超高倍显微镜在呼吸道支原体感染早期诊断中的价值

目的探讨超高倍显微镜直视活体检测法检测咽拭子中肺炎支原体对呼吸道支原体感染早期诊断的价值。方法采用超高倍显微镜直视活体检测法和支原体快速液体培养法以及支原体抗体(MP-IgM)胶体金沉淀法对94例已确诊的肺炎支原体感染(MPP)患儿咽拭子及血清进行支原体检测。结果病程7 d内咽拭子超高倍显微镜直视活体检测法、快速液体培养法、血清MP-IgM检测法的阳性率分别为71.28%、36.84%、19.15%,超高倍显微镜直视活体检测法早期阳性率高;3种方法总阳性率分别为82.98%、36.84%、100%,超高倍显微镜直视活体检测法阳性率,与MP-IgM法具有较高的一致性,而快速液体培养法阳性率较低,与MP-IgM检测法无一致性。结论超高倍显微镜直视活体检测法简单易行、准确快捷,不失为一种很好的支原体检测尤其是早期检测的新方法,其对小儿呼吸道支原体感染早期诊断有重要意义。     

小儿支原体肺炎54例胸部CT影像分析

目的分析总结小儿肺炎支原体肺炎(MPP)胸部CT影像学特点。方法回顾性分析本院儿科2010年9月—2011年2月间明确诊断的54例MPP患儿的临床资料及胸部CT。结果胸部CT显示病变部位:单侧者39例(72.22%),双侧者15例(27.78%);单侧中右侧者20例(51.28%),左侧者19例(48.72%);多个叶段受累30例(55.56%)多于单个叶段受累24例(44.44%),各受累叶段分布情况为:右下叶18例(33.33%),左下叶15例(27.78%),左上叶11例(20.37%),右上叶7例(12.96%),右中叶7例(12.96%),左中叶2例(3.70%);病变性质显示为大片实变影31例(57.41%),斑点状及斑片状实变影22例(40.74%),云絮状或磨玻璃样或网格样密度增高影各1例(1.85%),双肺散在斑片影7例(12.96%),其中非单个叶段受累者大片实变与斑点状及斑片状实变多同时存在。其他病变还有胸腔积液14例(25.93%),肺门淋巴结肿大7例(12.96%),肺不张7例(12.96%),心包积液1例(1.85%)。婴幼儿MMP胸部CT以散在斑片影为主,年幼儿以斑点状及斑片状实变影为主,年长儿则多表现为大片实变影。结论小儿MPP单侧病变多于双侧,右肺病变多于左肺,大片实变影最多,其次为斑点及斑片状实变影,也可见双肺散在斑片影。其影像学特点与年龄有关。胸部CT影像学特点有助于婴幼儿及年幼儿MPP的诊断及儿童MPP的早期诊断。     

抗支原体单克隆抗体试剂盒的研制和应用

从20株抗支原体MAb中筛选出1株能够对各种支原体起反应的MAb(3D1)组成试剂盒,用间接免疫荧光法(IFA) 检查了35株传代细胞和6份动物标本,支原体检出率为83%,为了验证此方法的准确性,将其中部分细胞同时做常规培养检查,符合率为90%。结果证明,MAb试剂盒具有特异性高,敏感性强,速度快等优点。     

泌尿生殖道沙眼衣原体、支原体感染情况调查及支原体药敏分析

目的探讨泌尿生殖道感染患者沙眼衣原体和支原体感染情况及支原体耐药情况。方法用金标法进行沙眼衣原体（Ct）检测，用支原体培养法进行解脲支原体（UU）、人型支原体（MH）培养并对阳性标本进行lO种抗生素的药物敏感性检测。结果533例患者检出Ct 81例，阳性率为15，2％；支原体222例，阳性率为41．7％，其中UU、MH和UU＋MH混合感染阳性率分别为36，8％、1．1％及3。8％；Ct与支原体混合感染阳性率为6．0％。UU对10种抗生素的敏感性依次为强力霉素（86．2％）、美满霉素（83．2％）、克拉霉素（76.0％）、司帕沙星（45．9％）、阿奇霉素（39．3％）、交沙霉素（38．8％）、氧氟沙星（21．9％）、罗红霉素（17．9％）、壮观霉素（17．3％）、环丙沙星（3，l％）。结论UU是主要的泌尿生殖道感染病原体；临床上应重视病原学检查及药敏试验，合理选择抗生素。     

支原体耐药性分析

目的：了解解脲支原体和人型支原体耐药情况及指导临床合理用药。方法：按试剂盒说明检测并观察结果。结果：对支原体敏感的药物依次是可乐必妥(96．7％)、美满霉素(85.6％)、强力霉素(78.5％)。对四环素、交沙霉素、乙酰螺旋霉素的耐药率分别为67．8％、61.8％、55．2％。结论：对支原体感染可首选可乐必妥、美满霉素、强力霉素；不宜选用四环素、交沙霉素、乙酰螺旋霉素。     

喹诺酮类药物诱导人型支原体耐药机理研究

目的 探讨人型支原体（Ｍｈ）对喹诺酮类药物的耐药机理,指导合理使用抗生素。方法 以含氧氟沙星、左旋氧氟沙星、盐酸环丙沙星的培养基培养标准敏感株及临床敏感株Ｍｈ１２代后,将其ｇｙｒＡ基因、ｐａｒＥ基因扩增,分析其核苷酸序列。结果 ３种药物诱导株均产生耐药及交叉耐药性,氧氟沙星、左旋氧氟沙星诱导Ｍｈ发生７０位Ｇ→Ａ的突变,导致４２６位的天冬氨酸转变为天冬酰胺;盐酸环丙沙星诱导１１３位Ｃ→Ｔ的突变,导致     

