用聚合酶链反应检测淋病奈瑟菌诊断慢性淋病及不显性淋菌感染

用聚合酶链反应检测淋病奈瑟菌诊断慢性淋病及不显性淋菌感染罗喜玲，袁阳，王稳，张振国大连市皮肤病防治所（邮政编码１１６０２１）我所用聚合酶链反应（ＰＣＲ）对临床有自觉症状、淋菌培养阴性疑似淋病患者９２例进行检测，现报告如下。病例和方法１２２例均为我所性...     

淋病双球菌DIF染色和酶染色观察

利用多株淋球菌作抗原免疫动物，建立了直接免疫荧光和直接酶标染色检测淋病双球菌方法。并与革兰染色和淋菌培养进行对照。结果：急性淋病１６例，革兰染色和淋菌培养阳性率分别为９３．７６％和１００％，ＤＩＦ和酶标染色阳性率均为１００％。慢性淋病１０例，ＤＩＰ和酶标染色阳性率均为７０％，革兰染色和淋菌培养阳性率分别为４０％和５１．１４％。作者认为直接免疫荧光和酶标法较能避免一般菌种不断变异的影响，可获得较为特异、能提高男性慢性及女性淋病患者，特别是无症状带菌者的淋菌检出率，而且诊断快速，方法简便。     

淋菌性皮炎、淋菌性脓肿 34例临床分析

淋病的病原体 - - 淋病奈瑟菌侵犯阴茎皮肤及皮下组织则可导致淋菌性皮炎、淋菌性脓肿 , 作者自 1998年 7月～ 1999年 12月共诊治 29例淋菌性皮炎、 5例淋菌性脓肿 . 诊断标准 : 淋菌性尿道炎、前列腺炎、淋菌性皮炎、淋菌性脓肿均有相应的临床症状、体征 , 取感染部位的分泌物涂片在脓细胞内查到 G- 双球菌和 /或淋菌培养阳性 .     

云南个旧市高危人群性病调查

于1990年2月上旬对我市戒毒所吸毒人员及看守所、收审所在押人员共650人(男615、女35)作性病检查,结果如下: 检出淋病及尖锐湿疣共106例(检出率17.07％)。其中淋病有淋菌细胞内(+)者5例(全为男性);淋病有淋菌细胞外(+)者89例(男91,女3):淋病有淋菌细胞外(+)伴尖锐湿疣者5例(男性),尖锐湿疣7例(男6,女1)。     

淋病快速检测法临床观察

我所门诊对80例患者同时采用淋菌涂片、淋病快速检测法(下称快速淋涂)及淋菌培养进行对照观察,现将结果报告如下。资料和方法1.病例来源　71例为本所STD门诊患者,9例为拘留所卖淫嫖娼者。男34例,女46例,年龄2.5～60岁。根据可疑病史及临床表现,临床诊断为淋病患者共33例,其中快速淋涂假阳性1例,假阴性4例,淋菌涂片假阳性1例,假阴性13例。2.取材　(1)淋菌涂片及培养法按常规鉴定。(2)快速淋涂:采用美国ABI公司生产的淋病快速检测试剂盒。其试验原理为一种酶检测方法。试剂由一种合成物质及显色剂组成,这一合成物可与拭子上的淋病奈瑟双球…     

力醇罗和氟哌酸治疗男性淋病疗效评价

我院分别采用进口力醇罗和国产氟哌酸治疗男性淋病54例,并做了药物疗效对比观察,现报告如下。一般资料:54例均经涂片确诊为淋病,随机分为两组。力醇罗组20例,年龄20～29岁15人,30～39岁5人,急性淋病5例,慢性淋病15人。氟哌酸组34例,年龄20～29岁19人,30～39岁8人,40岁以上7人,急性淋病26例,慢性淋病8例。     

早期梅毒39例误诊分析

淋病的病原体——淋病奈瑟菌侵犯阴茎皮肤及皮下组织则可导致淋菌性皮炎、淋菌性脓肿，作者自 1998年 7月～ 1999年 12月共诊治 29例淋菌性皮炎、 5例淋菌性脓肿。 诊断标准：淋菌性尿道炎、前列腺炎、淋菌性皮炎、淋菌性脓肿均有相应的临床症状、体征，取感染部位的分泌物涂片在脓细胞内查到 G－双球菌和 /或淋菌培养阳性。 临床资料： 34例患者均为男性。其中单纯性淋菌性皮炎： 14例，平均年龄 36岁、病期 18天。合并 Uu4例、梅毒 1例。淋菌性尿道炎合并皮炎： 15例，平均年龄 35岁、病期 34天。合并前列腺炎 4例。合并 Uu 3例、 Ct…     

