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。     

PCR法检测淋球菌,沙眼衣原体及解脲支原体感染

目的：评价聚合酶链反应（ＰＣＲ）技术对性病性尿道炎及宫颈炎诊断的临床实用价值。方法：采用ＰＣＲ法、淋球菌（Ｎｇ）涂片／培养、沙眼衣原体直接免疫荧光检查（ＣｔＤＩＦＡ）和解脲支原体（Ｕｕ）培养平行检测了１１９例患者的１８９份尿道／宫颈拭子标本。结果：以Ｎｇ涂片／培养、ＣｔＤＩＦＡ和Ｕｕ培养为对比标准，ＮｇＰＣＲ、ＣｔＰＣＲ和ＵｕＰＣＲ的敏感性分别为１００％（２８／２８）、９６９％（３１／３２）和９３３％（４２／４５），特异性分别为９４５％（８６／９１）、９１９％（８０／８７）和９４６％（７０／７４）。治疗结束后１周～２周内复查仍有２５９％（２１／７０）患者ＰＣＲ未阴转。结论：ＰＣＲ技术可以敏感、特异地检测泌尿生殖道标本中的ＮｇＤＮＡ、ＣｔＤＮＡ和ＵｕＤＮＡ，具有简便、快速的优点，然而对治疗后短期内复诊患者，似不宜仅以ＰＣＲ阳性结果作为重复治疗的依据。     

云南省7地州（市）职业人群鹦鹉热衣原体感染的调查

本文用间接血凝试验（ＩＨＡ）对云南１７个地州（市）中的１７个县，６７６位健康职业人员进行鹦鹉热衣原体感染的调查。查到鹦鹉热衣原体血清抗体阳性人员４４人，感染率为６．５１％，且分布于７个地县。鹦鹉热衣原体在我省感染的特征为：地区间差异显著（ｘ２＝１３．５６，Ｐ＜０．０５）；职业、性别、年龄、民族间差异不显著，说明人群对鹦鹉热衣原体普遍易感。     

男性泌尿生殖道沙眼衣原体感染的快速实验室诊断

用Ｇｉｅｍｓａ和衣原体荧光单克隆抗体两种染色法对１０９例男性非淋球菌性尿道炎患者的尿道脱落细胞进行沙眼衣原体检查，阳性率分别为４６．８％和５６．９％，吻合率为７８．９％。直接荧光抗体测定（ＤＦＡ）阳性率较高（Ｐ＜０．０５），是沙眼衣原体感染实验室快速诊断的特异方法。     

Population-Based Study of Trachoma in Guatemala

Abstract

Purpose: A prevalence survey for active trachoma in children aged under 10 years and trichiasis in women aged 40 years and older was carried out in four districts in the Sololá region in Guatemala, which is suspected of still having a trachoma problem.

Methods: Population-based surveys were undertaken in three districts, within 15 randomly selected communities in each district. In addition, in a fourth district that borders the third district chosen, we surveyed the small northern sub-district, by randomly selecting three communities in each community, 100 children aged under 10 years were randomly selected, and all females over 40 years. Five survey teams were trained and standardized. Trachoma was graded using the World Health Organization simplified grading scheme and ocular swabs were taken in cases of clinical follicular or inflammatory trachoma. Prevalence estimates were calculated at district and sub-district level.

Results: Trachoma rates at district level varied from 0–5.1%. There were only two sub-districts where active trachoma approached 10% (Nahualá Costa, 8.1%, and Santa Catarina Costa, 7.3%). Trichiasis rates in females aged 40 years and older varied from 0–3%. Trachoma was likely a problem in the past.

Conclusions: Trachoma is disappearing in the Sololá region in Guatemala. Health leadership may consider further mapping of villages around the areas with an especially high rate of trachoma and infection, and instituting trichiasis surgery and active trachoma intervention where needed.     

沙眼衣原体和解脲支原体感染与不孕关系的研究

目的:探讨生殖道沙眼衣原体和解脲支原体感染对不孕的影响。方法:采用聚合酶链反应技术(PCR),对113例原发不孕、97例继发不孕共210例不孕患者(不孕组)及92例正常生育者(对照组)进行CT和UU检测。结果:不孕组CT和UU阳性率分别为31.4％和38.1％,对照组CT和UU阳性率分别为10.8％和15.2％,两组间差异均有极显著性(P<0.01)。而原发不孕与继发不孕阳性检出率比较差异无显著性(P>0.05)。经治疗后CT和UU转阴者的妊娠率明显高于未转阴者(P<0.01)。结论:生殖道CT和UU感染是引起不孕的因素之一,对不孕夫妇进行CT、UU常规检查并及时治疗非常必要。     

