阴道假丝酵母菌病患者混合UU/CT感染的初步研究

目的 对女性下生殖道假丝酵母菌感染患者进行解脲脲原体(UU)和沙眼衣原体(CT)检测,以了解女性下生殖道假丝酵母菌感染患者中UU/CT的混合感染状况,为临床正确诊断和治疗提供依据.方法 对以外阴瘙痒及白带增多为主诉,拟下生殖道假丝酵母菌感染的女性患者进行临床检查,先取阴道分泌物进行假丝酵母菌检查,同时取宫颈管分泌物采用荧光定量PCR测定UU、CT.结果 在90例假丝酵母菌感染的患者中,UU阳性71例占78.89%,CT阳性14例占15.56%(其中11例同时存在UU阳性,占78.57%),均较对照组(分别为41.2%和7.2%)明显升高,差异有显著性,P<0.05.结论 女性下生殖道假丝酵母菌感染患者存在合并UU和(或)CT感染,有必要进行常规的检查,以便正确使用有效药物治疗.     

慢性阴道炎患者生殖道解脲脲原体和沙眼衣原体感染分析

目的通过荧光定量聚合酶链反应(PCR)技术检测慢性阴道炎患者阴道内解脲脲原体(Uu)和沙眼衣原体(Ct)感染状况,用以指导临床正确治疗。方法应用荧光定量聚合酶链反应对380例慢性阴道炎患者的阴道分泌物进行解脲脲原体和沙眼衣原体PCR检测。结果解脲脲原体阳性率为42.9%,其阳性标本的平均拷贝数为3.4×105copies/ml,沙眼衣原体阳性率为16.6%,其阳性标本的平均拷贝数为5.8×104copies/ml,解脲脲原体和沙眼衣原体合并感染的阳性率为12.6%。结论PCR技术具有简便、快捷、准确的优点,是目前快速诊断慢性阴道炎患者Uu、Ct感染状况的可靠诊断方法之一。     

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。     

1964例围产期孕妇阴道分泌物常见病原体分析

目的探讨围产期孕妇阴道分泌物常见病原体的感染状况,减少不良妊娠的发生。方法假丝酵母菌(C)、滴虫(T)检测采用涂片法,细菌性阴道炎(BV)检测采用唾液酸酶法,淋球菌(NG)检测采用平板培养法,解脲支原体(UU)检测采用人工培养法,沙眼衣原体(CT)检测采用乳胶免疫层析法。结果 1 964例围产期孕妇中病原体感染者共360例,占总人数的18.33%(C 9.41%、T 0.46%、BV 6.36%、NG 0.00%、UU 4.53%、CT 1.73%)。其中单一病原体感染者为281例,占总人数的14.31%;两种或两种以上病原体感染者为79人,占总人数的4.02%。结论抚顺地区围产期孕妇阴道分泌物病原体构成复杂,病原体主要以假丝酵母菌和细菌性阴道炎为主,其次是解脲支原体,部分孕妇可同时感染多种病原体。     

439例围绝经妇女阴道炎状况调查及相关因素研究

目的了解本地区围绝经妇女的阴道炎状况并探讨其相关影响因素。方法选择2016年7月至2017年6月来我院进行妇科体检的439例患者进行回顾性研究,对其阴道分泌物检查的结果以及个人信息进行分析。结果 439例患者中患阴道炎的有99例(22.6%),不同文化程度患者阴道炎的感染率不同,小学及以下文化程度组最高,为26.0%,组与组之间的差异无统计学意义(P=0.49);对比阴道炎患者的分泌物结果,其中支原体衣原体29例(29.3%),滴虫13例(13.1%),阴道加德纳菌22例(22.2%),假丝酵母菌35例(35.4%)。结论本地区围绝经妇女患阴道炎的比例与文化程度有一定的关系。其中假丝酵母菌最常见,支原体衣原体(包括解脲支原体、人型支原体和沙眼支原体)次之,且阴道炎极易反复感染,医院在检查过程中要重视细菌培养,患者要定期复查。     

1800例妇科门诊患者阴道分泌物的病原学分析

目的了解妇科门诊患者中阴道分泌物的病原学。方法用湿片法进行阴道分泌物及细菌性阴道病（BV）检查,革兰染色法检查G^-双球菌。观察分泌物的病原体分布情况。结果1800例妇科门诊患者中,其阴道分泌物假丝酵母菌阳性549例,阳性率为30．50％;阴道毛滴虫阳性34例,阳性率为1．89％;BV399例,阳性率为22．17％;G^-双球菌16例,阳性率为0．89％。混合感染：假丝酵母菌合并阴道毛滴虫感染2例（0．11％）;假丝酵母菌合并BV192例（10．67％）;假丝酵母菌合并G^-双球菌5例（0．28％）;假丝酵母菌合并BV和G^-双球菌3例（0．17％）。结论妇科门诊患者阴道分泌物的病原体构成复杂,阴道炎主要以外阴阴道假丝酵母菌病和BV为主,部分可多种病原体混合感染。     

大连市围产期妊娠妇女下生殖道感染常见病原菌调查

目的对大连市围产期妊娠妇女下生殖道感染情况和常见病原菌进行调查。方法对年龄25-34,孕周28—32周的2501名孕妇,取分泌物进行淋病双球菌培养和真菌培养及鉴定,衣原体抗原检测和阴道清洁度检查。结果2501名孕妇中阴道清洁度Ⅲ度以上为25．7％．念珠菌检出率为15．5％,滴虫占1．2％,线索细胞占6．2％;真菌培养检出率为16．0％,其中白假丝酵母菌占73．8％,衣原体占4．4％,淋病双球菌占0．08％。结论大连市围产期妊娠妇女下生殖道感染情况不容乐观,需进一步加以研究。     

