STD门诊患者泌尿生殖道沙眼衣原体及解脲脲原体检测结果分析

为分析近几年性病门诊就诊者中沙眼衣原体(Ct)和解脲脲原体(Uu)感染的流行趋势和特征。我们收集2001～2004年本院性病门诊病例,并对泌尿生殖道分泌物检测者的人口学特征和检测结果等资料进行统计分析。4年中共检测18727例,阳性7135例(38.10%),其中Ct阳性2066例(11.03%),Uu阳性4072例(21.74%),Ct Uu阳性576例(3.08%),Ct、Uu与NG混合感染506例(2.71%),Ct、Uu在19～40岁性活跃年龄段人群感染率较高,男性泌尿生殖道以Ct感染、女性泌尿生殖道以Uu感染较多,在性病防治及监测中应引起重视。     

汕头市性病门诊患者沙眼衣原体支原体检测情况分析

为了解沿海开放城市沙眼衣原体(Ct)、解脲支原体(Uu)、人型支原体(Mh)所致NGU的感染情况，我们对汕头市皮肤病医院2001年度性病门诊4413例泌尿生殖道炎患者标本检测结果进行了分析，现报道如下。     

反应性关节炎与解脲支原体感染的相关性研究

为研究反应性关节炎(reactive arthritis,RA)与解脲支原体(Uu)感染的相关性。对164例男女RA患者分别进行尿道、宫颈分泌物Uu、衣原体(Ct)检测分析,并与173例尿道炎、宫颈炎患者的Uu、Ct检测结果作对照。结果:164例RA患者中,Ct、Uu的检出率分别为3.04%和52.44%,Uu检出率显著高于Ct检出率;Uu检出率与无关节炎的患者检出率(22.31%)有显著性差异,Ct无显著性差异。Uu感染可能为RA的重要致病因素,对于关节炎患者应重视泌尿生殖道Uu的检测。     

性病门诊235例患者生殖支原体感染分析

目的研究分析我院皮肤性病门诊患者生殖支原体(Mg)的感染情况。方法收集2015年2—10月就诊于皮肤性病门诊疑似泌尿生殖系统感染的患者235例(男165例,女70例),采集男性尿道或女性宫颈分泌物分别进行超显微镜检、淋球菌培养、支原体培养、生殖道沙眼衣原体聚合酶链反应(PCR)检测和生殖支原体实时荧光核酸恒温扩增检测技术(SAT)检测。结果 235例患者中各种微生物检出情况分别为Mg 17例(7.23%),解脲脲原体(Uu)72例(30.64%),人型支原体(Mh)22例(9.36%),生殖道沙眼衣原体(Ct)10例(4.26%),淋球菌6例(2.55%),上述检测项目全部阴性122例(51.91%)。Mg阳性的17例患者中单一感染7例(41.18%),混合感染10例(58.82%),其中Mg+Uu感染6例,Mg+Uu+Mh感染4例。结论 Mg可单一感染,也可混合感染,临床上应加强对性病门诊患者Mg的筛查。Mg生长条件要求高,培养成功率低,SAT检测是目前可以选择用来检测Mg的方法之一。     

妇女生殖泌尿道解脲脲原体和人型支原体培养、分离鉴定、计数及药敏分析

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(M IN)(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。     

性病门诊男性就诊者尿道解脲支原体分群分型研究

目的：探讨性病门诊男性就诊者尿道解脲支原体（Uu）分群分型的特点。方法：采用病例对照研究,收集性病门诊单纯Uu阳性的男性NGU和非NGU就诊者尿道拭子标本,通过PCR法检测Uu基因分群和生长代谢抑制试验进行Uu血清分型。结果：男性就诊者尿道Uu基因群1占24．3％（18／74）,基因群2占59．5％（44／74）,基因群1,2同时阳性6．8％（5／74）,Uu分布均以基因群2为主,Uu基因群1,2在男性NGU组与非NGU组间分布没有统计学差异（P均〉0．05）;Uu血清分型显示,NGU和非NGU组优势血清型均以2、4、7、14型为主,且在两组间差异无统计学意义（P均〉0．05）。结论：不同基因群、不同血清型池在男性NGU患者与NGU就诊者之间的分布无差异,提示与非淋菌性尿道炎无相关性;本地区性病门诊男性尿道解脲支原体以血清型2、4、7、14型为主。     

