HPV在育龄妇女生殖道病原体感染分布及其基因分型

目的探讨人乳头瘤病毒(HPV)在育龄妇女生殖道病原体感染分布情况以及基因分型特点。方法收集2013年度来我院妇产科就诊及体检旳育龄妇女,阴道分泌物主要检查滴虫、真菌、淋球菌、细菌、衣原体和支原体,前三者采用涂片法,解脲支原体和人型支原体采用固体培养法,衣原体抗原检查采用乳胶免疫层析法;宫颈刮片标本采用核酸扩增和反向点杂交技术对23种HPV基因型进行检测,然后对检测结果进行分析。结果育龄妇女阴道分泌物标本病原体感染率为39.32%(7896/20080),宫颈刮片HPV感染率为35.09%(634/1807)。HPV感染中单一感染23.19%(419/1807),二重感染6.53%(118/1807),三重感染3.21%(58/1807),四重感染1.16%(21/1807),四重以上感染1.00%(18/1807),单一感染组与其他组比较差异具有统计学意义(P0.05)。高危中以HPV52、58、16较为常见,低危中以HPV43、6型较为常见;以25~35岁年龄段阳性率较高,其他次之。结论育龄妇女生殖道病原体感染比例较高,应引起高度重视。     

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。     

未婚阴道炎女性阴道分泌物检查结果调查

目的了解未婚女性阴道炎患者阴道分泌物检出情况。方法自愿接受本次调查的未婚有性生活史疑似阴道炎女性293名,对其进行阴道分泌物检查,内容包括念珠菌、支原体、衣原体、细菌性阴道病(BV)、滴虫、淋病等。结果病原体检出率为75.77%,21~25岁感染率最高(90.10%);感染率序位:解脲支原体(58.36%)>念珠菌(35.15%)>BV(16.04%)>人型支原体(14.33%)>衣原体(10.92%)>滴虫(2.39%)>淋病(0.68%)。单一病原体感染占32.08%,复合感染占43.00%。结论未婚女性阴道分泌物病原体种类多、检出率高,混合感染率高,应加强对这一人群生殖健康方面的监控。     

生殖道解脲支原体和沙眼衣原体的感染与输卵管妊娠关系探究

目的探讨分析生殖道解脲支原体和沙眼衣原体的感染与输卵管妊娠的关系。方法选取新疆医科大学第二附属医院2018年1月—6月妇科住院经腹腔镜手术证实输卵管妊娠并行患侧输卵管切除的患者作为研究组,同期腹腔镜下行妇科良性疾病输卵管或附件切除术者为对照组,分别采集两组宫颈管分泌物、输卵管组织进行解脲支原体培养以及沙眼衣原体检测,并作宫颈分泌物解脲支原体药敏试验。结果输卵管妊娠组的宫颈分泌物及输卵管组织中解脲衣原体检出率(34.3%、30.2%)及沙眼衣原体的检出率(18.6%、16.2%)明显高于对照组宫颈分泌物及输卵管中解脲衣原体检出率(16.2%、6.9%)及沙眼衣原体的检出率(4.6%、2.3%),对照组与实验组两组比较差异具有统计学意义(χ~2=3.909、4.074、7.679、4.962,Ps0.05)。本研究22例宫颈解脲支原体感染中,解脲支原体对交沙霉素、强力霉素、美满霉素、阿奇霉素、克拉霉素的敏感率均高于80%。结论输卵管妊娠与生殖道解脲支原体及沙眼衣原体感染有密切关系,临床工作中应尽早筛查和诊断,并根据药敏试验进行预防及合理治疗用药,减少输卵管妊娠的发生。     

生殖道衣原体、支原体感染与盆腔炎症的相关性分析

目的:探讨女性生殖道衣原体、支原体感染发生与盆腔炎症的相关性,并为相应人群提出相应的预防和治疗措施。方法:对我院2012年1月到2013年5月诊治的盆腔炎患者280例及60名健康妇女进行了衣原体、支原体的培养,采用试剂盒进行检查,并进行药敏实验,分析比较两组生殖道衣原体和支原体感染情况。结果:盆腔炎症组中衣原体感染的检出率为58.5%,支原体感染率为26.2%,衣原体合并支原体感染率为12.4%。健康妇女组衣原体感染、支原体感染及衣原体合并衣原体感染的检出率分别为:9.1%,6.2%和4.9%。两组的差异有统计学意义(P0.05)。在盆腔炎症患者组中,30岁人群中单纯衣原体感染和单纯支原体感染检出率分别为51.3%和26.4%,均要明显高于30岁以上的人群,差异有统计学意义(P0.05)。结论:盆腔炎症与生殖道衣原体,支原体感染有密切的相关性,盆腔炎的发病可能与生殖道衣原体、支原体感染有关,针对临床上盆腔炎患者应密切关注生殖道支原体、衣原体的感染问题。     

