阿奇霉素治疗淋菌性和非淋菌性尿道炎疗效观察

淋病奈瑟氏菌 (NG)、解脲支原体 (U U)和沙眼衣原体(CT)是泌尿生殖道感染的主要病原体之一。用阿奇霉素对淋菌性尿道炎 (GU)和非淋菌性尿道炎 (NGU) 133例进行治疗 ,现报告如下。1　资料与方法1.1　临床资料　 133例患者来自性病门诊 ,均有不洁性生活史 ,年龄 18～ 6 8岁 ,病程 2～ 6 0天 ,就诊时均进行尿道分泌物检查。 113例患者中 ,GU 5 9例 ,NGU 5 1例 ,GU合并NGU2 3例 ,其中 GU+U U10例 ,GU+CT9例 ,GU+U U+CT4例。1.2　标本采集及检查　用灭菌拭子插入男性尿道 2～ 4 cm处 ,取尿道分泌物 ,女性插入宫颈 1～ 2 cm处顺时针…     

1861例非淋菌性尿道炎支原体检测及药敏试验

非淋菌性尿道炎(nongonococcal urethritis,NGU)是指由性接触传染的一种尿道炎,本病20%～30%由支原体感染引起.自从60年代中期以来,NGU发病人数迅速增加,在西方国家已超过淋病,跃居性传播疾病(sexually transmitteddiseases,STD)首位.我国近年来NGU病例数也不断增加,其发病率为STD的第三位[1].解脲支原体(UU)和人型支原体(MH)是引起NGU的主要病原体之一[2].临床上一般首选四环素、红霉素治疗NGU,也常用其它大环内酯类和喹诺酮类药物.为探讨支原体在性病门诊患者中的感染及耐药情况,对2003年1～10月在杭州市第三人民医院性病门诊就诊患者的尿道(宫颈)分泌物进行支原体培养及药敏检测,现将结果报告如下.     

头孢克洛缓释胶囊治疗淋球菌性尿道炎(宫颈炎)附90例报告

2004-01~2004-12,作者应用头孢克洛缓释胶囊治疗淋球菌性尿道炎(宫颈炎),并与头孢曲松钠相比较,取得满意疗效。现报告如下。1资料与方法1·1一般资料90例患者均来自本科皮肤门诊,符合诊断标准。患者大多有尿急、尿痛、尿道口脓性分泌物,尿道口潮红水肿,或宫颈有程度轻重不等的红肿、触痛和出现脓性分泌物;并经尿道或宫颈分泌物革兰氏染色镜检,均发现细胞内革兰氏阴性双球菌,淋球菌培养阳性。并做氧化酶试验。同时排除前列腺或盆腔炎而确诊为淋球性尿道炎(宫颈炎)。剔除对青霉素及头孢克洛过敏患者和预期不能合作或顺应性差的患者,所有患者前…     

淋病合并白色念球菌感染1例报告

1 病历摘要患者,男,28岁。因尿频、尿急、尿痛伴尿道口流脓3天就诊。查:尿道口红、肿,少量脓性分泌物,包皮及龟头亦可见轻微红、肿与脓性分泌物。发病前1周有婚外不洁性交史。取尿道脓性分泌物涂片作Gram染色,在多形核白细胞内找到革兰阴性双球     

尿道口"糊"住有原因

正常男性晨起尿道口可以有1～2滴清亮的分泌物.而在淋球菌、衣原体、支原体以及病毒、霉菌等感染后,尿道口会出现异常分泌物,浑浊、量多,常伴有尿道烧灼感和排尿痛.如与淋病病人性接触后,2～10天出现尿道口大量脓性分泌物,呈深黄色、粘稠,常在内裤上形成脓痂.早期没有尿道症状,随着病情的发展,可出现尿频、尿急、尿痛等尿道刺激症状.     

