非淋菌性尿道(宫颈)炎患者中几种可能与艾滋病相关的支原体感染的调查研究

为了解非淋菌性尿道炎（NGU）和粘液脓性宫颈炎（MPC）患者中几种可能与艾滋病相关的支原体的感染情况。我们用培养法和PCR法对65例NGU／MPC患者的生殖道标本和咽部标本作了生殖支原体（Mg）、穿通支原体（Mpe）、梨支原体（Mpi）和发酵支原体（Mf）的检测。发现生殖道Mg、Mpe和Mpi的检出阳性率分别为23．1％（15／65）、12．3％（8／65）和1．5％（1／65）；咽部Mg、Mpe和Mpi的检出阳性率分别为26．2％（17／65）、15．4％（10／65）和1．5％（1／65）；生殖道和咽部同时检出Mtg、Mg、Mpe感染常见；Mg和Mpe可能通过性传播，并引起尿道炎和宫颈炎。     

76例男性性病患者7种支原体的检测分析

目的：了解扬州市男性性病(STD)与7种支原体的感染状况。方法：采用套式聚合酶链反应(nPCR)技术对76例扬州市男性STD患者尿道拭子进行解脲脲原体(Uu)、人型支厚体(Mh)、肺炎支原体(Mpn)、生殖支原体(Mg)、发酵支原体(Mf)、穿通支原体(Mpe)、梨型支原体(Mpi)、7种支原体检测。结果：7种支原体感染阳性数为55例，感染率为72．4％；Uu、Mh、Mpn、MS、Mf、Mpe、Mpi阳性率分别为64．5％、27．6％、26．3％、18．4％、2．6％，2．6％，0；单种、两种、三种、四种支原体合并感染率分别为32．9％、17．1％、14．5％、7．9％；7种支厚体均为阴性占27．6％。结论：男性STD者中存在较高的支原体感染。     

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     

性病患者泌尿生殖道支原体感染188例检测及药敏试验

目的了解泌尿生殖道支原体的感染状况，以及解脲支原体和人型支原体对不同药物的体外敏感性。方法对118例支原体标本做套式聚合酶链反应（nPCR）检测，支原体培养、药敏一体化试剂盒为珠海浪峰生物技术有限公司产品。结果188例样本中解脲支原体（Uu）、人型支原体（Mh）、肺炎支原体（Mpn）、生殖支原体（Mg）4种支原体阳性率分别为66．5％、31．9％、27．7％、17．O％，发酵支原体（Mf）和穿通支原体（Mpe）均为2．7％，梨支原体（Mpi）未检出。Uu和Mh对抗生素高度敏感的依次为交沙霉素、美满霉素、强力霉素、阿奇霉素。结论扬州市男性性病病人支原体感染率较高。Uu和Mh感染对常见的红霉素、四环素等已产生一定的耐药性，及时进行药敏试验、选择高效药物，对降低Uu和Mh耐药株的产生、防止复发和提高治愈率将起到重要作用。     

不同人群女性泌尿生殖道支原体检测及药敏试验

目的 :了解不同人群女性泌尿生殖道支原体的情况和耐药性。方法 :采用IES试剂盒对 41 6例患者进行支原体培养和药敏分析。结果 :41 6例患者中 ,妇产科门诊病人 3 0 2例 ,支原体阳性 1 48例 ,阳性率 49 0 % ,性病科门诊病人 1 1 4例 ,支原体阳性 5 4例 ,阳性率 47 4% ,两者阳性率比较无显著性差异 ( χ2 =0 0 9,P >0 0 5 )。药敏结果表明支原体对交沙霉素、美满霉素及司巴沙星较敏感 ,对罗红霉素、阿齐霉素、氧氟沙星及克林霉素耐药性较高。结论 :不同人群女性泌尿生殖道支原体阳性率妇产科门诊病人和性病科门诊病人无显著性差异 ,药敏结果是指导临床医生用药的主要依据之一。     

支原体感染与类风湿关节炎发病相关性研究

目的：明确支原体感染与类风湿关节炎发病的相关性。方法：选取2017年1~12月我院诊治的类风湿关节炎患者作为研究对象，采集尿道拭子（57例）、咽拭子（120例）、关节液（43例）、宫颈拭子(20例)标本，用PCR方法检测解脲脲原体（Uu）、关节炎支原体（Mar）、人型支原体（Mh）及发酵支原体（Mf）。结果：共收集患者120例，咽拭子Uu阳性率22.5%、Mh阳性率14.2%、Mar阳性率0.8%、Mf阳性率0.8%；尿道拭子Uu阳性率31.6%、Mh阳性率21.1%、Mar阳性率3.5%、Mf阳性率0.0%；关节液的Uu阳性率11.6%、Mh阳性率4.7%、Mar阳性率2.3%、Mf阳性率0.0%；宫颈拭子Uu阳性率45%、Mh阳性率10%、Mar阳性率5%、Mf阳性率0.0%。Uu阳性类风湿关节炎患者与阴性者比较，骨密度降低、关节疾病活动度评分（DAS）3.2~5.1、DAS＞5.1有统计学差异(P＜0.05)。结论：Uu与类风湿关节炎的严重程度可能具有相关性。     