女性生殖道解脲支原体感染与胎膜早破与新生儿窒息的相关性

摘要 目的：探讨女性生殖道解脲支原体(Ureaplasma urealyticum,UU)感染与胎膜早破与新生儿窒息的相关性。方法：2017年6月至2019年6月选择在地区门诊就诊的孕妇108例,检测生殖道解脲支原体感染情况,调查所有孕妇的一般资料、分娩方式、胎膜早破、新生儿窒息状况并进行相关性分析。结果：在108例孕妇中,48例检出解脲支原体感染,感染率为44.4 %。感染组的年龄、体重指数、产次、孕次、受教育年限、孕周等与非感染组对比差异无统计学意义(P>0.05)。感染组的胎膜早破与新生儿窒息发生率分别为22.9 %和18.8 %,显著高于非感染组的3.3 %和1.7 %(P<0.05)。感染组的剖宫产率高于非感染组,自然分娩率低于非感染组,对比差异都有统计学意义(P<0.05)。在108例孕妇中,Pearson分析显示解脲支原体感染与胎膜早破、新生儿窒息都存在相关性(P<0.05)。结论：女性生殖道解脲支原体感染比较常见,可导致剖宫产、胎膜早破、新生儿窒息发生率增加,也与胎膜早破、新生儿窒息存在显著相关性。     

外阴阴道假丝酵母菌病伴发支原体及沙眼衣原体感染的研究

为研究外阴阴道假丝酵母菌病(Vulvovaginal Candidiasis,VVC)患者合并支原体和衣原体感染情况,对86例复发性VVC(recurrent Vulvovaginal Candidiasis,RVVC)患者、219例单纯性VVC患者以及健康妇女200例,分别进行解脲脲原体(Ureaplasma urealyticum,Uu)、人型支原体(mycoplasma hominis,Mh)和沙眼衣原体(Chlamydia trachomatis,CT)检测;所有VVC病例均进行真菌培养。RVVC组和单纯VVC组与对照组之间Uu、Mh及Uu混合Mh阳性率比较,差异均有统计学意义(P0.05)。而三组之间CT和CT混合支原体阳性率比较,均无显著性差异(P0.05)。真菌培养阳性组与阴性组之间,Uu阳性率比较有显著性差异(P0.05),而CT阳性率比较无显著性差异(P0.05)。结果表明,VVC患者合并Uu感染较正常人群明显增高,假丝酵母菌与Uu混合感染可能导致VVC的发生和复发。     

广州地区女性下生殖道感染致病微生物分析

目的 对广州地区女性下生殖道感染致病微生物状况进行调查,用以指导临床正确诊断治疗。方法 对以外阴瘙痒及自带增多为主诉的妇女患者进行临床检查,先取阴道分泌物进行pH、胺试验及假丝酵母菌、滴虫和线索细胞检查,同时采用特制密封棉拭子宫颈管内取样,然后采用重量差减法,求出分泌物的重量,采用荧光定量PCR测定解脲脲原体、淋球菌、沙眼衣原体,可疑部位取材作HSV和HPV检测及梅毒血清学检查。结果 在533例入选患者中,解脲脲原体感染345例占64．7％,沙眼衣原体感染142例占26．6％,阴道假丝酵母菌病117例占22％,非特异性阴道炎81例占15％,细菌性阴道病17例占0．03％。尖锐湿疣12例占0．02％。淋病5例,梅毒4例,生殖器疱疹2例,滴虫阴道炎2例。结论 解脲脲原体、沙眼衣原体、阴道假丝酵母菌病是当前广州地区女性下生殖道感染的主要致病微生物,在选用抗生素时要兼顾解脲脲原体、沙眼衣原体。     

