怀化地区泌尿生殖道感染者支原体感染情况及耐药性分析

目的了解泌尿生殖道感染患者解脲支原体(Uu)和人型支原体(Mh)感染及耐药情况。方法采用深圳银科支原体检测试剂盒,培养Uu和Mh,并作药物敏感试验。结果支原体的总检出率为41.98%,其女性支原体检出率(50.34%)显著高于男性(31.09%)(P<0.01),单纯Uu阳性率(30.15%)明显高于Uu Mh混合(11.32%)和单纯Mh阳性率(0.51%)(P<0.01)。支原体对环丙沙星、氧氟沙星、司帕沙星、罗红霉素、螺旋霉素和左旋氧氟沙星耐药率均>60.00%,而强力霉素、美满霉素和交沙霉素对支原体抗菌活性好,敏感率均>80.00%。结论本地区支原体感染率高,分离出支原体具有多重耐药性和高耐药性,临床治疗需根据药敏结果选择合适的抗菌药物。     

Acute disseminated encephalomyelitis associated with Mycoplasma pneumoniae infection

An 8 year old girl with acute disseminated encephalomyelitis (ADEM) is described. Elevated serum antibody titers suggested recent Mycoplasma pneumoniae infection. T2-weighted image of magnetic resonance imaging (MRI) disclosed multiple lesions of high signal intensity in bilateral basal ganglia and thalami as well as in the white matter. Postcontrast T1-weighted image revealed an enhanced lesion in the deep white matter. She showed rapid clinical improvement in response to corticosteroid therapy. The lesions had disappeared completely on MRI performed 10 weeks after the onset. ADEM is believed to be a demyelinating disorder of probable autoimmune etiology. MRI findings in this case may support the hypothesis that the primary pathological event is vascular injury and demyelination occurs only as a secondary phenomenon.     

Microvascular remodelling in chronic airway inflammation in mice

1. Chronic inflammation is associated with blood vessel remodelling, including vessel proliferation and enlargement, and changes in vessel phenotype. We sought to characterize these changes in chronic airway inflammation and to determine whether corticosteroids that inhibit inflammation, such as dexamethasone, can also reduce microvascular remodelling. 2. Chronic airway inflammation was induced in C3H mice by infection with Mycoplasmapulmonis and the tracheal vessels treatment also decreased the immunoreactivity for P-selectin and the number of adherent leucocytes (595 +/- 203 vs 2,024 +/- 393 cells/ mm2 in treated and non-treated infected mice, respectively). 6. We conclude that microvascular enlargement and changes in vessel phenotype are features of some types of chronic inflammation and, furthermore, that dexamethasone reverses the microvascular enlargement, changes in vessel phenotype and leucocyte influx associated with chronic inflammatory airway disease.     

小儿支原体肺炎18例临床分析

目的 探讨小儿支原体肺炎的临床特点。方法 我院儿科1998年1月-2002年12月共收治该病患儿18例,对所获临床资料进行统计分析。结果 男8例,占44.4％,女10例,占55.6％,年龄5个月-12岁,其中<3岁5例,占27.8％,3—6岁8例,占44.4％,>6岁5例,占27.8％。临床表现以干咳、发热为主要症状,胸部体症少或无;17例胸部X线有改变。实验室检查血白细胞正常10例(55.6％)ELESA测MP—IgM均阳性。确诊后予以大环内酯类抗生素治疗,痊愈13例,占72.2％,好转5例,占27.8％。结论 对临床上遇到肺炎经多种抗生素治疗疗效不佳时,应想到该病的可能,及时进行MP-IgM检测,确诊后应予以大环内酯类抗生素治疗,其中又以阿奇霉素疗效优于红霉素,且副作用小,是治疗小儿支原体肺炎首选药物。     

Prevalence survey on condom use and infection of urogenital mycoplasmas in female sex workers in China

GOAL: We evaluated the prevalence of condom use and the effects of condom use on urogenital mycoplasma infection in female sex workers in Jinjiang, China. METHODS: Two-hundred ninety-nine female sex workers from Jinjiang city, Jiangsu Province, were interviewed, and three mycoplasmas of Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh) and Mycoplasma genitalium (Mg) were detected by nested polymerase chain reaction in genital secretions of 72 female sex workers and 42 female patients seen with symptoms of genital infection (control group). RESULTS: The results showed that 87.29% of the sex workers used condom in their last sexual intercourse, and that 2.68% did not use, 38.80% sometimes used and 58.52% used condoms every time in the last month. Those who were older, married and have a stable partnership used condoms less frequently. The infection rates of Uu, Mh and Mg were 77.78%, 34.72% and 16.67%, respectively, in sex worker subjects compared to those of controls at 59.52%, 9.62% and 21.43%, respectively. The infection rates of Uu and Mg were lower among all subjects (NS) who used condoms every time. In this observational study, genital mycoplasma infection was common and occurred more frequently among sex workers, and infection occurred less often when condoms were used. These results tend to support the efficacy of condom use in reducing urogenital mycoplasma infection among Chinese women.     