1例多种性病伴HIV感染报告

唐某、男、 30岁 ,工程师。曾到泰国工作 ,在国外有性乱史。回国后海关检测ＨＩＶ阴性。因尿道、尿道口分泌物 2周 ,来我部就诊。体检尿道口红肿、见有稀薄分泌物 ,挤压时流出少量脓性分泌物 ,冠状沟及包皮内有多个绿豆大小淡红色小丘疹 ,表面呈颗粒状增生 ,粗糙不平 ,酸醋白试验呈阳性 ,ＨＰＶ检查阳性 ,取患者分泌物检查 ,可见大量多型核白细胞。未查见革兰氏阴性双球菌 ,培养衣原体、支原体呈阳性。复查ＨＩＶ -Ａｂ抗体确认阳性 ,诊断 :ＨＩＶ感染伴尖锐湿疣。非淋球菌性尿道炎。治疗局部ＣＯ2 激光碳化。静脉输更昔洛韦2 5 0ｍｇ ,头孢…     

尿道口“糊”住有原因

正常男性晨起尿道口可以有1～2滴清亮的分泌物。而在淋球菌、衣原体、支原体以及病毒、霉菌等感染后，尿道口会出现异常分泌物，浑浊、量多，常伴有尿道烧灼感和排尿痛。如与淋病病人性接触后，2～10天出现尿道口大量脓性分泌物，呈深黄色、粘稠，常在内裤上形成脓痂。日期有尿道症状，随着病情的发展，可出现尿频、尿急、尿痛等尿道刺激症状。     

361例淋病合并非淋菌性尿道炎感染情况分析

目的 了解淋病(GU)患者合并非淋菌性尿道炎(NGU)感染情况.方法 采用解脲支原体(UU)、人型支原体(MH)培养加药敏;淋球菌(NG)培养;沙眼衣原体(CT)抗原检测.结果 361例淋球菌混合支原体或沙眼衣原体单一病原体感染中,以合并UU感染多见,其次为CT;在合并支原体与衣原体的混合感染中又以UU合并CT较多.NGU的单一病原体中以UU较多,其次为CT.NGU混合感染以UU+CT最多,其次为UU+MH;MH+CT和UU+MH+CT混合感染较少见.结论 361例淋病患者合并非淋菌性尿道炎感染率为70.08%(253/361),存在较高的多种病原体混合感染的情况.     

中药治疗淋病验方七则

淋病是性接触传播疾病中流行最广的一种疾病，约占性病中的７５％，由于淋病常以尿道炎为主要症状，故泌尿科门诊过程中常见到。急性淋病初期为急性尿道炎症状，如尿道灼热、疼痛、尿频、尿急以及排尿困难、尿液混浊、尿道口流黄白色粘液脓性分泌物，少数病人有低热、全身不适。体检见尿道口红肿，挤压尿道时流出脓性分泌物。女性病人除有上述症状外，尿频尿急更明显，易出现肉眼血尿。本病西医治疗以抗生素为主，有时疗效并不怎样理想，而中医治疗疗效好，价格低廉，现将临床疗效比较好的七则验方介绍如下，患者可根据情况酌情选用。１马齿…     

淋菌性尿道炎并发瘘管3例报告

例1．男性,39岁,个体户,1996年8月15日来本站门诊。患者3天前因尿道不适,有轻度尿痛,尿道口有分泌物,当天发现阴基体(约离冠状沟1cm处)有一瘘口,轻轻挤压有黄色脓液溢出,经尿道采样及瘘管脓液涂片检查,均找到细胞内G~-双球菌。患者今年以来已患过二次淋病,并有多次婚外性生活史。例2．男性,26岁,供销员,1996年11月12日来本站门诊。患者2个月前曾患过急性淋菌性尿道炎,用过状观霉素2克,次日症状消失。近3、4天尿道溢脓,尿痛,并发现尿道口两侧龟头顶端有二处瘘管,均有脓性分泌物溢出,经尿道采样及二侧瘘管脓液涂片检查,均找到细胞内G~-双球菌,患者有多     

