解脲脲原体感染及其垂直传播途径在新生儿疾病中的作用

目的:探讨解脲脲原体感染在新生儿疾病中的作用及其垂直传播途径。方法:对30例产妇的羊水及宫颈分泌物和161例新生儿鼻咽部及尿道口分泌物的解脲脲原体培养,并用ELISA法检测脐血中特异性抗体IgM。结果:正常产妇解脲脲原体阳性率为26.67%,解脲脲原体阳性产妇分娩的新生儿中,解脲脲原体阳性率为62.7%。无症状组新生儿解脲脲原体阳性率为20%,患病组新生儿解脲脲原体阳性率为46%,两者差异显著(P＜0.01)。有胎膜早破者新生儿解脲脲原体阳性率(40%)显著高于无胎膜早破者(17%)(P＜0.05)。而剖腹产儿与顺产儿解脲脲原体感染率无明显差别。结论:解脲脲原体可能是引起新生儿感染的主要病原体之一,有胎膜早破者新生儿解脲脲原体感染的发生率明显提高。     

解脲支原体感染与早产儿呼吸系统疾病的相关性

目的探讨解脲支原体定植在早产儿肺部疾病中的作用。方法对胎齢小于32w的行机械通气的早产儿的气道吸引物进行培养,查找分离解脲支原体,并对阳性组和阴性组进行对照分析。结果143个病例中有39例(27%)分离培养阳性。阳性者呼吸窘迫综合征发生率明显低于阴性者(P=0.002)。多元回归分析显示,在单胎儿中,只有解脲支原体定植是呼吸窘迫症(RDS)的独立预测因子(OR=0.38;P=0.02),胎龄(OR=0.47;P=0.006)和解脲支原体阳性(OR=3.1;P=0.05)都是慢性肺部疾病(CLD)的独立预测因子,这里的CLD是按新法定义的:纠正胎龄达到36周仍需要氧疗。结论解脲支原体气道内定植能预防早产儿发生RDS,但却使早产儿CLD的发病率增加。     

女性生殖泌尿道解脲脲原体和人型支原体培养分离鉴定、计数、药敏分析

目的探讨女性生殖泌尿道解脲脲原体（Uu）和人型支原体（Mh）感染及耐药情况,为临床提供用药参考。方法采用解脲脲原体和人型支原体培养分离鉴定、计数、药敏试剂盒,对我院妇科门诊疑似非淋菌性尿道炎（NGU）女性患者,取宫颈拭子进行支原体培养、鉴定及药敏试验。结果2662例疑似非淋菌性尿道炎患者中,总的支原体检出率为59.6%,其中主要为解脲脲原体,检出率为46.5%,人型支原体感染检出率为13.1%,混合感染检出率为3.3%。药敏结果表明支原体主要对强力霉素（DOX）（81.3%）、美满霉素（MIN）（79.2%）、交沙霉素（JOS）（75.9%）、克拉霉素（CLA）（72.6%）等抗生素敏感,对阿奇霉素（AZI）、氧氟沙星（OFL）、左旋氧氟（LEV）等抗生素为中介,对罗红霉素（ROX）、司帕沙星（SPA）等抗生素耐药。结论解脲脲原体和人型支原体是女性生殖泌尿道感染的主要病原体,其中感染率^UU〉^Mh,且混合感染已是一个越来越严重的问题。支原体对罗红霉素、司帕沙星等抗生素有较高的耐药性,对强力霉素、美满霉素、交沙霉素、克拉霉素等抗生素敏感,并提示该类抗生素可作为治疗NGU支原体感染的首选药物。     

87例培养阳性解脲脲原体的药敏分析

目的了解泌尿生殖道标本中解脲脲原体对不同抗生素的敏感性差异.方法用法国生物梅里埃生产的支原体IST试剂盒对泌尿生殖道分泌物等标本进行培养鉴定和药敏试验.结果其中有87例解脲支原体培养阳性,药敏结果分析发现解脲脲原体分别对6种抗生素敏感如下:四环素60例(69.00%)、强力霉素68例(78.16%)、交沙霉素82例(94.25)、原始霉素全部敏感率(100%)、红霉素只有7例(8.05%)、氧氟沙星28例(32.18%).结论应将原始霉素、交沙霉素、强力霉素、四环素列为临床治疗解脲支原体感染首先药物.     

