PCR检测解脲支原体65例结果分析

ＰＣＲ检测解脲支原体６５例结果分析罗燕春，陈挺尧解脲脲原体是一种支原体，定植于人类泌尿道，可引起男性非淋菌性尿道炎，前列腺炎，附睾炎，引起女性阴道炎、宫颈炎、盆腔炎，产后及流产后发热，不孕症，和低体重儿等。目前，讨论解脲支原体感染日渐被临床医生特别是...     

解脲脲原体及其生物群类别与盆腔炎相关性的研究

目的 研究解脲脲原体及其生物群类别与盆腔炎的相关性。方法 应用聚合酶链反应方法，对解脲脲原体标准株的14个血清型进行检测和分群，并对照检测了100例盆腔炎患者的宫颈分泌物。结果 解脲脲原体parvo生物群的扩增片段长度为403bp，T960生物群的扩增片段长度为448bp；盆腔炎患者中，解脲脲原体的检出率为34％，其中parvo生物群占9％，T960生物群占26％，二者混合感染率为1％；对照组中解脲脲原体的检出率为13％，其中parvo生物群占10％，T960生物群占3％。结论 解脲脲原体是盆腔炎的重要致病因素，其T960生物群与盆腔炎的致病性非常明显相关。     

解脲脲原体生物群分布与耐药性差异研究

目的 了解本地区泌尿生殖道感染人群中解脲脲原体感染的生物群分布特点及其耐药情况。方法 采用液体选择培养基对泌尿道分泌物标本进行培养、鉴定及药敏;选取解脲脲原体阳性标本进行PCR分群和分型;分析各生物群型别及其耐药性差异。结果 985例检测标本中,单独解脲脲原体阳性395例,总阳性率为40.10%,其中女性368例,男性27例,其阳性率分别为42.45%、22.88%,女性阳性率高于男性,其差异有显著统计学意义(χ²=16.550,P<0.01)。395例单独解脲脲原体阳性标本作PCR分群分型显示,单独生物一群阳性278例,阳性率为70.89%;单独生物二群阳性80例,阳性率为20.25%。单独生物一群中以单一血清6型(121例,43.21%)、3/14型(96例,35.53%)感染为主。单独生物二群均为混合血清型感染,基因亚型1(血清型2、5、8、9)和亚型3(血清型7、11)混合感染(49例,61.25%);基因亚型2(血清型4、10、12、13)和亚型3(血清型7、11)混合感染共检出(31例,38.75%)。结合药敏结果发现,解脲脲原体对喹诺酮类药物耐药率较高,对四环素类药物较敏感,且多重耐药现象严重。生物一群对司帕沙星的耐药性高于生物二群,二者差异有统计学意义(χ²=5.701,P=0.017<0.05),且生物一群对米诺环素、多西环素、阿奇霉素的耐药性远高于生物二群,其差异有显著统计学意义(χ²=10.811,χ²=19.103,χ²=7.541,P均<0.01)。进一步结合分型结果发现,生物一群中单一血清型S6耐药率最高的抗菌药为氧氟沙星(76.86%),S1型耐药率最高的抗菌药为罗红霉素(95.74%),S3/14型耐药率最高的抗菌药为罗红霉素和阿奇霉素(均为86.46%)。结论 泌尿生殖道感染人群中解脲脲原体阳性率较高,女性高于男性,以生物一群单一血清型感染为主;本地区耐药形势严峻,生物一群耐药性高于生物二群;生物一群中各血清型的耐药性存在不同程度的差异。结合解脲脲原体生物分群分型结果可辅助合理选用抗菌药物,以避免滥用致耐药株产生。     

柳州地区380例泌尿生殖道感染者解脲支原体培养结果分析

对性病门诊及妇科门诊３８０例患者泌尿生殖道标本进行了解脲支原体培养。结果３８０例患者中解脲支原体培养阳性８６例，阳性率为２２．６３％，其中男性１３７例，培养阳性２０例，阳性率为１４．６０％，女性２４３例，阳性６６例，阳性率为２７．１６％，两者阳性率差异有显著性意义（ｘ２＝７．８９，Ｐ＜０．０１），即女性阳性率明显高于男性。把患者分５个年龄组比较，结果不同年龄组阳性率差异有显著性意义（ｘ２＝１４．４８，Ｐ＜０．０１），提示ＵＵ感染与性生活活跃程度有关。３８例患者中ＮＧＵ２５４例，ＵＵ培养阳性６２例，占２４．４１％，阳性率最高，而前列腺炎，宫颈炎等ＵＵ感染亦不容忽视。     

