PCR技术检测性病病原体在男性泌尿生殖系感染中的意义

用ＰＣＲ技术对我院５８８例男性生殖泌尿系感染患者进行淋病Ｋ球菌（ＮＧＦ）沙眼衣原体（ＣＴ）及解脲支原体（ＵＵ）检测,结果淋球菌感染者７５例（１２．７６％）;沙眼衣原体感染者８４例（１４．２９％）;解脲支原体感染者５１例（８．６７％）。淋球菌与沙眼衣原体混和感染者２５例（４．２５％）;淋球菌与解脲支原体混合感染者９例（１．５３％）;沙眼支原体与解脲支原体混合感染者１２例（２．０４％）;未发现有三种病原体同时感染者,并对ＰＣＲ检测性病病原体的意义及性病病原体传播趋势进行讨论。     

实时荧光聚合酶链反应检测性病患者泌尿生殖道沙眼衣原体的临床分析

采用实时荧光聚合酶链反应（PCR ）检测性病患者泌尿生殖道沙眼衣原体,进行临床和实验室分析。采集380例男女性病患者泌尿生殖道分泌物,进行多形核白细胞数检测和荧光PCR。结果显示,216例男性患者中,尿道多形核白细胞数≥5个者占92．59％,荧光PCR检测沙眼衣原体阳性62例,阳性率为28．70％;沙眼衣原体合并淋病奈瑟菌感染30例,合并感染率为13．89％。164例女性患者中,87例宫颈管内多形核白细胞数≥10个（占53．05％）,荧光PCR检测沙眼衣原体阳性33例（占20．12％）。结果提示,性病门诊开展实时荧光PCR检测沙眼衣原体可提高检测阳性率和控制沙眼衣原体传播。     

沙眼衣原体和解脲支原体感染的女性生殖道炎症临床分析

目的：分析沙眼衣原体和解脲支原体在女性生殖道炎症发生过程中的重要致病作用和临床特征,以期达到早期诊断,早期诊治的目的。方法：对妇科门诊683例初诊为女性急性或慢性生殖道炎症患者的宫颈分泌物进行沙眼衣原体(CT)和解脲支原体(UM)培养和鉴定,及其所致生殖道炎症患者的临床特性、表现进行综合性分析。结果：683例女性生殖道炎症患者检测结果,确诊由沙眼衣原体(CT)和解脲支原体(UM)感染所致的生殖道炎症共计249例,占36．5％(249／683),沙眼衣原体感染者87例(12．7％),解脲支原体感染者205例(30．0％),沙眼衣原体及解脲支原体合并感染者43例(6．3％),淋球菌感染31例(4．5％),其中沙眼衣原体合并淋球菌感染者22例,解脲支原体合并淋球菌感染者5例。结论：在诊断女性生殖道炎症时,由沙眼衣原体和解脲支原体感染所致的生殖道炎症不容忽视,尽管由这两种病原体所致炎症在临床表现上不具有明显的特征,但特定的病原学检查能非常有效地做出早期诊断,结合特异的防治能使本病彻底治愈得以保证。     

2013至2017年4 542例泌尿生殖系感染者NG、CT和UU感染特点分析

探讨淋球菌（NG）、沙眼衣原体（CT）和解脲脲原体（UU）三种性传播疾病（STD）病原体在宁夏泌尿生殖系感染者中的感染状况,为临床防治提供参考。选取2013年1月至2017年12月在宁夏医科大学总医院就诊的患者4 542例,其中男性3 561例,女性981例,应用实时荧光PCR法检测上述病原体,并分析结果。3种病原体总感染率为26.51%（1 204/4 542）,NG、CT、UU单一病原体感染率分别为26.31%、15.21%和35.70%,男、女感染率分别为23.48%和37.51%,感染率有性别差异（P＜0.01）,NG、CT感染率男性显著高于女性,UU感染率女性显著高于男性;混合感染率为3.32%（151/4 542）,男、女混合感染率分别为3.82%和153%,主要以CT+UU为主,NG+UU次之;从年龄分布来说,男性≤20岁年龄段感染率最高,女性21～30岁年龄段感染率最高;5年来NG、CT和UU感染率呈上升趋势。泌尿生殖系感染者中NG、CT、UU感染情况严重,男性易感NG和CT,女性易感UU,同时,混合感染也较常见,提示应同时检测多种病原体以防漏检。     

