the Amsel's method. MATERIALS AND METHODS.: One hundred ninety vaginal exudates from pregnant women were studied from April to August 1997. The patients were examined in the Lower Genital Tract and Colposcopy Clinics of the Obstetrics Division at the University Hospital de Clínicas at the University of Buenos Aires, Argentina.The diagnosis of bacterial vaginosis (BV) was made by the presence of three or more of the following criteria: homogeneous vaginal discharge, pH >/= 4.5, positive KOH test for amines, and microscopic presence of clue cells. We also used the microscopic observation of coccobacilli forms in Gram stain (Nugent's method), diagnosing BV with a score >/= 7. RESULTS.: Nugent's method showed a sensitivity of 97% and specificity of 98%. The presence of clue cells showed a sensitivity of 92% and specificity of 97%. The sensitivity of the pH and KOH test for amines was 87% and 81%, whereas the respective specificity was 45% and 99%. CONCLUSIONS.: Because Nugent's method showed a very good specificity and sensitivity, it can be used as another method in the diagnosis of BV. The presence of clue cells diagnosed BV with better sensitivity and specificity than the other clinical criteria. In this way, we recommend the microscopic exam by Gram stain, using Nugent's method or the presence of clue cells, for diagnosing BV.     

Chronic prostatitis/chronic pelvic pain pyndrome): seminal markers of inflammation

The new prostatitis classification proposes the inclusion of seminal leukocytes in the diagnosis of inflammatory chronic pelvic pain syndrome (CPPS). The present study has been performed to clarify the role of seminal leukocytes and inflammatory seminal plasma parameters in order to contribute to the differential diagnosis between inflammatory (category IIIA) and non-inflammatory (category IIIB) CPPS. A total of 112 consecutive symptomatic patients (mean age 37.3 years; range 21-64) attending our prostatitis outpatient clinic were investigated. Men with evidence for bacterial infection were excluded by prior standardized lower urinary tract localization studies. Men were categorized into inflammatory and non-inflammatory CPPS according to the leukocyte analysis in expressed prostatic secretions (EPS) and urine after prostatic massage (VB 3). Ejaculate analysis was performed after lower urinary tract localization studies. Inflammatory markers included peroxidase positive leukocytes (PPL) and PMN-elastase. Receiver operating characteristic curves were constructed to analyze cutpoints provided that the differences were significant. Increased leukocyte counts in EPS/VB 3 were found in 64 men, while in 48 this was not the case. No differences could be detected in relation to patients' age ( P>0.05). In men with category IIIA prostatitis, PPL and elastase in the seminal fluid were significantly increased ( P<0.001). For PPL and elastase, a cutpoint of 0.113 x 10(6)/ml and 280 ng/ml, respectively, were suggested. Increased PPL (>0.113 x 10(6)/ml) and elastase (>280 ng/ml) in the seminal fluid indicate inflammatory disease provided that the ejaculate analysis is performed on the same day after lower urinary tract localization studies.     

The characterization of nonbacterial prostatitis: search for an etiology.

Nonbacterial prostatitis is often difficult to differentiate from other prostatic complaints and remains a vaguely characterized syndrome. Prostatic fluid inflammatory cells and elevated immunoglobulins raise the suspicion that this syndrome is caused by some undetected infection. Prostatic fluid antibodies against Chlamydia trachomatis, Ureaplasma urealyticum, staphylococcus, Staphylococcus faecalis, Bacteroides fragilis and Clostridium perfringens were measured in men with nonbacterial and bacterial prostatitis, and men without urinary symptoms by an enzyme-linked immunosorbent assay. Prostate specific antigen and prostatic acid phosphatase were measured in the prostatic fluid as indirect measures of secretory activity. Of 44 men with nonbacterial prostatitis 9 (20%) had detectable prostatic fluid antichlamydial antibody titers, compared with 3 of 25 control men (12%) and 2 of 13 (15%) with bacterial prostatitis--no evidence for a higher prevalence of prostatic fluid antichlamydial antibody in men with nonbacterial prostatitis. Prostatic antibodies to the other organisms were rarely detected. When compared with unaffected men the low levels of prostate specific antigen and prostatic acid phosphatase, and more alkaline prostatic fluid in men with bacterial and nonbacterial prostatitis suggest that secretory dysfunction accompanies the inflammation. These data show that none of the organisms studied caused the majority of the cases of nonbacterial prostatitis and that either an agent as yet unidentified or multiple agents may be involved in the etiology of nonbacterial prostatitis.     

