聚合酶链反应诊断男性沙眼衣原体尿道炎

近20年来,沙眼衣原体被认为是最常见的性传播菌。已有多种诊断试验可以用来检测沙眼衣原体,其中聚合酶链反应(PCR)技术近来已经建立。本文对用PCR检测尿道及尿液标本中沙眼衣原体进行了评价,并与广泛应用的酶标方法进行了比较。 标本是随机取自性病门诊的男性病人。474例取了尿道拭子标本,每份标本同时作PCR及酶标试验。474例中362例同时取了尿液标本作PCR检查。 PCR按常规方法进行,酶标试验用Chamydiazyme试剂盒(Abbott)检测抗原。     

阿奇霉素与血竭治疗男性沙眼衣原体尿道炎的疗效观察

非淋菌性尿道炎 (ＮＧＵ)的发病率在西方国家居性传播性疾病 (ＳＴＤ)的首位 ,40 %～ 5 0 %的ＮＧＵ由沙眼衣原体(ＣＴ)引起〔1〕。积极有效地治疗ＣＴ感染是控制ＮＧＵ的主要措施之一。我们采用阿奇霉素 (克罗地亚普利瓦大药厂生产 )、血竭 (中国科学院西双版纳热带植物园制药厂生产 )联合治疗男性沙眼衣原体尿道炎 43例 ,取得较好效果 ,现报告如下 :1　材料和方法1 1　病例选择　 86例男性患者均为性病专科门诊病例 ,年龄 2 3～ 48岁 ,病程 0 5～ 3月 ,均有不洁性交史 ,有排尿灼痛或尿道不适表现。部分病例尿道口有少许粘性分泌物。其中 …     

男性非淋菌性尿道炎沙眼衣原体感染检测分析

为探讨男性非淋菌性尿道炎 (ＮＧＵ)沙眼衣原体 (ＣＴ)感染状况 ,我们应用ＣｌｅａｒｖｉｅｗＣｈａｍｙｄｉａ(Ｃ -Ｃ快速法 )检测了 12 99例ＮＧＵ患者 ,现将结果报告如下。材料与方法　病例来源 :取尿道分泌物涂片作革兰染色镜检 ,在油镜下查多型核白细胞 (ＰＭＮＬ)数 ,平均视野≥ 3个的在排除淋病后为ＣＴ检测对象。 12 99例均来自我院门诊首诊者 ,年龄在 18～ 74岁之间。ＰＭＮＬ量化分段 3～ 4个 ( ) ,5～ 14( ) ,15～ 2 4 ( ) ,≥ 2 5个 ( )。试剂　Ｃ -Ｃ快速法试剂盒由英国Ｕｎｉｐａｔｈ公司生产 ,广东江门众诚公司提方法…     

大蒜素治疗沙眼衣原体致非淋菌性尿道炎的临床疗效观察

近年来，沙眼衣原体(Chlamydia trachomatis，Ct)所致非淋菌性尿道炎(NGU)的治疗是临床医生关注的一个课题。为了寻找对其较有效的药物，试用口服大蒜素治疗Ct感染的38例NGU患者，并以美满霉素治疗40例Ct所致的NGU患者为对照组。现将初步结果报告如下。     

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％。     

性病门诊男性尿道炎患者沙眼衣原体基因分型

目的 了解性病门诊就诊的尿道炎男性患者中,沙眼衣原体血清型分布情况。 方法 采集2013年1 - 12月中国医学科学院皮肤病医院性病门诊有尿道炎症状的男性患者的尿液,荧光定量PCR检测沙眼衣原体,对沙眼衣原体阳性患者的尿液提取DNA,用巢式 PCR法扩增沙眼衣原体主要外膜蛋白基因ompA的VS1-VS2片段,然后对此片段测序,测序结果用DNAStar5.0软件与每种血清型的参考菌株做比对,分析其血清型。 结果 对2013年432例男性尿道炎患者进行了沙眼衣原体筛查,阳性标本143例,阳性率33.1%。143例沙眼衣原体阳性标本,127例扩增出ompA的VS1-VS2片段,16例未扩增出。127例阳性标本经测序分析获得9种血清型。血清型分布情况如下：E型29（22.83%）、F型28株（22.05%）、D型19（14.96%）、G型16株（12.60%）、J型16株（12.60%）、K型8株（6.30%）、H株5株（3.94%）、I型3株（2.36%）、B型3株（2.36%）,E、F、D、J、G型占85.02%。与标准菌种比对,发现127例菌株中有14株存在碱基突变,为同义突变。 结论 性病门诊男性尿道炎沙眼衣原体血清型主要是E型、F型、D型和G型,与20年前相比,E型菌株比例有所下降,J型菌株比例增高。     

非淋菌性尿道炎男性病人尿标本检测沙眼衣原体的价值

尿道拭子取材是检测非淋菌性尿道炎(NGU)病人衣原体的常规采样方法。既往曾采用尿液标本培养来诊断衣原体感染,但不如尿道拭子培养方法敏感。随着衣原体免疫学诊断方法的发展,人们试图用尿液标本这种不需插入尿道的采样方法取代尿道拭子取材。本文对直接免疫荧光法(MT)及酶免疫法(IDEIA)检测尿液中衣原体进行了综合性的研究和评价。 112例研究对象为到圣玛丽医院就诊的患有急性NGU的同性恋病人,3个月内使用     

