消眼衣原体和支原体所引起非淋菌性尿道炎和宫颈？…

目的 对７６例临床症状不突出，容易被忽视的沙眼衣原体和支原体引起的非淋菌性尿道炎和宫颈管炎的临床资料进行分析。方法 设计调查表格，由有丰富临床经验的医生对病人进行调查和填写表格；沙眼衣原体实验诊断采用英国ＣＬＥＡＲＶＩＥＷ试剂盒，支原体由液体培养基培养。采用淋球菌培养方法除外淋球菌感染。结果 男性尿道沙眼衣原体或支原体感染，表现为尿道口稀薄分泌物占７４．４％（２９／３９）。女性宫颈管沙眼衣原体或支     

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。     

男性尿道分泌物病征处理流程图的临床应用和评价

目的 对男性尿道分泌物病征处理流程图进行了临床应用和评价。方法 应用修改后的男性尿道分泌物病征处理流程图,对有尿道分泌物的男性病人进行规范的病征处理,同时进行病原学诊断。结果 对159例有尿道分泌物的男性病人进行了性病病征处理和病原学检查。共有92例淋球菌感染（57.9％）,61例沙眼衣原体感染（38.4％）,34例淋球菌和沙眼衣原体合并感染（21.4％）。该流程图的敏感性为100％,阳性预期值74.8％～85.5％。结论 男性尿道分泌物病征处理流程图对有尿道分泌物的男性病人有较满意的临床治疗效果。     

男性尿道分泌物病征处理流程图的临床应用和评价

目的：对男性尿道分泌物病征处理流程图进行了临床应用和评价。方法：应用修改后的男性尿道分泌物病征处理流程图，对有尿道分泌物的男性病人进行规范的病征处理，同时进行病原学诊断。结果：对159例有尿道分泌物的男性病人进行了性病病征处理和病原学检查。共有92例淋球菌感染（57．9％），61例沙眼衣原体感染（38．4％），34例淋球菌和沙眼衣原体合并感染（21．4％）。该流程图的敏感性为100％，阳性预期值74．8％－85．5％。结论：男性尿道分泌物病征处理流程图对有尿道分泌物的男性病人有较满意的临床治疗效果。     

森澳欣治疗非淋球菌性尿道(宫颈)炎疗效观察

作者近年来用司帕沙星 (商品名森澳欣由郑州化学药品有限公司提供 )治疗非淋球菌性尿道 (宫颈 )炎 ,并与强力霉素作对比观察 ,取得较满意的疗效 ,现将结果报告如下 :1　一般资料病例选自门诊 ,选择标准为有尿道症状且淋球菌培养阴性者 ,共 4 0例 ,其中男性 2 2例 ,女性 18例 ,年龄 2 0至 4 5岁 ;病程半个月至 1年。男性患者均有非婚性交史 ,女性患者为配偶所感染。男性患者均有程度不等的尿频、尿急及尿道口少许粘性分泌物 ;女性患者多表现为白带增多 ,余无明显不适。 4 0例患者均做尿支原体培养和沙眼衣原体检测。2　检测方法及结果2 1　…     

老年男性尿道旁腺感染临床特点

目的探讨老年男性患者尿道旁腺感染的临床特点。方法对68例老年尿道旁腺感染患者临床病例资料进行分析,重点分析尿道旁腺分泌物微生物学检查资料,并对临床疗效进行评价。结果 68例患者均有≥1种反复发作的不同程度尿路疼痛刺激症状:尿频、尿急、尿痛、尿道外口有脓性或稀薄分泌物40例;排尿不畅、排尿后有灼热感、刺痛感、性交痛49例;自觉尿道外口疼痛、触痛38例;尿道外口尿道旁腺形成脓肿,破溃后伴有脓血性分泌物从直径约2 mm孔中溢出12例;下腹部会阴区胀痛不适20例;伴有严重包皮龟头炎13例,微生物检查68例均发现特殊微生物(包括解脲型支原体17例、淋球菌8例、沙眼衣原体5例、白色念珠菌3例)及其他普通细菌(粪肠球形菌15例、人葡萄球菌12例、溶血性葡萄球菌11例、金黄色葡萄球菌10例、大肠埃希菌8例、无乳链球菌2例)。68例患者经针对性治疗后62例症状消失,复查尿道旁腺分泌物、尿常规、尿中段细菌培养或(和)尿道膀胱镜均呈阴性。12例尿道旁腺脓肿患者行尿道旁腺脓肿切开引流同时配合敏感抗生素亦全部治愈。结论老年尿道旁腺感染比较痛苦、病程长、致病病原微生物复杂、诊断明确并规范的综合治疗可显著提高临床疗效。     

