性病门诊尿道/阴道炎患者阴道毛滴虫检测结果分析

目的研究性病门诊中阴道毛滴虫的检验方法,了解其感染状况。方法对383例尿道/阴道炎患者的尿道(阴道)分泌物同时采用湿片观察和培养法进行阴道毛滴虫(TV)的检测。结果在383例尿道/阴道炎患者中TV检出率为8.09%,其中男性尿道炎患者TV的检出率为零,明显低于女性阴道炎患者的21.68%(χ2=56.6,P<0.001),方法学比较显示女性TV检出率湿片检查法(18.18%)和培养法(21.68%)无明显差别(χ2=0.47,P>0.01)。结论性病门诊中TV的感染率占一定比例,均为女性感染;联合采用湿片检查法和培养法来检查阴道毛滴虫可提高检出率。     

前列腺及尿道分泌物中支原体检测男性泌尿生殖系统感染分析

目的:探讨前列腺及尿道分泌物中支原体检测和男性泌尿生殖系统感染的关系。方法:共收集在上海市浦东新区光明中医院泌尿科门诊就诊的男性共270例,通过检测其前列腺液和尿道分泌物中解脲支原体(Uu)和人型支原体(Mh)的感染率,以及泌尿生殖系统炎症的检出率,分析前列腺及尿道分泌物中支原体检测和男性泌尿生殖系统感染的关系。结果:所有研究对象中Uu检出58例,总检出阳性率21. 48%; Mh检出76例,总检出阳性率28. 15%;支原体(Un+Mh)检出98例,总检出阳性率36. 30%;泌尿生殖道炎症检出173例,总检出阳性率64. 07%;炎症组总Uu检出率、总Mh检出率、总Uu+Mh检出率均高于非炎症组,且差异有统计学意义(χ~2=4. 725,P=0. 029;χ~2=5. 859,P=0. 015;χ~2=15. 09,P=0. 0001);炎症组的尿道分泌物Uu检出率和Uu+Mh检出率高于非炎症组且差异有统计学意义(χ~2=6. 227,P=0. 013;χ~2=5. 461,P=0. 019)。炎症组的前列腺液Mh检出率和Uu+Mh检出率高于非炎症组,且差异有统计学意义(χ~2=5. 877,P=0. 015;χ~2=15. 09,P=0. 0001);在炎症组中慢性前列腺炎,非淋菌性尿道炎,睾丸/附睾炎三种疾病的Uu检出阳性率有统计学差异(χ~2=19. 614,P=0. 0001);三种疾病的Uu+Mh检出阳性率差异有统计学意义(χ~2=16. 802,P=0. 0001)。结论:在泌尿系统炎症的患者的前列腺及尿道分泌物支原体的检出阳性率较高。     

巢式聚合酶链反应检测男性尿道炎患者尿液中阴道毛滴虫

目的 建立两种巢式聚合酶链反应（PCR）方法检测男性尿道炎患者尿液中阴道毛滴虫感染状况,评价两种巢式PCR在临床诊断中的应用价值。 方法 2011年4月至2013年12月来我院性病门诊就诊的1 088例男性尿道炎患者为研究对象,收集尿道拭子标本做分泌物涂片镜检、阴道毛滴虫湿片检测以及淋球菌培养,同时收集尿液标本提取DNA,针对阴道毛滴虫重复基因组和β微管蛋白基因,采用两种巢式PCR法检测尿液中阴道毛滴虫。 结果 湿片法检测阴道毛滴虫的阳性率为0,而两种巢式PCR法均检测出29例阳性标本,阳性率为2.67%,且两种巢式PCR法检测出的阳性标本一致。 结论 与湿片法相比,巢式PCR法检测男性尿液标本阴道毛滴虫具有较高的灵敏度和特异性。     

培养法及聚合酶链反应检测男性非淋菌性尿道炎患者中阴道毛滴虫

目的：研究男性非淋菌性尿道炎（NGU）患者中阴道毛滴虫感染的状况;评价尿液及尿道拭子聚合酶链反应（PCR）检测阴道毛滴虫感染的敏感性和特异性,建立一种非侵入性检测男性阴道毛滴虫感染的方法。方法：共收集105例患者。每例取2份尿道拭子标本,分别进行InPouchTV培养和PCR检测;取1份尿液标本进行PCR检测。以培养法为“金标准”,将两种PCR法与之比较,分别计算其敏感性、特异性、阳性预测值和阴性预测值。结果：InPouchTV培养法检出率为4．76％（5／105）;尿液PCR法检出率为3．81％（4／105）;尿道拭子PCR法检出率为4．76％（5／105）。尿液PCR法和尿道拭子PCR法的敏感性,特异性,阳性预测值和阴性预测值分别为80％．100％、100％、99％和80％、99％、80％、99％。结论：阴道毛滴虫感染是男性NGU的病因之一,在本研究中,阴道毛滴虫感染在男性NGU中的检出率为4．76％。尿液PCR法具有较高的敏感性和特异性且适用于非侵入性标本的检测,是具有临床应用价值的检测阴道毛滴虫的方法。     