荧光半定量法检测肺炎支原体DNA的临床意义

目的 探讨荧光半定量技术检测肺炎支原体DNA（MP－DNA）在诊断小儿呼吸道支原体感染的临床价值。方法 运用荧光半定量PCR技术检测呼吸道感染患儿咽拭子MP－DNA,并与临床治疗和诊断结果进行相关分析。结果 对968例肺部感染的住院患儿进行了咽拭子MP－DNA的检测,307例（31．7％）阳性。185例临床诊断为支原体肺炎。临床诊断符合率为60．26％;相关分析表明：MP－DNA半定量的结果与临床诊断呈正相关,r=0.98。结论 荧光半定量PCR法检测咽拭子MP－DNA是一种快速、简便、易行、比较敏感的方法。且荧光半定量结果与临床诊断符合率呈正相关关系。     

人乳腺癌组织支原体感染的检测

目的探讨支原体感染和乳腺癌发生、预后的关系及可能的影响机制。方法应用免疫组化方法及逆转录多聚酶链反应．对165例乳腺癌组织及癌周正常乳腺组织、80例乳腺良性病变组织支原体感染及c—myc、H—ras基因表达进行检测。结果乳腺癌组织、乳腺癌周正常乳腺组织、乳腺良性病变组织猪鼻支原体PD4阳性率分别是30．30％、9．70％、7．50％,前者与后两者之间比较,差异均有统计学意义（x^2分别=21．89、15．89,P均〈0．05）。支原体感染阳性、171性的乳腺癌组织c—myc、H—ras基因表达率分别是50．00％、27．83％,两者之间差异有统计学意义（x^2=7．57,P〈0．05）;支原体感染阳性、阴性的乳腺癌患者5年生存率分别是80．01％、87．02％,两者之间比较差异无统计学意义（x^2=1．31,D0．05）。结论乳腺癌组织支原体感染率较高,支原体感染的乳腺癌组织c—myc、H-ras基因表达率增高,可能和乳腺癌的发生存在一定的相关性,但和预后没有相关性。     

Evaluation on blood coagulation and C-reactive protein level among children with mycoplasma pneumoniae pneumonia by different chest imaging findings

Mycoplasma pneumoniae infection may induce a systemic hypercoagulable abnormality, like organ embolism and infarction. Indexes of blood coagulation and C-reactive protein (CRP) have been reported different between healthy people and mycoplasma pneumoniae pneumonia (MPP) patients, but this difference in MPP patients with different chest imaging findings has rarely been reported.We performed a retrospective study of 101 children with MPP and 119 controls, combined with radiological examination and blood tests, to compare the blood coagulation and CRP level among MPP children with different chest imaging findings.For the MPP children with different chest imaging findings, there were significant differences in CRP, fibrinogen (FIB) and D-dimer (D-D) levels among subgroups (P = .004, P = .008 and P < .001 respectively). The CRP level in group of interstitial pneumonia was significantly higher than that in groups of bronchopneumonia and hilar shadow thickening (P = .003 and P = .001 respectively). And the FIB and D-D values in group of lung consolidation were significantly higher than that in the other 3 groups (all P < .05). When compared with controls, the white blood cell, CRP, FIB, and D-D levels in MPP children were significantly higher, and the activated partial thromboplastin time and thrombin time levels were significantly lower (all P < .05).Our results showed that CRP level changed most significantly in group of interstitial pneumonia, whereas FIB, D-D levels changed most significantly in the lung consolidation group.     

Mycoplasma genitalium: another important pathogen of nongonococcal urethritis

PURPOSE: We reviewed findings on the pathogenic role of Mycoplasma genitalium in nongonococcal urethritis and the treatment of men with M. genitalium positive nongonococcal urethritis. MATERIALS AND METHODS: We reviewed literature selected from peer reviewed journals listed in MEDLINE and from resources cited in those articles from 1967 to January 2001. RESULTS: M. genitalium was first isolated from 2 men with nongonococcal urethritis and thereafter it was shown to cause urethritis in subhuman primates inoculated intraurethrally. This mycoplasma has been detected significantly more often in patients with acute nongonococcal urethritis, particularly in those with nonchlamydial nongonococcal urethritis, than in those without urethritis. The prevalence of M. genitalium positive nonchlamydial nongonococcal urethritis is 18.4% to 45.5% of all nonchlamydial nongonococcal urethritis cases. In addition, the persistence of M. genitalium in the urethra after antimicrobial chemotherapy is associated with persistent or recurrent nongonococcal urethritis. M. genitalium is highly susceptible to tetracycline, macrolide and some new fluoroquinolones. The regimen of 100 mg. doxycycline orally twice daily for 7 days, which is recommended for chlamydial nongonococcal urethritis, seems to be effective for M. genitalium positive nongonococcal urethritis, although clinical data to substantiate this regimen are limited. CONCLUSIONS: The various results reported to date tend to support the proposition that M. genitalium is a pathogen of nongonococcal urethritis. However, currently diagnostic methods for this important mycoplasma are not available in clinical practice. Because of the possible association of the posttreatment presence of M. genitalium in the urethra with persistent or recurrent nongonococcal urethritis, eradication of this mycoplasma from the urethra is essential for managing M. genitalium positive disease. However, clinical data on treating M. genitalium positive nongonococcal urethritis are extremely limited. Thus, further studies are required to develop new diagnostic methods that would be available in clinical settings and establish a new treatment algorithm for nongonococcal urethritis, including M. genitalium positive disease.