脲原体所致疾病与致病机制的研究

脲原体和多种泌尿生殖道感染和新生儿疾病相关,本文就近几年来关于脲原体导致的疾病和可能的致病机制进行总结,为更有效的进行脲原体的诊断和治疗提供线索。     

棋盘稀释法在解脲脲原体药敏试验中的应用

解脲脲原体是引起泌尿生殖道感染的重要病原体。目前使用的药敏试验方法即药敏卡法没有考虑样本中脲原体的实际含量而存在局限性。本研究将棋盘稀释法应用于解脲脲原体的药敏试验,可获得脲原体的准确耐药情况,有助于临床治疗中抗生素的正确选择;同时,有利于控制耐药菌株的产生和在人群中的扩散。     

解脲脲原体的生物群、血清型与致病

解脲脲原体可以寄居于人泌尿生殖道,在性成熟无症状妇女40%～80%子宫颈或阴道内携带解脲脲原体,感染多见于年青、多性伴及口服避孕药者.作为一种条件致病微生物,女性子宫颈处的解脲脲原体不一定引起临床上可见的炎症改变,其致病性与多种因素有关,如宿主免疫力、性伴数、血清型别等,如果无明显的临床体征,要考虑这些因素的影响,本文主要论述其致病性与可能血清型别的关系.     

解脲脲原体感染动物模型的研究进展

解脲脲原体(Uu)是女性泌尿生殖道黏膜中常见的微生物,其致病性仍存在争议。Uu感染下生殖道可表现为尿道炎或宫颈炎,而定植于新生儿下呼吸道可引起肺炎、支气管肺发育不良、慢性肺部疾病等。研究Uu感染的发病机制、宿主的免疫反应以及Uu感染的防治,动物模型是不可缺少的。目前国内、外已成功建立多种Uu感染动物模型,主要包括下生殖道感染模型及呼吸道感染模型。在Uu生殖道感染动物模型的建立中,雌二醇的预处理必不可少,实验动物首选BALB/c小鼠;而呼吸道感染模型不需雌二醇预处理,多位学者成功使用C3H/HeN小鼠建立了该模型。     

解脲脲原体感染和不孕不育关系的研究

本文报道原因不明的不孕不育夫妇(甲组)2181例,解脲脲原体培养阳性1203例,阳性率55.16％。其中男性阳性率55.48％;女性为54.92％。正常生育夫妇(乙组)366例,阳性107例,阳性率为29.03％,其中男性18.93％,女性35.04％。两组比较,无论总阳性率,还是单独男性或女性,甲组均显著高于乙组(p<0.005)。经以强力霉素为主治疗后,转阴率达83.87％,其中妊娠390人,占38.65％。作者认为解脲脲原体感染和部分原因不明不孕不育是相关的。     

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。     

大学生解脲脲原体和人型支原体正常携带状况研究

目的探讨解脲脲原体(Uu)和人型支原体(Mh)在大学生中的正常携带状况.方法采用培养法对314名未婚统招大学生和232名已婚成教大学生进行解脲脲原体和人型支原体的检测.结果未婚大学生和已婚大学生泌尿生殖道支原体检出率分别为12.10%和22.41%,后者明显高于前者(x2=10.31,P＜0.005);已婚男、女大学生泌尿生殖道支原体检出率(分别为17.44%和27.78%)明显高于未婚男、女大学生检出率(分别为8.33%和16.44%,x2=5.84、4.77P＜0.05).未婚男、女大学生之间泌尿生殖道支原体检出率差异有显著性(y2=4.82,P＜0.05),而已婚男、女大学生之间泌尿生殖道支原体检出率差异无显著性(x2=3.34,P＞0.05).已婚和未婚大学生泌尿生殖道支原体检出者中均以同时携带Uu和Mh较为常见.结论在校大学生中也有一部分人正常携带Uu和/或Mh,从他(她)们体内检出Uu和/或Mh一般不代表疾病状态.     

PCR法检测正常女性宫颈中的溶脲脲原体生物群

目的了解正常妇女宫颈中溶脲脲原体两个生物群的分布及药物敏感性。方法采用PCR技术对妇科门诊的正常妇女宫颈的溶脲脲原体两个生物群进行检测。结果50例正常妇女经PCR-CE检测,21例(42.0%)溶脲脲原体阳性其中溶脲脲原体生物群1阳性16例(76.2%),生物群2阳性5例(23.8%)。结论溶脲脲原体生物群1可能是女性生殖道一种正常菌群。而溶脲脲原体生物群2能引起妇科疾病从而导致不孕。     

