1000例泌尿生殖道感染患者三种病原体检验结果分析

目的:了解男、女患者对淋病奈瑟菌、沙眼衣原体、解脲支原体三种病原体的易感性是否存在差异以及淋病奈瑟菌、沙眼衣原体、解脲支原体三种病原体在可疑人群中的感染情况。方法:对来自本院门诊的1000例(男360例、女640例)疑为泌尿生殖道感染的标本,用多聚酶链反应(PCR)分别检测淋病奈瑟菌、沙眼衣原体、解脲支原体。结果:淋病奈瑟菌在可疑人中的感染率88/1000(8.8%),其中男性30/360(8.0%)、女性58/640(9.1%),沙眼衣原体感染率198/1000(19.8%),其中男性77/360(21.4%)、女性121/640(19.0%),解脲支原体感染率321/1000(32.1%),男性66/360(18.3%)、女性255/640(40%),三重复合感染0.7%,二重复合感染8.3%。结论:淋病奈瑟菌、沙眼衣原体男、女性感染率无差异(P>0.05),解脲支原体男、女感染率差异非常显著(P<0.01)。淋病奈瑟菌、沙眼衣原体、解脲支原体三种病原体在可疑人中的感染率分别为8.8%、19.8%、32.1%,差异非常显著(P<0.01)。     

不孕不育与支原体、衣原体感染和抗精子抗体的关系

目的探讨不孕不育与支原体、衣原体感染和抗精子抗体（ASA）之间的关系。方法采用培养法分别对215例不孕妇女（观察组）和141例不育男性患者（观察组）进行解脲支原体（UU）和衣原体（CT）检测；采用ELISA法检测血清抗精子抗体（ASA）。同时分别选择61例正常妇女和45例正常男性作为对照。结果不孕症及不育症观察组UU、CT、ASA阳性检出率均明显高于对照组（P〈0．05）。不孕及不育组中ASA阳性患者UU、CT感染率较阴性患者高，差异有统计学意义（P〈0．05）。结论女性不孕和男性不育均与UU、CT感染及ASA有关，ASA的产生与UU、CT感染有关。     

肺炎衣原体的体外传代培养

目的探讨肺炎农原体（Chlamydia pneumoniae,Cpn）在体外连续扩增的方法。方法通过Cpn感染HEp-2细胞，采用高低速反复离心纯化的方法。并经Giemsa染色及DNA聚合酶链式反应（polymerase chain reaction，PCR）检测肺炎农原体的DNA。结果cpn感染HEp-2细胞可见包涵体形成，Cpn连续传三代后，应用Cpn特异性基因片段进行检测扩增，结果均可见437bp特异性扩增阳性带。结论Cpn能有效地在体外连续扩增。     

Urine testing for Chlamydia trachomatis and hassle-free follow-up is acceptable to street youth

OBJECTIVE:

To evaluate whether street youth would use a sexually transmitted disease (STD) screening program involving non-nominal, noninvasive testing of urine for Chlamydia trachomatis with hassle-free follow-up and partner self-notification.

DESIGN:

Cross-sectional pilot study in six centres frequented by street youth 13 to 25 years of age in the Regional Municipality of Ottawa-Carleton.

INTERVENTIONS:

A structured, non-nominal face-to-face interview using an 88-item questionnaire was administered by a trained research assistant. Immediate feedback was provided to participants about specific individual risk reduction strategies for high risk life styles. Each street youth provided a urine sample that was tested non-nominally for C trachomatis by polymerase chain reaction (PCR). A single dose of azithromycin therapy was provided to participants who tested positive, each of whom was requested to encourage recent sexual partners to come forward for testing and treatment.

RESULTS:

One hundred and sixty-three street youth were recruited (98 males and 65 females [male to female ratio 1.5:1]) over the four months of the study. The mean ages of participants were males 18.3±2.50 years and females 16.7±2.02 years. Ninety-two per cent (146) of all participants were sexually active and 99% of the sexually active youth (145 of 146) submitted urine samples. Urine samples were positive in 12 (8.2%) participants (seven males, five females), all of whom were asymptomatic. All those who tested positive were recruited from a single site (site specific rate 13.6%). Overall, only 25% of those tested returned spontaneously for test results; however, nine of 12 participants with positive results were treated due to investigator vigilance in locating the youth. Street youth partner self-notification resulted in five additional street youth requesting testing and treatment.

CONCLUSIONS:

Street youth participated in a STD testing program when a street friendly program and noninvasive methods were used. Although more expensive, urine PCR testing increased program acceptance by street youth compared with previous local results. Detection of C trachomatis was high in this hard-to-reach population. There is a need to address further the problem of poor return rates for results and treatment, as well as low rates of partner notification.     

Prevalence of Chlamydia pneumoniae specific antibodies in different clinical situations and healthy subjects in Izmir, Turkey

Serological markers for Chlamydia pneumoniae were investigated by using the microimmunofluorescence (MIF) test in various age and patient groups in a specific area in Turkey. IgG seropositivity to C. pneumoniae was 64.3% and 18.7% in healthy adults and children, respectively. The highest positivity rate (77%) was in the 15–19 age group. Among the groups investigated, serological findings revealed a possible etiological association between C. pneumoniae and the clinical condition in the groups with acute myocardial infarction, atypical pneumoniae and chronic obstructive pulmonary disease.     

New lymphogranuloma venereum Chlamydia trachomatis variant, Amsterdam

We retrospectively conducted a study of men who have sex with men who visited the Amsterdam, the Netherlands, sexually transmitted diseases clinic from January 2002 to December 2003 and had rectal Chlamydia trachomatis infections. We found that symptomatic (73%) as well as asymptomatic (43%) patients were infected with a new C. trachomatis LGV variant.     