在非淋菌性尿道炎(宫颈炎)患者中穿通支原体、梨支原体、发酵支原体和其他致病性支原体的检测

目的：为进一步探讨在泌尿生殖道和咽部的生殖支原体（Mg）、穿通支原体（Mpe）、梨支原体（Mpi）、发酵支原体（Mf）、解脲脲原体（Uu）和人型支原体（Mh）感染的致病范围、分布特点及其临床意义。方法：用培养法和聚合酶链反应对72例非淋菌性尿道炎（NGU)/粘液脓性宫颈炎（MPC）患者的生殖道（宫颈）及咽部分泌物作了6种支原体的检测。结果：生殖道中检出阳性率分别为生殖支原体23．6％（17／72）、穿通支原体12．5％（9／72）、梨支原体2．8％（2／72）、发酵支原体（0），解脲脲原体26．4％（19／72）和人型支原体8．5％（6／71）。在咽部检出阳性率分别为生殖支原体24．6％（17／69）、穿通支原体14．5％（10／69）、梨支原体（0／69）、发酵支原体（0／69）、解脲脲原体2．9％（2／69）和人型支原体2．9％（2／69）。在生殖道和咽部同时检出又属同种支原体者有10例14．5％（10／69）。结论：在NGU／MPC患者中，常见解脲脲原体、生殖支原体感染，支原体新种穿通支原体的检出值得引起重视。患者生殖道和咽部可同时检出同种支原体，提示生殖支原体、穿通支原体不仅可通过阴－阴性交传播，也可能通过口－阴性交传播。发酵支原体可能与NGU无关。     

生殖支原体和解脲脲原体与非淋菌性尿道炎相关性的研究

目的:研究生殖支原体(Mg)及解脲脲原体(Uu)与男性急性非淋菌性尿道炎(NGU)的相关性。方法:采用病例对照研究,收集性病门诊NGU病人、性病门诊有非婚性行为但无尿道炎的就诊者及健康体检者三组人群的尿道拭子,用AMPLICORCTNGPCRTest进行沙眼衣原体(Ct)的检测,巢式PCR(nPCR)和培养法进行Uu、人型支原体(Mh)的检测,nPCR及扩增产物DNA测序进行Mg的检测。结果:三组人群中Mg的检出情况分别为:25例(25%)、6例(6.4%)和0(P<0.0001),其中6例NGU病人为Ct与Mg混合感染。在NGU和门诊对照组中,Mg阳性者罹患急性NGU的危险性是Mg阴性者的3.917倍,(95%CI:1.618～9.126);在Ct阴性的NGU(NCNGU)中,Mg感染使罹患急性NGU的危险性增加7.2倍(95%CI:2.9～18.0)。nPCR检出三组人群中Uu的携带者分别为:40例(40%)、42例(44.7%)和46例(46.9%)。结论:Mg感染与男性急性NGU呈强相关,Uu与NGU无相关性。     

深圳市性病门诊就诊者生殖道支原体感染状况临床研究

目的:探讨深圳市性病门诊患者生殖道支原体感染状况。方法:选择2013年1月至2015年1月在本院性病门诊就诊患者作为研究对象。结果:70例入选患者中解脲支原体及人型支原体感染情况分别为24例(34.29%)、6例(8.58%),解脲支原体的感染率明显高于人型支原体,其差异有统计学意义(P<0.05)。男性及女性患者人型支原体感染情况分别为2例(4.26%)、4例(17.39%),其差异有统计学意义(P<0.05)。15例解脲支原体感染的男性患者中,解脲支原体≥104ccu/m L者为11例(73.33%),9例解脲支原体感染的女性患者中,解脲支原体≥104ccu/m L者为6例(66.67%),差异没有统计学意义(P>0.05)。结论:深圳市性病门诊患者受到解脲支原体感染较严重,而解脲支原体感染情况和性别无关;女性患者人型支原体感染率明显比男性高;支原体菌量和性别不相关,菌量和致病性之间的关系也有待于临床上进一步研究。     

