性病门诊泌尿生殖道沙眼衣原体感染临床调查研究

目的分析性病门诊泌尿生殖道沙眼衣原体感染患者的临床资料,为非淋球菌尿道（宫颈）炎的防治提供依据。方法采用细胞培养法检测沙眼衣原体,收集并分析181例阳性感染者的临床资料。结果181例中,男性占88．95％,女性占11．05％,男女之比为8：1。年龄以17～30组占51．67％。患者主要分布在广州市区,发病原因以非婚性接触为主。男性患者表现为尿道少量分泌物、轻度红肿、尿道瘙痒、尿痛;85％女性患者有症状,表现为外阴瘙痒、阴道分泌物有异味、宫颈粘液脓性分泌物。结论泌尿生殖道沙眼衣原体感染以青中年男性和非婚性传播为主,病人主要是当地居民,女性感染表现为生殖道异常等症状。     

生殖系多种病原体感染与男性不育的关系

目的 探讨男性不育患者弓形体，解脲支原体，沙眼衣原体感染情况和抗精子抗体感染情况和抗精子抗体在男性不育中的作用。方法 应用多聚酶链反应（PCR）技术分别对112例男性不育病人和62例正常生育者的精液进行精浆弓形体DNWA，解脲支原体和沙眼衣原体DNA的检测，用金标免疫斑点试验检测精浆抗精子抗体（AsAb)。结果 男性不育组弓形体阳性20例（17．86％），解脲支原体阳性35例（31．25％），沙眼衣原体阳性18例（16．07％），抗精子抗体阳性33例（29．46％）。3种病原体感染率与抗精子抗体的阳性率均明显高于正常对照组（P＜0．01，且多种病原体感染患者抗精子抗体的阳性率明显高于单项感染者。结论 男性不育患者多种病原体感染后，导致抗精子抗体拉生是男性不育的重要免疫因素。     

老年人呼吸道衣原体感染的研究

目的探讨老年人呼吸道衣原体感染的状况。方法采用放线菌酮处理的Ｈｅｌａ２２９细胞、单克隆抗体免疫荧光对健康老年组、老年呼吸道感染组及肺部肿瘤组的咽拭子及纤维支气管镜标本进行了衣原体的分离培养鉴定。结果健康老年组６６例的咽拭子标本中均未分离到衣原体。呼吸道感染组１３５保做了沙眼在原体分离，７例阳性，阳性率为５．１８％；其中１１３例亦做了肺炎衣原体分离，也有７例阳性，阳性率为６．１９％；而１１３例标本中均未检出鹦鹉热衣原体。４２例肺部肿瘤患者的上述３种衣原体检出的结果分别为沙眼衣原体阳性率１１．９０％（４２例中５例阳性），肺炎衣原体阳性率为１４．２８％（２１例中３例阳性），２１例标本中均未检出鹦鹉热衣原体。结论肺炎衣原体和沙眼衣原体均可能是老年人呼吸道感染的重要病原因之一，对老年人肺部肿瘤患者呼吸道衣原体感染亦应引起重视     

热启动多聚酶链反应快速检测泌尿生殖道沙眼衣原体的应用研究

应用热启动多聚酶链反应技术,对泌尿生殖道沙眼衣原体感染进行快速检测。共检测８０６例泌尿生殖道炎症病人,其中ＳＴＤ病人４０４例,阳性１０５例,阳性率２６．０％;普通病人４０２例,阳性１０例,阳性率２．５％。经统计学估计,福州市ＳＴＤ患者沙眼衣原体感染率范围为２１．７～３０．３％。     