沙眼衣原体空气传播感染

沙眼衣原体是泌尿生殖道及结膜的病原体。通常认为直接接触或与感染的粘膜和分泌物接触后才会传播。本文报告3例沙眼衣原体感染,其中1例可能为空气传播.例1 29岁男性,发病开始为眼灼热及搔痒伴结膜分泌物。症状持续10个月。后因阴茎头红痒时才从咽部、结膜及尿道分离出沙眼衣原体。经用四环素及强力霉素治疗无效,改用利福平治疗。例2 27岁女性,为例1之妻子。在例1发病后10个月开始结膜灼热发红,随后阴道痒,性交困难及白带过多。从结膜、咽喉、尿道及宫颈找到沙眼衣原体。四环素及强力霉素治疗无效,采用利福平治疗。     

性病门诊患者中泌尿生殖系病原体感染分析

本文对２６５泌尿生殖系感染的现患病人进行分析，以了解性传播疾病病原体分布状况。结果表明：单一病原体感染构成比高低依次为淋球菌（４８７％）、沙眼衣原体（３８３４％）、解脲支原体（１２９５％）；混合感染占病例总数的２４６１％，其中淋球菌与解脲支原体混合感染的比例最高（６９８４％）；支原体、衣原体感染性别构成比无明显区别，而淋球菌感染的性别构成比是男性高于女性。在性病防制中，非淋菌性尿道炎。不可忽视。     

290例泌尿生殖道感染患者淋球菌、沙眼衣原体和解脲支原体的检测分析

随着非淋球菌性尿道或宫颈炎 (NGU)发病率的增高 ,泌尿生殖道感染中两种或以上病原体混合感染已成为性病治疗的一大难题。为了探讨性传播疾病 (STD)混合感染情况 ,我们对 1997～ 1999年性病门诊收治的 2 90例泌尿生殖道感染患者 ,同时检测淋球菌 (NG)、沙眼衣原体 (CT)、解脲支原体(U U) ,现将结果报告如下。一般资料 :本组男 110例 ,女 180例 ;平均年龄 2 9岁。82 %患者有性乱史 ,所有患者均有不同程度的泌尿生殖道感染症状。方法 :将棉拭子插进男性尿道内 2～ 3cm、女性宫颈内 1～ 1.5 cm捻转 ,取出标本送检。淋球菌及解脲支原体检测…     

阿奇霉素治疗沙眼衣原体感染性尿道炎30例

沙眼衣原体性尿道炎为性接触传染，临床上发病率较高，占非淋菌性尿道炎的３０％～４０％。近年来我们采用北京太洋药业有限公司生产的阿奇霉素（ＡＺＭ，商品名泰力特）治疗此症３０例，取得良好疗效，现报告如下。临床资料：本组３０例均为男性患者，年龄２５～４５岁、平均３３岁；病程１周至８个月，平均５８天。患者均有非婚性接触史或配偶感染史，表现为尿道有稀薄粘液脓性分泌物２０例，尿痛１６例，尿道刺痒５例，尿道不适感１例，尿道口粘膜红肿６例，尿频５例。患者１周内以均未使用其他抗生素，对红霉素类药物无过敏史，无严重肝…     

Quantitative culture of Chlamydia trachomatis: relationship of inclusion-forming units produced in culture to clinical manifestations and acute inflammation in urogenital disease.