三种常见性病感染情况调查

淋球菌（ＮＧ）、沙眼衣原体（ＣＴ）和解脲支原体（ＵＵ）是引起泌尿生殖系统感染的三种常见性传播病原体。为了解高危人群性病传播情况,从１９９６年起对５１１名门诊性病患者的生殖泌尿系分泌物,用ＰＣＲ法进行ＮＧ、ＣＴ、ＵＶ基因检测。结果：男性３５７人中阳性２...     

聚合酶链技术检测淋球菌、沙眼衣原体、解脲支原体感染的方法与分析

由淋球菌和沙眼衣原体、解脲支原体感染引起的特异性和非特异性尿道炎,临床上缺乏快速准确的诊断方法。近年来发展起来的聚合酶链反应技术,通过对每种病原体特有的DNA 序列进行体外特异扩增,可以快速准确鉴定之。本文用该技术对引起泌尿系统感染的三种病原体进行检测研究,它具有快速、特异、准确等优点,并检测123 例感染者,结果,淋球菌感染占74 % ,沙眼衣原体感染占39 % ,解脲支原体感染占30-9 % 。     

慢性盆腔炎患者支原体、衣原体感染状况分析

目的了解慢性盆腔炎患者支原体与沙眼衣原体的感染状况并对支原体的药敏试验结果进行分析,为临床防治提供依据。方法选取2011年1月至2013年12月来院就诊的慢性盆腔炎患者680例,无菌采集宫颈分泌物,培养法检测解脲支原体和人型支原体,用免疫层析法检测沙眼衣原体。结果共检出解脲支原体（Uu）290例（42.6%）,人型支原体（Mh）53例（7.8%）,两者混合感染（Uu＋Mh）76例（11.2%）,沙眼衣原体（Ct）感染58例（8.5%）。Uu感染在20~40岁年龄段阳性率最高（P〈0.05）,Mh、Uu＋Mh和Ct在各年龄段阳性率差异无统计学意义（P〉0.05）。药物敏感染性结果显示,支原体对交沙霉素、强力霉素和美满霉素的耐药率较低,对环丙沙星、左氧氟沙星和加替沙星的耐药率较高。结论解脲支原体和沙眼衣原体为慢性盆腔炎的重要致病因素,临床应重视宫颈解脲支原体和沙眼衣原体的检测。防治解脲支原体和沙眼衣原体感染,可能有益于预防慢性盆腔炎的发生。     

男性尿道炎尿道多形核白细胞与沙眼衣原体和淋病奈瑟菌感染临床相关性分析

目的：沙眼衣原体和淋病奈瑟氏球菌是引起泌尿生殖系统尿道炎疾病常见的致病菌。临床化验一般采用美蓝染色检查男性尿道多形核白细胞或病原微生物阳性可提示尿道炎症状,指导临床的早期治疗。在缺乏临床症状体征和尿道多形核白细胞的情况下,临床的治疗将是不同的。本研究采用美兰染色检查男性尿道炎患者多形核白细胞数量、沙眼衣原体抗原和淋病奈瑟氏球菌培养,评价非淋菌性尿道炎和淋病的临床意义。方法：3,000例性病患者的尿道分泌物进行美兰涂片染色镜检,衣原体抗原检测和淋病奈瑟氏球菌染色镜检和培养。结果：3,000例性病患者中,387例患者（12.9%）沙眼衣原体抗原阳性。 在沙眼衣原体患者中,242例（62.5%）≥5个多形核白细胞, 59例（15.2%）为1~4个多形核白细胞,86例（22.2%）为0个多形核白细胞,其中36例患者（9.3%）无症状,141例患者（36.4%）无体征。415例（13.8%）淋病奈瑟氏球菌阳性,在淋病患者中,397例（95.7%）≥5个多形核白细胞, 10例（2.4%）1~4个多形核白细胞, 8例（1.9%）为0个多形核白细胞,其中5例（1.2%）患者无症状, 46例(11.1%)无体征。86例沙眼衣原体和淋病奈瑟氏球菌合并感染的患者中,76例阳性患者≥5个多形核白细胞,5例阳性患者为1~4个多形核白细胞, 5例阳性患者无多形核白细胞。结论：本研究分析了尿道炎患者尿道多形核白细胞,沙眼衣原体和淋球菌感染的相互之间的关系,男性尿道炎患者尿道多形核白细胞数量与沙眼衣原体感染和淋球菌感染存在明显的差异（P<0.001）。86例（22.2%）沙眼衣原体感染和8例（1.2%）淋病患者的尿道中无多形核白细胞。因此,加强临床与实验室诊断可提高男性尿道炎的诊断和控制性病的传播。     

