Emerging Chlamydial Infections

Chlamydiae are important intracellular bacterial pathogens of vertebrates. In the last years, novel members of this group have been discovered: Parachlamydia acanthamoebae and Simkania negevensis seems to be emerging respiratory human pathogens, while Waddlia chondrophila might be a new agent of bovine abortion. Various species have been showed to infect also the herpetofauna and fishes, and some novel chlamydiae are endosymbionts of arthropods. In addition, molecular studies evidenced a huge diversity of chlamydiae from both environmental and clinical samples, most of such a diversity could be formed by novel lineages of chlamydiae. Experimental studies showed that free-living amoebae may support multiplication of various chlamydiae, then could play an important role as reservoir/vector of chlamydial infections. Here we reviewed literature data concerning chlamydial infections, with a particular emphasis on the novely described chlamydial organisms.     

327例输卵管性不孕患者生殖道衣原体、支原体检测及药物敏感分析

目的 探讨输卵管性不孕症患者生殖道衣原体和支原体感染的状况及药物敏感性,指导临床合理用药.方法 随机选取327例输卵管性不孕症患者作为不孕组和286名健康孕妇作为对照组,采集宫颈分泌物,检测沙眼衣原体(CT)、解脲支原体(UU)和人型支原体(MH),以及UU和MH耐药性.结果 不孕组CT感染率(14.99%)、UU感染率(23.24%)、UU+MH感染率(29.05%)、CT+UU+MH感染率(9.17%)及总感染率(88.99%)均高于对照组(依次为:2.80%、6.99%、8.39%、4.55%、29.02%),两组比较,差异有统计学意义(P＜0.05);UU对罗红霉素(敏感性为96.05%)、交沙霉素(敏感性为96.05%)、四环素(敏感性为82.89%)强力霉素(敏感性为92.11%)、克拉霉素(敏感性为96.05%)敏感率较高,对环丙沙星和乙酰螺旋霉素相对耐药;MH对交沙霉素(敏感性为95.83%)、强力霉素(敏感性为91.67%)、美满霉素(敏感性为83.33%)、壮观霉素(敏感性为75.00%)较敏感,对红霉素、罗红霉素、阿奇霉素、克拉霉素不敏感,耐药性较高;UU+MH仅仅对交沙霉素(敏感性为90.52%)较敏感,对红霉素、罗红霉素、乙酰螺旋霉素、环丙沙星、氧氟沙星、阿奇霉素、克拉霉素的耐药性极高(77.89%-91.58%).结论 CT、UU、MH感染与输卵管性不孕有一定相关性,输卵管性不孕患者CT、UU和MH感染率较高于能生育者;UU和MH及UU+MH对多种常见抗菌药物具有较强的耐药性,临床治疗应重视病原学检测,合理使用抗生素.

Abstract：

Objective To explore the effects of mycoplasma and chlamydia infections on tubal infertilityand to assess the antibiotic susceptibility and resistance of female urogenital, and consequently to guide clinical rational drug use. Methods 327 tubal infertility women as infertility group and 286 healthy pregnant women as control group were randomly selected, detected chlamydia trachomatis ( CT) , ureaplasma urealyticum ( UU) and mycoplasma hominis ( MH) in cervical secretions and drug resistance of UU and MH. Results CT infection rates ( 14. 99% ), UU infection rates (23. 24% ) , UU + MH infection rates (29.05% ) ,CT + UU + MH infection rates(9. 17% )and total infection rates(88.99% )in infertility group is higher than those (order: 2. 80% ,6. 99% , 8. 39% ,4. 55% ,29.02% ) in the control group, comparisons of two groups are statistically significant differences (P ＜ 0.05 ), the susceptibility of UU to roxithromycin (sensitivity is 96. 05% ), josamycin ( sensitivity is 96.05% ), tetracycline ( sensitivity is 82.89%), vibramycin( sensitivity is 92. 11% ) and clarithromycin( sensitivity is 96.05% ) were relatively high and low to ciprofloxacin and acetyl spiramycin. The susceptibility of MH to josamycin ( sensitivity is 95. 83% ) , vibramycin ( sensitivity is 91. 67% ), minocin ( sensitivity is 83.33%) and actinospectacin ( sensitivity is 75. 00% ) were relatively high and low to erythromycin, azithromycin, roxithromycin and clarithromycin. UU + MH was only sensitive to josamycin ( sensitivity is 90. 52% ), high resistance ( 77. 89% -91. 58% ) to erythromycin, azithromycin, acetyl spiramycin, ciprofloxacin, ofloxacin, azithromycin and clarithromycin.Conclusion Infection of CT, UU, MH and tubal infertility have certain relevance, the rates of CT, UU and MH infection in tubal infertility patients higher than fertile people. For many commonantibacterial drugs, UU, MH and UU + MH has strong resistance, the etiology detection and using adapted antibios should be taken seriously in clinical treatment.     