儿童泌尿生殖道沙眼衣原体、解脲脲原体的检测及其意义

目的 探讨儿童泌尿生殖道沙眼衣原体（Ct）、解脲脲原体（Uu）等病原体的感染情况。方法 对门诊就诊的155例儿童，取尿道分泌物、阴道分泌物检测炎症细胞、Ct、Uu、淋球菌（Ng）、念珠菌、阴道毛滴虫、蛲虫卵。结果 22例女童阴道分泌物检出白细胞（WBC）阳性，Q检出率6．45％（10／155），Uu检出率22．58％（35／155），检出淋球菌2例（1．29％），念珠菌2例（1．29％），蛲虫卵3例（1．94％）。结论 对儿童泌尿生殖道炎症，要注意查找性病因素。儿童泌尿生殖道内存在Ct、Uu健康携带或正常定植情况。     

泌尿生殖道衣原体和支原体感染检测分析

非淋菌性尿道炎(NGU)主要是沙眼衣原体(Ct)和解脲支原体(Uu)所致。为了解这些病原体在本地区的流行状况,感染特点及在STD中所占的比重,作者收集了1999年1月~2003年1月本院皮肤性病门诊确诊的感染者100例,现报道如下。临床资料检验对象:100例感染者均有性乱史。绝大部分在治疗淋     

重庆地区妇科门诊沙眼衣原体、解脲支原体的检测及分析

目的：了解重庆地区疑有泌尿生殖道感染的女性患者沙眼衣原体(Ct)、解脲支原体(Uu)的感染情况。方法：运用荧光探针PCR法(FQ—PCR)对妇科门诊453例疑为泌尿生殖道感染患者同时进行Ct和Uu检测。结果：Ct阳性感染者39例，阳性率8．61％；Uu阳性感染者26例，阳性率5．74％，其中仅有2例Ct和Uu同时阳性，各年龄段之间阳性率无显著差异。结论：(1)重庆地区Ct和Uu感染在妇科病人中占有一定比例，值得重视；(2)荧光PCR技术检测Ct和Uu具有操作简单、反应时间短、结果客观准确、敏感性和特异性好的优点，适宜门诊初查。     

泰州地区108株解脲支原体药敏测定

解脲支原体(Uu)是泌尿生殖道的主要病原体之一，除了可引起非淋菌性尿道炎(宫颈炎)外尚可导致附睾炎、输卵管炎、不孕不育等多种疾病。为了解本地区Uu对抗菌药物的敏感性及耐药情况，我们于2002年7月～2003年4月，对性病实验室培养出的108株Uu进行了体外药敏测定，报道如下。材料与方法试剂盒采用珠海银科生物技术应用研究所生产的支原体药敏试剂盒。标本来源：108株Uu来自我院皮肤性病科、泌尿科、妇科门诊的320例NGU患者。实验方法：严格按试剂盒说明书操作。     

Aetiology of urethral discharge in Bangui, Central African Republic

OBJECTIVES: To determine the aetiology of urethritis in Bangui, Central African Republic. METHODS: 410 men presenting with urethral discharge and 100 asymptomatic controls were enrolled. Urethral swabs were obtained and processed by gonococcal culture and polymerase chain reaction for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis, and Ureaplasma urealyticum. RESULTS: In multivariate analyses, M genitalium and C trachomatis were significantly associated with urethral discharge when comparing cases of non-gonococcal urethritis (NGU) with controls. T vaginalis was also more common in cases than in controls, but this reached statistical significance only among cases in whom N gonorrhoeae was also detected. U urealyticum was not associated with urethritis. The gonococcus was found in 69% of cases of urethral discharge. M genitalium was the predominant pathogen in patients with NGU, being found in 42% (53/127) of such patients while C trachomatis was found in only 17% (22/127). T vaginalis was found in 18% (23/127) of patients with NGU, but also in 15% (43/283) of patients with gonococcal urethritis, and two thirds of patients with T vaginalis also had the gonococcus. Multiple infections were common. M genitalium caused a syndrome similar to chlamydial urethritis, with a less severe inflammation than in gonococcal infection. No behavioural or clinical characteristic could discriminate between the various aetiological agents. CONCLUSIONS: M genitalium is more prevalent than C trachomatis and is the most common cause of NGU in BANGUI: It causes a syndrome similar to chlamydial urethritis. T vaginalis is weakly associated with urethritis, and is often found along with other pathogens.     