聚合酶链技术检验淋球菌,沙眼衣原休,解脲支原体感染的方法与分析

由淋球菌和沙眼衣原体、解脲支原体感染引起的特异性尿道炎,临床上缺乏快速准确的诊断方法。近年来发展起来的聚合酶链反应技术,通过对每种病原体特有的ＤＮＡ序列进行体外特异扩增,可以快速准确鉴定之。本文用该技术对引起泌尿系统感染的三种病原体进行检测研究,它具有快速、特异、准确等优点,并检测１２３例感染者,结果,淋球菌感染占７４％,沙眼衣原体感染占３９％,解脲支原体感染占３０．９％。     

淋球菌与沙眼衣原体在性传播疾病感染情况的研究

目的研究淋球菌(NG)与沙眼衣原体(CT)在性传播疾病感染情况及特点。方法对90例性病患者泌尿生殖道分泌物做NG培养及血清用ELISA试验检测CT抗体。结果90例性病患者NG、CT 的感染率分别为70%、16.7%,NG合并CT的感染率达13.3%。男女性别间NG感染率差异有显著性( P<0.05)。NG、CT单一或合并感染率之间差异有非常显著性(P<0.01)。结论性病患者中NG感染率高,且有性别分布差异。淋病患者合并CT感染率较高。     

Sexually transmitted diseases among prostitutes in Fukuoka, Japan

The prevalence of sexually transmitted diseases (STDs) among prostitutes was investigated at a genitourinary hospital in Fukuoka, Japan, in 1985 and 1986. The most common STD was Chlamydia trachomatis infection, followed by gonorrhea and condyloma acuminatum. Candidiasis, trichomoniasis and genital herpes were relatively uncommon. The rate of prostitutes who had STD but had no subjective symptoms were 42.9% in 1985 and 30.9% in 1986. The rate of prostitutes having mixed STD infection was 35.8% among the summed 162 STD-contracted prostitutes.     

Chlamydia trachomatis serovar distribution and other sexually transmitted coinfections in subjects attending an STD outpatients clinic in Italy

We studied the prevalence of Chlamydia trachomatis (CT) urogenital infection and the distribution of different genotypes in a non-selected STD population of 1625 patients, evaluating presence of coinfections with other sexually transmitted diseases. Each patient was bled to perform serological tests for syphilis and HIV, then urethral or endocervical swabs were obtained for the detection of CT and Neisseria gonorrhoeae by culture. DNA extracted from remnant positive swabs was amplified by omp1 Nested PCR and products were sequenced. Total prevalence of CT infection was 6.3% (103/1625), with strong differences between men and women (11.4% vs 3.9%, P<0.01). Clinical symptoms and coinfections were much more frequent in men than in women (P<0.01). The most common serovar was E (prevalence of 38.8%), followed by G (23.3%), F (13.5%) D/Da (11.6%) and J (4.8%). Serovars distribution was statistically different between men and women (P=0.042) and among patients with or without coinfection (P=0.035); patients infected by serovar D/Da showed the highest coinfection rate. This study can be considered a contribution in increasing knowledge on CT serovar distribution in Italy. Further studies are needed to better define molecular epidemiology of CT infection and to investigate its correlation with other STDs.     