不同引物对PCR检测沙眼衣原体结果的影响

为了解不同引物对PCR检测泌尿生殖道沙眼衣原体（CT）感染的影响,作者以直接免疫荧光法（DIFA）为标准,选用引物不同的市售PCR试剂盒检测了209例泌尿生殖道可疑CT感染标本。结果引物1RCR阳性29例,引物2PCR阳性28例;在DIFA阳性25例中,引物1PCR阳性24例,引物2PCR阳性23例;引物1PCR敏感性为96．0％,特异性为97．8％;引物2PCR敏感性为92．0％,特异性为98．4％。与DIFA比较,两者在统计学上无显著差异（P＞0．05）,提示不同引物对PCR检测CT感染无明显影响。     

1268例衣原体免疫检测和支原体培养结果分析

应用衣原体抗原快速免疫测定法检测分泌物中沙眼衣原体，用选择培养法检测分泌物中解脲支原体和人型支原体。结果为ＣＴ阳性率为１７．７％，ＵＵ阳性率为２５．８％；ＭＨ阳性率为１１．８％；其中ＣＴ女性阳性率为２９％，男性阳性率为１１．８％，ＵＵ女性阳性率为３９．３％，男性为１８．３％，女性患者检出阳性率显著高于男性。     

热启动多聚酶链反应快速检测泌尿生殖道沙眼衣原体的应用…

应用热启动多聚酶链反应技术，对泌尿生殖道沙眼衣原体感染进行快速检测。共检测８０６例泌尿生殖道炎症病人，其中ＳＴＤ病人４０４例，阳性１０５例，阳性率２６．０％，普通病人４０２例，阳性１０例，阳性率２．５％，经统计学估计，福州市ＳＴＤ患者沙眼衣原体感染率范围为２１．７￣３０．３％。     

乙型肝炎PreS1抗原、HBV DNA、HBeAg的相关性分析及临床应用

目的 分析乙型肝炎患者血清乙型肝炎病毒PreS1抗原、HBV DNA和HBeAg的临床意义。方法 采用双抗体夹心法检测前S1蛋白,采用荧光PCR法检测HBV DNA,采用ELISA法检测HBeAg。结果 在1258例乙型肝炎患者中PreS1抗原阳性率为26．39％,HBV DNA阳性率为83．39％;在1049例血清HBV DNA阳性患者中,PreS1抗原阳性299例（23．94％）,HBeAg阳性447例（42．61％）;在PreS1抗原阳性患者中,HBV DNA阳性率为92．57％（299,332）。结论 本组资料显示,PreS1抗原的检测无更多的临床意义。     

Cpn感染与急性脑梗死的关系研究

用PCR法检测93例急性脑梗死患者（观察组）和90例非脑梗死患者（对照组）外周血白细胞肺炎衣原体（Cpn）DNA表达情况。发现观察组CpnDNA阳性率为58．89％,明显高于对照组的36．67％（P〈0．01）。观察组中,≤60岁者中Cpn DNA阳性率高于〉60岁者,男性高于女性,吸烟者高于非吸烟者（P〈0．05）。提示Cpn感染与急性脑梗死可能有明显关系,且Cpn感染可能与年轻、男性、吸烟者关系较大。     

泌尿生殖道疾患与沙眼衣原体感染的相关性研究

对155例慢性前列腺炎患者，52例非前列腺炎的其它泌尿生殖遣疾患和正常人对照；123例宫颈炎患者、52例正常育龄妇女对照，30例疗后复查患者，同时进行沙眼衣原体（Ct）PCR检测。结果显示：慢性前列腺炎患者的前列腺液Ct阳性率为27.1％（42／155），而且均为非细菌性前列腺炎，对照组皆为阴性，二者具有非常显著性差异。对53例在前列腺按摩前初始尿和尿道脱落的上皮细胞，PCR结果：9例仅前列腺液阳性，3例仅尿液阳性，3例前列腺液与尿液同时阳性．其余皆为阴性，这结果似可说明，前列腺液的Ct主要来源于前列腺并非来源于尿道。123例宫颈炎患者的宫颈分泌物Ct阳性率为31．7％（39／123）．52例正常育龄妇女，Ct阳性单为3．8％（2／52）．从显示的阳性率来看．二者具有非常显著性差异（P＜0．01）。30例PCR阳性的疗后复查患者Ct皆转为阴性。     