Polymerase chain reaction-based subtyping of ureaplasma parvum and ureaplasma urealyticum in first-pass urine samples from men with or without urethritis

BACKGROUND: Our previous study suggested a significant association between Ureaplasma urealyticum and nongonococcal urethritis (NGU). However, association of the serovars of U. urealyticum with NGU remains unclear. A polymerase chain reaction (PCR)-based assay can distinguish 4 serovars of Ureaplasma parvum from each other and categorize 10 serovars of U. urealyticum into 3 subtypes: subtype 1 (serovars 2, 5, 8, and 9), subtype 2 (serovars 4, 10, 12, and 13), and subtype 3 (serovars 7 and 11). GOAL: The goal of this study was to determine which subtypes of U. urealyticum are associated with NGU as determined by PCR-based assay. STUDY: The prevalence of U. urealyticum subtypes in 106 ureaplasma-positive men with urethritis was compared with that in 30 ureaplasma-positive men without urethritis. RESULTS:: In men with nonchlamydial NGU and men with Mycoplasma genitalium-negative nonchlamydial NGU, only U. urealyticum subtype 1 (serovars 2, 5, 8, and 9) was detected significantly more often than in men without urethritis. CONCLUSION: This study suggests that subtype 1 of U. urealyticum (serovars 2, 5, 8, and 9) is associated with NGU independently of Chlamydia trachomatis or M. genitalium.     

A randomized, double-blind study comparing single-dose rifalazil with single-dose azithromycin for the empirical treatment of nongonococcal urethritis in men

OBJECTIVES: To determine the safety and effectiveness of single-dose rifalazil, a new rifamycin, for the treatment of nongonococcal urethritis (NGU). STUDY DESIGN: Randomized, double-blind trial comparing rifalazil, 2.5, 12.5 or 25 mg, with 1.0 g azithromycin for the treatment of NGU. One hundred and seventy men were evaluated for Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma genitalium infection before therapy and 2- and 5-weeks posttreatment. RESULTS: C. trachomatis, M. genitalium, and U. urealyticum were present in 42%, 24%, and 28% of subjects, respectively. Microbiologic eradication of C. trachomatis with rifalazil 25 mg at 2- and 5- weeks was 85% and 83%, respectively. Rifalazil was ineffective in eradicating M. genitalium and U. urealyticum. Overall clinical cure rates at 2- and 5-weeks were 86% (95% CI 67-96) and 59% (39-78) in the rifalazil-treated 25 mg group, and 77% (56-91) and 63% (41-81) in the azithromycin-treated group. CONCLUSIONS: Rifalazil was well tolerated and eradicates C. trachomatis but not M. genitalium and U. ureaplasma in men with NGU.     

Microbiological and serological study of non-gonococcal urethritis with special reference to Mycoplasma genitalium.

Twenty-two men with non-gonococcal urethritis (NGU), 19 with gonorrhoea, and 22 without urethritis were examined for various micro-organisms. Chlamydia trachomatis was isolated from the urethra of 45% of men with NGU, 21% of those with gonorrhoea, but from none without urethritis. Ureaplasma urealyticum but not Mycoplasma hominis was recovered from a larger proportion of men with NGU than from those in the other groups. M genitalium was isolated presumptively from 32% of men with NGU, 12% of those with gonorrhoea, from 10% of men without urethritis, and from 42% of the men with NGU from whom chlamydiae were not isolated. U urealyticum, M hominis, and M genitalium were sought also in the rectum of men in the three groups. The first two micro-organisms were confined almost exclusively to homosexual men, whereas M genitalium was apparently not restricted in this way and was found particularly in this site in men with NGU. The latter mycoplasma may be a resident primarily of the intestinal tract. A fourfold or greater rise in the titre of antibody to C trachomatis was detected in about 20% of the patients with NGU, but not in other men. A similar rise in the titre of antibody to M genitalium was seen in 29% of the patients with NGU and in 12% of those without urethritis. A concomitant antibody response to M pneumoniae, which is antigenically related to M genitalium, was seen in one patient only. The responses to M genitalium suggest infection by this mycoplasma and indicate the need for further serological studies.     