Understanding STDs in Malawi

AIDS control efforts in Malawi include efforts to control other sexually transmitted diseases (STDs). STD control requires a thorough understanding of specific STD prevalence, the potential for managing the STDs without laboratory diagnosis, the efficacy of various antibiotic regimens, and appropriate health-seeking behavior on the part of STD sufferers. Data from several studies were used to modify the World Health Organization STD syndrome management guidelines for use in Malawi. In one ethnographic study, 154 men and women in 2 rural towns were interviewed about their knowledge, beliefs, and experiences with STDs. They described 21 illnesses as sexually transmitted, including several with commonly recognizable biomedical aliases. The people seemed able to differentiate various STDs by their symptoms, although they often described early and late symptoms of the same disease as 2 separate diseases. Information gleaned on health-seeking behavior led to recommendations that communication efforts be undertaken to encourage abstinence during symptoms and the early seeking of treatment from biomedical personnel as well as to provide positive reinforcements of the image of biomedical healers. Another study was undertaken to determine the relative contribution of chancroid and syphilis to genital ulcer disease (GUD), to evaluate the effectiveness of 5 antibiotic therapies for GUD, and to collect data on the characteristics of 778 men presenting with GUD at an urban clinic between September 1992 and March 1993. It was found that cancroid contributed as much to GUD as syphilis in this population, and the cancroid prevalence rate was between 32.8 and 44.6%. Therefore, the researchers recommended treating patients with GUD for both syphilis and chancroid. Erythromycin and ciprofloxacin were effective treatments, whereas trimethoprim sulfamethoxazole was not. A third study assessed relative frequency of gonococcal and nongonococcal urethritis in urban men. The data from this study suggested that asymptomatic infection could be significant in cases where urethritis is treated ineffectively (through self-medication or inappropriately prescribed drugs). Therefore, researchers recommended that highly effective treatment for gonococcal and nongonococcal urethritis be given at the first visit and that inexpensive and easy screening methods be developed to identify asymptomatic male urethritis.     

Chlamydiae as agents of sexually transmitted diseases.

Chlamydiae are being increasingly recognized as an important cause of human disease. The known geographical distribution of lymphogranuloma venereum and the role of chlamydiae as agents of sexually transmitted diseases are reviewed. The presence of chlamydiae in the urethra and the cervix, and their etiological relationship to genital infections, first recognized in connexion with ocular infections, have been proved in a number of studies in selected populations in a few countries. Chlamydiae appear to be the most important agent of nongonococcal urethritis, which in some cases appears now to be more frequent than gonococcal urethritis. In addition to their association with cervicitis, chlamydiae appear also to be fairly frequent in the cervix of apparently normal, asymptomatic, and sexually active women. The role of chlamydiae as agents of other human diseases still requires to be clarified. The organisms have been found in association with pelvic inflammatory disease, neonatal pneumonia, pharyngitis, and otitis. There is need for additional studies in view of the fact that effective chemotherapy is available. An outline is given of laboratory methods that may be useful for the diagnosis of chlamydial infections.     

泌尿生殖道分离支原体及其耐药性

目的了解某地区泌尿生殖道分离支原体及其药敏情况,为临床合理治疗提供依据。方法对2008—2014年该院57 904例门诊患者泌尿生殖道标本进行解脲脲原体(Uu)和人型支原体(Mh)培养、鉴定及药敏试验。结果 57 904例泌尿生殖道感染患者,21 614例(37.33%)培养阳性,女性支原体分离率为42.14%(18 917/44 889),男性为20.72%(2 697/13 015);支原体培养阳性人群主要集中在21~40岁。Uu、Mh混合感染患者中,以Uu≥104 CFU/mL、Mh104 CFU/mL的感染组合占相对优势(69.35%)。药敏结果显示支原体对多西环素、交沙霉素、四环素的耐药率较低(10%);Mh培养阳性者对多西环素、红霉素、克拉霉素、罗红霉素的耐药率均高于仅Uu培养阳性者,差异有统计学意义(均P0.05)。结论门诊患者中支原体感染/携带率女性高于男性,Uu和Mh的药敏谱不一致,交沙霉素和多西环素可作为治疗支原体感染非淋菌性尿道(宫颈)炎的首选药物。     