宫颈管支原体、衣原体感染局部微波治疗效果分析

目的:妇女宫颈管支原体、衣原体感染造成宫颈红、肿、充血后用微波局部治疗,在非药物方面找到临床依据。方法:用微波直接加热法,使宫颈受感染的柱状上皮细胞层凝固、轻微变色。结果:123例病人术后6个月内观察,均无宫颈损伤及粘连。复查3次以上,宫颈分泌物无阳性反应,临床症状明显恢复正常。结论:微波治疗宫颈管内支原体、衣原体感染极其有效,特别是改善临床症状更为明显。     

广东省9个城市性病门诊男性就诊者生殖道沙眼衣原体感染危险因素分析

目的 了解性病门诊男性就诊者生殖道沙眼衣原体（genital Chlamydia trachomatis,GCT）感染现状及危险因素,加强该人群GCT监测,为针对该人群开展干预工作提供依据。方法 2015年4-6月结合HIV监测哨点开展研究,选取性病门诊男性就诊者为调查对象,开展匿名问卷调查及检测。结果 本次共纳入就诊者1 749例,平均年龄（39.53±14.36）岁,多数为已婚（73.87%,1 292/1 749）、广东籍（92.28%,1 614/1 749）、汉族（99.49%,1 740/1 749）;GCT阳性率、HIV阳性率、梅毒阳性率、HCV阳性率、淋球菌阳性率、尿常规白细胞阳性率分别为6.06%（106/1 749）、0.46%（8/1 749）、3.43%（60/1 749）、0.45%（7/1 550）、2.74%（48/1 749）、7.89%（138/1 749）。多因素logistic分析显示,GCT感染相关危险因素包括注射吸毒（OR=13.98,95% CI：3.35～58.38）、与男性发生过肛交（OR=3.11,95% CI：1.45～6.71）、淋球菌阳性（OR=9.64,95% CI：5.09～18.24）、尿常规白细胞阳性（OR=1.96,95% CI：1.08～3.55）。结论 广东省性病门诊男性就诊者GCT感染率较高,该人群为性病艾滋病防控的高危人群,应针对不同地区的人群特点,实施精准干预。     

Chlamydia trachomatis testing sensitivity in midstream compared with first-void urine specimens

PURPOSE

Traditionally first-void urine specimens are used to test for Chlamydia trachomatis. In contrast, midstream urine specimens are traditionally recommended for microscopy and culture of presumptive bacterial urinary tract infections. The ability to test for both C trachomatis and urinary tract infection on a single midstream urine specimen would greatly aid clinical practice, as an urinary tract infection is an extremely common complaint in primary care. This study set out to determine how well positive C trachomatis results obtained on first-void specimens would correlate with positive findings in matched midstream specimens.

METHODS

One hundred women with a first-void urine specimen positive for C trachomatis also provided midstream specimens for comparison. All specimens had C trachomatis testing performed using a DNA detection method.

RESULTS

Of the 100 eligible participants with a first-void specimen positive for C trachomatis, 96 (96%) also had a positive midstream specimen (95% exact confidence limits, 90.1%, 98.9%).

CONCLUSIONS

These results suggest that by using newer nucleic acid amplification techniques (NAATs), timing of specimen collection is not so important in testing for C trachomatis as previously thought. The sensitivity of NAAT testing on midstream urine specimens in women is sufficiently equivalent to testing on first-void specimens to consider in clinical practice and research settings where first-void specimens have formerly been collected.     

1636例宫颈拭子支原体、衣原体检测及支原体耐药性分析

目的 探讨宫颈沙眼衣原体（CT）、解脲支原体（UU）和人型支原体（MH）的感染情况及了解支原体耐药情况。方法 应用金标法及支原体培养＋药敏分析，对1636例宫颈拭子进行CF、UU和MH三种病原体检测。结果 （1）三种病原体总检出率为49．08％（803／1636）。其中单种病原体检出率为39．06％（639／1636），混合感染率为10.02％（164／1636）；衣原体检出率为11.61％（190／1636）；支原体检出率为37．47％（613／1636）。（2）衣、支原体感染以21～40岁为主，占阳性患者的79．58％。（3）对支原体耐药率最高的是壮观霉素（耐药率〉90％），其中人型支原体及解脲＋人型混合感染者对壮观霉素、罗红霉素、红霉素、阿齐霉素、克拉霉素等耐药率均〉80％；对交沙霉素最敏感，其次是强力霉素。结论 （1）UU、CF、MH是宫颈感染的主要病原体，其感染率依次为UU〉CT〉MH。（2）支原体的耐药菌株较常见，临床治疗应根据药敏结果选择敏感药物。