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。     

Sexually transmitted infections in rural Madagascar at an early stage of the HIV epidemic: a 6-month community-based follow-up study

BACKGROUND AND OBJECTIVES: Sexually transmitted infections (STIs) in Madagascar have primarily been monitored in selected groups of patients attending STI clinics in major cities as part of the HIV surveillance program in Madagascar. GOAL OF THE STUDY: The aim of the study was to provide complementary data related to STI prevalence in a general rural population. STUDY DESIGN: STIs were investigated in 643 subjects aged 15 to 49 years as part of a cross-sectional morbidity study of urogenital schistosomiasis. Infection rates were reassessed 3 weeks and 6 months after systematic STI treatment at baseline. RESULTS: Neisseria gonorrhoeae (Ng), Chlamydia trachomatis (Ct), Mycoplasma genitalium (Mg), Trichomonas vaginalis (Tv), and/or antibodies to Treponema pallidum (Tp) were diagnosed in 125 (37.5%) of 333 women and in 83 (26.8%) of 310 men. In addition, 49% of the women and 28% of the men were infected with herpes simplex virus-2. Six (0.9%) subjects were found HIV-antibody positive. Between the 3-week and 6-month follow-up surveys Ng, Ct, and/or Mg prevalence increased most prominently in women aged 15 to 24 years. CONCLUSION: Study findings suggest that rural areas in Madagascar should be as closely monitored and assisted in STI and HIV control as their urban counterparts. Following the current consensus, young adults should constitute a priority target group in the control programs.     

An evaluation of sexually transmitted infection case management in health facilities in 4 border provinces of Cambodia

BACKGROUND: Cambodia has reported the highest prevalence of HIV in the general population in Asia. Sex work and high sexually transmitted infection (STI) prevalences are thought to be major contributory factors. GOAL: The goal of this study was to assess standards of STI care through a survey of public sector health facilities in 4 border provinces of Cambodia. METHODS: Healthcare facilities providing STI care were identified. Interviews were held with healthcare providers and STI patients and a manual check made of the STI register and standard medical history forms for female sex workers (SWs) registered with the 100% condom use program. Clinical management was assessed for SWs, women with vaginal discharge, and men with urethral discharge. Advice about condom use, partner notification, STI and HIV education, and availability of STI drugs were reviewed. RESULTS: Seven percent of all patients seeking health care at health centers (HCs) had STI-related problems. Coverage of sex workers was high in 3 provinces. Drug stock outs, particularly cefixime, occurred at all levels of assessment. In STI clinics, almost all (99-100%) cervicitis and urethritis cases were diagnosed and treated correctly. In HCs with integrated STI services, according to national guidelines, cervicitis was diagnosed in 65% of women with vaginal discharge of whom 47% were diagnosed correctly, and in these, 88% were treated correctly. Sixty-six percent of SWs seen at STI clinics were diagnosed with cervicitis and 54% at follow up. CONCLUSIONS: STI services should be expanded further to health centers not currently offering STI care. Overtreatment for cervicitis in both SWs at reattendance and low-risk women with vaginal discharge are continuing problems. The WHO/UNAIDS STI service indicator criteria had limited application for the assessment of SW services but were adapted for local needs. Attendance of SWs in designated STI clinics appears to be a useful indicator for the acceptability and efficiency of the current national STI program.     

Research on sexually transmitted infections in asymptomatic heterosexual males whose partners have cervical intraepithelial neoplasia

IntroductionHuman papillomaviruses (HPV) are the etiological agents of genital warts and of cervical intraepithelial neoplasia (CIN), and they are sexually transmitted. The aim of this study is to determine the prevalence of sexually transmitted infections (STI) in asymptomatic heterosexual males who consult their physicians seeking advice after their partners have been diagnosed with CIN.Methods181 asymptomatic males whose partners were women diagnosed with CIN were studied at the STI unit in Gijón over a five-year period (1999-2003). The same diagnostic protocol was used in all cases: clinical exam, genitoscopy and the taking of samples for bacterial, fungus and Trichomonas cultures, as well as samples for the genomic detection of Chlamydia, and syphilis, HIV and viral hepatitis serology.Results101 infections were diagnosed in 85 patients (47 %). By order of greatest prevalence, these were: urethritis from Ureaplasma urealyticum (35/181; 19.3 %), genital warts (31/181; 17.1%), Haemophilus spp. (12 de 181; 6.6%) and mycotic balanoposthitis (10/181; 5.5 %).ConclusionsThe prevalence of STI in the partners of women with CIN is high, and in these cases it is necessary to establish STI detection and control programs in both members of the couple.     

Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention

Sexually transmitted co-infections increase HIV infectiousness through local inflammatory processes. The prevalence of STI among people living with HIV/AIDS has implications for containing the spread of HIV in general and the effectiveness of HIV treatments for prevention in particular. Here we report a systematic review of STI co-infections in people living with HIV/AIDS. We focus on STI contracted after becoming HIV infected. Electronic database and manual searches located 37 clinical and epidemiological studies of STI that increase HIV infectiousness. Studies of adults living with HIV/AIDS from developed and developing countries reported STI rates for 46 different samples (33 samples had clinical/laboratory confirmed STI). The overall mean point-prevalence for confirmed STI was 16.3% (SD=16.4), and median 12.4% STI prevalence in people living with HIV/AIDS. The most common STI studied were Syphilis with median 9.5% prevalence, Gonorrhea 9.5%, Chlamydia 5%, and Trichamoniasis 18.8% prevalence. STI prevalence was greatest at the time of HIV diagnosis, reflecting the role of STI in HIV transmission. Prevalence of STI among individuals receiving HIV treatment was not appreciably different from untreated persons. The prevalence of STI in people infected with HIV suggests that STI co-infections could undermine efforts to use HIV treatments for prevention by increasing genital secretion infectiousness.     

荧光定量PCR检测女性商业性性工作者性传播感染

目的：了解女性商业性性工作者(FSWs)沙眼衣原体(Ct)、淋球菌(NG)、单纯疱疹病毒(HSV)及人乳头瘤病毒(HPV)等常见性传播感染(STI)的患病情况。方法：选取深圳市收容教育所2002年11～12月因卖淫而收容教育的130例FSWs作为研究对象，采用荧光定量PCR(FQ—PCR)检测宫颈分泌物Ct、NG、HSV及HPV感染。结果：FQ—PCR检测130例FSWs宫颈分泌物的Ct阳性检出率为32．3％、NG阳性检出率为16．2％、HSV为5．4％、HPV6／11、HPV16和HPV18分别为7．7％、23．8％和12．3％。STI总的阳性检出率为60．8％，混合感染率为25．4％。结论：女性商业性性工作者的STI患病率高，应引起足够重视。     

Sentinel surveillance of sexually transmitted infections in South Africa: a review

OBJECTIVES: To review studies of sexually transmitted infection (STI) prevalence in South Africa between 1985 and 2003 in selected sentinel populations. To examine how STI prevalence varies between populations and to identify the limitations of the existing data. METHODS: Studies of the prevalence of syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, chlamydia, trichomoniasis, bacterial vaginosis, candidiasis, and herpes simplex virus type 2 (HSV-2) were considered. Results were included if they related to women attending antenatal clinics or family planning clinics, commercial sex workers, individuals in the general population (household surveys), patients with STIs, patients with genital ulcer disease (GUD), or men with urethritis. RESULTS: High STI prevalence rates have been measured, particularly in the case of HSV-2, trichomoniasis, bacterial vaginosis and candidiasis. The aetiological profile of GUD appears to be changing, with more GUD caused by HSV-2 and less caused by chancroid. The prevalence of gonorrhoea and syphilis is highest in "high risk" groups such as sex workers and attenders of STI clinics, but chlamydia and trichomoniasis prevalence levels are not significantly higher in these groups than in women attending antenatal clinics. CONCLUSIONS: The prevalence of STIs in South Africa is high, although there is extensive variability between regions. There is a need for STI prevalence data that are more nationally representative and that can be used to monitor prevalence trends more reliably.     

Gender differences in the prevalence of sexually transmitted infections and genital symptoms in an urban setting in southern India

OBJECTIVES: To examine gender differences in sexual behaviour, the prevalence of laboratory-detected sexually transmitted infections (STIs) and self-reported genital symptoms in urban Chennai, Tamil Nadu, India. STUDY DESIGN: The data were based on a cross-sectional survey (n = 1649) of residents from low-income communities in Chennai. Data were collected during community-wide health camps comprising physical examinations, interviews and laboratory testing between March and June 2001. RESULTS: The population was young, sexually active, with a low prevalence of STI. The most commonly detected STI was Herpes simplex virus type 2 (HSV2; 13.2%). Women had a higher prevalence of HSV2, but were more likely than men to be asymptomatic. Most of the self-reported genital symptoms could not be linked to a laboratory-detected STI. >10% of the cohort had a history of an ulcerative STI and >5% had an inflammatory STI. CONCLUSIONS: Given a high prevalence of HSV2 in the study population, interventions targeting HSV2 transmission may be particularly relevant for this population.