An evaluation of urethral smear by Papanicolaou stain in men with urethritis

The objective of this study was to evaluate the usefulness of a Papanicolaou stained urethral smear (Pap smear) to identify sexually transmitted disease (STD) pathogens in men with urethritis. Specimens from the endourethra were obtained for Chlamydia trachomatis and Neisseria gonorrhoeae cultures, a Gram stain, and a Pap smear in 24 symptomatic men aged 16–22 years. All Pap smears were read independent of the culture results. Based on the laboratory techniques employed, nine subjects had gonococcal urethritis (GU), and 11 had nongonococcal urethritis (NGU). Four subjects with GU had concomitant infection with another STD pathogen(s). Papanicolaou smear alone identified four different pathogens in 16 subjects, chlamydia in ten, trichomonads in two, intracellular diplococci in two, multinucleate giant cells of herpes in one, and chlamydia and trichomonad together in one. Out of 11 chlamydia-positive Pap smears, three had a positive culture. One subject had a positive chlamydia culture and a negative Pap smear. Two subjects with intracellular diplococci on Pap smear had culture-confirmed gonorrhea. The Pap smear was useful in identifying some of the different pathogens in NGU, especially trichomonads and herpes, not recoverable by commonly used techniques and in the diagnosis of concomitant infection by more than one STD pathogen in GU. Adding the Pap smear to the diagnostic tests for urethritis increased the etiologic diagnoses from 37.5% to 79%.     

Circumcision as a risk factor for urethritis in racial groups.

A retrospective population-based case-control study of sexually transmitted urethritis was conducted at a large military base over a 21-month period. During the study, 9,514 patients were seen for sexually transmitted disease. The analysis was restricted to active duty males and showed that Blacks had 14.8 times the incidence rate of gonococcal urethritis (GCU) and 4.7 times the rate of nongonococcal urethritis (NGU) compared to Whites. There were slightly fewer cases of NGU than GCU. A case-control study of active duty soldiers showed that both Black and White circumcised subjects were 1.65 times as likely to have NGU as uncircumcised subjects (95% CI: 1.37-2.00). However, circumcision was not associated with an increased incidence of GCU.     

男性泌尿生殖道感染奈瑟菌属菌种的基因检测分析

目的 研究男性泌尿生殖道感染奈瑟菌属菌种的基因的检测分析,同时探讨非淋球菌奈瑟菌引起男性泌尿生殖道感染的病原学诊断及临床意义.方法 自2010年3月～2011年10月采集的102例慢性前列腺炎患者的前列腺的精液或按摩液标本,接种于淋球菌琼脂培养基中,放入烘箱中进行培养,采用聚合酶链反应(PCR)检测淋球菌隐蔽性质粒pJDL基因.结果 102例患者的前列腺液、精液标本分离到103株革兰阴性双球菌,其中粘液奈瑟菌39株、灰色奈瑟47株、嗜乳糖奈瑟菌7株、干燥奈瑟菌6株、微黄奈瑟菌2株、多糖奈瑟菌2例.pJDL基因经PCR检测结果显示,99株(95.19％)形成与淋病奈瑟菌一致的阳性反应;103株奈瑟菌对头孢菌素类、喹诺酮类抗生素具有显著的耐药性(35.6％～99.9％).结论 常规的细菌学形态检查、氧化酶试验以及检测隐蔽性质粒,其他淋球菌非特异性基因的方法,可导致对于非淋球菌奈瑟菌感染的误诊与漏诊.感染了泌尿生殖道非淋球菌奈瑟菌对临床常用的多种抗生素具有耐药性或多重耐药性,在疑似奈瑟菌属菌种感染的实验室检查中联合使用常规细菌学方法与基因检测方法,可有助于提高奈瑟菌属菌种鉴定及其感染诊断的准确率.     