Mycoplasma genitalium: prevalence, clinical significance, and transmission

OBJECTIVES: To study the prevalence, symptoms and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in STD clinic attendees and in partners of M genitalium infected patients. METHODS: M genitalium and C trachomatis were detected by polymerase chain reaction from urethral and endocervical swab specimens in a cross sectional study among 445 female and 501 male STD clinic attendees. Partners of 26 female and 26 male M genitalium positive index patients were examined. RESULTS: The prevalence of C trachomatis and M genitalium was 4% and 6.3%, respectively, among the women and 5.4% and 6%, respectively, among the men. Dual infections were uncommon. M genitalium was strongly associated with urethritis in both men and women and with cervicitis in women. Among M genitalium infected men, symptomatic urethritis was more common than asymptomatic urethritis. M genitalium and C trachomatis were not associated with symptoms of urethritis or cervicitis in women. Of 26 male partners of M genitalium positive female index patients, 38% were positive, and 77% of the negative partners had symptoms of urethritis. The concordance rate for 22 female partners of male index patients was 45%. For both men and women the M genitalium prevalence was significantly higher in partners of M genitalium positive index patients than in M genitalium negative index patients with urethritis and/or cervicitis. CONCLUSIONS: M genitalium is associated with urethritis in both men and women and with cervicitis in women. A high concordance rate was found among sexual partners of M genitalium infected patients, indicating that the infection is sexually transmitted.     

Association of Mycoplasma genitalium persistence in the urethra with recurrence of nongonococcal urethritis

BACKGROUND: Most patients with recurrent symptomatic nongonococcal urethritis receive negative test results for Chlamydia trachomatis and Ureaplasma urealyticum, and the cause of such recurrence usually is unknown. GOAL: To assess the association of Mycoplasma genitalium with recurrent nongonococcal urethritis. STUDY DESIGN: In this study, 72 men with nongonococcal urethritis were treated with levofloxacin. Before and after treatment, symptoms and signs were assessed and first-pass urine was examined for C trachomatis, M genitalium, U urealyticum, and Mycoplasma hominis by polymerase chain reaction-based assays. RESULTS: In 6 of 45 men who had no symptoms and no evidence of inflammation after treatment, nongonococcal urethritis recurred. Of these 6 men, 5 had positive test results for M genitalium before levofloxacin treatment, which remained positive afterward. After the second treatment for recurrent nongonococcal urethritis, one man was still had a positive test result for the mycoplasma and experienced a subsequent recurrence. CONCLUSIONS: This study suggests that the persistence of M genitalium in the urethra may be associated with recurrence of nongonococcal urethritis.     

Coexistence of urethritis with genital ulcer disease in South Africa: influence on provision of syndromic management

OBJECTIVE: To assess whether syndromic management of genital ulcer disease was sound, if based on the premise that men with genital ulcers rarely have a concomitant urethral infection. METHODS: Specimens were taken in 1998 from 186 mine workers in Carletonville, South Africa, who were seen consecutively with genital ulcers. The specimens comprised a swab from the ulcer, a urethral swab for a Gram stained smear, and 10-15 ml of a first catch urine sample. The latter was tested by ligase chain reaction assays for Neisseria gonorrhoeae and Chlamydia trachomatis specific DNA sequences and by a polymerase chain reaction (PCR) assay for Mycoplasma genitalium. Ulcer inducing micro-organisms were detected either by a multiplex PCR assay, or in the case of lymphogranuloma venereum (LGV) serologically, and human immunodeficiency virus (HIV) infection was detected by an enzyme linked immunosorbent assay (ELISA) test. RESULTS: Most (54%) of the ulcers were chancroidal, 18% were herpetic (HSV type 2), 6.5% primary syphilitic, and 3.2% due to LGV. More than one micro-organism was detected in 9.1% of the ulcers and less than 10% were undiagnosed. Microscopic examination of the urethral smears showed that 99 (53%) of the men had urethritis, of whom 45 (45%) were infected with N gonorrhoeae. Of the 54 men (55%) who had non-gonococcal urethritis (NGU), 11 (19.6%) harboured C trachomatis or M genitalium. Almost two thirds (64.5%) of the men had HIV infection, but this did not seem to have influenced the aetiology of the ulcers. Nor was a particular ulcer associated with one type of urethritis more than the other. Neither C trachomatis nor M genitalium was associated significantly with non-gonococcal urethritis (NGU) in either HIV positive or HIV negative men. CONCLUSION: The combination of antibiotics used for the management of genital ulcer disease in men in this South African mining population needs to be widened to encompass frequently occurring concomitant gonococcal urethritis and NGU infections. This means treatment with long acting penicillin, combined with ciprofloxacin and azithromycin or erythromycin. A similar situation may exist in other geographical locations with a need to provide appropriate antimicrobial combinations depending on the patterns of infection detected.     