Acute severe spinal cord dysfunction in a child with meningitis: Streptococcus pneumoniae and Mycoplasma pneumoniae co-infection

Tetraplegia developed abruptly in an 11-y-old with pneumococcal meningitis. Magnetic resonance imaging showed multiple hyperintensities at the brainstem–spinal cord junction. Serological tests were positive for Mycoplasma pneumoniae (microparticle agglutination and specific IgMs). Erythromycin and dexamethasone were started promptly, and 10 d later the patient was discharged with normal neurological function.
Conclusion: Tetraplegia during the course of pneumococcal meningitis in an 11-y-old girl disappeared after treatment with ceftriaxone, erythromycin and dexamethasone.     

Placental lesions caused by experimental infection of Sprague-Dawley rats with Mycoplasma pulmonis

PROBLEM: Sprague-Dawley (SD) rats infected during pregnancy with Mycoplasma pulmonis display adverse pregnancy outcomes that are similar to those observed in women with chorioamnionitis and may provide a good model system for this disease. The placental lesions caused by this microorganism, however, have not been thoroughly characterized. METHOD OF STUDY: Rats were infected with 10(7) colony-forming units (CFU) M. pulmonis or vehicle control on gestation day (gd) 14 and were euthanized on gd 16-18. Tissues were fixed in 10% neutral buffered formalin, embedded in paraffin, sectioned at 4 microm, and stained with hematoxylin and eosin (H & E). The slides were coded and examined by a blinded pathologist using light microscopy. RESULTS: Infection with M. pulmonis was associated with necrosis of trophoblast giant cells at gd 18. Significantly more neutrophils were observed in the decidual region of the apex of the placenta in M. pulmonis infected animals. The vast majority of neutrophils, however, were observed in the decidua in the lateral regions of the placenta and in the adjacent endometrium. CONCLUSIONS: Infection of SD rats with M. pulmonis resulted in histological placentitis similar to that described in deciduitis of humans and represents a good model system for investigations into the pathophysiology of intrauterine infection. The influx of neutrophils seems to migrate from the endometrium towards the lateral regions of the placenta near Reichert's membrane and the divergence of the parietal yolk sac.     

2130例解脲支原体合并感染情况研究

目的：探讨2130例解脲支原体合并感染情况,本文主要研究解脲支原体合并感染人型支原体、沙眼衣原体的情况。方法：对门诊确认为解脲支原体感染患者同时进行UU、MH、CT检测;用培养法检测UU和MH,用“立明”衣原体免疫快速法检测CT。结果：合并感染情UU MH、UU CT、UU MH十CT分别为14.8％、4.0％、1．5％。UU MH的合并感染率最高。结论：解脲支原体合并感染以UU MH为主,UU MH CT三者合并感染较少。     

女性生殖道中新型致病支原体的分离及其临床意义

目的：了解我国妇女生殖道感染性疾病患者中生殖道是否存在新型致病 支原体（穿通支原体、发酵支原体和梨支原体）的感染,为临床诊治提供依据。方法：采集女性生殖道感染患者和正常人（各172例）的宫颈分泌物,接种在改良的SP－4培养基,进行分离培养。阳性培养物用生化反应、协同凝集试验、代谢抑制试验、聚合酶链反应和DNA序列测定等方法进行鉴定。结果：从172例患者宫颈分泌物中分离到1株穿通支原体（0．58％）,2株发酵支原体（1．16％）。从172名正常女性的宫颈分泌物中没有分离到相应的菌株。结论：从病原学首次证实,南京地区女性生殖道感染性疾病患者中存在穿通支原体、发酵支原体的感染。     

581例泌尿生殖道支原体、衣原体感染耐药性分析及对策

目的观察581例泌尿生殖道支原体、衣原体感染情况,分析其对抗菌药物的耐药性并提出治疗对策。方法采用单克隆抗体胶体金法检测衣原体抗原,采用培养法检测支原体及其药物敏感试验。结果581例标本检出沙眼衣原体（Ct）阳性42例,阳性率为7.2%;检出支原体阳性239例,阳性率为41.1%,其中解脲脲支原体（Uu）阳性率为28.4%（165例）,人支原体（Mh）阳性率为3.1%（18例）,Uu＋Mh混合感染阳性率为6.7%（39例）,Uu＋Ct混合感染阳性率为2.9%（17例）;支原体药敏试验结果显示,Uu对红霉素、罗红霉素耐药率分别为64.8%、62.6%,Mh也呈同样趋势,两种支原体合并感染的耐药率升高;多西环素、米诺环素、交沙霉素有较高的抑菌能力。结论随着支原体感染病例不断增多,出现多重耐药现象,临床应参照药敏试验结果选用抗菌药物,并进行足量、足疗程治疗,以减少耐药菌株的产生,多西环素、米诺环素、交沙霉素可作为临床支原体感染首选药。