阴道加德纳菌生物学分型、药敏和感染途径的研究

目的了解兰州地区阴道加德纳菌(GV)的生物学分型、药敏和感染途径。方法根据Briselden方法对GV进行生物学分型和传播途径研究,采用微量稀释法进行药敏试验。结果细菌性阴道炎组(BV组)GV检出率51.8%,对照组(NBV组)GV检出率10.0%,差异有统计学意义(P<0.01)。共检出6种生物型,两组生物型分布有显著性差异(P<0.01)。对GV敏感的药物为:克林霉素、罗红霉素、四环素和甲硝唑。配偶间与自身不同部位检出同型菌株的几率差异无统计学意义。结论GV的不同生物型与BV发病有关,GV可通过多种途径传播,对常用药物敏感性不高。     

细菌性阴道病与生殖道支原体感染的相关性分析

目的初步探讨细菌性阴道病(bacterial vaginosis,BV)合并生殖道支原体感染的相关性。方法根据Amsel的BV诊断标准选择95名BV患者,同时选择91名非BV患者,以及84名健康体检者做为对照组,取宫颈分泌物做支原体培养。结果 95例BV患者支原体感染阳性55例,阳性率57.89%;非BV患者支原体感染30例,阳性率32.97%;健康体检者支原体感染18例,阳性率21.43%,BV患者支原体感染明显高于其他两者,具有非常显著差异(P0.01)。BV患者感染以人型支原体为主,其余两组以解脲脲原体为主。结论细菌性阴道病与生殖道支原体感染有一定的相关性,可能是支原体感染的诱因之一,临床诊治时应该注意。     

阴道加德纳菌的生物学分型

采用Piot分型法对76株临床标本中分离出的加德纳菌进行了生物分型分析。结果：1型22％，2型16％，4型30％，5型9％，6型16％，8型7％，3型和7型未检测到。细菌性阴道病患者主要为1、2、4型，显著高于非细菌性阴道病患者（86％比37％，P＜0．01）。     

细菌性阴道病临床表现特征及其与解脲支原体的关系研究

目的:分析细菌性阴道病患者临床表现特征,探讨其与解脲支原体(Uu)的关系。方法:400例疑为细菌性阴道病患者入院时均对外阴、宫颈和阴道粘膜进行检查,采集阴道分泌物。依据阴道状况及分泌物情况对患者进行诊断,将其分为BV组和健康人群组。比较两组阴道临床症状特征和微生态(细菌培养情况及菌群密集度)特征,并进行解脲支原体培养,分析其与BV的关系。结果:250例细菌性阴道病患者主要临床症状:白带异味患者127例,占50.8%;发作时间14天至2年半,平均发作时间(3±6.1)月;白带增多者84例,占33.6%;外阴瘙痒者70例,占28%;64例无明显症状,占25.6%。阴道分泌物检查表明,186例(74.4%)分泌物呈均匀稀薄状,235例(94.0%)阴道pH值高于4.5,所有患者线索细胞呈阳性;139例(55.6%)氨性实验成阳性。与健康人群相比,BV组的pH值、Nugent评分、白带异味、白带增多、无显著症状、均质稀薄分泌物、阴道pH值高于4.5、氨性实验阳性(%)、线索细胞阳性比例患者百分比显著高于健康人群(P<0.05)。BV患者沙眼衣原体和人型支原体检出率分别为6.0%和41.6%,卡方检验表明其显著高于健康人群(P<0.05);BV组乳酸菌密集度较高,集中于0-Ⅰ级,阴道加特纳菌密集度增加,Ⅱ-Ⅳ级占77.6%,组间Ridit分析表明两组的乳酸菌密集度和阴道加特纳菌密集度差异差异具有统计学意义(P<0.05)。250例BV患者中,复发性BV共7例(2.8%)。250例细菌性阴道病患者中,190例(76.0%)解脲支原体呈阳性;150例健康人群中,90例(60.0%)呈解脲支原体阳,二者差异显著(χ2=8.69,P=0.00);215例人群菌量高于104ccu/mL,其中含172例(80%)BV患者,185例菌量低于104ccu/mL,合并BV阳性者78例(42.2%),二者差异显著(χ2=9.92,P=0.00)。经Logistic回归分析表明,BV阳性率与Uu检测菌量之间呈正相关,相关系数R2=0.99,P=0.01。结论:细菌性阴道病患者临床多表现为白带异常、阴道分泌物呈稀薄状、阴道pH值高于4.5和微生态失调,其解脲支原体阳性率较高,其量与BV发生率呈正相关,临床中应注意合并治疗。     