解脲脲原体感染研究进展

解脲脲原体属于支原体科中的脲原体属,与男女性生殖道炎症、HIV感染、不孕不育、不良妊娠结局以及新生儿疾病等有关。该文从以上几个方面就解脲脲原体与人类健康的关系进行阐述。     

128例原发性不育患者精液解脲脲原体的检测

采用解脲脲原体检测试剂对１２８例原发性不育患者的精液进行解脲脲原体病原学诊断，阳性率为３１．２５％（４０／１２８）。本文结果提示在山西省大同地区，解脲脲原体感染可能是引起男性原发性不育的重要原因之一。     

解脲脲原体感染对附睾上皮分泌功能影响的研究

目的　探查解脲脲原体感染与男性不育的关系。方法　本文采用DTNB法及Tremblay方法 ,分别对 4 0名患有解脲脲原体感染的男性不育患者 (不育组 )和 4 2名正常生育男性 (对照组 )精浆肉毒碱含量及α 糖苷酶活性测定。结果　解脲脲原体感染的男性不育患者的这两项指标明显低于正常生育男性 ,其中不育组和对照组精浆肉毒碱含量分别为 (94 1 2± 5 7 5 9)和 (2 5 6 4 6± 99 5 8)nmol/ml,两者间差异有显著性 (P <0 0 1 ) ;α 糖苷酶活性分别为 (2 8 4 2± 2 1 84 )和 (4 2 1 2± 2 1 5 5 ) ,两者间差异有显著性 (P <0 0 5 )。结论　解脲脲原体感染可能破坏附睾上皮 ,影响附睾的分泌功能而导致男性不育     

支原体感染与孕妇早产的关系研究

目的 探讨支原体感染与早产的关系。方法分别对138例早产孕妇和117例正常足月分娩孕妇进行解脲支原体、人型支原体培养及其药物敏感性试验。结果’早产孕妇解脲支原体阳性率为31．16％，人型支原体阳性率为10．87％。正常孕妇解脲支原体阳性率为15．38％，人型支原体阳性率为6．83％。结论早产孕妇生殖道支原体感染率高，为预防早产的发生，及时诊断和治疗孕妇支原体感染十分必要。     

广州地区新生儿解脲脲原体感染及高危因素调查

对１４１例新生儿做鼻咽部及尿道口分泌物的解脲脲原体（ＵＵ）培养，结果显示：无症状正常组的新生儿（ＵＵ的阳性率为２０％，患病组的新生儿ＵＵ的阳性率为４５％，两者差异有显著性（Ｐ＜０．０５）。新生儿出生前其母有胎膜早破的，其ＵＵ阳性率为２５％，出生前其母无胎膜早破的新生儿ＵＵ阳性率为１９％，两者差异显著（Ｐ＜０．０５）。本文认为ＵＵ是引起新生儿感染的重要病原体之一。     