解脲支原体耐药性与tetM基因关系的研究

从流行病学角度进一步探讨解脲支原体耐药性与其ＴｅｔＭ基因之间的关系。方法对１７７株Ｕｕ临床菌株采用微量肉汤稀释法检测其对四环素和强力霉素的敏感性,用聚合酶链反应（ＰＣＲ）法检测其ｔｅｔＭ基因携带情况,并用Ｒ＊Ｃ表Ｘ＾２检验分析Ｕｕ对四环素族药物的耐药性与ｔｅｔＭ基因之间的关系。结果（１）Ｕｕ对四环素和强力霉素的耐药性与ｔｅｔＭ基因关系密切（Ｐ〈０．０５）;（２）ＰＣＲ法检测Ｕｕ临床菌株ｔｅｔＭ基因     

柳州地区380例泌尿生殖道感染都解脲支原体培养结果分析

对性病门诊及妇科门诊３８０例患者泌尿生殖道标本进行了解脲支原体培养。结果３８０例患者中解脲支原体培养阳性８６例，阳性率为２２．６３％，其中男性１３７例，培养阳性２０例，阳性率为１４．６０％，女性２４３例，阳性６６例，阳性率为２７．１６％。     

解脲脲原体与宫内感染的相关性研究Ⅰ.解脲脲原体感染与自然流产及药物不全流产

目的研究解脲脲原体（Ｕｕ）与自然流产和药物不全流产的关系，探讨Ｕｕ与宫内感染的可能机制。方法采用分离培养分别对４５例自然流产和２７例药物不全流产（试验组）和３１例人工流产（对照组）的母亲宫颈分泌物及胚胎组织进行Ｕｕ检测，分别对部分试验组和对照组进行超薄切片，并与其培养物负染电镜检查相比较。结果试验组流产组织中Ｕｕ检出率分别为５３．３％和６３％，与对照组相比较，具显著性差异（ｐ＜０．００１，ｐ＜０．００１）；经超薄切片观察，试验组流产组织的绒毛膜下滋养层细胞周围见大量的Ｕｕ颗粒及空泡内增殖的子细胞，并与其流产组织中阳性培养物经负染后的颗粒相似。而对照组胚胎流产组织中无此颗粒。结论绒毛膜下滋养层Ｕｕ增殖这一结果充分证实了Ｕｕ是引起宫内感染的病原体之一。     

解脲脲原体小鼠宫内感染的实验研究

目的　建立解脲脲原体（Ｕｕ）小鼠宫内感染的动物模型。方法　分别将４、１ 和９ 型Ｕｕ（２×１０４ ｃｆｕ／ｍ ｌ）接种于妊娠第１２．５、１３．５、１４．５ 天孕鼠阴道内（３４ 只）,以最后一次攻击后的４８ｈ 内分娩为早产。以腹腔内接种４型Ｕｕ（６ 只）和阴道内注入灭菌盐水（９ 只）为对照组。结果　经阴道内接种Ｕｕ４型的４３．７％ （７／１６）孕鼠在４８ｈ 内早产,显著高于１ 型Ｕｕ（８．３％ ,１／１２,Ｐ＜ ０．０５）和９型Ｕｕ（０％ ,０／６,Ｐ＜ ０．０５）以及对照组（０％ ,０／１５,Ｐ＜ ０．０１）;接种４、１ 和９型Ｕｕ 后,早产和不早产孕鼠子宫角Ｕｕ 的检出率分别为９７％ 、４６％ 和２５％ ;接种４ 型Ｕｕ 后,早产幼鼠的心、肺Ｕｕ 检出率为４６％ （２５／５４）,而注射灭菌盐水、１和９ 型Ｕｕ 的非早产幼鼠中Ｕｕ 的检出率均为０％ （０／４５,０／５５,０／４５,Ｐ＜ ０．０１）。三种血清型Ｕｕ 感染后早产或不早产幼鼠脑组织中Ｕｕ 的检测均为０％ （０／５９）。结论　小鼠Ｕｕ４ 型和１型阴道内接种可导致部分孕鼠宫内感染动物模型的建立将有助于对人类Ｕｕ 早产发病机制的进一步研究。     