细菌性阴道病和支原体感染的相关性分析

目的: 评估细菌性阴道病(bacterial vaginosis, BV)与解脲脲原体(Ureaplasma urealyticum, UU),人型支原体(M. hominis, MH)感染的相关性.方法: 根据Amsel标准分组,选BV组81例,非BV组(包括念珠菌性阴道炎,滴虫性阴道炎等)75例,健康体检者52人.取宫颈分泌物做支原体培养,判断支原体感染与BV的相关性.结果: BV组支原体培养阳性56例(69.1%),非BV组30例(40.0%),体检组16人(30.8%).BV组的感染以MH或MH+UU混合感染为主,其余两组以单纯UU感染为主.结论: UU和MH相互协同作用是BV的致病机制之一.     

细菌性阴道病患者及性伴临床资料分析

目的了解细菌性阴道病(BV)的发生和性伴之间的关系。方法收集59例BV患者及40名性伴的相关临床资料以及性病病原体的检测结果并进行分析。结果59例BV患者及性伴多数都存在多次不洁性行为的病史,50%以上的BV患者有支原体感染、25%的有衣原体感染,约25%的合并阴道真菌感染,约25%的患尖锐湿疣,40名性伴也有相似的情况。BV组患者的人型支原体(MH)和衣原体感染率高于非BV组。结论细菌性阴道病的发生与自身或性伴不洁性行为有关,患有BV的女性患者更易感染各种性病病原体。     

人乳头状瘤病毒感染与阴道微生态环境之间的关系研究

目的探讨人乳头状瘤病毒(human papilloma virus,HPV)感染与阴道微生态环境之间的关系。方法选择2016年1月至2016年12月在昆明市妇幼保健院妇科门诊进行健康体检宫颈癌筛查者3064例为研究对象,将宫颈HPV分型检测阳性者1614例设为观察组,将同期在妇科门诊进行健康体检和孕前常规宫颈HPV分型检测阴性者1450例设为对照组,对两组患者的临床资料进行分析比较。结果在3064例就诊者中,检出HPV感染者1614例(24. 00%),其中,高危型别HPV感染者占比67. 97%(1097/1614),低危型别HPV感染者占比15. 99%(258/1614),高低危混合型感染者占比16. 05%(259/1614);同时,单一型别感染者占比83. 02%(1340/1614),多重型别感染者占比16. 98%(274/1614)。高危型别感染前5位的型别分别为HPV52 (22. 00%)、HPV16 (14. 00%)、HPV58 (9. 98%)、HPV51 (8. 98%)、HPV18(8. 00%)。HPV感染者中,阴道微生态正常者占比18. 90%(305/1614),HPV检测阴性者1450例中,阴道微生态正常者占比36. 07%(523/1450),两组差异具有统计学意义(P 0. 05),HPV阳性者阴道微生态失调发生率较HPV阴性者增高。HPV检测阳性者细菌性阴道病(BV)感染者占比6. 57%(106/1614),需氧菌性阴道炎(AV)感染者占比18. 34%(296/1614),HPV检测阴性者BV感染者占比3. 45%(50/1450),AV感染者占比6. 69%(97/1450),两组差异具有统计学意义(P 0. 05),提示HPV感染增加了AV、BV的感染率。高危型HPV感染与低危型HPV感染人群中,阴道微生态各项指标比较差异均无统计学意义(均P 0. 05)。结论 HPV感染对阴道微生态环境具有一定的影响,HPV感染增加了BV和AV的感染率。阴道微生态状态与HPV高低型别感染无关。     