MIC 基因多态性与解脲脲原体感染的易感关联性研究

目的:研究MIC 等位基因多态性与解脲脲原体感染易感性之间的关联性。方法:采用PCR-SSP 和PCR-SBT方法对样本MIC 等位基因的多态性进行检测。结果:解脲脲原体患者中检出12 种MICA、5 种MICA-STR 和14 种MICB 等位基因;和对照组相比较,解脲脲原体患者组中MICA* 010 和MICB*009N 等位基因分布频率更高(MICA*010:OR=3.85,95%CI:2.12-6.99,Pc<0.05;MICB*009N:OR=3.22,95% CI:1.33-7.80,Pc<0.05),MICA-A5.1 和MICB*00502 等位基因分布频率更低(MICA-A5.1:OR=0.61,95%CI:0.40-0.94,Pc<0.05;MICB*00502:OR=0.58,95%CI:0.40-0.83,Pc<0.05),差异均具有统计学意义;基因型方面,MICA*010/010、MICA*01201/01201 纯合子分布频率更高(MICA*010/010:OR = 14.84,95%CI:1.90-115.9,Pc<0.05;MICA*01201/01201:OR=10.83,95% CI:1.35-86.79,Pc<0.05),差异均具有统计学意义;解脲脲原体患者中MICB*00502/00502 纯合子分布频率较高,但差异不具有统计学意义(Pc>0.05)。结论:MIC 等位基因多态性与解脲脲原体的易感性间存在关联性。     

早产儿及低体重儿四种支原体感染状况研究

为了解早产儿、低体重儿人型支原体 (Mh)、解脲脲原体 (Uu)、生殖支原体 (Mg) ,发酵支原体 (Mf)等 4种支原体的感染状况 ,我们于 1997年～ 1998年分别收集了 2 7例早产儿和 2 1例低体重儿的咽拭子标本应用套式PCR (nPCR)法进行上述 4种支原体特异性核酸检测。结果早产儿和低体重儿的Mh阳性率分别为 92 6 %、95 2 % ;Uu阳性率分别为 5 5 5 %、38 1%。Mh Uu合并感染状况严重 ,分别为 5 5 5 %、33 3%。Mg只有 1例阳性 ,Mf无阳性病例发现。无论是早产儿 ,还是低体重儿 ,剖宫产与阴道产的各种支原体检出率无差别 (P均 <0 0 5 )。剖宫产娩出儿咽部查出支原体可确认为宫内感染 ,由此可见 ,支原体宫内感染状况严重。本文并就支原体感染与早产和新生儿出生低体重的发生原因进行了讨论。     

The role of mycoplasmas, ureaplasmas and chlamydiae in the genital tract of women presenting in spontaneous early preterm labour

The genital carriage of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis was assessed in 72 women admitted to hospital in spontaneous preterm labour and in 26 women requiring preterm delivery for other reasons who formed a control group. Women in preterm labour significantly more often carried ureaplasmas, had large numbers of M. hominis and subsequently developed chorioamnionitis than women in the control group. M. hominis, in particular, occurred more frequently and in large numbers in women who had chorioamnionitis associated with ruptured membranes. Genital carriage of the various micro-organisms appeared not to be associated with fetal growth retardation, although subsequent isolation of ureaplasmas from infants was common. It is suggested that mid-second-trimester vaginal specimens should be cultured on a research basis to establish whether these various micro-organisms identify women at risk of labouring preterm.     

未足月胎膜早破母婴结局的临床资料分析

目的探讨未足月胎膜早破（PPROM）的母婴预后。方法回顾性分析我院2004年1月-2008年12月收治的PPROM单胎妊娠的537例孕产妇的临床资料。结果孕23-32＋6周PPROM患者的死产率为83.3%,新生儿死亡率为63.3%,围产存活新生儿发病率与孕33-36＋6周的PPROM患者相比,两组差异具有统计学意义（均为P〈0.01）。PPROM患者的围产儿结局与破膜孕周密切相关。结论孕23-32＋6周PPROM的早产儿预后较差,在保守治疗期间应根据具体情况适时终止妊娠,而孕33-36＋6周PPROM患者建议在积极期待治疗期间及时分娩,以减少早产儿并发症。     