正常妇女和下生殖道炎症及不孕症时泌尿生殖道中的溶脲脲原体

本文报道165例妇女宫颈阴道分泌物和部分不育男性精液的溶脲脲原体的分离结果。正常妇女组检出率为33％(11/33)、宫颈炎和阴道炎组为67％(39/59)、不孕症组80％(35/44)、富颈癌组24％(5/21)。不孕夫妇中,13例男性精液检查有9例溶脲脲原体阳性。经比较有炎症组和不孕症组的溶脲脲原体检出率高于正常组2倍多,差异显著(P<0.01和<0.005)。鉴于溶脲脲原体作为人泌尿生殖道中的常住菌,其微生态意义与下生殖道炎症和某些不孕症的关系值得进一步深入研究。     

1796例泌尿生殖道支原体培养及药敏结果分析

目的分析新乡地区1796例泌尿生殖道标本的支原体培养及抗生素药物敏感试验,指导临床合理使用抗生素。方法支原体培养鉴定、药敏试剂盒购自贝瑞特公司。同时检测解脲支原体和人型支原体,并进行10种抗生素的药敏试验。数据统计采用χ^2检验。结果支原体培养1596例标本中,541例解脲脲原体（Uu）阳性,阳性率为33.9%;39例人型支原体（Mh）阳性,阳性率为2.4%;解脲脲原体、人型支原体均阳性76例,阳性率为4.8%。200例正常对照组27例阳性,阳性率为13.5%。药敏结果显示,强力霉素、克拉霉素和美满霉素的抗菌活性较强。结论支原体感染以Uu为主,Uu＋Mh次之,正常人泌尿生殖道支原体阳性率为13.5%。只有某些血清型感染且在达到一定浓度以上同时宿主处于多种病原体感染或免疫机制紊乱时,Uu才能致病。避免滥用抗生素引起生殖道菌群失调。临床上治疗Uu感染、Mh感染或Uu＋Mh混合感染时,建议选用强力霉素、克拉霉素和美满霉素。     

Frequency of detection of Ureaplasma urealyticum and Mycoplasma hominis in cervical canal and the Douglas pouch of infertile and fertile women

The group of organisms commonly referred to as genital mycoplasmas comprise species most often found in genitourinary tract of sexually active adults as common commensal inhabitants, or pathogens which can possibly cause many different pathologies like: non-gonococcal urethritis, bacterial vaginosis, cervicitis, endometritis or pelvic inflammatory disease. The problem of their morbidity and the possible influence they have on human fertility is still not clear. The aim of this study was to find out whether two investigated species- Ureaplasma urealyticum and Mycoplasma hominis can be detect more often in a group of infertile women. 74 women participated in the study and were assigned to one of 2 groups of patients: infertile women and fertile women without any sign of genital tract infection. Swabs from the cervical canal of the uterus and the fluid from the Douglas pouch were taken during the gynecological examination and laparoscopic procedure. Two diagnostic methods were used: biochemical method- commercial diagnostic kit- Mycoplasma IST 2 and PCR method. The results showed that Ureaplasma urealyticum and Mycoplasma hominis were detected among both fertile and infertile women with nearly the same frequency, much more often in cervical canal than in the Douglas pouch. Ureaplasma urealyticum was more common pathogen than Mycoplasma hominis in both groups and locations. The achieved results point out that the role of genital mycoplasmas in human infertility is still unclear and require further investigations.     

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。     

女性生殖道支原体感染与不孕症的关系及药敏分析

目的探讨女性生殖道支原体感染与不孕症之间的关系及对11种抗生素的敏感率,指导临床明确诊断,合理用药。方法随机选择2007年至2009年来长治市妇幼保健院就诊的女性不孕症患者360例,进行宫颈分泌物支原体培养和药敏试验。结果 360例宫颈分泌物标本中检出解脲支原体(Uu)阳性者161例、人型支原体(Mh)阳性者3例、解脲支原体(Uu)+人型支原体(Mh)混合阳性者29例;对阳性标本都做了11种抗生素的药敏试验,其中交沙霉素敏感率为93.47%、美满霉素敏感率为92.00%、强力霉素敏感率为90.21%、克拉霉素敏感率为83.69%、甲砜霉素敏感率为73.91%、环脂红霉素敏感率为61.95%和阿奇霉素敏感率为53.26%等。结论女性不孕症伴随高发的生殖道支原体感染,支原体感染与不孕症可能有关;长治地区生殖道支原体对交沙霉素、美满霉素、强力霉素、克拉霉素、甲砜霉素敏感性较高,环脂红霉素、阿奇霉素次之,对红霉素、罗红霉素敏感性较低,对环丙沙星、左氧氟沙星敏感性很低。     

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。     

不育患者精子溶脲脲原体的分离和活动力的观察

本文对８７例不明原因不育的男性患者的精液，进行了溶脲脲原体的分离，检出率为６２．０７％，而３８例正常对照中，溶脲脲原体的检出率为１８．４２％，二者差别非常显著（Ｐ＜０．００１）。溶脲脲原体感染者精子的活动率与活动力同正常人相比，差异显著（Ｐ＜０．０５），提示溶脲脲原体感染与部分男性不育有关。     