女性生殖道解脲脲原体感染与细菌性阴道病的关系

目的探讨解脲脲原体(UU)感染和细菌性阴道病(BV)的相互关系。方法对本院性病门诊2008年6月～2009年1月本院性病门诊就诊的1491例患者进行了UU和BV的检测。UU阳性的696例纳入观察组,UU阴性795例作为对照组,调查两组BV的阳性率,并对年龄、职业分布、避孕方式和阴道清洁度等因素进行分析。结果观察组BV的阳性率(22.41%)明显高于对照组BV的阳性率(11.45%);观察组BV的阳性率先随着年龄的增加而增高,至31～40岁到达高峰,随后又随着年龄的增长而降低,对照组中BV的阳性率随着年龄的增长而降低,与年龄呈负相关;职业分布在两组间差异无显著性意义。观察组中采用屏障避孕法BV的检出率明显比非屏障避孕法低。观察组BV阳性患者以阴道清洁度Ⅲ度和阴道清洁度Ⅳ度为主,对照组中BV患者以阴道清洁度Ⅱ度为主。结论女性生殖道UU感染可以增加BV的发病率;屏障避孕法可以降低UU患者BV的发病率;女性生殖道UU感染合并BV感染时,阴道清洁度下降。     

IVF-ET周期中控制性超促排卵对阴道微生态的影响

目的:了解IVF-ET周期中控制性超促排卵(COH)对阴道微生态的影响。方法:选取2010年4月～2010年10月在北京大学第一医院生殖与遗传中心接受GnRHa-长方案降调节IVF-ET治疗的患者100例,在COH前检查阴道微生态,在HCG注射日再次检查阴道微生态情况,两次结果进行自身对照研究。结果:100例患者中,COH前有微生态失调者13例,其中BV 2例(2%),菌群正常功能下降9例(9%),菌群异常2例(2%)。COH后,菌群失调者42例(42%),其中VVC 9例(9%),BV 6例(6%),BV中间型3例(3%),菌群正常功能下降15例(15%),菌群异常9例(9%),有统计学差异(P<0.05)。87例COH前检查阴道微生态正常者中,COH后34例发生微生态失调(39.9%)。13例COH前检查阴道微生态失调者中,COH后8例发生微生态失调(61.5%),有统计学差异(P<0.05)。结论:接受COH治疗的患者容易发生阴道微生态失调,COH前已经有阴道微生态异常的患者更容易发生微生态失调,建议在进行COH治疗前和取卵手术前进行阴道微生态检查,对BV和VVC患者取卵前采取药物治疗,阴道菌群异常和功能下降患者要密切观察。     

杭州地区22454例人乳头瘤病毒感染患者基因分型的研究

目的分析杭州地区22454例人乳头瘤病毒(HPV)感染患者的感染情况及基因分型。方法选取2013年7月至2019年12月在杭州市第三人民医院皮肤科?妇科?泌尿外科等科室就诊的22454例患者作为研究对象,取其泌尿生殖道分泌物,使用聚合酶链反应(PCR)-反向点扩增法进行23种HPV基因分型检测。结果22454例患者中,检测出HPV阳性患者9816例,阳性率为43.7%;高危型-HPV(HR-HPV)中最常见的基因型是HPV52,其次是16?58?53,低危型-HPV(LR-HPV)中最常见的基因型是HPV6,其次是11?81?43;10~19岁女性患者HPV感染率显著高于男性,30~89岁男性患者感染率显著高于女性(P<0.05);单一和多重HPV感染率分别为25.5%和18.3%,单一感染率明显高于多重感染率(P<0.001),男性患者单一?多重感染率均显著高于女性(P<0.001)。结论杭州地区HR-HPV中HPV52?16及58感染率最高,LR-HPV中HPV6?11及81感染率最高;女性HPV感染率呈“U”型双高峰,男性感染率总体呈持续上升趋势;单一HPV感染率显著高于多重感染,男性单一及多重感染率均显著高于女性。     