乌鲁木齐女性泌尿生殖道支原体感染状况及其 耐药性探讨

目的探讨新疆乌鲁木齐市女性泌尿生殖道感染支原体的状况及其耐药情况。方法采用支原体分离培养药敏试剂盒检测2013年7月至2017年8月间7 899例在本院首次就诊的女性患者的泌尿生殖道分泌物样本,分析支原体培养及药敏结果。结果 7 899例女性泌尿生殖道样本中,支原体阳性1 913例,总阳性率为24.22%,其中单纯解脲脲原体(MH-UU+)1 772例,占支原体感染阳性构成比92.63%。民族中,汉族、维吾尔族、回族、哈萨克族、蒙古族中支原体感染率分别为24.18%、22.85%、24.34%、27.94%、24.21%,差异无统计学意义(P0.05)。单纯人型支原体(MH+UU-)感染对左氧氟沙星、氧氟沙星的耐药率均高于MH-UU+与解脲脲原体和人型支原体混合感染(MH+UU+)(P0.05)。MH+UU+感染对司巴沙星的耐药率高于MH-UU+和MH+UU-感染(P0.05)。结论本地区女性泌尿生殖道支原体以MH-UU+感染为主,首选抗生素为交沙霉素,目前在这5个民族感染的支原体体外抗生素耐药性差异不明显。     

1860例阴道炎患者阴道分泌物病原体结果分析

目的了解阴道炎妇女阴道分泌物病原体感染状况。方法应用病原体培养,显微镜下直接检测等方法,对1 860例女性阴道炎患者取分泌物检测淋球菌(NG)、沙眼衣原体(CT)、解脲支原体(UU)、细菌性阴道病(BV)、念珠菌及滴虫等进行病原体感染状况调查。结果 NG阳性检出率为1.08%,CT阳性检出率为16.7%,UU阳性检出率为32.2%,BV阳性检出率为9.2%,念珠菌阳性检出率为35.0%,滴虫阳性检出率为5.8%,同时发现多种病原体混合感染模式。结论临床上应重视分泌物病原体检查,只有明确病因,患者才能得到及时有效的治疗。     

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。     

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。     

Community perceptions and treatment-seeking behaviour regarding reproductive tract infections including sexually transmitted infections in Lao PDR: a qualitative study

Creating community awareness of reproductive tract infections (RTI), including sexually transmitted infections (STI), and how to prevent them is essential to minimize their spread. Data on people's views about RTI/STI are entirely lacking in Laos. The aim of this study was thus to explore people's perceptions, treatment-seeking behaviour and understanding of information about RTI/STI, in urban and rural communities in two provinces in Laos. Fourteen focus group discussions and 20 in-depth interviews were held with 76 women and 56 men, selected purposively to provide diversity of socio-demographic backgrounds. Qualitative content analysis was employed for the data analysis. The major finding was that both male and female participants had a variety of misconceptions about the causes and symptoms of RTI/STI and their cure, and a reluctance to seek health care, which could cause delay in appropriate diagnosis and treatment. The most common treatment-seeking behaviour was self-medication through private pharmacies, following advice mostly given by friends and drug sellers. The main reasons for not going to health facilities were fear of social discrimination or shyness of genital examination. Complaints were also made about clinicians' negative attitudes towards 'dirty disease'. Although condom use was mentioned as a way to prevent RTI/STI, an unwillingness to use condoms was commonly expressed. The main media sources of RTI/STI information were radio and television, and access to health information was more difficult in rural areas. The health messages provided were mostly understood, except for some technical terms. The findings indicate that strengthening health education and promotion through interventions at the community level is recommended to improve quality of RTI/STI management. Health education messages should be more accessible in rural areas. There is also an urgent need to improve communication between RTI/STI patients and clinicians.     