中西医结合治疗Ⅲb型前列腺炎伴早泄临床观察

目的:探讨中西医结合治疗Ⅲb型前列腺炎伴早泄的临床疗效。方法:将66例患者分为对照组和治疗组,对照组给予那妥治疗,治疗组给予那妥联用中药治疗,观察其治疗效果。结果:治疗组Ⅲb型前列腺炎总有效率、早泄总有效率较对照组均有显著性差异(P0.05)。结论:中西医结合治疗慢性前列腺炎伴早泄疗效优于单用西药治疗。     

3例L型淋球菌分离鉴定及临床报告

细菌L型的感染,往往导致疾病慢性化,迁延不愈,治疗棘手。1995年我们发现3例L型淋菌感染,病程分别为6、8、12个月,经L型细菌培养鉴定明确诊断后治愈,报告如下。材料与方法　(1)标本:2例女性无菌取宫颈分泌物,1例男性取前列腺液。(2)培养基:淋球菌培养基购自上海医化所。L型平板:胎盘浸液100ml加蛋白胨2g、氯化钠2g、琼脂1g,高压灭菌后冷至50℃左右,加入羊血浆15ml、辅酶Q105mg、维生素B120.1mg,混匀倾注平板,冷凝后置无菌无毒食品塑料袋,4℃保存备用。(3)培养与鉴定:新鲜标本直接点种L型平板和划种淋球菌培养基置约10%CO2烛缸中35℃培养,…     

男性尿道炎致病菌检查200例结果分析

目的 探讨男性尿道炎患者的致病菌，了解性病的发病趋势。方法 对200例有尿道炎症状的男性患者，进行分泌物涂片、淋菌培养、沙眼衣原体(CT)检测、解脲支原体(UU)、人型支原体(MH)培养。结果 200例患者中33例未检出病原体，占16．5％；培养检出淋菌20例，占10．％；涂片检出念珠菌6例，占3％；滴虫6例，占3％；CT62例，占31％；UU87例，占43．5％；MH51例，占25．5％。其中20例淋病患者中有14例合并CT、UU、MH感染。结论 在检测的200例男性患者中淋菌的感染率较低，非淋菌感染率升高，以CT、UU、MH感染为主。     

The sociomedical efficacy of the enzyme therapy of gonorrhea patients

The study has involved 3702 male patients with gonorrhea. Of these 62 percent were fresh cases, 38 percent chronic ones; there were 218 patients (5.9 percent) with recurrences, of these 63.3 percent with new relapses and 36.7 percent with chronic ones. 85.3 percent of patients developed monorelapses. The recurrences were equally frequent after antibiotic therapy (50.2 percent) and after combined treatment (49.8 percent). Proteolytic enzymes (chymotrypsin, trapsin 5 mg twice daily with a 12 hrs interval) in combination with an antibiotic were administered to 242 patients with gonorrhea complicated by epididymo-orchitis and with gonorrhea relapses. Etiologic cure was achieved in all of them; postgonorrheal conditions were recorded in 6-7 percent and depended on the antibiotic administered; in reference patients recurrences were recorded in 4.2-6.5 percent of cases, postgonorrheal conditions in 14-21.4 percent of cases. Enzymic therapy helped reduce the length of inpatient therapy of a patient by 5.93 days on an average in cases with orchidoepididymitis and by 14.64 days in gonorrhea relapses, with the economic effect per worker being 131.4 and 307.2 rubles, respectively.     

细胞培养法检测淋病患者泌尿生殖道沙眼衣原体的研究

用衣原体细胞培养法和淋球菌培养法，对我中心脏病门诊的４５例初步诊断为淋病（涂片检查）的患者进行了泌尿生殖道标本检测。结果显示：４５份标本淋球菌培养均为阳性，其中衣原体细胞培养检测阳性的７份，阳性检出率为１５．６％。对资料的分析还提示，与淋病患者合并衣原体感染发病率显著相关的危险因素是性伴数和既往性病史。     

Multicenter, comparative study of enoxacin and ceftriaxone for treatment of uncomplicated gonorrhea