Correlation between Propionibacterium acnes biotypes, lipase activity and rash degree in acne patients

We examined the possible correlation between biotypes of Propionibacterium acnes, lipase activity, and rash degree in acne patients. Among 5 P. acnes biotypes, P. acnes biotype 3 (B3) was the most common, followed by P. acnes biotypes 1, 2 and 4; P. acnes biotype 5 was not found. P. acnes B3 was isolated from more severe skin rashes than those of the other biotypes. Production of propionic acid (PA) and butyric acid (BA) by P. acnes B3 was higher than those by the other P. acnes biotypes. As the rash degree in acne patients was more severe, the production of PA and BA elevated. Although only a few P. acnes strains were examined in the present study, P. acnes B3 had the highest lipase activity and might have the greatest influence on skin rash in acne patients.     

A 24 hour plastic envelope method for isolating and identifying Gardnerella vaginalis (PEM-GVA)

A new plastic envelope culture test that is selective for Gardnerella vaginalis was compared with a conventional method. Vaginal specimens from 92 women were cultured. Results from both methods were compared with the results of pelvic examinations and clinic screening tests used to diagnose bacterial vaginosis (BV). G vaginalis was isolated more often in the envelope than by the conventional method from patients with BV and those without, though the difference was not significant. Isolation and identification of G vaginalis was completed in 18-24 hours by the envelope method; the conventional method took a mean of 72 hours (range two to six days). Polymorphonuclear leucocytes (PMNLs) occurred significantly more in specimens from the patients without BV than from those with BV. Both clue cells and a positive amine test reaction were found significantly more in specimens from patients with BV than from those without BV. Clue cells and G vaginalis isolation correlated best with BV (in 47 women), followed by clue cells and positive amine test results (in 39). Adherence of G vaginalis in the envelope also correlated more with BV, clue cells, and positive amine test results (32) than with patients without BV (14). When there were no clue cells and amine test results were negative the results correlated totally with a prediction of no BV. The use of the rapid envelope culture test would have confirmed BV in 20% of the cases where clue cell and amine test results were discordant.     

Biotypes of Candida albicans isolated from cardiovascular system and skin surveillance cultures of hospitalized patients

The aim of the study was to biotype 59 isolates of Candida (C.) albicans from cardiovascular system samples (blood and intravenous catheter) and 123 isolates of the same species from skin surveillance cultures (swabs of the armpit, groins and intravenous catheter insertion sites) of hospitalized patients using the Odds and Abbott biotyping method. Biotyping of 59 isolates of C. albicans taken from the cardiovascular system samples revealed the presence of 16 biotypes. Biotype 355 was the most common biotype, accounting for 35.6% of all biotype isolates from this system. Biotyping of 123 C. albicans isolates from skin surveillance cultures detected 21 biotypes. Biotype 355 was most common, accounting for 17.9% of all biotype isolates from these samples. The two systems had 10 biotypes in common: 355, 155, 257, 305, 105, 315, 300, 015, 157, and 345. These biotypes accounted for 88.3% and 81.4% of all C. albicans biotypes isolated from the cardiovascular system and skin surveillance cultures, respectively. Biotypes 355, 155, and 257 were the biotypes most frequently shared in isolates from the two systems. These biotypes accounted for 57.7% and 43.1% of all C. albicans biotypes isolated from the cardiovascular system and skin surveillance cultures, respectively.     

