Seroprevalence and risk factors of Chlamydia infection in dogs in Southwestern China

Chlamydia spp. are obligate intracellular bacteria distributed globally, known to cause various forms of diseases in animals and humans. To date, there is limited information about the seroprevalence of Chlamydia and the risk factors associated with Chlamydia infection in dogs in the world. In the present study, a serological survey was undertaken to examine the seroprevalence and risk factors associated with dog chlamydiosis in Yunnan Province, southwestern China. A total of 591 dogs were sampled, antibodies to Chlamydia were determined by indirect hemagglutination assay (IHA). The overall seroprevalence was estimated at 17.6%. The risk factors associated with seroprevalence were determined by a multivariate logistic regression analysis. Gender and age of dogs were not significant in the logistic regression analysis (P > 0.05) and left out of the final model. Type and geographical origin of dogs were considered as main risk factors associated with Chlamydia infection, stray dogs (31.37%) were more than 16 times (OR = 16.167, 95% CI = 6.283–41.599, P < 0.01) at risk of acquiring the infection compared to the police dogs (7.62%), while pet dogs (14.41%) had a 3 times (OR = 2.968, 95% CI = 1.349–6.529, P = 0.007) higher risk. Positive dogs were found in 5 districts of Yunnan Province with prevalence ranging from 2.56% to 31.67% except Diqing (0/56). Dogs in Kunming (20.21%) had a 9 times higher risk of being seropositive compared to dogs in Lijiang (2.56%) (OR = 9.057, 95% CI = 1.211–67.714, P = 0.032), although no regional differences were found in other 4 administrative divisions compared to Lijiang (P > 0.05). Our study revealed a widespread and high prevalence of Chlamydia infection in dogs in Yunnan Province, southwestern China, with higher exposure risk in stray dogs and distinct geographical distribution. These findings suggest the potential importance of dogs in the transmission of zoonotic Chlamydia infection, and thus Chlamydia should be taken into consideration in diagnosing dog diseases.     

社区获得性肺炎患者联合监测肺炎支原体与肺炎衣原体的临床意义

目的 探讨联合监测肺炎支原体(Mp)和肺炎衣原体(Cp)对社区获得性肺炎(CAP)患者的临床意义.方法 选取2012年2月至2014年10月我院收治的CAP患者1 580例,监测患者咽拭子标本中Mp、Cp,培养并鉴定其主要病原菌,比较不同抗感染方案的疗效.结果 CAP病原体以Mp (30.0%)、肺炎链球菌(15.9%)、流感嗜血杆菌(12.9%)、Cp (10.1%)比例最高,且同时合并2种病原体感染者较为多见(10.1%);治疗中β-内酰胺类药物使用频率最高(76.71%);β-内酰胺类联合大环内酯类或联合氟喹诺酮类药物对CAP治愈率(66.72%)显著高于单独应用β-内酰胺类药物治疗(56.73%,P<0.01);单用β-内酰胺类药物治疗与应用β-内酰胺类联合氟喹诺酮类(65.4%)或大环内酯类药物(68.5%)对单纯Mp或Cp感染CAP治愈率比较差异均无统计学意义(P>0.05),而在细菌合并Mp或Cp感染时,联合用药治愈率(69.7%)明显高于单用β-内酰胺类药物(44.4%),差异有统计学意义(P<0.05).结论 CAP患者感染Mp与Cp较多见,β-内酰胺类药物是常用治疗药物,β-内酰胺类联合大环内酯类或氟喹诺酮类药物可提高患者治愈率,Mp与Cp联合检测对于敏感抗生素的选择及疗效的提高具有重要临床意义.     

女性生殖道支原体及衣原体感染对妊娠的影响

目的：探讨女性生殖道支原体及衣原体感染对妊娠的影响。方法选择2012年7月至2015年7月处于妊娠期发生衣原体及支原体感染的202例产妇,将其作为感染组,其中120例为治疗组,其余82例为未治疗组,另外选取同时间段内于我院进行产检的未发生生殖道感染的185例孕妇作为对照组。比较对照组与感染组孕产妇、围产儿合并症发生情况;治疗组与未治疗组孕产妇、围产儿合并症发生情况。结果感染组出现流产、早产、宫内生长受限、未足月胎膜早破、死胎死产、产褥病、低体重儿及新生儿肺炎发生率均显著高于对照组(P＜0.05);治疗组流产、早产、宫内生长受限、未足月胎膜早破、死胎死产、产褥病、低体重儿及新生儿肺炎发生率均显著低于未治疗组(P＜0.05)。结论女性生殖道支原体及衣原体感染对妊娠结局产生不良影响,应注意加强产前检查,及时治疗,改善妊娠结局。     