沙眼衣原体和解脲支原体培养结果分析

目的　通过培养了解由沙眼衣原体 (CT)、解脲支原体 (Uu)引起非淋菌性尿道 (宫颈 )炎感染的现状和特点。方法　对 135 0例临床拟诊非淋菌性尿道 (宫颈 )炎患者的生殖道拭子 ,同时采用CT细胞培养及Uu液体培养。结果　总阳性率为 35 .0 % ,CT阳性率为 8.0 %。Uu为 2 0 .3% ,混合阳性率 6 .8%。男女性别间感染率差异有非常显著的统计学意义 (χ2 =6 0 .4 4 ,P <0 .0 1)。初诊患者 5 17例 ,其中阳性 2 4 5例 ,阳性率为 4 7.4 %。复诊患者833例 ,阳性 2 2 8例 ,阳性率为 2 7.4 %。两者差异有非常显著的统计学意义 (P <0 .0 1)。结论　广州市皮肤病防治所性病门诊拟诊非淋菌性尿道 (宫颈 )炎患者 135 0例中 ,检出阳性 4 73例 ,尤其混合性感染应引起重视。     

生殖系多种病原体感染与男性不育的关系

目的　探讨男性不育患者弓形体、解脲支原体、沙眼衣原体感染情况和抗精子抗体在男性不育中的作用。　方法　应用多聚酶链反应 (PCR)技术分别对 112例男性不育病人和 6 2例正常生育者的精液进行精浆弓形体 DNA、解脲支原体和沙眼衣原体 DNA的检测 ,用金标免疫斑点试验检测精浆抗精子抗体 (As Ab)。　结果　男性不育组弓形体阳性 2 0例 (17.86 % ) ,解脲支原体阳性 35例 (31.2 5 % ) ,沙眼衣原体阳性 18例 (16 .0 7% ) ,抗精子抗体阳性 33例 (2 9.4 6 % )。3种病原体感染率与抗精子抗体的阳性率均明显高于正常对照组 (P<0 .0 1) ,且多种病原体感染患者抗精子抗体的阳性率明显高于单项感染者。　结论　男性不育患者多种病原体感染后 ,导致抗精子抗体的产生是男性不育的重要免疫因素。     

Simultaneous detection of Neisseria gonorrhoeae and Chlamydia trachomatis by PCR in genitourinary specimens from men and women attending an STD clinic

Neisseria gonorrhoeae and Chlamydia trachomatis are the two most common bacterial sexually transmitted infections that manifest primarily as urethritis in males and endocervicitis in females, though the infection may be asymptomatic especially in women. Since complications may occur in untreated symptomatic and asymptomatic infected individuals, early diagnosis and treatment of infected individuals is required to prevent severe sequelae and spread of these diseases. Recently molecular amplification assays like Polymerase Chain Reaction (PCR) and Ligase Chain Reaction (LCR) have been found to be highly sensitive and specific methods for detection of N. gonorrhoeae and C. trachonmatis not only in urethral and cervical specimens but also in urine. The objective of this study was to screen male and female Sexually Transmitted Disease (STD) clinic attenders, with and without symptoms suggestive of urethritis and cervicitis for presence of N. gonorrhoeae and C. trachomatis using a multiplex PCR based assay, to compare its performance with culture for N. gonorrhoeae and Direct Fluorescent Antibody (DFA) staining for C. trachomatis and also to compare the efficacy of PCR test performed on urine and genital swab specimens collected from this high risk group. Genital specimens and urine was collected from STD clinic attenders. N. gonorrhoeae and C. trachomatis was detected in genital specimens by culture and DFA respectively. Multiplex PCR was used to detect N. gonorrhoeae and C. trachomatis infection in both genital and urine specimens. Among men with urethritis, N. gonorrhoeae was detected in 70% by culture and 77% by PCR, while C. trachomatis as detected in 7.5% by DFA and 17.5% by PCR. Among females with endocervicitis, N. gonorrhoeae was detected in 7.7% by culture and 30.7% by PCR, while C. trachomatis was detected in 7.7% by DFA and in 15.4% by PCR. None of the asymptomatic males were positive for N. gonorrhoeae and C. trachomatis by conventional methods, while 43.9% were positive for N. gonorrhoeae and 7.5% for C. trachomatis by PCR. Fifty per cent of asymptomatic women were positive for C. trachomatis by PCR alone. We encountered PCR positive but culture/DFA negative results and also PCR negative but culture/DFA positive results. In view of this a single PCR test cannot be used for diagnosis and treatment of N. gonorrhoeae and C. trachomatis infection unless confirmed by a second test.     