性病门诊患者泌尿生殖道分泌物单纯疱疹病毒的检测及临床特点分析

目的:探讨性病门诊患者泌尿生殖道单纯疱疹病毒(HSV)感染的临床特点。方法:应用酶联免疫吸附试验(ELISA)对性病门诊患者泌尿生殖道分泌物及周围病损渗出液和疱液进行HSV检测。结果:1848例标本应用ELISA法检测HSV。1077例男性尿道分泌物中,伴生殖器疱疹(GH)者(47.9%,227/474)HSV阳性率高于不伴GH者(27.2%,55/202);771例女性中伴GH者宫颈分泌物(34.8%,103/296)HSV阳性率高于不伴GH者(20.7%,76/367)。男性尿道及女性宫颈分泌物HSV阳性率均低于病损渗出液和疱液阳性率。病损渗出液和疱液不同病期HSV阳性率对比,病期<3d者明显高于病期≥4d者。泌尿生殖道分泌物HSV阳性78例,同时并发其他性病病原体阳性312例(39.7%)。结论:在性病患者中部分无GH者的泌尿生殖道分泌物中可检测到HSV感染,且可并发其他性病病原体感染,对无GH的性病患者进行HSV检测是十分必要的。     

儿童泌尿生殖道沙眼衣原体、解脲脲原体的检测及其意义

目的 探讨儿童泌尿生殖道沙眼衣原体（Ct）、解脲脲原体（Uu）等病原体的感染情况。方法 对门诊就诊的155例儿童，取尿道分泌物、阴道分泌物检测炎症细胞、Ct、Uu、淋球菌（Ng）、念珠菌、阴道毛滴虫、蛲虫卵。结果 22例女童阴道分泌物检出白细胞（WBC）阳性，Q检出率6．45％（10／155），Uu检出率22．58％（35／155），检出淋球菌2例（1．29％），念珠菌2例（1．29％），蛲虫卵3例（1．94％）。结论 对儿童泌尿生殖道炎症，要注意查找性病因素。儿童泌尿生殖道内存在Ct、Uu健康携带或正常定植情况。     

Microtrak Ⅱ EIA法检测泌尿生殖道沙眼衣原体感染

目的 :评价MicrotrakⅡEIA法用于女性宫颈拭子、男性尿道拭子和尿沉渣标本沙眼衣原体检测效果。方法 :采用细胞培养法作为“金标准”方法 ,PCR为辅助标准 ,MicrotrakⅡEIA法平行测定。结果 :共检测 1 64例标本 ,以细胞培养法作金标准 ,总体MicrotrakⅡEIA检出率高于细胞培养法 ( χ2 =5 0 0 ,P <0 0 5 ) ;对于女性宫颈和男性尿沉渣标本 ,MicrotrakⅡEIA法与培养法的检出率无显著性差异( χ2 =1 0 0和 χ2 =0 2 0 ,P均 >0 0 5 ) ,而男性尿道拭子标本的MicrotrakⅡEIA法检出率高于培养法 ,差异有统计学意义 ( χ2 =4 0 0 ,P <0 0 5 )。以细胞培养法加PCR法作标准 ,检测各样本的结果差异无统计学意义。结论 :MicrotrakⅡEIA法具有较高的敏感性和特异性 ,适合于泌尿生殖道沙眼衣原体感染的实验室诊断。     

pH值测定在非淋菌性尿道炎中的临床应用价值

pH值与人体微环境的变化密切相关，当体内雌激素水平或泌尿生殖道的菌丛有异常时，会导致微环境改变，pH值也可能会发生一定的变化。本研究分别以UU培养法和Clearview衣原体快速检测法为“金标准”，以女性阴道、宫颈分泌物，男性尿道分泌物pH值作为观测指标，探讨泌尿生殖道pH值的测定在NGU诊断中的应用价值。     

353例男性泌尿生殖道疾病患者加德纳菌的检测

表1 77例GV荧光抗体阳性病例相关疾病及标本来源分析 疾病组标本来源受检例数阳性例数阳性率(％)不育症组精液79810.1前列腺炎组前列腺液1272318.1龟头及尿道炎组尿道口分泌物691623.2泌尿道感染组尿液291137.9妻现患BV男配偶组尿液9777.8吸毒组尿液401230.0合计3537721.8 加德纳菌 (Gardnerella vaginalis,GV)是育龄妇女常见阴道定殖的细菌之一，可以通过性接触传播。 GV是否为男性泌尿生殖道感染的病原菌，目前报道较少 [1,2]，为此我们于 1999年 4～ 5月对我院泌尿外科门诊的男性泌尿生殖道疾患和住院戒毒患者进行 GV检测，并对 G…     