Mycoplasma genitalium: a cause of male urethritis?

BACKGROUND--Male urethritis may be caused by mycoplasmas. Since Mycoplasma genitalium has previously been isolated from the urethra of two men with non-gonococcal urethritis (NGU), it was the aim of the study further to elucidate its role by measuring the prevalence of this organism in men with NGU. MATERIAL AND METHODS--The polymerase chain reaction was used. Two different sequences of the gene coding for the main adhesin MgPa were amplified. Urethral, rectal, and throat samples from 99 male sexually transmitted disease (STD) patients with and without urethritis were studied. RESULTS--M genitalium DNA was demonstrated in 17/99 (17%) of the urethral swabs, but in none of the rectal and throat swabs. Significantly more patients with urethritis (13/52) were positive for M genitalium DNA than were patients without urethritis (4/47) (p < 0.03). In those with urethritis M genitalium DNA was found more often in Chlamydia trachomatis negative NGU (12/34) than in those with chlamydial NGU (1/14) (p = 0.05). Attempts to culture M genitalium from the PCR positive specimens were unsuccessful. CONCLUSION--M genitalium DNA was found significantly more often in male STD patients with non-chlamydial NGU than in men with chlamydial urethritis (p = 0.05) and in men without urethritis (p = 0.003), suggesting that M genitalium may be a cause of NGU. M genitalium DNA was not demonstrated in any of the throat or rectal swabsindicating that the urogenital tract is probably the primary site of infection or colonisation of this species.     

Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis

OBJECTIVES: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in men attending a Swedish STD clinic and to study the criteria for urethritis. METHODS: A cross sectional study among STD clinic attendees in Orebro, Sweden. Attendees were examined for microscopic urethritis and first void urine (FVU) was tested for M genitalium and C trachomatis. RESULTS: The prevalence of M genitalium and C trachomatis was 7% (34/512) and 12% (61/512), respectively. Dual infection was diagnosed in four men. In both infections 90% of the patients had signs of microscopic urethritis. M genitalium positive men had symptomatic urethritis significantly more often than those infected with C trachomatis (73% v 40%, RR 1.8; 95% CI 1.2 to 2.7). 63% of female partners of men infected with M genitalium were infected with M genitalium compared with chlamydial infection in 67% of female partners of men infected with C trachomatis. Non-chlamydial non-gonococcal urethritis without evidence of M genitalium infection was diagnosed in 180 men (35%). Symptoms and/or visible discharge were reported in 49% in this group. CONCLUSIONS: M genitalium is a common infection associated with symptomatic urethritis and with a high prevalence of infected sexual partners supporting its role as a sexually transmitted infection.     

非淋菌性尿道炎的生殖支原体检测

目的　为了探讨生殖支原体 (Mycoplasmagenitalium ,Mg)感染与非淋菌性尿道炎 (NGU )的关系。方法　对 6 4例采自STD门诊的NGU患者尿道 (宫颈 )分泌物标本作了Mg检测。采用改良SP 4培养基作分离培养。结果与结论　实验结果表明 ,9例阳性 ,占检测总数 14 1%。其中男 6例 ,女3例。 2例合并解脲支原体感染 ,另 1例伴有沙眼衣原体感染。 9例阳性培养物经菌落形态观察、传代试验、生化反应、电镜观察及聚合酶链反应等鉴定试验证明 ,临床分离培养阳性株同Mg标准株 (G 3 7)的实验结果完全一致。对Mg与NGU关系作了初步分析