Oral health and history of respiratory tract infection in frail institutionalised elders

Objectives: The purpose of this study was to look for a relationship between history of respiratory tract infection (RTI) and oral health in very old subjects. Setting and Subjects: 302 frail elders (mean age: 85 years) living in a medical care facility were examined by one dentist. Outcome Measures: The incidence of RTI over 1 year had been recorded along with markers of nutritional status and degree of dependency. The oral examination comprised an evaluation of hygiene, quality of prostheses and the prevalence of caries, periodontal disease and mucosal disorders. Results: One third (33%) of the subjects had experienced at least one episode of RTI and a fifth (19%) had visited the dentist in emergency. The incidence of RTI had been greater among dentate subjects and those who came to the dentist in emergency. The dentate subjects with a history of RTI had higher plaque score (P=0.02). Half (49%) of the subjects had oral disorders that could develop in a dental emergency and these subjects had had a higher risk of RTI (relative risk: 1.9, 95% confidence interval: 1.1–3.9). The presence of selected oral disorders associated with low serum albumin increased the relative risk of having had RTI to 3.2 (1.5–6.7). The association between presence of actual oral health problems and previous experience of RTI was more noticeable in those who had poor general health or were more debilitated. Conclusions: The present study suggests that poor oral hygiene and the presence of potential emergency could be major risk factors for RTI among the frail elderly.     

四川地区孕妇产后子宫内膜炎主要致病菌的检测及其耐药性分析

大肠杆菌(Escherichia coli)、化脓隐秘杆菌(Trueperella pyogenes,Arcanobacterium pyogenes)和坏死梭杆菌(Fusobacterium necrophorum)是与子宫内膜病变相关的主要病原体。本研究使用聚合酶链式反应(PCR)直接鉴定四川地区139例孕妇宫颈分泌物中的病原体,而不进行细菌培养。此外,对上述3种病原体的耐药性进行了考察。结果显示,第1次生产后检查发现子宫内膜炎的发生率(35.25%)高于第2次生产后检查(15.53%)。在6个样品中检测到大肠杆菌,在11个样品中检测到化脓隐秘杆菌,并在10个样品中检测到坏死梭杆菌。在第1次检查中,化脓隐秘杆菌和坏死梭杆菌的子宫污染感染高于第2次检查。药敏实验结果显示,大肠杆菌、化脓隐秘杆菌和坏死梭杆菌分别对9种、6种和7种药物产生耐药性。总之,本研究建立了用于诊断孕妇产后子宫内膜炎的3种主要病原体的标准PCR,该方法更简单、成本低和快捷,且对主要细菌检测具有较高的灵敏度。此外,大肠杆菌的耐药性高于另外2个菌种。     

Chlamydia trachomatis Pgp3 Antibody Persists and Correlates with Self-Reported Infection and Behavioural Risks in a Blinded Cohort Study

Chlamydia trachomatis (Ct) serological studies in populations could help monitor changes in lifetime cumulative risk of infection. We developed a double-antigen sandwich ELISA based on the Ct-specific Pgp3 antigen, then tested blind stored sera from over 800 participants in a New Zealand birth cohort from Dunedin at ages 26, 32 and 38. The double-antigen sandwich ELISA was more sensitive than our previously characterised indirect Pgp3 ELISA. Pgp3 antibody was detected more often in women compared to men and correlated with increasing numbers of sexual partners, self-reported Ct, and younger age at sexual debut in both women and men. At age 26, 24.1% (99/411) of women were Pgp3 seropositive, as were 79.5% (35/44) of those reporting Ct infection; Pgp3 antibody persisted to age 38 in 96.5% (83/86). In men at age 26, the figures were 10.7% (47/442) and 25.0% (6/24), respectively, with high (83.9%) antibody persistence to age 38. At age 38, among those Pgp3 seropositive, 63.3% of women and 83.1% of men had not reported Ct infection. Thus, Ct-specific Pgp3 antibody was detected in most women reporting Ct infection and correlated with risk of infection in those who did not, with most infections remaining undetected. As this antibody persisted for at least twelve years in 96% of these women, serology could be used to evaluate Ct prevention programmes among women.     