Epidemiological survey of Chlamydia trachomatis infections from 1984 to 1988

We continued the epidemiological survey on sexually transmitted disease due to Chlamydia trachomatis in Okayama Prefecture. The results obtained from October 1984 to October 1988 are briefly summarized in this paper. 1) Sera from outpatients with suspected chlamydial infections were tested for IgG antibodies to Chlamydia trachomatis by the microplate immunofluorescence antibody technique (MFA). Fifty five percent of the male and 61% of the female patients were positive for anti C. trachomatis IgG. 2) Clinical swabs obtained from 735 males and 251 females were examined for Chlamydia trachomatis antigens by the isolation method and direct immunofluorescence tests (DFA) were carried out simultaneously. C. trachomatis was recovered from 34% of the male and 22% of the female patients. 3) The age structure of the female patients was younger than the male patients. Female patients under 29 years of age were 57% of all female antigen-positive cases.     

Usefulness of real-time PCR in detecting Chlamydia trachomatis and Neisseria gonorrhoeae in endocervical swabs and first-voided urine specimens

We evaluated performance of Abbott RealTime CT/NG assay (real-time PCR, Abbott Japan) for detect Chlamydia trachomatis and Neisseria gonorrhoeae by real-time PCR in 88 female patients with cervicitis symptoms seen at gynecological clinics and 100 male patients with urethritis symptoms seen at urological or dermatology clinics in Kitakyushu, Japan. Endocervical swab and first-voided urine (FVU) specimens were then collected from women and FVU specimens from men. Detection rates of C. trachomatis and N. gonorrhoeae by real-time PCR in the 3 types of specimens were compared to those by ProbeTec ET assay (ProbeTec, BD Diagnostic System). The overall positive concordance between real-time PCR and ProbTec were 97.1% (66/68) for C. trachomatis and 100% (33/33) for N. gonorrhoeae, C. trachomatis detection yielded 3 discordant results in endocervical specimens and 1 discordant result in male FVU by real-time PCR and ProbTec. Three of 4 reexamined using Aptime Combo 2 Assay (Fuji Rebio Inc.) were positive for C. trachomatis. Endocervical swab and FVU specimen results for C. trachomatis were discordant in 3 cases in real-time PCR and 4 in ProbeTec. Subjects with 2 or more positive endocervical awab results in female or male FVU specimens were assumed to be "true positive" for C. trachomatis. The sensitivities of real-time PCR for detecting C. trachomatis was 94.4% in endocervical swabs, 77.8% in female FVU and 97.4% in the male FVU. The sensitivities for real-time PCR for detecting N. gonorrhoeae was 100% in all 3 specimentypes. Abbott RealTime CT/NG assay was useful for detecting C. trachomatis using endocervical swabs or male FVU specimens and for detecting N. gonorrhoeae using endocervical swabs and all FVU specimens.     

