男性不育患者精液细菌学分析

目的:探讨病原体感染男性生殖道后对精液质量的影响及其与男性不育的关系。方法:对2298例不育男性患者的精液进行细菌培养,采用法国梅里埃公司的微量生化反应系统进行细菌鉴定,采用K-B纸片扩散法进行药敏试验,采用MAR法检测抗精子抗体。结果:2298例标本中208份分离出细菌208株,总检出率为9.05%,其中G+菌188株,占90.38%,G-菌20株,占9.62%,主要优势菌株为金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌;药敏试验显示,以头孢呋辛、头孢唑啉、万古霉素抑菌最为显著;病原体感染不育组的精子活率、活力明显低于未感染的正常对照组,其差异有统计学意义(P<0.05;P<0.01),而在抗精子抗体的检查中,病原体感染不育组的阳性率显著高于对照组。结论:在男性不育的诊治过程中,精液的细菌培养是非常必要的。

Bacteriological Analysis of Semen in Male Infertility

Objective: To evaluate the impact of male genital tract infection on semen quality and male infertility. Methods: Bacterial culture was undertaken among 2 298 cases of infertile men's semen. The bacteria spectrum was identified by micro-biochemical reaction system from Biomerieux Company. The drug sensitivity test was done by K-B disk diffusion method. And the anti-sperm antibodies (AsAb) were detected by MAR-test. Results: Among the 2 298 cases of semen samples, 208 were infected by bacteria. The total detection rate was 9.05%. The infection of G~+ bacteria accounted for 90.38% (188/208), whereas G bacteria 9.62% (20/208). The dominant bacteria strains were the Staphylococcus aureus (SA), Staphylococcus epidermidis (SE), and Staphylococcus haemolyticus (SH). The drug sensitivity test showed that the most effective drugs with bacteriostasis were cefuroxime, cefazolin and vancomycin. The sperm motility and vitality in infertile men with infection (infection group) were lower than that in fertile men without infection (the control). The differences were statistically significant (P<0.05 and P<0.01, respectively). Moreover, the positive rates of AsAb in infection group were significantly higher than those in the control. Conelusion: In the process of diagnosis and treatment on male infertility, semen culture for detecting bacteria infections is very important.