Microelements in seminal plasma of infertile men infected with Ureaplasma urealyticum

The purpose of this study was to assess the association among male infertility, infection of Ureaplasma urealyticum (Uu), and microelements in seminal fluid. Semen analysis and cultivation of Uu were carried out on 160 samples of seminal fluid. The concentrations of microelements, such as arsenic (As), molybdenum (Mo), magnesium (Mg), lead (Pb), copper (Cu), cadmium (Cd), and zinc (Zn) in the samples were measured by an inductively coupled plasma quantometer (ICP). The ratios Cu/Zn and Cd/Zn in the poor spermatic quality group were obviously higher than those in seminal plasma of the group with normal spermatic quality (p<0.01 and p<0.05, respectively), whereas the concentrations of As, Mg, Mo, and Pb showed no difference in the two groups. The ratios Cu/Zn and Cd/Zn and the concentrations of As and Mg in seminal plasma infected with Uu were markedly higher than those not infected with Uu (p<0.05, p<0.01, p<0.05, and p<0.05, respectively), whereas the concentrations of Mo and Pb showed no statistical difference. The ratios Cu/Zn and Cd/Zn and the concentrations of As and Mg in seminal plasma of the semen with poor spermatic quality and Uu infection were obviously higher than those not infected with Uu (p<0.05), whereas the concentrations of Mo and Pb showed no statistical difference. Abnormally high ratios Cu/Zn and Cd/Zn as well as an overdose of As were found to be predisposed to Uu infection. Uu infection resulted in an increase of the ratios Cu/Zn and Cd/Zn and the concentrations of As and Mg in seminal fluid, which therefore caused spermatic quality decline.     

女性激素状态与生殖道支原体寄居的关系

本文调查了959名不同性激素状态妇女生殖道溶脲支原体(Uu)和人型支原体(Mh)的寄居情况。结果表明新生女婴、产后妇女和绝经妇女Uu和Mh寄居率较低,妊娠妇女Uu和Mh寄居率则相当高;已婚非孕妇女Uu和Mh寄居率高于未婚者。提示了女性激素水平与生殖道支原体寄居状态有密切联系。     

Symptoms of respiratory tract infection and associated care-seeking in subjects with and without obstructive lung disease; The Tromso Study: Tromso 6

ABSTRACT: BACKGROUND: Respiratory tract infections (RTIs) may be more severe in those with asthma or COPD and these patients are more frequently in need of health care. The aim of the study was to describe the frequency of RTI symptoms in a general adult population and how care-seeking is associated with the presence of obstructive lung disease. METHODS: Cross-sectional data including spirometry and self-reported chronic diseases were collected among middle-aged and elderly subjects in the Tromso population survey (Tromso 6). Self- reported RTI symptoms, consultations and antibiotic use were the main outcome variables. Possible predictors of RTI symptoms were evaluated by multivariable logistic regression. RESULTS: Of the 6414 subjects included, 798 (12.4 %) reported RTI symptoms in the previous week. RTI symptoms were reported less frequently by subjects aged 75 years or above, than by those younger than 55 years (OR 0.5). Winter season (OR 1.28), current smoking (OR 1.60), low self-rated health (OR 1.26) and moderate to severe bronchial obstruction (OR 1.51), were also statistically significant independent predictors of RTI symptoms, but these variables did not predict RTI symptoms that had started within the previous seven days. Among subjects with RTI symptoms, 5.1 % also reported a consultation with a doctor. In those with bronchial obstruction by spirometry, who did not report asthma or COPD, this frequency was 2.4 %. Antibiotic treatment was reported by 7.4 % of the participants, among whom one third had consulted a doctor. Antibiotics were taken more frequently when asthma or COPD was reported (13.7 %), but not in subjects with bronchial obstruction who did not report these diseases (7.2 %). CONCLUSIONS: RTI symptoms seldom led to consultation with a doctor and not even in subjects with obstructive lung disease. This was in particular the case in subject who did not know about their obstructive lung disease. Strategies for early diagnosis of COPD and providing health care to subjects with such disease cannot rely on their doctor visits due to respiratory symptoms.     

女性泌尿生殖道标本支原体检测及体外耐药性分析

分析了长沙市女性泌尿生殖道解脲支原体(Uu)和人型支原体(Mh)感染的现状,分布及耐药情况。应用支原体培养药敏试剂盒,对476例女性泌尿生殖道分泌物标本进行Uu和Mh的检测和药敏试验。476份标本支原体总检出率为37.0%。Uu检出率26.0%;Mh检出率为3.0%;两者混和感染检出率为8.0%。感染年龄集中在20~30岁的年龄段。支原体对常见抗生素的耐药率11.9%~79.5%。支原体感染是女性泌尿生殖道常见的感染病原体,对支原体感染敏感的抗生素是多西环素和美满霉素。