The relationship of Chlamydia trachomatis inclusion-forming units in quantitative culture to clinical manifestations and inflammation in urogenital disease was assessed in 1179 patients attending a sexually transmitted diseases clinic. In women, greater inclusion-forming unit counts were associated with cervical mucopus (3000 vs. 450 ifu), amount and character of cervical discharge, > or =30 polymorphonuclear cells (PMNL) per high-power field (hpf) on Gram stain (2050 vs. 320 ifu), and diagnoses of mucopurulent cervicitis (MPC; 2550 vs. 300 ifu) and pelvic inflammatory disease (PID; 3000 vs. 578 ifu). In men, greater inclusion-forming unit counts were associated with urethral discharge (85 vs. 44 ifu), amount and character of discharge, and > or =10 PMNL/hpf (95 vs. 50 ifu). These associations persisted on multivariate analysis. Thus, chlamydial replication is associated with MPC and PID in women, urethritis in men, and inflammation in both. Since infections with high inclusion counts may be the most transmissible, identification and treatment of patients with these chlamydia-associated syndromes is important in control programs.     

Serum C-reactive protein cannot differentiate bacterial and viral aetiology of community-acquired pneumonia in children in primary healthcare settings

Whether serum C-reactive protein (CRP) can be used to distinguish bacterial from viral pneumonia was studied in 193 paediatric patients who were identified in a prospective, population-based study. The proportion of patients < 5 y of age was 51%, 53% of these and 12% of the older patients were treated in hospital. Pneumococcal aetiology of infection was studied in paired sera by antibody and immune-complex assays, and chlamydial, mycoplasmal and viral aetiologies by routine antibody assays. CRP concentration was measured by immunoturbidometry. Pneumococcal infection (mixed infections with other agents included) was present in 57 cases, mycoplasmal and/or chlamydial infection (pneumococcal infections excluded) in 43, and viral infection (pneumococcal, mycoplasmal and chlamydial infections excluded) in 29 cases. The mean CRP concentrations (95% confidence interval) in these groups were 26.8 mg/l (20.1-33.5 mg/l), 31.8 mg/l (20.5-33.1 mg/l) and 26.1 mg/l (19.1-33.1 mg/l), respectively, and 24.9 mg/l (18.8-31.0 mg/l) in patients with no aetiological findings. When CRP values were compared between the 2 diagnostic groups of pneumococcal infections (antibody and immune-complex positive) no difference was found. In infants < 12 months of age the mean CRP concentration was 14.6 mg/l, and in 11 (65%) of them it was unmeasurable (< 10 mg/l). No significant differences were seen between hospitalized patients and outpatients. In conclusion, CRP concentration had no significant association with the microbial aetiology of pneumonia.     

Detecting cervical infection among family planning clients: difficulties at the primary health-care level in Indonesia

In developing and testing an operational model for the integration of reproductive tract infection/sexually transmitted disease (RTI/STD) management into existing family planning (FP) services in Indonesia, this study allowed for assessment of disease prevalence and evaluation of diagnostic methods for detection of endocervicitis caused by chlamydial infection and/or gonorrhoea. Data were collected over 28 weeks in 1997 at 2 FP clinics in the low-income harbour neighbourhood of North Jakarta. Among 486 consenting female FP clients, prevalence of chlamydial infection was 9.3%, gonorrhoea 1.2%, trichomoniasis 4.5% and syphilis 0.8%. Clinically observed abnormal vaginal discharge, cervical inflammation and vaginal lesions/ulcers were all associated with cervical infection (P<0.05), but insufficiently sensitive (<60%). Clinical diagnosis for cervical infection had 48.8% sensitivity, 75.4% specificity, but only 18.3% positive predictive value (PPV). On-site Gram stains for gonorrhoea were 83.3% sensitive and 94.5% specific, but had only 16.1% PPV. Presence of mucopurulent cervicitis was only 39.6% sensitive for cervical STD, with PPV of only 16.3%. Development of an affordable and accurate detection tool for chlamydial infection remains the main obstacle to effective RTI/STD management in this population.     