Prevalence of cervical Chlamydia trachomatis infection in sexually active adolescents from Salvador, Brazil

The incidence of sexually transmitted diseases among adolescents is increasing worldwide. Genital Chlamydia trachomatis infection is one of the most prevalent sexually transmitted diseases in young women, and undetected disease is highly associated with long-term complications in women. Our goal was to determine the prevalence of cervical Chlamydia trachomatis infection in a sexually active population of female adolescents from Salvador, Brazil, and to describe their socio-demographic, behavioral, and clinical characteristics. 100 sexually active adolescents (10-19 years) were included in this study, between 2008 and 2010. Endocervical samples were obtained during gynecological examination. Inhouse polymerase chain reaction of cervical specimens was used for Chlamydia trachomatis detection. The overall prevalence of cervical Chlamydia trachomatis infection was 31% (95% CI 22-40). There were no statistically significant differences in the age at first sexual intercourse, number of sexual partners, and frequency of condom use between Chlamydia infected and uninfected adolescents. The prevalence of cervical Chlamydia trachomatis infection among adolescents from Salvador was the highest in Brazil up to the present date. These results demonstrate an urgent need for continued and comprehensive prevention strategies along with proper screening for Chlamydia in high-risk populations in order to decrease the rates of infection.     

Screening for Chlamydial infection in women attending STD clinic by polymerase chain reaction, ELISA and cell cytology

Thirty five female patients with endocervicitis attending STD clinic were studied for the presence of Chlamydial infection by Polymerase Chain Reaction (PCR), Enzyme Immunoassay (EIA) and Cell Cytology. PCR was found to be positive in 54.2% of patients, Enzyme-Linked Immunosorbent Assay (ELISA) in 25.7% of patients, but cell cytology revealed the presence of inclusion bodies only in 3% of the cases, thereby showing that polymerase chain reaction is a better method for detection of Chlamydia trachomatis than EIA and cell cytology.     

Detection of Mycoplasma genitalium in the genitourinary tract of women by the polymerase chain reaction

A polymerase chain reaction (PCR) was used to demonstrate the presence or absence of Mycoplasma genitalium in the lower genital tract of 57 women who attended a sexually transmitted diseases clinic. The mycoplasma was detected in the cervix of 10 (17.5%) women and also in the vagina of 4 (16%) and the urethra of 6 (24%) of 25 women from whom multiple samples were obtained. Chlamydia trachomatis was detected also by a PCR in 9 (16%) of the women, but only 3 were chlamydia-positive and mycoplasma-positive. M. genitalium was detected occasionally in women with vaginal disease (for example, bacterial vaginosis), whereas C. trachomatis was not, but whether there is any causal relationship between the mycoplasma and vaginal or cervical disease requires further study.     

发热门诊呼吸道感染患者中的肺炎衣原体感染调查

目的 了解发热门诊呼吸道感染患者中的肺炎衣原体感染状况,为临床诊断和治疗提供依据。方法 采集2010年11月15日至12月15日在北京友谊医院发热门诊就诊,诊断为呼吸道感染患者的咽拭子标本92例,采用国际肺炎衣原体参考菌株TW-183作为阳性对照和优化PCR条件。用肺炎衣原体种特异性引物对其16S rRNA基因进行PCR检测,阳性产物进行基因测序,结果采用SPSS 10.0软件进行数据统计分析,计数资料比较用(²检验,P≤0.05为差异有统计学意义。结果 CpnA-CpnB PCR可检测到5 ×10^-1 IFU 的肺炎衣原体。92例呼吸道感染患者的咽拭子标本中PCR阳性者为30例,阳性率为32.6%。男性和女性、不同年龄组、以及上呼吸道和下呼吸道感染病例的阳性率间差异均无统计学意义(P>0.05)。结论 在发热门诊有呼吸道症状的病例中,肺炎衣原体感染率较高。临床医生应对肺炎衣原体感染加以重视。CpnA-CpnB PCR法是一灵敏快速的肺炎衣原体筛查方法。