Acute and chronic bacterial prostatitis due to E. coli

Summary Inoculation of Escherichia coli (serotype O:6) into the bladder of male and female Mastomys (Praomys) natalensis produced severe prostatitis. In this rodent both male and female animals possess a well developed prostatic gland. The histologic and microbiologic course of the prostatic infection resembled strongly the human disease. Acute bacterial prostatitis was followed by the development of chronic bacterial or nonbacterial prostatitis. The infection persisted in some animals for up to six months. Prostatitis was observed histologically in all animals sacrificed six months postinfection. Animals responded to the infection with a rise of anti-lipopolysaccharide antibodies. No major morphologic differences were detected in the histologic pattern of the inflammatory process between animals with positive and negative bacterial cultures and between male and female animals.     

男性人乳头瘤病毒检测方法的建立及临床应用

目的:建立一种适合临床男性人乳头瘤病毒(HPV)基因亚型检测的新方法,并通过检测棉拭子采集男性尿道口分泌物来验证该方法的临床检测效果。方法:通过计算机辅助,参考经典通用引物(MY09/11)和加以改进的PGMY09/11设计23种HPV基因亚型的PCR扩增引物,根据GenBank中的HPV的型特异性序列设计及合成探针,制备可同时对18种高危型:HPV-16,18,31,33,35,39,45,51,52,53,56,58,59,66,68,73,83,MM4和5种低危型:6,11,42,43,44进行分型检测的特定纸质膜芯片,并且对112例采用棉拭子采集的男性尿道口分泌物进行检测加以验证,同时,对单一阳性标本进行测序验证,对标准品进行灵敏度检测。结果:112例男性尿道口分泌物中检测出25例HPV阳性标本,其中单一HPV亚型感染13例,多重感染12例,检测出的男性HPV基因亚型有:HPV-6,11,16,18,33,35,43,56和73型九种。灵敏度可达10个拷贝HPVDNA分子。结论:该方法适用于临床进行男性HPV感染的诊断以及为开展相应的流行病、病因学调查提供切实可行的检测手段。     

内毒素测定评价预防性抗生素在前列腺穿刺活检中的应用价值

目的 :探讨内毒素 (ET)测定在评价经直肠前列腺穿刺活检的感染危险性和预防性抗生素中的应用价值。方法 :4 8例患者随机分成无预防性处理组 (A组 ,12例 )、预防性抗生素组 (B组 ,13例 )、术前灌肠组 (C组 ,12例 )和联合处理组 (D组 ,11例 )共 4组 ,穿刺前、后分别留取血液和尿液 ,用于细菌培养和ET测定。其中ET采用鲎试验的偶氮显色法 (LQACT)测定。　结果 :前列腺穿刺前、后各组血清ET浓度变化和血培养结果无统计学意义 (P >0 .0 5 ) ;A和B组穿刺后尿ET明显升高 (P <0 .0 5 ) ,而C和D组无明显升高 (P >0 .0 5 ) ;A和B组穿刺后尿培养细菌阳性率明显增高 (P <0 .0 5 ) ,而C和D组无明显增高 (P >0 .0 5 )。　结论 :前列腺穿刺活检引起内毒素血症可能性很小 ;术前灌肠和 /或联合预防性抗生素可减少前列腺穿刺引起尿路感染 ;血液、尿液ET测定对经直肠前列腺穿刺活检所致感染的诊断意义较大。     