Diagnosis of gonorrhoea using a genetic transformation test at a venereal disease clinic in Thailand

A genetic transformation test (GTT), a technique in which gonococcal DNA is detected in clinical specimens, was used to search for Neisseria gonorrhoeae infections in 37 men and 159 women at the Venereal Disease clinic in Cholburi, Thailand. Swabs were collected in duplicate from cervical specimens from 159 women and from urethral specimens from 37 men. One of each specimen was cultured on Thayer-Martin media while the other was mailed to the United States at room temperature for the GTT which involved a delay of 10 to 14 days. With the urethral specimens N. gonorrhoeae was identified in 84% (31/37) of specimens and there was 100% concordance between the results of the GTT and culturing specimens directly on Thayer-Martin media. With cervical specimens N. gonorrhoeae was isolated from 26% (41/159) by the standard culture technique and 19% (13/159) by the GTT. Seventy-six percent of the culture positive specimens were positive with the GTT and two specimens from which N. gonorrhoeae were not isolated were positive in the GTT. The GTT technique enables physicians to send swab collected from patient with suspected gonorrhoea without any special transport media to a central laboratory for laboratory diagnosis of gonorrhoeal infections. This technique which uses reagents which are available in most bacteriology laboratories, should facilitate surveillance of gonorrhoea especially when specimens are collected in clinics where bacteriology laboratory facilities are not available.     

Screening for Chlamydia trachomatis infection in college women with a polymerase chain reaction assay.

This study sought to determine factors associated with chlamydial infection in a low-prevalence college health setting and to determine the testing characteristics of a polymerase chain reaction (PCR) assay for chlamydial infection (AMPLICOR chlamydia test; Roche Diagnostic Systems, Indianapolis) in this population. Young women (n = 1,149) at a university student health clinic underwent testing for cervical chlamydial infection by PCR assay and culture; the characteristics of women with and without chlamydial infection were compared. Chlamydial infection was diagnosed for 26 students (2.3%). The sensitivity and specificity of PCR assay and culture were 85% and 100% and 54% and 100%, respectively. Students with chlamydial infection were more likely to be 20 years of age or younger, have symptoms, report prior chlamydial infection or gonorrhea, report exposure to a sexually transmitted disease (STD), be black, or have cervical signs during examination; however, none of these were significant predictors for asymptomatic women. PCR assay detected significantly more cervical infections than did culture in this college student population. These data are consistent with recommendations for testing college women with symptoms, STD exposure, or age of younger than 25 years.     

Comparison of cervical, urethral, and urine specimens for the detection of Chlamydia trachomatis in women

Cervical, urethral, and first void urine (FVU) specimens from 937 women were tested for Chlamydia trachomatis by culture or EIA to determine the most sensitive combination of tests and specimens. For cervical and urethral specimens the prevalence of infection by culture or confirmed EIA was 7.2% (67/937) at either site, 6.8% (64/937) at the cervix, and 4.3% (40/937) at the urethra. Of 67 specimens, 37 (55.2%) yielded a positive test from both the cervical and urethral swabs. Three (4.5%) of the 67 infections were only at the urethra and none were only in FVU. Only 37.3% (25/67) of all positive women had a positive FVU. The most sensitive combination was cervical swab culture and EIA, which detected 95.5% (64/67) of the infections, a substantial increase over culture only (76.1%) or EIA of the cervical swab (79.1%). The testing of urethral and FVU specimens apparently offers only minimal advantage over testing of cervical specimens only for chlamydia.     