核酸体外扩增技术诊断骨结核的临床研究

目的探讨核酸体外扩增（ＰＣＲ）技术在骨结核诊断中的价值。方法对６０例骨结核标本与２０例非骨结核标本分别应用ＰＣＲ、抗酸染色镜检及分离培养法进行结核分支杆菌检测。同时，分析了影响ＰＣＲ结果的有关因素与相应处理措施。结果６０例骨结核标本中三种方法的阳性检出率分别为：ＰＣＲ法８３％，镜检法３％，培养法７％。经统计学处理，Ｐ＜０．００５，ＰＣＲ法与镜检及培养法对结核分支杆菌的阳性检出率比较具有显著性差异，ＰＣＲ法明显优于镜检及培养法。２０例非骨结核标本镜检及培养法均阴性，ＰＣＲ法阳性率１０％。盲法结核分支杆菌和对照菌ＰＣＲ检测结果表明，ＰＣＲ的特异性为１００％。ＰＣＲ扩增整个过程自动化控制，可在数小时内完成。结论ＰＣＲ技术是一种快速、敏感、特异与简便的骨结核标本结核分支杆菌检测方法，对骨结核的诊断与鉴别诊断具有重要价值。     

解脲脲原体与宫内感染的相关性研究：Ⅰ.解脲脲原体感染与 …

目的 研究解脲脲原体与自然流产和药物不全流产的关系,探讨Ｕｕ与宫内感染的可能机制。方法 采用分离培养分别对４５例自然流产和２７例药物不全流产和３１例,人工流产的母亲宫颈分泌物及胚胎组织进行Ｕｕ检测,分别对部分试验组和对照组进行超薄切片,并与其培养物负染电镜检查相比较。     

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。     

Studies on the role of Ureaplasma urealyticum and Mycoplasma hominis in prostatitis

It has definitely been demonstrated that Ureaplasma urealyticum is one etiologic agent of nongonococcal urethritis, a sexually transmitted disease. For this reason it seemed possible that the organisms might cause ascending inflammatory reactions of the prostate. Quantitative determinations of ureaplasmas and Mycoplasma hominis, together with localization studies, were therefore performed to elucidate the importance of these microorganisms in patients with chronic prostatitis. U. urealyticum was found in high numbers in expressed prostatic secretions and urine voided after prostatic massage from 82 (13.7%) of 597 patients with chronic prostatitis. Because numbers of ureaplasmas in first-voided urine and midstream urine were significantly lower, the source of the organisms in these patients was assumed to be the prostate. These data and the results of tetracycline treatment provide sufficient evidence for the etiologic importance of ureaplasmas in chronic prostatitis.     

A study of IgA.IgG titers for C. trachomatis in serum and prostatic secretion of chronic prostatitis

In order to study the correlation between chronic prostatitis and C. trachomatis, IgA and IgG titers for C. trachomatis in serum and prostatic secretion were measured using the indirect immunoperoxidase assay (Ipazyme Chlamydia). 1) Positive rate of IgA and IgG titers in serum and prostatic secretion was higher in cases of chronic prostatitis than that in cases of suspected chronic prostatitis or the normal male group. 2) In cases of chronic prostatitis, IgA titers showed a tendency to be high in prostatic secretion, and IgG titers showed the same tendency in serum. This result was considered C. trachomatis infection was appeared local immunization in prostate. 3) After treatments with DOXY for cases of positive IgA titers in prostatic secretion, IgA titers of those cases were decreased and inflammations of prostate were cured. 4) The positive rate of IgA and IgG titers in serum was higher in wives with IgA positive cases than in those with the IgA negative. Those results suggested that chronic prostatitis was correlated by C. trachomatis.     