[Fréquence des maladies transmises sexuellement chez des étudiants universitaires.]

OBJECTIVE: To estimate the incidence rate of sexually transmitted diseases (STDs) among university students and evaluate the associated sociodemographic factors. DESIGN: Mail survey in April 1990. Included in the questionnaire were questions about the subjects'' STD experience since their admission to the university and the type and date of the infection. SUBJECTS: Of the 19,682 undergraduate students 2920 subjects, in 10 groups of 292, were randomly selected. A total of 1731 (59.4%) completed the questionnaire. MAIN OUTCOME MEASURES: Estimated annualized incidence rates of genital human papillomavirus infection and Chlamydia infection. RESULTS: The estimated annualized incidence rates of genital human papillomavirus and Chlamydia infections were 2.2% and 1.5% respectively. Among the students who indicated being infected with genital human papillomavirus 59% were 18 to 21 years old (p < 0.05), 76% were women (p < 0.01) and 69% had more than one sexual partner (p < 0.01). No statistically significant associations were observed between age, sex and Chlamydia infection. On the other hand, 95% of the cases of Chlamydia infection were found among those who had more than one sexual partner (p < 0.01). CONCLUSION: University students continue to have sexual activities at risk for STDs and should be specifically targetted by general practitioners and health services in an effort to slow the spread of STDs.     

How often is genital yeast infection sexually transmitted?

We analysed data from a computer-based bank of clinical records of patients seen in a clinic for sexually transmitted diseases over a three-year period to investigate the association between genital yeast infections and sexually transmitted diseases (STDs). We classified STDs as primary and secondary syphilis; gonorrhoea; lymphogranuloma venereum; trichomoniasis; scabies; pediculosis; genital herpes; warts; and molluscum contagiosum. Of a total of 2984 disease episodes among women, 1054 (35-3%) included yeast infections, whereas only 382 (6-9%) of 5501 episodes in heterosexual men were associated with yeast infections, We found a significant association between yeast infection and STD and non-specific genital infection (non-specific urethritis (NSU) and procitis in men, and female contacts of men with NSU), which suggested that yeast infection was sexually acquired in 414 out of 1054 disease episodes in women (39%) and 110 out of 382 episodes in heterosexual men (29%). We conclude that sexually active patients with genital yeast infections should be screened for other STDs particularly non-specific genital infection.     

A clinical study on the association of Trichomonas vaginalis and Mycoplasma hominis infections in women attending a sexually transmitted disease (STD) outpatient clinic

Swabs from the posterior vaginal fornix were obtained from 804 consecutive female patients visiting a large Dutch sexually transmitted diseases (STD) outpatient clinic. A detailed clinical history was obtained and complaints concerning the lower genital tract, such as vaginal discharge or vulval and vaginal irritation, were recorded. Patients were examined and the presence of non-physiological vaginal secretions was established by speculum examination. The swabs were monitored for bacterial vaginosis (BV) or Candida albicans infection. PCR diagnosis of Chlamydia trachomatis and Trichomonas vaginalis was performed as well. Four groups of patients (n=14-21) with BV or single infections caused by one of these three pathogens and a control group with no pathogens were selected and Mycoplasma hominis PCR was performed additionally. At clinical presentation, controls and single-infected patient groups were comparable with regard to complaints of the lower genital tract and sexual risk behavior defined as having prior STDs and/or admitted prostitution. Only in the T. vaginalis-positive group significantly more women reporting sexual risk behavior were found than in controls. In agreement with former in vitro observations, an in vivo association between the PCR-detected presence of M. hominis and T. vaginalis was established. In 79% of all samples positive for T. vaginalis, M. hominis could be detected, as compared to only 6% in control samples (P=0.0004). However, since single infections by either of the two pathogens were regularly observed, there does not seem to be an exclusive association between the species, as the bacterium is also more frequently found in cases of BV (P=0.026). Co-infection of M. hominis with C. albicans (11%) or C. trachomatis (0%) did not differ significantly from controls (6%). M. hominis did not associate with complaints of the lower genital tract. However, if all groups were combined there appears to be a very significant association between the presence of M. hominis and sexual risk behavior (P=0.0004). M. hominis and sexual risk behavior were more closely associated than M. hominis and T. vaginalis. No indications were found for an enhanced pathogenicity by either of the symbionts.     