Antichlamydial antibodies and citric acid in patients with chronic prostatitis

Introduction The aim of the study was to evaluate the correlation between the presence of anti-C. trachomatis (C.t.) antibodies in serum and expressed prostatic secretions (EPS) and the concentration of citric acid in patients with chronic prostatitis. Materials and Methods The study involved 34 men with chronic prostatitis. The leukocyte count, presence of anti-C.t. antibodies (IgA, IgG), and citric acid concentration were determined in the EPS. The serum was examined for IgM, IgA, and IgG anti-C.t. antibodies. Specific antibodies were determined using the EIA method. The concentration of citric acid was measured using the ultraviolet method. Results Inflammation of the prostate ( ≥ 10 PMN) was found in 61.8% of the patients. A reduction in citric acid concentration in the EPS was detected in 58.8% of the men. Specific serum antibodies were detected in 58.8% of the patients, including 23.5% with IgM, 32.4% with IgA, and 44.1% with IgG. In all patients, serum IgM and IgA antibody titers were low, while those of IgG antibodies were strongly positive in 46.7% of the patients. Anti-C.t. antibodies in the EPS were detected in 44.1% of the patients, including 32.4% with IgA and 35.3% with IgG. In contrast to serum, the titers of IgG antibodies in the EPS were low in all the patients, while those of IgA were strongly positive in 54.5% of cases. In patients with positive serological outcomes, 85% had reduced concentrations of citric acid. Conclusions The occurrence of anti-C.t. antibodies is usually accompanied by a decrease in the concentration of citric acid in the prostatic secretion.     

A patient with seminal vesiculitis prior to acute chlamydial epididymitis

This is the first report of a case of seminal vesiculitis prior to acute chlamydial epididymitis. At the first visit to the clinic, the patient wished to check whether he had Chlamydia trachomatis in his genital tract, because his wife had been diagnosed as having chlamydial cervicitis. He had no specific symptoms at that time; however, transrectal ultrasonograpy (TRUS) revealed swelling of seminal vesicles, which suggested the presence of seminal vesiculitis. Two days after the first visit, he had high-grade fever and was diagnosed as having acute epididymitis caused by C. trachomatis. We had previously reported that seminal vesiculitis was always complicated with acute epididymitis, so this case could provide important evidence that seminal vesiculitis might precede acute epididymitis. It suggested that acute epididymitis could be affected by seminal vesiculitis via the retrograde transmission route.     

166例支气管哮喘急性发作期患儿呼吸道病原学分析

目的：了解东莞市儿童支气管哮喘急性发作期的病原学分布特征,指导临床治疗。方法：选择东莞市太平人民医院2012年6月至2013年6月收治住院的支气管哮喘急性发作患儿共166例,根据年龄分为〈3岁婴幼儿组和≥3岁儿童组,分别检测病毒、支原体（MP）、衣原体（CP）及细菌等病原体分布情况。结果：166例患儿检出病毒、MP、CP、细菌感染任何一项阳性者共132例,占79.5%,其中检出病毒69例（41.6%）、CP 16例（9.6%）、MP 39例（23.5%）,细菌培养阳性39例（23.5%）。结论：东莞市儿童哮喘急性发作与感染密切相关,病毒感染最多见,MP、细菌感染亦较常见。     

慢性宫颈炎患者支原体和沙眼衣原体检测分析研究

目的探讨慢性宫颈炎患者支原体[解脲支原体（UU）、人型支原体（MH）]及沙眼衣原体（CT）感染情况及临床检测的意义,便于为临床治疗提供参考依据。方法回顾性分析2010年2月至2013年1月女性科门诊收治的420例慢性宫颈炎患者所实施的培养法检测UU、MH及免疫层析法检测cT等药敏试验的有关资料。结果本研究结果显示,在所有慢性宫颈炎患者中,UU检出共计197例,阳性检出率为46．9％;MH检出共计84例,阳性检出率为20．0％;CT检出共计146例,阳性检出率为34．8％;混合感染共检出53例,感染阳性率为12．6％。观察可见UU的检出率明显高于CT及MH的检出率。结论支原体和沙眼衣原体在慢性宫颈炎患者中检出率较高,故采用敏感或特异的技术检测支原体和沙眼衣原体,可有助于指导临床合理用药及慢性宫颈炎患者得到及时有效的治疗。     