The efficacy of single dose enoxacin, 400 mg was compared to ceftriaxone, 250 mg IM for therapy of uncomplicated gonorrhea in 152 evaluable patients attending sexually transmitted disease clinics in Baltimore, Indianapolis and Seattle. Anogenital gonorrhea was cured in 75 (99%) of 76 patients treated with enoxacin and 73 (97%) of 75 patients treated with ceftriaxone. Three of three patients with pharyngeal gonorrhea were not cured by enoxacin while all three ceftriaxone treated cases of pharyngeal gonorrhea were cured. All cases of anogenital gonorrhea caused by beta-lactamase producing Neisseria gonorrheae (11 patients), gonococci with high-level, plasmid-mediated tetracycline resistance (11 patients), or gonococci with chromosomally mediated penicillin resistance (22 patients) were cured. The IC90 for enoxacin of N. gonorrhoeae isolated in this study was 0.06 microgram/ml. Enoxacin appears to be a well tolerated, efficacious alternative to currently recommended therapy for patients with uncomplicated, anogenital gonorrhea including cases potentially caused by antibiotic resistant N. gonorrhoeae.     

Pharyngeal Gonorrhea in female sex workers: Response to a single 2-g dose of azithromycin

OBJECTIVES: A sharp increase in the incidence of gonorrhea has been observed in Tel Aviv, Israel, since 1999. Almost one half of interviewed patients admitted contracting the infection from a sex worker. In two thirds of the cases, oral sex (fellatio) was the most probable route of acquiring the disease. In the current study, we assessed the prevalence of pharyngeal gonorrhea among sex workers in Tel Aviv and evaluated the efficacy of a single 2-g dose of azithromycin in eradicating the infection. METHODS: Throat specimens were obtained for gonococcal culture from 301 female sex workers practicing in brothels. A questionnaire covering demographic and sexual behavior information was administered to all participants, and a single 2-g dose was administered orally under supervision. Women with positive cultures were reexamined a week later for eradication of Neisseria gonorrhoeae. RESULTS: N gonorrhoeae was isolated from 27 women (9%). The median age of women with pharyngeal gonorrhea was 23 years (range, 18-32 years); 85% were born in former Soviet Union (mostly Russia, Ukraine, Moldavia). Regular condom use in vaginal sex was reported by 88% of the participants, whereas only 60% reported always using condoms in oral sex. All isolates were susceptible to azithromycin (MIC < or = 0.5 microg/ml). Gonococci were eradicated in 20/21 individuals (95%). CONCLUSION: A high carriage rate of gonococci in the throat and a low rate of condom use in oral sex were documented among sex workers in Tel Aviv. A single 2 g dose of azithromycin was very effective in eradicating gonococci from the throat.     

Auxotypes and antibiotic susceptibilities of Neisseria gonorrhoeae from women with acute salpingitis. Comparison with gonococci causing uncomplicated genital tract infections in women

An investigation of the MICs of various antibiotics and the nutritional requirements (auxotypes) of Neisseria gonorrhoeae recovered from the cervix, fallopian tubes, and peritoneal cavity of women with acute salpingitis was done. These MICs and auxotypes were compared to those of gonococci isolated from the cervix of women with uncomplicated or asymptomatic genital tract gonorrhea. The MICs of minocycline, penicillin G, ampicillin, cefoxitin, and cefaclor for gonococci isolated from women with acute salpingitis were significantly higher. Significant differences in auxotype patterns were identified between isolates from salpingitis cases and uncomplicated cases. The prototrophic form was the most common (75%) among salpingitis strains. No strains requiring arginine, hypoxanthine, and uracil were identified among the salpingitis isolates. In contrast, strains that required these nutrients were the most frequent auxotype among isolated from women with uncomplicated genital tract gonorrhea. Discriminant analysis revealed that the MIC of minocycline and the auxotype were the most powerful discriminators between groups of patients with different manifestations of gonorrhea.     

Incidence of disseminated gonococcal infection correlated with the presence of AHU auxotype of Neisseria gonorrhoeae in a community

Strains of Neisseria gonorrhoeae requiring arginine, hypoxanthine, and uracil (AHU) may cause disseminated gonococcal infection (DGI). A significant epidemiologic association was noted between the incidence of disseminated gonococcal infection and the presence of gonococci of the AHU auxotype in the community over a nine-year period. Thirty-nine patients with DGI were identified from hospital records of January 1974-December 1982. During this interval, gonococcal isolates from patients in the community were collected at a venereal disease clinic and a hospital emergency room. The incidence of patients hospitalized for DGI dropped significantly after 1978. The year of highest incidence of DGI was 1977, when there were 429 cases of DGI per 100,000 cases of uncomplicated gonorrhea; the incidence of gonococcal isolates of the AHU auxotype in that year was 26.3%. In contrast, this auxotype accounted for only 4.6% of gonococcal isolates in 1980, when the incidence of DGI had decreased to 58 cases per 100,000 cases of uncomplicated gonorrhea. When DGI and gonococci of the AHU auxotype from the community were ranked for incidence by year, a significant correlation between the two was found (P less than .001). Thus the incidence of patients with DGI in the hospital reflected the presence of gonococci of the AHU auxotype in the community.     