Bacteria in the chronic prostatitis-chronic pelvic pain syndrome: molecular approaches to critical research questions

PURPOSE: There is a pressing need to determine the causes and consequences of, and optimal therapy for the chronic prostatitis-chronic pelvic pain syndrome. MATERIALS AND METHODS: New data suggest that bacterial infection may be critical in some patients. We examined the rationale for and technical approaches to hypothesis driven studies of bacteria in the chronic prostatitis-chronic pelvic pain syndrome. RESULTS: The first hypothesis was that patients with the chronic prostatitis-chronic pelvic pain syndrome have prostatic bacteria that distinguish them from controls. In pilot studies patients with inflamed expressed prostatic secretions were more likely to have bacterial DNAs, that is 16S ribosomal DNAs. Current goals are to clone, sequence and compare ribosomal DNAs from patients and controls to determine which bacteria are most specific to the chronic prostatitis-chronic pelvic pain syndrome and which should be targeted in clinical trials. The second hypothesis was that bacterial viability correlates with the severity of the chronic prostatitis-chronic pelvic pain syndrome. Quantitative assays for bacterial elongation factor messenger RNA (tufA messenger RNA) provide tools to correlate bacterial viability with patient characteristics, will provide insights into the potential value of antimicrobial therapy and identify characteristics that distinguish patients most likely to respond. The third hypothesis was that patients with prostatic bacteria have similar bacteria in expressed prostatic secretions or on seminal fluid analysis and, furthermore, these bacteria differ from bacteria in controls. These studies would determine whether expressed prostatic secretions or seminal fluid analysis can be used to identify prostatic bacteria and may result in clinical methods for noninvasive diagnosis of prostatic infection. CONCLUSIONS: These studies should provide important insights into the causes of the chronic prostatitis-chronic pelvic pain syndrome and may elucidate optimal clinical evaluation and treatment in patients.     

Usefulness of oral wash specimens for detecting Chlamydia trachomatis from high-risk groups in Japan

Orogenital sex is recognized as a route for the transmission of Chlamydia trachomatis (CT) which thus causes male chlamydial urethritis. Patients with a pharyngeal CT infection have no gross lesions, but CT was tested by pharyngeal swabs. In this study, the usefulness of oral wash specimens for detecting CT was compared to that of swab specimens. In addition, oral wash specimens were also used to screen for CT pharyngeal infection. Eighteen female commercial sex workers in whom CT was detected from pharyngeal swabs were re-examined using both methods. The positive rate for CT was 44% by swabs and 61% by oral wash specimens. Forty-eight male students with CT-positive urine were also screened for pharyngeal CT infection. The positive rates were 6% by swabs and 10% by oral wash specimens. Our findings therefore indicate that oral wash specimens more effectively detected pharyngeal CT infection than pharyngeal swabs.     

Accurate detection of male subclinical genital tract infection via cervical culture and DNA hybridization assay of the female partner

The accuracy of the PACE2 DNA hybridization assay of the cervix and cervical culture in female partners for the diagnosis of male subclinical genital tract infection were assessed in a male infertility population. A total of 184 men were screened for the presence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis. Seventy-one men were identified with a positive test for one or more of the above mentioned micro-organisms. The overall prevalence of bacterial infection was 39%. Female partners of all men were tested with the PACE2 DNA hybridization assay to detect a C. trachomatis infection. Sensitivity was 100% and specificity was 100%. In 67 female partners (94%) of men who tested positive for U. urealyticum and/or M. hominis, a cervical swab culture was performed. The sensitivity of the cervical swab culture was 100%. In view of the high prevalence of U. urealyticum and M. hominis in the male genital tract and the role these sexually transmitted pathogens may play in infertility, one might question whether all couples should be screened for the presence of these pathogens. Transurethral swab culture after digital prostatic massage is disincentive to men. The cervical culture in their female partner, performed as part of the routine fertility work-up, is a suitable alternative to detect the presence of these micro-organisms in the male genital tract.