Atypical pneumonia: Pathophysiology,diagnosis, and treatment

Atypical pneumonia is caused by atypical pathogens that are not detectable with Gram stain and cannot be cultured using standard methods. The most common causative organisms of atypical pneumonia are Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella species. The therapeutic approach for atypical pneumonias is different than that for typical pneumonia. Typical bacterial pathogens classically respond to β-lactam antimicrobial therapy because they have a cell wall amenable to β-lactam disruption. On the contrary, most atypical pathogens do not have a bacterial cell wall, some are intracellular (e.g., Legionella), and some are paracellular (e.g., M. pneumoniae). To prevent an increase in the number of antimicrobial-resistant strains, the Japanese pneumonia guidelines have proposed a differential diagnosis for typical bacterial pneumonia and atypical pneumonia to select an appropriate antibiotic for the management of mild-to-moderate pneumonia. The guidelines have set up six parameters and criteria based on the clinical symptoms, physical signs, and laboratory data. However, in the elderly individuals and patients with underlying diseases, the differential diagnosis may be difficult or a mixed infection may be latent. Therefore, in these individuals, the administration of a β-lactam drug plus a macrolide or tetracycline, or only fluoroquinolone should be considered from the beginning to cover bacterial and atypical pneumonia.     

广州地区女性不同人群沙眼衣原体感染调查及危险因素分析

目的 调查广州地区不同人群女性泌尿生殖道沙眼衣原体(CT)感染情况,分析CT感染的危险因素.方法 由医护人员组成性病艾滋病高危人群干预队,为目标人群提供性病防治知识讲座、问卷调查,发放健康处方和安全套,采集生殖道拭子用于萘瑟氏淋球菌(GC)、CT、解脲/人型支原体(UU/MH)等的常规检测.结果 共问卷调查788人,对715人采集了宫颈拭子.CT总感染率为10.5%(75/715),其中流动人口育龄妇女、妇科门诊就诊者、暗娼的CT感染率分别为6.4%(15/234),11.1%(31/279),14.4%(29/202),各组间差异有统计学意义(P<0.05).CT合并GC、UU/MH、单纯疱疹病毒Ⅱ型(HSV-2)、粘液脓性宫颈炎(MPC)感染者分别为5.3%、57.3%、36.0%、32.0%.暗娼中CT合并GC、HSV-2、MPC感染者分别为10.3%、51.7%、27.6%.CT感染与20岁以前发生性行为、未婚、配偶从事商业服务业、中重度宫颈炎以及每周性生活频率超过3次等5个因素有关.固定人群因素后发现,首次性生活年龄越早、口服避孕药为危险因素.结论 性工作者是性病行为干预的重点,减少性生活频率,加强青少年禁欲宣传有助于减少CT感染的流行.     

支原体、衣原体感染与不孕症的关系及耐药性分析

目的：分析人支原体（Mh）、脲脲支原体（Uu）、沙眼衣原体（Ct）与不孕症的关系,并对支原体药敏试验结果进行分析,以指导临床治疗,促进不孕症治疗效果的提升。方法：选取2012年5月-2013年8月在本院门诊收治的220例不孕症患者作为观察组,并选择同期自愿参与本研究的220例正常生育妇女作为对照组,比较两组宫颈分泌物Uu、Mh、Ct检测结果。同时对支原体感染者做药敏实验,了解支原体对抗菌药物的敏感率和耐药性。结果：观察组Ct、Uu、Uu＋Mh、Uu＋Ct阳性检出率分别为19.54%、36.82%、8.63%、3.18%,与对照组比较差异均有统计学意义（P〈0.05）。Uu对米诺环素、多西环素、交沙霉素、环酯红霉素的敏感率较高,均超过了80%。Uu＋Mh对米诺环素、多西环素、交沙霉素的敏感率较高,分别为95.0%、85.0%、75.0%。单独Uu感染的耐药性较低,但是Uu＋Mh感染的耐药率明显升高,多药耐药情况严重。结论：Uu、Mh、Ct是引起不孕症的主要原因,是不孕症诊断重要的检测项目。对于因Uu、Mh、Ct感染引起的不孕症,要根据药敏试验结果予以针对性的治疗,从而提升治疗效果。