我国六城市性病高危人群生殖支原体感染状况的分子流行病学研究

目的　对我国部分地区不同类型的性病人群进行生殖支原体 (Mg)感染状况检测分析 ,以明确Mg感染在非淋菌性尿道炎中的可能致病作用。 方法　采用两对引物的聚合酶链反应技术 ,根据Mg粘附蛋白基因及支原体种属内核糖体基因序列设计引物 ,收集广东、昆明、上海、南京、常州等地性病门诊和 (或 )性罪错者的泌尿生殖道分泌物标本。结果　性病高危人群的Mg DNA检出率明显高于正常体检组 ( χ2 =7 82 2 ,P <0 0 1) ,其中广东性病门诊及昆明性罪错人群的Mg DNA检出率明显高于南京、上海、常州等地两种人群的检出率 ( χ2 =8 5 3 6,P <0 0 1及 χ2 =5 885 ,P <0 0 5 )。未查到其他相关病原体者亦可查及Mg DNA ;有Mg感染者亦可同时感染其他微生物 ,如衣原体、解脲支原体等 ;有尿道炎症状病例中Mg DNA的检出率高于无尿道炎症状者 ( χ2 =11 667,P <0 0 1)。结论　性病高危人群中存在生殖支原体的感染 ,在不同地区不同类型人群组中Mg感染率有一定差异     

我国六城市性高危人群生殖支原体感染状况的分子流行病学研究

目的 对我国部分地区不同类型的性病人群进行生殖支原体感染状况检测分析，以明确Ｍｇ感染在非淋菌性尿为中的可能致病作用。方法 采用两对引物的聚合酶链反应技术，根据Ｍｇ粘附蛋白基因及支原体种属内核糖体基因序列设计引物，收集广东，昆明，上海，南京，常州等地性病门诊或性罪错者的泌尿生殖道分泌物标本。     

1847例性病门诊患者支原体感染及药敏结果分析

目的了解本地区近年性高危人群泌尿生殖道支原体感染情况及对不同药物的耐药情况。方法对1 847例2014年10月至2016年9月到我院性病门诊就诊患者支原体分离培养鉴定结果及药敏试验结果进行回顾性统计分析。结果 1 847份标本有790例支原体阳性,阳性率42.77%,男性患者感染率为28.18%,女性患者感染率为61.88%,女性患者支原体感染率为男性患者的2.22倍。790例阳性标本中UU感染579例,占所有阳性标本73.29%,MH单项感染29例,占3.67%,UU+MH混合感染182例,占23.04%。药敏试验结果显示,无论UU、MH单项感染或UU+MH混合感染均对四环素族的美满霉素和强力霉素保持较高的敏感性,耐药率较低,对喹诺酮类的氧氟沙星、左旋氧氟沙星、司帕沙星敏感性较低,耐药率较高。结论本地区性病门诊患者泌尿生殖道支原体感染以UU感染为主,建议临床在对支原体感染者用药前选择进行支原体分离培养及药物敏感试验,对于无条件或未做药物敏感试验的支原体感染者,建议选择美满霉素和强力霉素等对支原体敏感性较高的抗菌药作为支原体治疗的首选药物。     

生殖支原体及解脲脲原体在男性不同人群中的感染与定植研究

目的了解生殖支原体及解脲脲原体在男性不同人群中的流行状况,分析生殖支原体及解脲脲原体与男性非淋菌性尿道炎的相关性。方法病例对照研究结合横断面研究,采集性病门诊非淋菌性尿道炎患者、性病门诊无尿道炎的就诊者、男男性接触者及健康体检者4组人群的尿道拭子标本,运用培养法和套式PCR法检测解脲脲原体,套式PCR和产物DNA测序检测生殖支原体。结果生殖支原体检出率非淋菌性尿道炎患者组为25.0％,无尿道炎的就诊者组6.4％,男男性接触者组5.5％,健康体检者组未检出。各组与健康体检者组比较差异均有统计学意义,而非淋菌性尿道炎患者与无尿道炎的就诊者、非淋菌性尿道炎患者与男男性接触者比较,P均<0.01,无尿道炎的就诊者与男男性接触者比较,P>0.05。多因素回归分析发现,尿道炎与生殖支原体阳性率显著相关,P=0.004,OR=6.754,95％CI1.833～24.893。解脲脲原体PCR阳性率在非淋菌性尿道炎患者、无尿道炎的就诊者、健康体检者组间差异无统计学意义。男男性接触者组的解脲脲原体阳性率明显低于其他三组。结论生殖支原体与非淋菌性尿道炎高度相关,男性高危性行为人群中生殖支原体的感染率较普通人群高。解脲脲原体定植在男性非淋菌性尿道炎患者、性行为高危人群及普通人群间无差异,与非淋菌性尿道炎无相关性。     