A study of Ureaplasma urealyticum pathogenicity in human genitourinary tract]

Ureaplasma urealyticum was investigated in urine from 765 outpatients who visited Jikei University Affiliated Hospital and Tokyo Metropolitan Taito Hospital from June, 1988 to December, 1989 in order to clarify the pathogenicity of U. urealyticum in human genitourinary tract. U. urealyticum in urine was detected by means of Taylor-Robinson's method. The positive rates of U. urealyticum were 31.5% in 146 patients with gonococcal urethritis, 33.8% in 334 patients with non-gonococcal urethritis, 17.5% in non-bacterial chronic prostatitis and 27.5% in the other patients without infectious diseases, respectively; no significant difference was seen among these groups. U. urealyticum was detected in the urine from 32.1% of the 28% patients who were younger than 12. However, U. urealyticum was detected in the urine from 5.6% of the 18 patients who were older than 70. Therefore, there was no relationship between the age and U. urealyticum-positive rate in urine. Furthermore, there was no relationship between the detection of U. urealyticum and the subjective and objective findings in the patients with urethritis before and after the treatment. From these results, it is presumed that U. urealyticum has no pathogenicity in human genitourinary tract.     

生殖道沙眼衣原体和解脲支原体感染与反复自然流产关系的研究

为探讨生殖道沙眼衣原体 ( CT)和解脲支原体 ( UU)感染与反复自然流产 ( RSA)的关系。采用聚合酶链反应技术 ( PCR)对 10 8例 RSA妇女 (观察组 )和 10 2例正常妇女 (对照组 )进行生殖道 CT和 UU检测。结果观察组 CT和 U U阳性率分别为 31.4 0 %和 37.10 % ,对照组分别为 10 .5 0 %和 12 .80 %。两组比较均有极显著差异( P<0 .0 1)。生殖道 CT和 UU感染是引起反复自然流产的原因之一 ,故对反复自然流产妇女应常规行生殖道CT、UU检测并及时治疗。     

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。     

成人咽部解脲支原体定植与性行为的关系

对１６３名性乱者咽部和尿生殖道标本和６３名健康成人咽部标本进行解脲支原体（Ｕｒｅａｐｉａｓｍａｕｒｅａｌｙｔｉｃｕｍ，Ｕｕ）检测，结果表明性乱人群咽部Ｕｕ定植率（４１．１％）极显著高于健康成人（６．３％），（Ｐ＜０．００１），咽部Ｕｕ定植与性活动、多性伴、性乱交和口交等不洁性行为以及Ｕｕ尿道炎有明显关系，性乱人群咽部Ｕｕ阳性者中，７３．１％的人有直接不洁性行为史，４４．７％的人有Ｕｕ尿生殖道感染，２９．６％和８５．２％的女性患者有间接不洁性行为史和阴道炎。但咽部Ｕｕ阳性者咽部自觉症状不明显，仅１０．４％的人有咽部充血或咽炎表现。提示Ｕｕ在成人咽部可能以共生形式定植，其定植率随性活动而增加，并可通过性活动而传播     

Prostatitis--clinical and bacterial studies.

Forty men with clinical prostatitis were studied to determine the value of symptomatology and categorization and 30 (75%) were classified as having prostatitis on the basis of prostatic localization studies. Of these 3 (10%) had chronic bacterial prostatitis, 18 (60%) had chronic abacterial prostatitis, and 9 (30%) had prostatodynia. No patient had acute bacterial prostatitis. Although Enterobacteriaciae were isolated from the 3 men with chronic bacterial prostatitis, these bacteria along with Staphlococcus aureus, Streptococcus faecalis, and Chlamydia trachomatis were isolated from a further 6 patients. The mean pH of the expressed prostatic secretion was measured for each group and was found to be 7.6 for those with chronic bacterial prostatitis, 7.1 for chronic abacterial prostatitis, 6.5 for prostatodynia, and 6.9 for those with urethritis suggesting that this test may be of value in the diagnosis of chronic bacterial prostatitis.     

Chronic lung disease of the newborn is not associated with Ureaplasma urealyticum

To clarify the association of Ureaplasma urealyticum infection with chronic lung disease of the newborn 145 preterm infants less than 34 weeks of gestation were examined. The infants were enrolled during two separate periods. The presence of U. urealyticum was studied by obtaining endotracheal culture samples and blood samples; if either of these samples grew the organism, the child was regarded as having U. urealyticum infection. Infection with U. urealyticum was detected in 33%, and chronic lung disease (defined as the need for oxygen, and typical chest radiograph at 28 days of age) in 43% of infants. The development of chronic lung disease was not associated with the presence of U. urealyticum. Our results suggest only a minor indirect role for U. urealyticum in the development of chronic lung disease of the newborn.