聚合酶链反应检测男性非淋菌性尿道炎沙眼衣原体和解脲支原体

应用聚合酶链反应(PCR)检测了139例男性非淋菌性尿道炎(NGU)患者泌尿道标本中的沙眼衣原体(CT)和解脲支原体(UU)的DNA,结果:沙眼衣原体的阳性率为53.96％(75例),解脲支原体的阳性率为19.43％(27例),其中仅1例患者二种病原体同时阳性。结果表明沙眼衣原体和解脲支原体是男性非淋菌性尿道炎的主要致病菌;对检测阴性的患者,有必要做进一步的检测,以利于临床有效治疗。     

聚合酶链反应检测310例男性非淋菌性尿道炎沙眼衣原体和解脲支原体的观察

聚合酶链反应检测３１０例男性非淋菌性尿道炎沙眼衣原体和解脲支原体的观察雍刚李绍兴廖巫山本组对排除淋菌感染的３１０例男性尿道分泌物标本，用聚合酶链反应（ＰＣＲ）检测沙眼衣原体（ＣＴ）和解脲支原体（ＵＵ），根据分泌物涂片中多形核白细胞（ＰＭＮ）数在油镜下...     

Asymptomatic Chlamydia trachomatis urethritis in men

Ten men with asymptomatic urethritis due to Chlamydia trachomatis were identified through culture screening and were treated with ceftriaxone (1 g given intramuscularly). Seven of the eight men who were followed for at least 21 days before and after therapy remained asymptomatic but culture-positive. One originally asymptomatic man had onset of symptomatic non-gonococcal urethritis 18 days after his first positive culture. Among asymptomatic men with positive cultures, pyuria was present in urine specimens obtained at 17 of 18 visits, while the leukocyte count on the urethral gram stain was above normal at ten of 29 visits (P less than .01). Therefore, one may conclude that ceftriaxone (1 g given intramuscularly) was ineffective therapy for chlamydial urethritis; male urethral infection with C. trachomatis can remain asymptomatic for 21-45 days; and in this population pyuria detected by urinalysis correlates better with infection than does a urethral gram stain.     

Partial efficacy of clindamycin against Chlamydia trachomatis in men with nongonococcal urethritis

Tetracyclines are the drugs of choice for treatment of Chlamydia trachomatis infection, but alternative antimicrobial agents are needed. Clindamycin has moderate in-vitro activity against C. trachomatis. In this study clindamycin (600 mg orally three times daily for seven days) was given to 76 men with nongonococcal urethritis. Initial microbiologic and clinical responses were significantly better in men from whom C. trachomatis was initially isolated, compared with men from whom Ureaplasma urealyticum was initially isolated, but by 42 +/- 7 days after initiation of treatment, persistence or recurrence of urethritis had occurred in 39% of men with either organism initially isolated. C. trachomatis was ultimately reisolated at follow-up evaluation from seven of 23 men who initially had had positive cultures for C. trachomatis. There was no apparent relationship between the in-vitro susceptibility of C. trachomatis and the ultimate response. These results indicate that clindamycin cannot be relied upon to eradicate C. trachomatis from men with urethritis.     

1568例非淋菌性尿道炎患者的衣原体,支原体感染情况分析

对１５６８例非淋菌性尿道炎（ＮＧＵ）用衣原体抗原快速免疫测定法检测分泌物中沙眼衣原体（ＣＴ）；用选择培养法检测分泌物中解脲支原体（ＵＵ）和人型支原体（ＭＨ）。结果ＣＴ阳性４０５例（２５．８％）；ＵＵ阳性３８４例（２４．５％）；ＭＨ阳性２０１例（１２．８％）。健康对照组１１５例检出ＣＴ２例（１．７％）；ＵＵ３例（２．６％）；ＭＨ１例（０．９％）。两组之间有非常显著性差异（Ｐ＜０．０１）。同时发现ＣＴ和ＵＵ；ＵＵ和ＭＨ，ＣＴ和ＭＨ，ＣＴ和ＵＵ及ＭＨ混合感染占有一定比例，分别为６．６％，１．６％，０．６％和０．４％     

Bacterial flora in the urethra of men with Chlamydia trachomatis urethritis before and after treatment with ofloxacin

From urethra of 40 men with CTU, 190 bacterial strains were isolated, 110 before and 80 after treatment with OFX (400 mg daily for 5 days). Among the strains coexisting with Chlamydia trachomatis, Staphylococcus epidermidis (30.9%), Micrococcus (13.6%), Streptococcus group D (10.9%) and Staphylococcus aureus (10.9%) were isolated more frequently than others. The in vitro susceptibility testing showed that, in comparison to erythromycin, doxycycline, oxytetracycline and co-trimoxazole, OFX was the most active antimicrobial agent against the majority of bacteria (except streptococci) isolated from urethra in CTU cases in men. The OFX treatment was found to reduce the total number of isolated strains, including Staphylococcus aureus and Staphylococcus saprophyticus, without disturbing normal urethral flora.     