419例疑似非淋菌性尿道炎(宫颈炎)患者支原体、衣原体检测结果分析

[目的]了解2002～2004年河北省疾病预防控制中心性病门诊419例泌尿生殖道感染者支原体、沙眼衣原体(CT)感染现状。[方法]采集的尿道或宫颈标本通过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]CT阳性率为25.99%(79/304),男女无差别;UU培养阳性率34.91%(133/381),女性48.03%非常显著地高于男性26.20%;Mh的阳性率7.06%,男女无差别;Uu Mh阳性率为4.52%。衣原体和支原体的双重感染率,CT Uu为9.40%;CT Mh为2.33%;CT Uu Mh三重感染率为1.95%。[结论]河北省CDC性病门诊疑似非淋菌性尿道炎(宫颈炎)患者3种病原体均有检出,Uu检出阳性率女性显著高于男性,性病高危人群集中于21～40岁年龄组,患病年龄有提前趋势,应加强性安全知识的健康教育和行为干预。     

412例复发性阴道炎患者NUC感染的PCR检测分析

目的研究复发性阴道炎患者淋球菌（NG），解脲支原体（UU），沙眼衣原体（CT）的感染情况。方法应用聚合酶链反应（PCR）检测患者宫颈分泌物中NG，UU，CT的特异性DNA。结果412例阴道炎中检出三种病原体共185例，阳性率为44．9％。其中单一病原体感染178例，NG，UU，CT的阳性检出率分别为15．67％，61．62％，18．91％。混合感染7例，NG＋UU2例，占1．08％，UU＋CT5例，占2.70％。结论NG，UU，CT是女性生殖道常见的病原体，应加强门诊筛查。     

支原体与衣原体感染检测及耐药性分析

目的探讨女性泌尿生殖道支原体与衣原体感染的现状及耐药性,为临床医生合理使用抗菌药物提供依据。方法支原体采用IST2培养及药敏试剂盒、衣原体采用法国VEDALAB试剂盒检测。结果376例疑似非淋菌性尿道炎(NGU)患者中,216例解脲脲支原体(Uu)培养阳性,阳性率为57.4%;35例Uu与人支原体(Mh)混合培养阳性,占9.3%;125例沙眼衣原体(Ct)阳性,占33.3%;药敏结果除对交沙霉素、氧氟沙星、多西环素外,Uu Mh混合感染对其他6种抗菌药物的耐药率均高于单纯Uu感染,多西环素、交沙霉素、普拉特霉素对支原体感染敏感性最高。结论女性泌尿生殖道感染主要以Uu发病率最高,治疗支原体感染应根据药敏结果合理使用抗菌药物。     

支原体及衣原体感染与慢性宫颈炎物理治疗愈后的关系

目的探讨支原体、衣原体感染与慢性宫颈炎物理治疗愈后的关系。方法应用培养法和免疫层析法,对156例慢性宫颈炎物理治疗后愈合不良的妇女和130例宫颈炎物理治疗后愈合正常妇女的宫颈分泌物进行解脲支原体和沙眼衣原体的检测。结果愈合不良组156例宫颈分泌物中检测出解脲支原体64例,阳性率为41·0%;沙眼衣原体51例,阳性率为32·7%;同时检测出解脲支原体和沙眼衣原体10例,阳性率为6·4%。愈合正常组130例宫颈分泌物中检测出解脲支原体23例,阳性率为17·7%,沙眼衣原体3例,阳性率为2·3%;同时检测出解脲支原体和沙眼衣原体0例。两组阳性率比较,差异有极显著性(P<0·05)。结论慢性宫颈炎物理治疗的愈合与宫颈支原体、衣原体感染有关,物理治疗前应重视对病原体的检查,以提高治愈率。     

肺炎衣原体感染对急性脑梗死患者脑血流动力学的影响

目的探讨肺炎农原体（CPn）感染的急性脑梗死患者脑血流动力学变化情况。方法对有CPn慢性感染的121例急性脑梗死患者作为观察1组和有CPn急性感染的25例急性脑梗死患者作为观察2组进行经颅多谱勒超声检查，并与同期非CPn感染的39例急性脑梗死患者（对照组）进行对比分析。结果观察1组中颅内血流动力学异常的血管有3支和3支以上的患者明显少于观察2组和对照组（均P〈0．01），供应梗死病灶的主要血管的平均峰流速度低于对照组（P〈0．05），而阻力指数和脉动指数均高于观察2组和对照组（均P〈0．05），尤其大脑中动脉和基底动脉。结论CPn慢性感染的急性脑梗死患者脑血管病变虽不如非CPn感染的急性脑梗死患者广泛，但其梗死，区供血血管不仪血流慢，且阻力高和弹性差。     

冠心病与感染和炎症反应的相关性分析

目的探讨冠心病患者肺炎衣原体（CP）、幽门螺杆菌（HP）感染与炎症标记物C-反应蛋白的水平及其关系。方法分别检测冠心病组75例、非冠心病组50例和正常健康组55例的血清CPIgG、IgM和HPIgG及IgM，同时测定3组受试者血清超敏C-反应蛋白（hs-CRP）含量。结果冠心病组血清CPIgG、IgM和HPIgG、IgM及hs-CRP含量高于非冠心病组（均为P〈0．05）和正常健康组（P〈0．01）。结论CP和HP感染及hs-CRP含量变化与冠心病的发病有密切关系。     

非淋菌性泌尿生殖道感染患者病原体及耐药性分析

目的比较不同性别患者标本中支原体和衣原体分离率及对9种抗生素的耐药性。方法对1425例疑为非淋菌性泌尿生殖道感染(NGU)患者的泌尿生殖道标本进行支原体和衣原体检测,同时对支原体检测阳性标本进行菌落计数和抗生素敏感性检测。结果1425例标本中支原体和衣原体总分离率为28.2%,其中男性标本中支原体和衣原体分离率为11%,女性标本中支原体和衣原体总分离率为38.7%。Uu菌落计数结果为≥104cfu/ml,女性(32.2%)明显高于男性(7.8%);Mh菌落计数结果≥104cfu/ml,女性(2.3%)与男性(1.1%)基本相同。支原体对九种抗生素的耐药率各不相同,其中强力霉素(DOX)和美满霉素(MIN)具有较高的敏感性。结论NGU患者中支原体和衣原体是主要的病原,监测支原体的耐药性对指导临床治疗具有重要意义,DOX和MIN可作为治疗支原体感染NGU的首选药物。