The assessment of the efficacy of introducing a new method for treating gonorrhea

Proteolytic enzymes (chymotrypsin, trypsin) i.m. injections in a dose of 5 mg twice daily for 4 to 10 days were used in combined therapy of 218 patients with recurrences of gonorrhea, gonorrheal epididymitis and orchiepididymitis; 23 patients with acute orchiepididymitis were injected heparin intramuscularly in a dose of 5000 U twice daily for 7 weeks. Etiologic cure was achieved in 99.7 percent, postgonorrheal residual phenomena were detected in 5.7 percent of cases (93.9 and 17.5 percent, respectively, in a reference group). The length of treatment of a patient with gonorrhea relapse shortened by 8.6 days on an average and of that with orchiepididymitis and epididymitis by 5.9 days. Formula are presented for calculating the economic efficacy of treatment of those working and not working patients.     

Recurrences of gonorrhea in men (the characteristics of the course and treatment)

The examination has involved 218 patients. The incidence of relapses in acute and subacute gonorrhea has made up 6.3%, 5.2% in chronic and 4.5% in complicated condition. Recurrences were observed in 5.3 days on an average after therapy of new gonorrhea cases and in 8.8 days after treatment of chronic disease. Mixed urogenital infection was recorded in 37.8% of cases; in gonorrhea eventuating in clinical cure it was observed in 24% of cases. Relapses developed in 50.2% of patients after antibiotic therapy and in 49.8% after combined treatment. A single relapse occurred in 85.6% of patients; two and more relapses in 14.4%. The disease recurred after penicillin therapy in 6.5% after aminoglycosides in 6.9%, and after tetracyclin treatment in 4.2% of cases. Therapy with proteolytic enzymes (chymotrypsin, trypsin 5 mg i.m. twice a day) combined with antibiotics resulted in etiological cure in 99.3% of patients, the incidence of postgonorrheal symptoms reduced and made up 6.8% (in the patients not administered protease this share made up 19.2%), and the length of inpatient treatment shortened by 8-14.6 days.     

Criteria of recovery from gonorrhea

A total of 563 case histories of gonorrhea patients and 218 ones of patients with gonorrhea recurrences are analyzed. 86.7-87.5% of recurrences were recorded in the first week after treatment for acute or chronic condition (before the provocation test). The relapses develop earlier after the treatment for acute or subacute gonorrhea than for the chronic condition, and are most common between the third and seventh days after therapy. The share of patients timely consulting the doctors is in inverse proportion with the time of the check-ups (the criterion of cure being 96.2%, the first control 84.1%, the second one 62%). The validity of cure should better be checked up on the fifth-sixth days after therapy, and not on days 7-10. Patients with complicated urogenital diseases (prostatitis, orchiepididymitis, infiltrative urethritis) should be followed up after the first check-up.     

Effects of partner notification on reducing gonorrhea incidence rate

OBJECTIVE: The objective of this study was to estimate the effectiveness of partner notification (PN) by linking measures of PN with the gonorrhea incidence rate in New York State exclusive of New York City. STUDY DESIGN: Gonorrhea cases were identified from the Communicable Disease Confidential Case Reports system. Case interview data were obtained from the case management database. Gonorrhea incidence data and interview data were aggregated from individual records and then linked at the county level. RESULTS: From 1992 to 2002, 100,756 gonorrhea cases were reported and 37% were interviewed. A total of 34,807 partners were elicited from 37,393 index cases: 18,291 (52.5%) partners sought medical evaluation, 10,159 (29.2%) received preventive treatment, and 7,474 (21.5%) were infected and treated. The gonorrhea incidence rate was inversely correlated with the percent of partners given preventive treatment and positively related to the percent of infected partners. CONCLUSIONS: Our study adds new evidence that PN is an effective mechanism to detect new cases and interrupt disease transmission within communities.