Diagnosis and treatment of urethritis in men

Urethritis in men may be divided into gonococcal or non-gonococcal. These cannot be distinguished by symptoms and signs. Gram stain and culture remain the best methods for diagnosing uncomplicated lower genital tract gonorrhoea. Uncomplicated gonorrhoea responds to a single dose of a suitable antimicrobial, the choice of dose and drug depending on antimicrobial sensitivity. In non-gonococcal urethritis, Chlamydia trachomatis may be identified in up to 58% of cases by cell culture or antigen identification methods, such as immunofluorescence or enzyme assay, with cell culture being the gold standard. Chlamydia responds to a minimum 6-day course of a tetracycline or erythromycin, though longer courses are frequently prescribed. Resolution of symptoms, signs and evidence of urethritis may be a problem. Management of urethritis includes sexual partner notification, examination, investigation and treatment. Rapid accurate diagnosis and effective treatment are vital to prevent complications, to control spread, and to minimize the role of gonococci and chlamydia in the transmission of human immunodeficiency virus (HIV) infection.     

口服盐酸莫西沙星治疗非淋菌性尿道(宫颈)炎临床观察

目的 观察口服盐酸莫西沙星治疗非淋菌性尿道(宫颈)炎的临床疗效和安全性.方法 沙眼衣原体或/和解脲脲原体感染引起的非淋菌性尿道(宫颈)炎患者504例,采用盐酸莫西沙星口服,每次400 mg,每日1次,连续12天.结果 504例患者痊愈率为68.4%,总有效率为83.1%.沙眼衣原体和解脲脲原体感染清除率分别为84.8%和87.2%.不良反应发生率为7.9%.结论 盐酸莫西沙星治疗非淋菌性尿道(宫颈)炎疗效好,安全性高.     

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in Turkey among men With urethritis.

BACKGROUND: Chlamydia trachomatis and Neisseria gonorrhoeae are known to cause urethritis. However, only a small number of studies in Eastern European countries have investigated the causes of urethritis. GOALS: To determine the prevalence of C trachomatis and N gonorrhoeae among men with symptomatic urethritis in Istanbul, Turkey, and to determine whether contact with a commercial sex worker increased the likelihood of chlamydial infections. STUDY DESIGN: Men with a diagnosis of urethritis at the Istanbul Faculty of Medicine were screened for C trachomatis and N gonorrhoeae by Abbott's ligase chain reaction (LCR) using either urethral swabs or first-void urine. N gonorrhoeae cultures were done on a subset of these patients. RESULTS: The study enrolled 813 men. All of the men denied condom use during their previous sexual exposures. The overall prevalence of C trachomatis, as determined by LCR, was 15.7%. Only 192 patients were screened for both organisms. N gonorrhoeae prevalence was 9.4%. There was no difference in the chlamydia prevalence between men who had contact with commercial sex workers (CSWs) and men who had no such contact (15.3% versus 17.2%). However, clients of foreign CSWs were more likely to have chlamydia than clients of registered Turkish CSWs. CONCLUSIONS: C trachomatis and N gonorrhoeae are commonly found in Turkish men with urethritis. The findings did not show more chlamydial infection among men who had contact with CSWs than among men who had no such contact. The failure to use condoms among these men must be addressed.     

Single-dose minocycline in the treatment of gonococcal urethritis. Clinical efficacy in relation to bacterial resistance and its effects on associated Chlamydia trachomatis infections.

Seventy-two men with gonococcal urethritis were given a single 300-mg dose of minocycline. The failure rate was 13% and the trial was terminated at an early stage. Failure was correlated with increased resistance of Neisseria gonorrhoeae to minocycline. The activity of penicillin, spectinomycin, erythromycin, tetracycline, sulphamethoxazole, cefuroxime, cefotaxime, rosamicin, thiamphenicol, and piperacillin against N. gonorrhoeae were examined in vitro. With the exception of spectinomycin, parallel patterns of resistance to the other antibiotics and minocycline were found. Resistance to spectinomycin was not found, confirming the usefulness of this antibiotic in the treatment of gonorrhoea. The incidence of PGU was significantly lower after a single dose of minocycline than in previous studies.     

Single-dose minocycline in the treatment of gonococcal urethritis. Clinical efficacy in relation to bacterial resistance and its effects on associated Chlamydia trachomatis infections.

Seventy-two men with gonococcal urethritis were given a single 300-mg dose of minocycline. The failure rate was 13% and the trial was terminated at an early stage. Failure was correlated with increased resistance of Neisseria gonorrhoeae to minocycline. The activity of penicillin, spectinomycin, erythromycin, tetracycline, sulphamethoxazole, cefuroxime, cefotaxime, rosamicin, thiamphenicol, and piperacillin against N. gonorrhoeae were examined in vitro. With the exception of spectinomycin, parallel patterns of resistance to the other antibiotics and minocycline were found. Resistance to spectinomycin was not found, confirming the usefulness of this antibiotic in the treatment of gonorrhoea. The incidence of PGU was significantly lower after a single dose of minocycline than in previous studies.