男女性生殖道支原体感染药敏谱对比分析

目的:了解男性和女性生殖道支原体的感染状况,分析男性和女性感染支原体的药物敏感情况,为临床工作提供参考。方法:统计分析门诊675例疑似或需排除非淋菌性尿道炎(NGU)或粘液脓性宫颈炎(MPC)的患者尿道或宫颈分泌物支原体分离、鉴定及药敏检测结果。结果:男性支原体的感染占53.2%(202/380),女性占55.3%(163/295)。在9种抗生素的药物敏感试验中,仅强力霉素在高度、中度敏感和耐药的比例分布上,两性差异有统计学意义(P<0.05)。结论:男女两性支原体的感染率,无论是单一解尿支原体(Uu)感染、单一人型支原体(Mh)感染或是Uu和Mh混合感染,差异均无统计学意义。对交沙霉素、美满霉素、阿奇霉素、司巴沙星、罗红霉素、左氧氟沙星、氧氟沙星、克林霉素等8种抗生素的敏感度,两性差异均无统计学意义。     

泌尿生殖道沙眼衣原体感染患者实验室检测分析

目的分析181例实验室诊断沙眼衣原体感染患者的相关实验室检查资料。方法采用细胞培养法进行沙眼衣原体实验室检测,同时检测患者相关性传播疾病的实验室指标。结果沙眼衣原体细胞培养检出率5.45%,患者中单纯由沙眼衣原体感染128例(70.72%),合并解脲脲支原体感染53例(29.28%),亦较少合并生殖器疱疹病毒和真菌感染;沙眼衣原体引起的非淋菌性尿道炎或宫颈炎疾病的治疗主要为大环内酯类、四环素族及喹诺酮类的联合用药,治疗效果未见明显耐药。结论单纯沙眼衣原体感染及其与解脲脲支原体合并感染导致非淋菌性尿道炎或宫颈炎,男性患者亦合并其他性传播疾病,疾病的治疗以联合应用抗菌药物为主。     

Urethritis caused by Neissena meningitidis: A case report

Isolation of N. meningitidis from the male urethra has become more common in recent years and this has been attributed to sexual activities and changes in social attitudes. We describe a further case of acute urethritis caused by transmission of N. meningitidis occurring after a single sexual contact (fellatio) in a heterosexual man. The urethritis was initially diagnosed as being caused by N. gonorrhoeae on a presumptive basis, then attributed to N. meningitidis serogroup Y. This case shows the need of accurate diagnostic procedures in all cases resembling gonococcal urethritis.Corresponding author.     

2156例泌尿生殖道疾病患者衣原体和支原体感染检测与药敏分析

目的通过对2156例可疑非淋球茵性尿道炎（NGU）患者泌尿生殖道沙眼衣原体（CT）、支原体检测及药敏分析，了解其感染与耐药状况。方法应用衣原体试剂盒（胶体金法）检测衣原体。支原体培养及药敏选用支原体药敏试剂盒，并对10种抗生素的敏感性进行分析。结果2156例可NGU患者中，共检出阳性780例（36．18％），男349例，女431例。病原体种类CT214例（9．93％），解脲脲原体（UU）512例（23．75％），人型支原体（MH）12例（O．56％），UU合并MH感染42例（1．95％）。支原体敏感药物多是多西环素、交沙霉素、米诺环素。结论NGU患者中女性感染率明显高于男性，病原体以UU为主，其次为CT、UU＋MH及MH感染。对NGU患者及时进行UU和MH培训及耐药性检测，对指导临床合理使用抗生素具有重要意义。