Relationship between Propionibacterium acnes biotypes and Jumi-haidoku-to

We examined the relationship between Propionibacterium acnes biotypes and Jumi-haidoku-to (JHT). In all the P. acnes strains tested, the production of propionic acid (PA) and butyric acid (BA) was suppressed in a medium containing 1 mg/ml JHT compared with the control medium without JHT. There were no significant differences in the rates of decreased PA and BA production between P. acnes biotype 3 (B3) and the other biotypes or between isolates from mild skin rash and more severe skin rash. P. acnes B3 was the most commonly identified biotype. The clinical effects on acne due to the anti-P. acnes lipase activity of JHT did not seem to be influenced by the degree of acne rash or the P. acnes biotype.     

性病门诊378例女性宫颈分泌物的HPV基因型分析

目的检测和分析性病门诊女性患者宫颈分泌物中人乳头瘤病毒(HPV)的基因型别。方法收集我院性病门诊就诊的女性患者378例,按患者有无高危接触和宫颈口有无尖锐湿疣症状划分为3组,即有接触有症状组(161例)、有接触无症状组(117例)和无接触无症状组(100例)。取3组患者脱落细胞,采用反向分子杂交法进行HPV基因分型检测。结果性病门诊378例女性宫颈分泌物HPV阳性率为56.61%(214/378),有接触有症状组、有接触无症状组和无接触无症状组的阳性率分别为98.75%(159/161)、40.17%(47/117)和8.00%(8/100),3组分别检出22种、14种和5种HPV基因型别,检出的主要型别是HPV6、11、16、58、56、18、33、68。有接触有症状组和有接触无症状组单一感染和复合感染的感染率差异无统计学意义(P0.05),在多重复合感染中,以二重和三重感染为主,最多发现八重感染。有接触有症状组低危型121例次(76.10%),高危型99例次(62.26%),有接触无症状组低危型35人次(74.46%),高危型26例次(55.32%),两组感染率较高,但差异无统计学意义(P0.05)。结论 HPV6、11、16、58、56、18、33、68是性病门诊女性患者宫颈感染HPV的主要型别,健康体检者中亦能查出,临床应加强对性病门诊女性就诊者宫颈HPV基因的检测,及对HPV阳性患者进行定期的跟踪随访,尤其是高危型和复合感染患者。     

Propionibacterium acnes biotypes and susceptibility to minocycline and Keigai-rengyo-to

BACKGROUND: Propionibacterium acnes is the predominant organism in acne lesions, but the sensitivity of different biotypes of P. acnes to therapeutic agents has seldom been reported. METHODS: To characterize biotypes of P. acnes and to measure the effects of Keigai-rengyo-to (KRT) and minocycline (MINO) on clinical P. acnes isolates. RESULTS: Propionibacterium acnes biotype III (BIII) is the most common form of identified acne lesion, followed by P. acnes biotype I. BIII was isolated from mild, moderate and severe severity and the average lipase activity of BIII was higher than that of Biotypes I, II, IV and V. No significant differences in the decrease of free fatty acid production elicited by KRT or by MINO were found between BIII and the other biotypes. The degree of decreased butyric acid production was greater than that of propionic acid production in the medium supplemented with MINO. The percent decrease of butyric acid production elicited by 1 mg/mL of KRT was the same as that elicited by 0.1 microg/mL of MINO. Among biotypes of P. acnes, the minimal inhibitory concentrations of agents tested were generally higher in erythritol-positive biotypes than in erythritol-negative biotypes. CONCLUSION: The high frequency of BIII might be responsible for the severity of acne in patients. It seems that if the same concentrations of MINO and KRT are used, the antilipase activity of MINO is stronger than that of KRT. Minocycline also has a direct anti-lipase activity against P. acnes. The mechanism underlying the influence of erythritol on the susceptibility of P. acnes to these agents remains unknown.     

An association between non-gonococcal urethritis and bacterial vaginosis and the implications for patients and their sexual partners.