Molecular characterization of thymidine kinase from Ureaplasma urealyticum: nucleoside analogues as potent inhibitors of mycoplasma growth

Ureaplasma urealyticum (U. urealyticum), belonging to the class Mollicutes, is a human pathogen colonizing the urogenital tract and causes among other things respiratory diseases in premature infants. We have studied the salvage of pyrimidine deoxynucleosides in U. urealyticum and cloned a key salvage enzyme, thymidine kinase (TK) from U. urealyticum. Recombinant Uu-TK was expressed in E. coli, purified and characterized with regards to substrate specificity and feedback inhibition. Uu-TK efficiently phosphorylated thymidine (dThd) and deoxyuridine (dUrd) as well as a number of pyrimidine nucleoside analogues. All natural ribonucleoside/deoxyribonucleoside triphosphates, except dTTP, served as phosphate donors, while dTTP was a feedback inhibitor. The level of Uu-TK activity in U. urealyticum extracts increased upon addition of dUrd to the growth medium. Fluoropyrimidine nucleosides inhibited U. urealyticum and M. pneumoniae growth and this inhibitory effect could be reversed by addition of dThd, dUrd or deoxytetrahydrouridine to the growth medium. Thus, the mechanism of inhibition was most likely the depletion of dTTP, either via a blocked thymidine kinase reaction and/or thymidylate synthesis step and these metabolic reactions should be suitable targets for antimycoplasma chemotherapy.     

泌尿生殖系统感染支原体培养及药敏结果分析

目的 :了解解脲支原体和人型支原体在泌尿生殖系统感染中的致病作用和对抗生素的药敏情况。方法 :对 5 87例泌尿系感染患者进行支原体培养 ,并对阳性标本行 12种抗生素药敏试验。采用支原体培养、鉴定、药敏一体化试剂盒进行检测。结果 :5 87例患者中支原体阳性 16 4例 ,感染率为 2 7 9% ,解脲支原体 (Uu)、人型支原体 (Mh)及Uu +Mh混合感染的阳性率分别为 2 1 3%、1 5 %和 5 1%。女性感染率显著高于男性 (P <0 0 1)。支原体对 12种抗生素敏感性最高的是交沙毒素 (92 7% ) ,其次为可乐必妥(85 4 % )、司帕沙星 (84 8% )。结论 :泌尿生殖系统感染者支原体感染率为 2 7 9% ,主要由解脲支原体引起 (占 76 2 % ,12 5 / 16 4 ) ,泌尿生殖系感染支原体患者应首选交沙霉素治疗。     

Pathogenicity of Ureaplasma urealyticum and Ureaplasma parvum in the lower genital tract of female BALB/c mice

The aim of this study was to establish a murine model of lower genital tract infection by Ureaplasma urealyticum and Ureaplasma parvum and evaluate differences in pathogenicity of five serotypes. BALB/c female mice were divided into seven groups (five mice in each group), including five groups infected in the lower genital tract after treatment with estradiol with U. urealyticum serotypes 4 and 8 and U. parvum serotypes 1, 3, and 6, respectively, and two control groups of untreated mice and estradiol treated mice. The presence of infection was determined on solid and liquid culture media. Tumor necrosis factor-alpha (TNF-α) expression in lower genital tract secretions was determined by PCR, and morphological and histological changes of the lower genital tract were observed. The genital secretions of all inoculated mice were positive for U. urealyticum and U. parvum on culture in both liquid and solid media. TNF-α expression at 7 and 14 days after infection was markedly increased as compared with that of the controls. Morphological changes of the external genitalia included hair loss and erosions, and histological examination revealed infiltration by inflammatory cells. The five serotypes tested were all found to be pathogenic, and the pathogenicity varied with serotype 4 showing the greatest pathogenicity.     

Development of real-time PCR for the differential detection and quantification of Ureaplasma urealyticum and Ureaplasma parvum

Ureaplasma parvum and Ureaplasma urealyticum are recently recognized species of the genus Ureaplasma. In humans, Ureaplasma spp. can be found on mucosal surfaces, primarily in the respiratory and urogenital tracts. They have been implicated in various human diseases such as nongonococcal urethritis, intrauterine infections in association with adverse pregnancy outcome and fetal morbidity, and pneumonitis in immunocompromised hosts. We have developed two quantitative real-time PCR assays to differentially detect U. parvum and U. urealyticum. Based upon the sequence information of the urease gene (ureB), we designed two TaqMan primer and probe combinations specific for U. parvum and U. urealyticum, respectively. The assays did not react with nucleic acid preparations from 16 bacterial species commonly encountered in relevant clinical specimens, including seven urease-producing species. Each assay had a detection limit of approximately five copies per reaction of the respective gene target. The results suggest that these assays are both sensitive and specific for U. parvum and U. urealyticum. Further investigation of both assays using clinical specimens is appropriate.