IL-6、MMP-9、TNF-α在胎膜早破早产孕妇血清、羊水中的表达及意义

目的研究IL-6、MMP-9、TNF-α在未足月胎膜早破早产孕妇的血清、羊水中的含量及表达,探讨其与胎膜早破早产的关系。方法采用酶联免疫吸附法检测30例胎膜早破早产孕妇（PPROM组）与20例正常孕妇（对照组）血清和羊水中的IL-6、MMP-9、TNF-α的含量,同时进行胎膜的病理检查。结果 PPROM组母血清及羊水中IL-6、MMP-9的含量均高于对照（P〈0.05）,羊水中TNF-α的含量较对照组高（P〈0.05）。PPROM组绒毛膜羊膜炎者血清、羊水中IL-6、TNF-α（P〈0.05）、MMP-9（P〈0.01）水平均高于非绒毛膜羊膜炎者。结论孕妇血清、羊水中IL-6、MMP-9、TNF-α水平与PPROM感染引起的早产有关,检测其水平可作为PPROM良好的预测指标。     

Ureaplasma urealyticum modulates endotoxin-induced cytokine release by human monocytes derived from preterm and term newborns and adults

We previously observed that Ureaplasma urealyticum respiratory tract colonization in infants with a birth weight of < or =1,250 g was associated with increases in the tracheal aspirate proinflammatory cytokines tumor necrosis factor alpha (TNF-alpha) and interleukin-8 (IL-8) relative to the counterregulatory cytokine IL-6 during the first week of life (A. M. Patterson, V. Taciak, J. Lovchik, R. E. Fox, A. B. Campbell, and R. M. Viscardi, Pediatr. Infect. Dis. J. 17:321-328, 1998). We hypothesized that U. urealyticum alters the host immune response in the presence of a coinflammatory stimulus (e.g., bacterial infection or hyperoxia) by shifting the balance of cytokine expression towards the proinflammatory cytokines. To test this hypothesis, we compared the release of TNF-alpha, IL-8, IL-6, and IL-10 in vitro by unstimulated and U. urealyticum (with or without lipopolysaccharide [LPS])-stimulated human monocytes from adult peripheral blood and from term and preterm cord blood. U. urealyticum alone and in combination with LPS induced concentration- and development-dependent changes in cytokine release. In vitro inoculation with low-inoculum U. urealyticum (10(3) color-changing units [CCU]) (i) partially blocked the LPS-stimulated IL-6 release by all cells and reduced LPS-stimulated IL-10 release by preterm cells, (ii) stimulated TNF-alpha and IL-8 release by preterm cells, and (iii) augmented LPS-stimulated TNF-alpha release in all cells. In preterm cells, high-inoculum U. urealyticum (10(6) CCU) (i) stimulated TNF-alpha and IL-8, but not IL-6 or IL-10, release and (ii) augmented LPS-stimulated TNF-alpha and IL-8 release. High-inoculum U. urealyticum (i) stimulated release of all four cytokines in term cells and IL-8 release in adult cells and (ii) augmented LPS-induced TNF-alpha, IL-10, and IL-8 release in term cells but did not significantly affect LPS-induced cytokine release in adult cells. We speculate that U. urealyticum enhances the proinflammatory response to a second infection by blocking expression of counterregulatory cytokines (IL-6 and IL-10), predisposing the preterm infant to prolonged and dysregulated inflammation, lung injury, and impaired clearance of secondary infections.     

Cytokine concentrations in seminal plasma from subfertile men are not indicative of the presence of Ureaplasma urealyticum or Mycoplasma hominis in the lower genital tract

The inflammatory response to the presence of Ureaplasma urealyticum or Mycoplasma hominis in the lower genital tract of subfertile men without any signs or symptoms of infection was investigated by measuring the concentrations of interleukin (IL)-6, IL-8, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) in seminal plasma. Semen samples were collected from 30 culture-positive subfertile males and 23 culture-negative subfertile males. Enzyme-linked immunosorbent assays showed that IL-8 was present in relatively high concentrations (0.12-4.8 ng/ml) in all semen samples investigated. In contrast, the other cytokines were only detectable in 72% (IFN-gamma), 44% (IL-6) and 19% (TNF-gamma) of the samples and were present in relatively low concentrations (1-410 pg/ml). Seminal plasma cytokine concentrations were similar in samples from culture-positive and culture-negative males. These data strongly indicate that the presence of U. urealyticum or M. hominis in the lower genital tract of subfertile males reflects a silent colonisation rather than infection.     