洛阳地区泌尿生殖道炎患者解脲支原体和人型支原体检测

目的　研究泌尿生殖道炎患者与解脲支原体 (UU)及人型支原体 (MH)感染的相关性。方法　采用培养法和PCR法对 2 81例泌尿生殖道炎患者进行UU和MH检测。结果　 2 81例中UU和MH的检出率分别为 3 9.5 %和11.7% ,两者混合感染率为 15 .3 % ,总阳性率为 66.5 %。男女之间UU和MH的感染差异无显著性 (χ2 =0 .0 41,P >0 .0 5 ) ,UU、MH、UU +MH三者检出率之间差异有非常显著性 (χ2 =74.18,P <0 .0 0 5 )。结论　提示UU及MH感染是泌尿生殖道炎的重要致病因素 ,对泌尿生殖道炎患者应尽可能地做UU和MH检查。     

Comparative prevalence of infection with Trichomonas vaginalis among men attending a sexually transmitted diseases clinic

OBJECTIVE: Although established in women as a common cause of vaginal discharge, the prevalence of Trichomonas vaginalis (TV) in men compared with other classic urethral pathogens has not been well characterized. To assess this issue, the authors compared the prevalence of Neisseria gonorrhoeae (GC), Chlamydia trachomatis (CT), and TV in consecutive men attending a sexually transmitted diseases (STD) clinic. METHODS: From June 1, 1998 to July 27, 1998, 454 consecutive men presenting to the Denver Metro Health Clinic with a new problem were tested for GC by urethral swab culture, for CT by polymerase chain reaction of urine, and for TV by urine sediment culture. RESULTS: GC, CT, and TV were detected in 23 (5.1%), 34 (7.5%), and 13 (2.8%) of men, respectively. There were significant differences by age for both CT (11.3% in men younger than 30 years versus 3.3% in men 30 years and older, P < 0.05) and TV (0.8% in men younger than 30 years versus 5.1% in men 30 years and older, P < 0.05). In 50 men 30 years or older with symptoms of urethral discharge, TV prevalence (12.0%) rivalled that of GC (12.0%) and CT (14.0%). In 45 men 30 years and older with nongonococcal urethritis, the prevalence of TV and CT were each 13.3%. Multivariate logistical regression analysis showed the presence of discharge and nongonococcal urethritis in men 30 years and older to be an independent predictor of TV. CONCLUSIONS: TV is common in men attending sexually transmitted disease clinics, especially in those 30 years or older, in whom it may account for as much urethritis as GC or CT. These findings suggest that in older men with nongonococcal urethritis, diagnostic evaluation, empiric treatment, and partner management should include the possibility of TV infection.     

男性尿道分泌物1314份病原谱分析

目的分析男性尿路感染的病原谱,探讨防止男性尿路感染慢性化的途径。方法对男性尿道分泌物进行湿片及干片染色镜检和尿常规分析,明确有无尿道感染及病原体种类,检测滴虫和白念珠菌等;以细菌培养法检测淋球菌、加德纳菌、金黄色葡萄球菌、白念珠菌等致病菌,以免疫金标法检测衣原体等;按病原体的种类和种数进行数据统计。结果 1314例尿道分泌物共检出病原体12类2084株,根椐检出的病原体种类可将尿道炎细分为9种。多数急性尿道炎是由淋病奈瑟菌、支原体和衣原体等单一感染引起(580/736),菌株数为946株;由MCP、加德纳菌等多重感染引起的慢性尿道炎有431例,菌株数为1124株。两者病原体株数差异有统计学意义(P<0.01)。部分病例有5种以上病原体感染,部分病例镜检白细胞、红细胞、上皮细胞数明显异常,但培养均未检出细菌。结论急、慢性尿道炎的病原体有明显差异,尿道分泌物的病原谱分析可为临床正确诊断、治疗尿道炎症提供依椐。慢性尿道炎病例可出现MUBV现象及ASU病例。     

利用男性非淋菌性尿道炎患者尿沉渣检测沙眼衣原体

１０２例男性非淋菌性尿道炎患者，以尿道拭式沙眼衣原体培养为金标准，用ＷｅｌｌｃｏｚｙｍｅＣｈｌａｍｙｄｉａ检测清晨首次尿沉渣中沙眼衣原体的敏感性和特异性分别为８９．７％及９２．１％，用ＰＣＲ检测清晨首次尿沉渣中沙 眼衣原体敏感性和特异性分别为９７．４％及９２．１％。     

Prevalence of Trichomonas vaginalis in a male sexually transmitted disease clinic population by interview, wet mount microscopy, and the InPouch TV test.