1281例泌尿生殖道感染患者的病原体分析

目的了解汕头地区泌尿生殖道炎患者病原体感染情况。方法应用培养、衣原体快速免疫测定法及镜检,对性病科和妇科门诊1281例泌尿生殖道感染患者进行淋球菌(NG)、沙眼衣原体(Ct)、解脲支原体(Uu)、人型支原体(Mh)、念珠菌(Cd)和滴虫检测。结果男577例．检出262株病原体,女704例．检出656株病原体。6种病原体阳性率男女性分别为(括号内为女性)：NG3．5％(3．1％)、Ct11．6％(10．9％)、Uu24．1％(50．6％)、Mh1．5％(6．3％)、Cd4．5％(20．2％)和滴虫17％(2．0％),感染率为37．3％(65．2％),混合感染占19．1％(37．3％)。结论汕头地区非淋球菌性和条件致病性病原体Ct、Uu和Cd占主导,混合感染普遍．男、女性感染情况除NG、Ct外,女性明显高于男性。     

Rapid one step detection of pathogenic bacteria in urine with sexually transmitted disease (STD) and prostatitis patient by multiplex PCR assay (mPCR)

We developed a multiplex PCR (mPCR) assay to simultaneously detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Ureaplasma urealyticum, Corynebacterium spp. and seudomona aeruginosa. This method employs a single tube and multiple specific primers which yield 200, 281, 346, 423, 542, and 1,427 bp PCR products, respectively. All the PCR products were easily detected by agarose gel electrophoresis and were sequenced to confirm the specificity of the reactions. To test this method, DNA extracted from urine samples was collected from 96 sexually transmitted disease or prostatitis patients at a local hospital clinical center, and were subjected to the mPCR assay. The resulting amplicons were cloned and sequenced to exactly match the sequences of known pathogenic isolates. N. gonorrhoeae and Corynebacterium spp. were the most frequently observed pathogens found in the STDs and prostatitis patients, respectively. Unexpectedly, P. aeruginosa was also detected in some of the STD and prostatitis samples. More than one pathogen species was found in 10% and 80.7% of STD and prostatitis samples, respectively, indicating that STD and prostatitis patients may have other undiagnosed and associates. The sensitivity of the assay was determined by sing purified DNA from six pathogenic laboratory strains and revealed that this technique could detect pathogenic DNA at concentrations ranging from 0.018 to 1.899 pg/ul. Moreover, the specificities of this assay were found to be highly efficient. Thus, this mPCR assay may be useful for the rapid diagnosis of causative infectious STDs and prostatitis. useful for the infectious STDs and prostatitis.     

Prévalence de l'infection cervicale à Chlamydia trachomatis dans une population féminine consultant pour contraception.