OBJECTIVES: The aetiology of non-gonococcal urethritis (NGU) in a considerable proportion of men remains unaccounted for. We wished to investigate the possible aetiological role of bacterial vaginosis (BV), the commonest cause of abnormal discharge in women, in this condition. METHODS: We carried out two studies. In the first, case-control, study, we recruited men with and without NGU and examined their female partners for evidence of BV. The second, cohort design, study which ran concurrently with the first study involved recruiting women with and without BV and examining their male partners for evidence of NGU. The diagnoses of both NGU and BV were made microscopically to include symptomatic and asymptomatic individuals in both disease categories. RESULTS: In the case-control study 51 couples were recruited. Of these 39 men had NGU and 12 (31%) of their female contacts had BV. In contrast, of 12 men without NGU, only one (8%) of the female partners had BV (odds ratio 4.89, 95% CI: 0.51-42.27). When only Chlamydia trachomatis negative patients were considered, the odds ratio for an association between BV and NGU was increased to 6.77, 95% CI: 0.73-62.68). Thirty eight couples were recruited to the cohort design study. Of 17 women with BV, 12 (71%) of their male partners had NGU. In contrast, of 21 women without BV, seven (33%) of their male partners had NGU (p = 0.049, odds ratio 4.8). When only C trachomatis negative patients were considered, the significance of the association was increased (p = 0.037; odds ratio 5.42). CONCLUSIONS: An association exists between NGU and BV, and vice versa. If BV arises de novo the findings could help to explain the development of urethritis in stable sexual relationships.     

Bacterial vaginosis in women attending STD clinic: diagnostic criteria and prevalence of Mobiluncus spp.

The diagnostic criteria of bacterial vaginosis (BV) and the prevalence of Mobiluncus spp as detected by monoclonal antibodies were investigated in all new women patients attending the sexually transmitted disease (STD) clinic in Uppsala during a four month period. Of 455 patients, 164 fulfilled the generally accepted criteria for BV, but in 57 of them simultaneous infection with a recognised pathogen was diagnosed. BV was thus the only clinical diagnosis in 107 (24%) of the women. The sniff test and clue cells in the wet smear were the two criteria most relevant for the diagnosis of BV. The sniff test was positive in 95% (156) of the 164 patients with BV and negative in all other cases. The corresponding figure for the clue cells was 98% (160 of 164), but clue cells were also detected in 19 patients without BV. Though 99% (162) of women with BV had a vaginal pH of more than 4.5, so did 83 women without BV. Only 59% (96) of women fulfilling the criteria of BV had a characteristic discharge. Mobiluncus spp were present in 20% (90) of the 455 women and in 50% (53) of the 107 women with BV only. Of the 90 Mobiluncus spp isolates, M curtisii comprised 44% (40), M mulieris 34% (31), and both strains together 21% (19). Mobiluncus spp were detected with monoclonal antibodies in 35 women who had no motile curved rods on wet smear microscopy. Furthermore, Mobiluncus spp were often detected in women infected with recognised pathogens, as well as in a few women without signs of genital infection.     

Staphylococci of the normal human skin flora

Summary 352 strains of Staphylococci of the normal human skin flora were sampled from one volunteer by single scrabbing in a ca. 3 cm² measuring area. They were biotyped by the scheme of Pelzer et al. (1973)—a modified Baird-Parker-Scheme (1963)— and the resistance to antibiotics was investigated by the method of Bauer et al. (1966).All the nine biotypes of Staphylococci were found in variable quantities. It seems problematic to call one biotype as the main type. Morphologically identical colonies of Staphylococci from the indigenous flora of the human skin were not identical in their biotypes as previously described by Pelzer (1976).Only the investigation of all Staphylococci colonies from the culture plate can evaluate all biotypes of Staphylococci of the normal human skin flora, and can give the right quantitative correlation. Staphylococci were found to be sensitive and resistant up to four antibiotics, and one biotype did not show one type of antibiogram.