性病门诊患者生殖支原体感染的检测

生殖支原体(ｍｙｃｏｐｌａｓｍａｇｅｎｉｔａｌｉｕｍ,Ｍｇ)在1981年首次从2例男性ＮＧＵ患者的尿道分泌物中分离培养成功,它可能是急、慢性ＮＧＵ、慢性非细菌性前列腺炎、盆腔炎症性疾病的病原体之一[1～5]因为Ｍｇ培养困难,为探讨性病高危人群Ｍｇ的感染情况,我们建立了Ｍｇ的聚合酶链反应(ＰＣＲ)检测方法,并对236例泌尿生殖道标本进行了检测,结果报告如下。1材料与方法11　标准株:肺炎支原体ＦＨ株、人型支原体、解脲支原体、口腔支原体、唾液支原体均由首都儿科研究所惠赠;生殖支原体Ｇ37来源于衡阳医学院微生物教研室;金葡菌ＡＴＣ…     

生殖支原体与黏液脓性宫颈炎相关性的研究

目的 探讨生殖支原体与女性非衣原体非淋球菌感染的黏液脓性宫颈炎的相关性。方法 对象包括性病门诊就诊的女性非衣原体非淋球菌感染的黏液脓性宫颈炎患者226例及健康体检人群118例。采集宫颈拭子标本，运用PCR检测生殖支原体。一般情况、病史和性行为等采用问卷调查。结果生殖支原体在非衣原体非淋球菌感染的黏液脓性宫颈炎患者中的检出率为11.06%（25/226），健康体检人群中的检出率为0.85%（1/118），两组间差异有统计学意义（χ2 = 11.58，P < 0.001）。分析226例黏液脓性宫颈炎患者显示，有异位妊娠史、宫颈糜烂、附件压痛及宫颈内管分泌物镜检多型核白细胞≥10个/油镜视野的患者生殖支原体的感染率分别为27.78%，16.36%，18.28%，14.12%，而无异位妊娠史、宫颈糜烂、附件压痛及宫颈内管分泌物镜检多型核白细胞 < 10个/油镜视野的患者分别为9.62%，6.03%，6.02%，1.79%，生殖支原体的感染率差异在四组人群间均有统计学意义（P < 0.05），而多性伴数和宫颈口有黏液脓性分泌物在两组间差异均具有统计学意义（P < 0.01）。结论 性病门诊就诊的非衣原体非淋球菌感染黏液脓性宫颈炎患者中，生殖支原体感染率高于普通人群。     

体检和性罪错人群宫颈中解脲脲原体的检测

目的了解解脲脲原体(Uu)在体检人群和性罪错人群的宫颈检出情况及生物分群分型。方法用支原体液体选择培养基筛查妇科体检人群和性罪错人群,对阳性标本再用PCR法进行生物分群分型。结果性罪错人群共筛查了卖淫妇女98例,体检人群共筛查了体检妇女164例。性罪错组中Uu液体培养阳性89例(90.8%),其中生物1群64例(71.9%),1+2群7例(7.9%),2群18例(20.2%);71例生物1群阳性的标本中,以血清1、3、6、14型两个或两个以上的同时感染为混合感染,以血清1、3、6、14型的单独感染为单纯感染。性罪错组中混合感染17例(23.9%),单纯感染54例(76.1%);54例单纯感染中血清1型17例(31.5%),3型22例(40.7%),6型15例(27.8%)。体检人群组中Uu液体培养阳性104例(63.4%),其中生物1群97例(93.3%),2群7例(6.7%);97例生物1群阳性的标本中,混合感染11例(11.3%),单纯感染86例(88.7%),86例单纯感染中血清1型22例(25.6%),3型37例(43.0%),6型27例(31.4%)。结论Uu在性罪错人群中的检出率高于体检人群(P<0.01),在Uu培养阳性的标本中,生物2群的检出率性罪错人群高于体检人群(P<0.01),在Uu生物1群阳性的标本中,混合感染的检出率性罪错人群高于体检人群(P<0.05),而生物1群中各血清型的单纯感染两组间没有统计学差异。     