Successful pregnancy following conservative treatment of massive ascites associated with acute <Emphasis Type="Italic">Chlamydia trachomatis</Emphasis> peritonitis

It is well known that Chlamydia trachomatis causes acute and chronic pelvic inflammatory disease including salpingitis. We describe a case of successful pregnancy following conservative treatment of massive ascites associated with acute Chlamydia trachomatis peritonitis. In this present case, we conservatively treated a woman with acute chlamydial salpingitis accompanied with marked ascites and an adnexal mass that simulated a malignant neoplasm. Elevated CA125 and CA19-9 also suggested a malignancy at the time of diagnosis, however following treatment they decreased to below the cut-off value, and were useful in identifying the efficacy of medical treatment. The patient subsequently became pregnant after infertility treatment and underwent a normal vaginal delivery. We conclude that the possibility of Chlamydia trachomatis peritonitis should be considered when a patient presents with ascites and an adnexal mass in sexually active women. (Reprod Med Biol 2004; 3 : 217–221)     

肺炎衣原体感染增加血脂紊乱者患冠心病的危险性

目的探讨肺炎衣原体(CP)感染对血脂紊乱者患冠心病的影响。方法选择1998年6月至2001年5月在阜外医院进行冠状动脉造影或诊断为急性心肌梗死的患者1719例,其中血脂紊乱523例,非血脂紊乱1196例,应用间接酶联免疫吸附实验检测患者血清中的特异性CP IgG抗体。多元Logistic回归方法分析冠心病的危险因素。结果调整年龄、性别、吸烟、高血压和糖尿病的影响后,在血脂紊乱组,CP感染对冠心病危险度比值比(OR)为2．5,95％可信区间为1．4—4．6(P=0．002),显著高于非血脂紊乱组OR为0．967(0．7—1．4,P=0．851)。CP感染和吸烟同是男性血脂紊乱者冠心病的独立危险因素,调整OR分别为2．1(1．1—4．1)和3．3(1．9—5．9);但在女性血脂紊乱组,只有CP感染能显著增加冠心病易感性,调整OR值为4．4(1．4—14．6,P=0．016)。结论CP感染能增加血脂紊乱者患冠心病的危险性,此影响在女性血脂紊乱者中尤为重要。     

Intrathecal production of Chlamydia pneumoniae-specific high-affinity antibodies is significantly associated to a subset of multiple sclerosis patients with progressive forms

The purpose of this study was to provide further insight into the effective relevance of the association between Chlamydia pneumoniae and MS. We evaluated by ELISA technique cerebrospinal fluid (CSF) and serum levels of anti-C. pneumoniae IgG in 46 relapsing-remitting (RR), 14 secondary progressive (SP) and 11 primary progressive (PP) MS patients grouped according to clinical and Magnetic Resonance Imaging (MRI) evidence of disease activity. Fifty-one patients with other inflammatory neurological disorders (OIND) and 52 with non-inflammatory neurological disorders (NIND) were used as controls. A C. pneumoniae-specific intrathecal IgG synthesis as detected by the relative specific index was present in a small proportion of MS (17%), OIND (22%) and NIND (2%) patients and was significantly more frequent in MS and in OIND than in NIND (p<0.001) and in SP and PP MS than in RR MS patients (p<0.02). Among the patients with C. pneumoniae-specific intratecally produced antibodies, CSF high-affinity anti-C. pneumoniae IgG were found in the majority of SP or PP MS, occasionally in OIND, but not in RR MS and NIND patients. These findings confirm that the presence of a humoral immune response to C. pneumoniae within the central nervous system (CNS) is not selectively restricted to MS, but is shared by several inflammatory neurological conditions. In addition, our results suggest that an intrathecal production of C. pneumoniae-specific high-affinity IgG can occur in a subset of patients with MS progressive forms in which a C. pneumoniae brain chronic persistent infection may play an important pathogenetic role.     

沙眼衣原体子宫内感染途径的研究

目的 探讨沙眼衣原体子宫内感染的途径。方法 采用聚合酶链反应－单链构象多态性（PCR－SSCP）法和DNA测序法,对772例临产孕妇宫颈分泌标本进行沙眼衣原体检测。对沙眼衣原体检测阳性孕妇,进行宫颈分泌物、羊水、脐血、新生儿眼结膜和鼻咽拭子等标本组成的母婴配对标本的检测;另选择24例沙眼衣原体检测阴性孕妇的母婴配对标本作为对照。结果 （1）772例孕妇宫颈沙眼衣原体检测有87例阳性,阳性率为11．3％。（2）对其中81例宫颈沙眼衣原体阳性的母婴配对标本检测显示,脐血中均未检出沙眼衣原体;新生儿沙眼衣原体阳性30例（羊水、新生儿眼结膜和鼻咽拭子等标本阳性）,垂直传播率为37．0％（30／81）。（3）新生儿30例阳性中,有26例经阴道分娩,4例经剖宫产分娩。两种分娩方式的垂直传播率比较,差异有极显著性（P＜0．01）。（4）羊水沙眼衣原体阳性11例,基配对新生儿均受沙眼衣原体感染。PCR－SSCP分析显示,同一组配对标本电泳图谱完全相同;DNA测序结果显示,配对标本沙眼衣原体DNA序列完全一致。（5）宫颈沙眼衣原体阴性孕妇的母婴配对标本均未检测出沙眼衣原体。结论 沙眼衣原体经宫颈上行进入羊膜腔是胎儿宫内感染的重要途径;沙眼衣原体经胎盘传播途径未得到证实;剖宫产能显著降低宫颈沙眼衣原体阳性孕妇的垂直传播率。