OBJECTIVES: To determine the prevalence and risk indicators of cervical infection due to Chlamydia trachomatis among female patients consulting for contraception and to evaluate an enzyme immunoassay for the detection of C. trachomatis in this setting. DESIGN: Prevalence study. Endocervical specimens were analysed by means of culture and enzyme immunoassay. C. trachomatis infection was diagnosed through culture. SETTING: A hospital family planning clinic in Trois-Rivières, Que. SUBJECTS: All 533 female patients who consulted for contraception between November 1986 and March 1988. Results of culture were available for 495 patients. MAIN OUTCOME MEASURE: Demographic, epidemiologic and clinical information was collected by means of a standard questionnaire and a gynecologic examination. MAIN RESULTS: The prevalence rate of chlamydial infection was 9% (45/495). Enzyme immunoassay detected 37 (82%) of the infections. The mean age of the patients was 19.8 years, and 98% of the infections were diagnosed in those aged 25 years or less. The variables significantly associated with C. trachomatis infection were having more than one sexual partner in the preceding year (odds ratio [OR] 2.9; 95% confidence limits [CL] 1.7 and 5.0) and having more than one partner in the preceding 3 months (OR 2.3; 95% CL 1.2 and 4.3). These two indicators would have detected 58% and 22% of the infections respectively. CONCLUSIONS: Screening for C. trachomatis infection by means of enzyme immunoassay should be proposed to all female patients aged 25 years or less consulting for contraception in our clinic. Such screening may prove to be an effective preventive measure in other similar clinical settings.     

Predictors of chlamydial infection and gonorrhea among patients seen by private practitioners.

OBJECTIVE: To identify the predictors of chlamydial infection and gonorrhea among patients tested by general practitioners. DESIGN: Prospective study. SETTING: General private practice, family planning and abortion clinic, adolescent clinic, sexually transmitted disease (STD) clinic and community health clinic in downtown Montreal. PATIENTS: The 2856 patients were included because of symptoms compatible with an STD, a history of sexual contact with a person known or suspected to have chlamydial infection, a history of a nonexclusive sexual relationship or presentation for an abortion. MEASURES: Patient information was obtained by the attending physician on a standard form. Enzyme immunoassay (EIA) for Chlamydia trachomatis and culture for Neisseria gonorrhoeae were performed on cervical (female) or urethral (male) samples. Stepwise logistic regression was used to identify the predictors of infection. RESULTS: The EIA results were positive in 11.1% of the cases and the culture results in 2.3%. Among the males chlamydial infection was independently associated with low age (odds ratio [OR] = 0.88 per year), heterosexuality (OR = 4.99), urethral discharge (OR = 3.74) and the absence of a history of gonorrhea (OR = 0.51). Gonorrhea was associated with urethral discharge (OR = 24.3) and homosexuality (OR = 3.68). Among the females chlamydial infection was associated with low age (OR = 0.79 per year), a history of sexual contact with a person known to have chlamydial infection (OR = 2.30), multiple sexual partners in the previous 12 months (OR = 1.60) and a reason for the test other than screening purposes (OR = 0.60). Gonorrhea was associated with a reason other than screening (OR = 0.24) and low age (OR = 0.74 per year). Among the patients tested for screening purposes age was the only significant predictor of chlamydial infection (OR = 0.79 per year), and the prevalence of gonorrhea was 0.4%. The actual rate of chlamydial infection was 11.8% among the patients younger than 25 years, 5.7% among those 25 to 34 years and 0.6% among those over 34. CONCLUSIONS: Age alone can be used as a criterion to screen for chlamydial infection among asymptomatic patients without a history of sexual contact with a person known or suspected to have such infection and with a history of a nonexclusive relationship. The prevalence in our population justifies screening people up to 34 years of age.     

抵抗女性生殖道沙眼衣原体感染的免疫新策略

沙眼衣原体是引起沙眼和泌尿生殖道感染的主要病原体。据世界卫生组织2015年统计,全球每年约有1.3亿沙眼衣原体感染新发病例。研究表明CD4^+Th1型细胞免疫应答在抵抗沙眼衣原体感染中发挥着重要作用。因此,研究者依照抗沙眼衣原体感染的免疫应答特点,构建出许多候选疫苗,但都没有成功地应用于临床。近年研究发现,生殖道黏膜组织不仅存在体液免疫和细胞免疫,还驻留着一些引人注目的免疫细胞,提示增强黏膜免疫可作为预防沙眼衣原体感染的潜在途径,是抵抗生殖道沙眼衣原体感染的免疫新策略。本文全面概述了黏膜免疫与女性生殖道沙眼衣原体感染的研究进展,并为今后研制沙眼衣原体疫苗提供一些建议。