南汇区991例性罪错人员性病流行病学分析

目的：了解南汇区看守所在押性罪错人员性传播疾病感染情况。方法：对2006～2008年南汇区看守所在押991例性罪错人员进行问卷调查、体格检查及性传播疾病实验室检测,收集相关资料进行流行病学分析。结果：991例性罪错人员检出性传播疾病173例,感染率为17.46%;女性检出率高于男性。结论：性罪错人员作为传播性传播疾病的高危人群,必须加强对该类人群的性病流行病学监测及干预。     

济南市332例性罪错妇女性传播感染检测结果分析

性罪错妇女是性传播疾病（STD）、AIDS的高危人群，其性病病原体检出率常高于一般人群。为了解近年来济南市性罪错妇女性病感染情况，我们于2004年9月～2005年11月对济南市公安局收容教育所卖淫妇女泌尿生殖道分泌物、血液进行检测，结果如下。     

性病患者及性罪错者HIV流行病学监测及高危因素研究

目的：了解ＳＴＤ患者和性罪错人群中ＳＴＤ／ＨＩＶ感染的危险因素,以便制订了ＳＴＤ／ＨＩＶ的控制对策。方法：所有人选的ＳＴＤ患者及男女性罪错者,采用匿名问卷方式,然后应用ＲＷＢ或ＥＬＩＳＡ法对其进行ＨＩＶ抗体和其他有关性病的实验室检测。结果：应用ＲＷＢ和ＥＬＩＳＡ法分别对９７４例和２０２６例检测ＨＩＶ抗体,结果均阴性,但发现了一些危险因素,包括多性伴、非保护性接触及梅毒硬下疳。结论：虽然目前山东ＨＩＶ感染的流行率较低,但感染的危险因素尤其在高危人群中应予重视。     

泌尿生殖道生殖支原体分离及PCR电镜鉴定的实验研究

目的联合采用培养、电镜观察及ＰＣＲ检验技术,对沪、宁两地部分高危人群的泌尿生殖道分泌物标本进行分离及鉴定。方法沪宁受检者７１例,宫颈或尿道口内拭子分泌物接种于５ｍｌＳＰ－４培养基３７℃培养。对初代分离的阳性株用ＰＣＲ技术进行扩增以鉴定ＭＧ ＤＮＡ。对阳性株再行电镜负染观察其形态特征。结果７１份标本中培养分离出２株ＭＧ,分离率为２．８２％。分离培养的阳性株满足ＭＧ生长代谢的基本特性,ＰＣＲ在标本及培养物中均可扩增出特异性序列片段;电镜下呈现ＭＧ特征性外观,可呈烧瓶状、鸭梨状或纺锤状。结论采用培养方法可在高危人群中分离ＭＧ感染株,其分离株具生长时间长,需特制培基和特殊生化反应性能,具特征性外观形态等。     

Mycoplasma genitalium: prevalence, clinical significance, and transmission

OBJECTIVES: To study the prevalence, symptoms and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in STD clinic attendees and in partners of M genitalium infected patients. METHODS: M genitalium and C trachomatis were detected by polymerase chain reaction from urethral and endocervical swab specimens in a cross sectional study among 445 female and 501 male STD clinic attendees. Partners of 26 female and 26 male M genitalium positive index patients were examined. RESULTS: The prevalence of C trachomatis and M genitalium was 4% and 6.3%, respectively, among the women and 5.4% and 6%, respectively, among the men. Dual infections were uncommon. M genitalium was strongly associated with urethritis in both men and women and with cervicitis in women. Among M genitalium infected men, symptomatic urethritis was more common than asymptomatic urethritis. M genitalium and C trachomatis were not associated with symptoms of urethritis or cervicitis in women. Of 26 male partners of M genitalium positive female index patients, 38% were positive, and 77% of the negative partners had symptoms of urethritis. The concordance rate for 22 female partners of male index patients was 45%. For both men and women the M genitalium prevalence was significantly higher in partners of M genitalium positive index patients than in M genitalium negative index patients with urethritis and/or cervicitis. CONCLUSIONS: M genitalium is associated with urethritis in both men and women and with cervicitis in women. A high concordance rate was found among sexual partners of M genitalium infected patients, indicating that the infection is sexually transmitted.     

Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis

OBJECTIVES: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in men attending a Swedish STD clinic and to study the criteria for urethritis. METHODS: A cross sectional study among STD clinic attendees in Orebro, Sweden. Attendees were examined for microscopic urethritis and first void urine (FVU) was tested for M genitalium and C trachomatis. RESULTS: The prevalence of M genitalium and C trachomatis was 7% (34/512) and 12% (61/512), respectively. Dual infection was diagnosed in four men. In both infections 90% of the patients had signs of microscopic urethritis. M genitalium positive men had symptomatic urethritis significantly more often than those infected with C trachomatis (73% v 40%, RR 1.8; 95% CI 1.2 to 2.7). 63% of female partners of men infected with M genitalium were infected with M genitalium compared with chlamydial infection in 67% of female partners of men infected with C trachomatis. Non-chlamydial non-gonococcal urethritis without evidence of M genitalium infection was diagnosed in 180 men (35%). Symptoms and/or visible discharge were reported in 49% in this group. CONCLUSIONS: M genitalium is a common infection associated with symptomatic urethritis and with a high prevalence of infected sexual partners supporting its role as a sexually transmitted infection.     

生殖支原体感染与女性黏液脓性宫颈炎相关性研究

目的建立生殖支原体Taqman MGB荧光聚合酶链反应(PCR)检测方法,检测宫颈炎患者生殖支原体感染情况,以期发现生殖支原体感染与女性黏液脓性宫颈炎之间的相关性。方法参照国内、外文献建立Taqman MGB荧光PCR检测技术;采集大连市皮肤病医院性病门诊有黏液脓性宫颈炎的女性患者生殖道分泌物标本74例、体检中心对照组标本63例,应用上述检测方法检测标本中的生殖支原体。结果 Taqman探针荧光PCR法敏感性和特异性均较好。黏液脓性宫颈炎患者生殖支原体阳性率为24.3%,对照组未检测出生殖支原体;除不孕以外其他几项调查内容包括尿道炎症状、非婚性接触史、复发性宫颈炎以及治疗史均与生殖支原体感染有关联(P0.001),其阳性率分别为17.6%、52.9%、42.5%、100%。结论 Taqman MGB荧光PCR法是目前较为适用的生殖支原体检测方法。生殖支原体感染可能是黏液脓性宫颈炎的致病因素;生殖支原体的检测在指导复发性宫颈炎的治疗中有较为重要的意义。     

Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection

OBJECTIVES: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme. METHODS: A cross sectional study among female STD clinic attendees in Orebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis. RESULTS: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80). CONCLUSIONS: M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection.     

Mycoplasma genitalium: a cause of male urethritis?

BACKGROUND--Male urethritis may be caused by mycoplasmas. Since Mycoplasma genitalium has previously been isolated from the urethra of two men with non-gonococcal urethritis (NGU), it was the aim of the study further to elucidate its role by measuring the prevalence of this organism in men with NGU. MATERIAL AND METHODS--The polymerase chain reaction was used. Two different sequences of the gene coding for the main adhesin MgPa were amplified. Urethral, rectal, and throat samples from 99 male sexually transmitted disease (STD) patients with and without urethritis were studied. RESULTS--M genitalium DNA was demonstrated in 17/99 (17%) of the urethral swabs, but in none of the rectal and throat swabs. Significantly more patients with urethritis (13/52) were positive for M genitalium DNA than were patients without urethritis (4/47) (p < 0.03). In those with urethritis M genitalium DNA was found more often in Chlamydia trachomatis negative NGU (12/34) than in those with chlamydial NGU (1/14) (p = 0.05). Attempts to culture M genitalium from the PCR positive specimens were unsuccessful. CONCLUSION--M genitalium DNA was found significantly more often in male STD patients with non-chlamydial NGU than in men with chlamydial urethritis (p = 0.05) and in men without urethritis (p = 0.003), suggesting that M genitalium may be a cause of NGU. M genitalium DNA was not demonstrated in any of the throat or rectal swabsindicating that the urogenital tract is probably the primary site of infection or colonisation of this species.     