OBJECTIVE--To determine the prevalence of trichomoniasis in male patients from their urine at a Sexually Transmitted Disease (STD) Clinic using the InPouch TV culture system. METHODS--Two hundred and four patients were examined for STD infections. Their ages ranged between 17 and 72 years. Depending on their clinical symptoms tests were ordered for Neisseria gonorrhoeae, chlamydia, and for syphilis. Each patient submitted a clean catch urine specimen for trichomonas testing. A 15 ml aliquot of urine was centrifuged and a drop of the sediment examined microscopically. The remainder was cultured in the InPouch TV test. Each pouch was examined at 24 h, 48 h, and 5 days. RESULTS--Twenty-four of the 204 patients (12%) were culture positive for Trichomonas vaginalis and only three of these were wet mount positive. CONCLUSION--The InPouch TV test demonstrated an epidemiological important infected male population that was not indicated by wet mount microscopy.     

Comparison of the Gram-stained urethral smear and first-voided urine sediment in the diagnosis of nongonococcal urethritis.

The diagnostic sensitivity of the numbers of leukocytes in the sediment of first-voided urine and in gram-stained smears of urethral secretions was evaluated by a study of 62 men with symptoms of nongonococcal urethritis. Fifty-one patients (82.3%) had pyuria (defined as ten or more leukocytes per high-power field) in the sediment of first-voided urine, whereas 8 (45.2%) had more than four leukocytes per oil-immersion held in gram-stained urethral smears. Frequencies of positive first-voided urine sediments and urethral smears were similar in Chlamydia trachomatis--positive and -negative cases. Results of cultures, urinalyses, and urethral smears were not affected by recent micturition. Pyuria in the first-voided urine but not a positive urethral smear is a sensitive sign of urethritis whether or not urethral discharge is evident. Specimens of urethral secretions were subjected to different storage conditions to determine the effect on subsequent isolation of C. trachomatis. Equal rates of isolation were demonstrated for specimens that had been held at 4 degrees C for either four or 20-24 hr or frozen to -70 degrees C for one week prior to culture.     

Dot-immunobinding assay with monoclonal antibody for detection of Trichomonas vaginalis in clinical specimens.

A rapid and specific dot-enzyme immunoassay (DIBA) using monoclonal antibody was introduced for detection of Trichomonas vaginalis antigen in vaginal and urethral materials. The results of DIBA were compared with culture findings of the parasite in 245 female patients. Taking culture as the reference method, DIBA had a sensitivity of 92% and a specificity of 93%. The predictive value of a positive test was 98% and that of a negative test 77%. The efficacy of wet mount, culture and DIBA were compared in 134 women with trichomonal infection. The most sensitive method was cultivation with a positivity of 99.3%. DIBA was as sensitive as the wet mount (92%). In 51 sexual partners of women with trichomoniasis DIBA proved to be ineffective. The sensitivity of the assay with corpuscular antigen of T vaginalis was 1 x 10(4) cells/ml, with soluble antigen 47 micrograms/ml. Specificity of the assay was confirmed by lack of any cross-reactivity with Trichomonas tenax. Tritrichomonas mobilensis and Candida albicans.     

Characterisation of Neisseria gonorrhoeae in semen during urethral infection in men.

OBJECTIVE: To determine the number of Neisseria gonorrhoeae organisms in urine and semen in men with gonococcal urethritis, and to compare selected phenotypic characteristics of organisms harvested from the urethra and semen. DESIGN: Samples from two groups of subjects were examined. Patients with symptomatic urethritis receiving treatment at an STD clinic, as well as six subjects with experimental urethritis. Semen and urine specimens were obtained after the urethral exudate was sampled. RESULTS: Using quantitative cultures, we found an average of 6 x 10(6) gonococci in urine or semen of 17 men with symptomatic urethritis seeking treatment at an STD clinic, and 2 x 10(4) gonococci in secretions of six male subjects with early experimental infection. Gonococcal outer membrane opacity (Opa) proteins and lipo-oligosaccharide (LOS) recovered from urine and semen of these subjects were very similar. CONCLUSIONS: Men with symptomatic gonorrhoea excrete a large number of gonococci in semen which is not affected by the duration of symptoms. The similar phenotype of organisms in urine and semen suggests the bacteria come from the same compartment. These data help to explain the efficiency of gonococcal transmission from men to their partners, and identify an appropriate target for a preventative vaccine or immunotherapy designed to reduce the inoculum in infected patients.