Immunoblot analysis of anti-Ureaplasma urealyticum antibody in pregnant women and newborn infants.

The purpose of the present study was to determine the frequency in which antibody reactive to Ureaplasma urealyticum could be detected in a population of pregnant women and newborn infants. Serum samples from a prospective cohort of 80 healthy, U. urealyticum culture-positive and culture-negative pregnant women and a retrospective cohort of 522 infants born at between 25 and 42 weeks of gestation were studied by immunoblot analysis. Cultures of specimens from the lower genital tract were positive for U. urealyticum for 83% of the pregnant women, and serum immunoglobulin G (IgG) antibody which reacted to U. urealyticum was detectable in 93% of the pregnant women. Samples from five women (8%) had increases in the number of anti-U. urealyticum IgG bands over the course of the pregnancy. Samples from four of these five women had corresponding increases in the number of antibody bands present in IgA immunoblots. Six of the 522 samples from newborns or cord blood (1.1%) were positive for anti-U. urealyticum IgA; 5 of these 6 samples were also positive for IgM. The six anti-U. urealyticum IgA-positive infants were distributed as follows; 3 of 67 (4.5%) infants were delivered at 25 to 30 weeks of gestation, 3 of 176 (1.7%) infants were delivered at 31 to 34 weeks of gestation, and 0 of 279 infants were delivered at > or = 35 weeks of gestation. An antibody response to U. urealyticum can be detected in pregnant women and preterm infants and may serve as a marker of infection.     

Characterization of ureaplasmas isolated from preterm infants with and without bronchopulmonary dysplasia

A PCR assay was used to analyze endotracheal aspirates from preterm infants for Ureaplasma parvum versus U. urealyticum. U. parvum was detected more often than U. urealyticum. There was no significant difference or trend in the prevalence of either species between infants with or without bronchopulmonary dysplasia when isolated alone.     

Effect of experimental genital mycoplasmosis on production of matrix metalloproteinases in membranes and amniotic fluid of Sprague-Dawley rats

PROBLEM: Preterm, premature rupture of membranes (PPROM) is a dire pregnancy outcome that is frequently associated with infection by the genital mycoplasmas, Mycoplasma hominis, Ureaplasma parvum, and U. urealyticum. One potential mechanism by which these microorganisms may cause PPROM is by increasing the concentration of matrix metalloproteinases (MMPs) in the membranes and amniotic fluid. We tested this hypothesis in a well-defined model system of genital infection with M. pulmonis, a natural reproductive pathogen of rats. METHOD OF STUDY: Timed-pregnant, specific pathogen-free, Sprague-Dawley rats were infected with 10(7) CFU M. pulmonis at gestation day (gd) 14. Controls received an equivalent volume (100 microL) of sterile medium. At gd 18, rats were euthanized, and membranes and amniotic fluids were harvested and stored at -70 degrees C until analysis. Proteinase activity of amniotic fluid and membranes was resolved on discontinuous 7.5% sodium dodecyl sulfate-polyacrylamide gel electrophoresis gelatin zymography gels. Band intensity was determined using a digital gel documentation system and the manufacturer's software (Kodak). RESULTS: Gelatinolytic activity associated with a band similar in molecular weight to ProMMP-9 (92 kDa, the inactive precursor of MMP-9) was significantly increased in amniotic fluids and membranes harvested from M. pulmonis-treated pups at gd 18 when compared with tissues harvested from control pups. Both ProMMP-9 and ProMMP-2 (72 kDa, the inactive precursor of MMP-2) were increased in infected animals at gd 21. CONCLUSION: Our study suggests that the genital mycoplasmas can increase MMP-9 production in vivo.