451例STD患者的生殖支原体感染

为了解性传播疾病（STD）患者中感染生殖支原体（Mg)的状况及其临床意义，在本所的STD门诊部收集451例患者的尿道（宫颈）分泌物作了Mg检测。标本接种于改良的SP－4培养基作Mg分离培养，并同时用聚合酶链反应（PCR）进行Mg检测，以PCR结果作为最终判断依据。患者中69例非淋病性尿道炎（NGU）病人还作了咽部拭子的Mg检测。结果证明，Mg阳性患者有67例（14．9％），其中NGU 59例（20．6％），其他STD仅8例（4．9％），二者差异有统计学显著性（P＜0．0001），表明Mg感染与NGU发生关系密切。尿道（宫颈）分泌物及咽拭子同时检测Mg的69例NGU病人中，7例在二部位均检出Mg，提示有口淫的可能性。     

Seroepidemiologic study of hepatitis C virus in sexually transmitted disease risk groups.

To identify the importance of heterosexual activity as a possible route for the transmission of the hepatitis C virus (HCV), a screening of antibodies against HCV (anti-HCV) was performed in 200 sexually transmitted disease patients with different risks for incurring genital infections as well as in 100 registered prostitutes. Out of all 300 persons tested, 14 cases of HCV infection were detected. Anti-HCV was present in 3 of the prostitutes and in 11 of the STD patients. Evaluating known risk factors, such as intravenous drug use or blood transfusion, 6 out of the 11 STD patients and all of the prostitutes in whom anti-HCV was present were intravenous drug users and exhibited highly promiscuous behavior. Intravenous drug use was the probable means of acquisition in 9 of the 14 subjects in whom anti-HCV was present, and homosexual promiscuous behavior was assumed to be the means of acquisition in another 2 subjects. In heterosexual patients engaging in high-risk behavior (high number of sexual partners and genital infections), the exclusion of intravenous drug use decreased the prevalence of anti-HCV from 12.1% to 4.1%, demonstrating no significant increase from the prevalence among low-risk persons. Most of the patients were screened for STDs, such as syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, human immunodeficiency virus (HIV), hepatitis B virus (HBV), trichomoniasis, and yeast infections. The highest rate of coinfection with anti-HCV was found in patients with serologic evidence of an HIV infection (50%).(ABSTRACT TRUNCATED AT 250 WORDS)     

High prevalence of Mycoplasma genitalium in the lower genitourinary tract of women attending a sexually transmitted disease clinic in Paris,France

BACKGROUND: Previous studies have suggested that Mycoplasma genitalium is associated with cervicitis and may be a cause of pelvic inflammatory disease. This study attempted to investigate further the possible role of M genitalium in genital symptoms of women attending a sexually transmitted disease (STD) clinic. GOAL: To determine the prevalence of and the association of clinical and microbiologic features with M genitalium in women presenting with genital symptoms. STUDY DESIGN: Between April 1994 and June 1996 a prospective study of 170 consecutive women with abnormal vaginal discharge, with or without urethral itching, dysuria, or pelvic pain, was conducted at the STD clinic at Saint-Louis Hospital in Paris. Information was collected on each subject's characteristics, and a clinical vulvar, vaginal, and cervical examination was performed. Cervical, vaginal, and urethral samples were obtained to identify infecting organisms. RESULTS: DNA of M genitalium was identified by polymerase chain reaction (PCR) at one or more genital sites in 65 women (38%; 95% CI, 31-46%) and was statistically more frequently detected in the vagina (39%) than in the cervix (21%) or urethra (28%) (P = 0.001 and 0.048, respectively). PCR inhibitors were detected in 17 specimens (4%). M genitalium was found in 6/14 (43%) positive for Chlamydia trachomatis, but no significant association between M genitalium and any demographic, clinical, or microbiologic data was noted in univariable or multivariable analysis. CONCLUSION: This study indicates that M genitalium is frequently encountered in the female genital tract and is not associated with cervicitis or any particular clinical or microbiologic data.