Chlamydia trachomatis infection and non-gonococcal urethritis in homosexual and heterosexual men in Edinburgh

In 1998, when ligase chain reaction testing for chlamydial infection was introduced in our clinic in Edinburgh, routine clinic protocol included the testing of all heterosexual, but not homosexual, men for urethral chlamydial infection. We audited all new homosexual and bisexual male attendees with a diagnosis of chlamydial infection or non-gonococcal urethritis (NGU) in 1999, together with heterosexual men with the same diagnoses attending in alternate months of the same year. Urethral Chlamydia trachomatis infection was detected in 14.6% (350/2402) of heterosexual men and 2.4% (11/465) of homosexual men tested. Fifty percent of chlamydial infections were asymptomatic. In this population 44% (84/190) of NGU in heterosexual men is attributable to C. trachomatis as opposed to only 10% (6/59) of that in homosexual men. These rates of chlamydial infection differ from previous reports in Scotland and recent studies from the USA. Our clinic protocol has been revised to include routine testing for chlamydial infection in all men.     

Asymptomatic gonorrhoea and chlamydial infection in a population-based and work-site based sample of men in Kilimanjaro, Tanzania

The aim of this study was to screen healthy rural and urban Tanzanian men for chlamydial infection and gonorrhoea, and determine the prevalence and the predictive value of urethral symptoms, signs and pyuria. In 2 cross-sectional surveys, 796 men were interviewed regarding symptoms and examined for signs of urethritis. Gonorrhoea was detected by culture/gram-stained smears, Chlamydia trachomatis by antigen immunoassay, and pyuria by leukocyte esterase dipstick test. The prevalence of chlamydial infection, gonorrhoea and pyuria among rural men was 9.6%, 0.4%, and 12.7%, and among urban bar workers 7.4%, 8.1% and 6.3% respectively. Among all, 0.6% had urethral discharge confirmed by examination, while 2.6% reported urethral discharge and 7.4% dysuria. Among chlamydia-infected men, 59 (89%) of the 66 cases did not have urethritis symptoms or signs. Similarly, 24 (88%) of 28 men with gonorrhoea were asymptomatic. Treatment based on the urethral discharge sign, would have detected only one out of 92 cases with gonorrhoea and/or chlamydia in these populations.     

Asymptomatic urethral infection in male sexually transmitted disease clinic attendees

The purpose of this study is to determine the prevalence of asymptomatic male patients with urethral infections attending a government sexually transmitted infection clinic in Hong Kong and their microbiological profile. A total of 274 consecutive male patients without any symptoms for urethral infections were recruited. A questionnaire was used to record the symptoms, sexual history and demographics. Further assessment, including urethral smear for Gram stain, gonococcal culture and polymerase chain reaction (PCR) for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) were performed. In 274 asymptomatic patients, 36 patients had non-gonococcal urethritis (NGU) and two patients had positive gonococcal culture. Among the asymptomatic patients with NGU, there were 6 (16.6%), 10 (22.8%) and five (13.9%) patients with positive PCR for CT, UU and MG, respectively. In addition, there were 14 asymptomatic patients with positive PCR for CT but without evidence of NGU. In conclusion, urethral infections were identified in a significant number of asymptomatic male patients and therefore, routine screening for this group is warranted.     

1 010例泌尿生殖道感染者支原体及衣原体检测分析

目的：了解河北省疾病预防控制中心(CDC)性病门诊泌尿生殖道感染者支原体、沙眼衣原体(CT)感染状况。方法：支原体培养法检测解脲支原体(UU)和人型支原体(Mh)；快速免疫法检测CT。结果：UU培养阳性率(38．65％)非常显著地高于Mh的阳性率(8．55％)。UU Mh阳性率为6．64％，CT阳性率为11．09％。女性UU培养阳性率55．47％，Mh阳性率为14.82％，UU Mh阳性率为10．99％，均非常显著高于男性的28．23％、4．74％、4．00％。CT抗原检测阳性率女性为13．21％，男性为9．86％。衣原体和支原体的双重感染率，CT UU为5．97％。CT Mh为1．29％；CT UU Mh三重感染率为0．93％。结论：河北省CDC性病门诊泌尿生殖道感染者UU培养阳性率为38．65％，Mh为8．55％，CT抗原阳性率为11．09％。