385例女性阴道混合感染的临床分析

目的 通过对阴道分泌物进行微生态菌群检查,细菌、真菌培养鉴定及生殖道支原体检测,全面评估女性阴道混合感染的微生态状况,为临床诊断治疗提供适宜的依据.方法 2011年1月至201 1年8月,取在甘肃省妇幼保健院就诊的385例阴道炎患者阴道分泌物,革兰染色后油镜下观察阴道菌群,采用生化快速检测技术进行阴道微生态功能测定,同时进行细菌、真菌培养鉴定及解脲脲原体和人型支原体检测.结果 在385例患者中,单一感染90例(23.4％),混合感染154例(40.0％),菌群失调141例(36.6％).其中需氧菌阴道炎(AV)20例(5.2％)、细菌性阴道病( BV)27例(7.0％)、外阴阴道假丝酵母菌病(VVC)18例(4.7％)、生殖道支原体感染(MP) 25例(6.5％)、AV+BV+ VVC 18例(4.7％)、AV+ BV+ MP 72例(18.7％)、AV+ MP 18例(4.7％)、VVC+ MP 9例(2.3％)、AV+ TV 1例(0.25％).结论 阴道炎是妇科常见感染性疾病,混合感染和微生态失衡为其主要原因.客观评价阴道感染,及时、全面、有效的诊治是治疗阴道炎的关键.     

抗生素治疗解脲支原体感染时阴道补充乳杆菌的效果评价

目的评估在用抗生素治疗解脲支原体感染的过程中,使用定君生胶囊补充阴道乳杆菌在促进感染治愈,预防并发症外阴阴道假丝酵母菌病的效果。方法 2014年7月至2016年7月开展临床试验研究,研究组中100名患者口服盐酸多西环素同时阴道补充乳杆菌活菌胶囊定君生每天1粒共10d,对照组127名患者仅口服盐酸多西环素。计算治疗期间以及复查前停药阶段外阴阴道假丝酵母菌病发生率,停药满14d后解脲支原体治愈率以及被治愈患者停药满3个月内解脲支原体复发率。结果研究组停药14d后解脲支原体的治愈率高于对照组(88.0%vs 77.2%,P=0.035),同时,治疗期间和复查前停药阶段外阴阴道假丝酵母菌病的发生率较低(8.0%vs 18.9%,P=0.019),但两组停药满3个月内解脲支原体感染复发率差异无显著性(8.9%vs 16.1%,P0.05)。结论抗生素治疗解脲支原体感染同时阴道补充乳杆菌有利于提高其治愈率,降低治疗和停药期间外阴阴道假丝酵母菌病发生率。     

海宁地区19519例女性生殖道感染情况分析及临床意义探讨

目的通过对19 519例门诊阴道分泌物标本的检测,探讨阴道炎病原体的分布情况和定期进行阴道分泌物检查的意义。方法通过显微镜镜检等方法检测19 519例阴道分泌物标本的清洁度、假丝酵母菌、线索细胞、滴虫等。结果 19 519例标本中,共检出阴道炎9 142例,占46.84%,病因不明的阴道炎占26.83%。假丝酵母菌、线索细胞及滴虫检出率分别为15.30%、3.84%、0.87%。各种病原体感染既可单独存在,也可混合感染。清洁度Ⅲ~Ⅳ度的患者中病原菌检出率明显高于Ⅰ~Ⅱ度(P0.05)。结论阴道炎在门诊病例中的比例非常高,女性应定期进行阴道分泌物检查,并对育龄妇女和老年女性开展阴道感染防治健康教育以降低生殖泌尿系感染风险。     

Identification and susceptibility against fluconazole and albaconazole of 100 yeasts' strains isolated from vaginal discharge

Vulvovaginal candidiasis is a condition that affects a great number of fertile women. It is considered the second cause of genital infection after vaginosis due to GAM complex. Candida albicans is the most frequent isolated species from vaginal discharge. However, sometimes more than one yeast species could be found in the same clinical sample that are more resistant to antifungal drugs. Nowadays, it is necessary to identify properly up to species level the isolated microorganism and to determine the antifungal susceptibility profile. One hundred strains obtained from vaginal discharge of 94 patients suffering acute vulvovaginal candidiasis were studied. The identification of the isolates showed: C. albicans 86%, Candida glabrata 6%, Candida inconspicua 3%, Candida krusei 2% and Candida intermedia, Candida holmii and Trichosporon asahii one case each. Minimal inhibitory concentrations (MIC) of all the yeasts against fluconazole and albaconazole were performed. C. glabrata, C. krusei and C. inconspicua were the most resistant against fluconazole, on the other hand albicans was susceptible to this drug. All the isolates presented MIC against albaconazole much lower than fluconazole.     

Chlamydia trachomatis infections in women with urogenital symptoms.

Chlamydia trachomatis was isolated from 30 to 100 women attending a family physician''s office with dysuria, frequency or vaginal discharge, compared with 2 of 30 asymptomatic women. Multiple infections were common: C. trachomatis coexisted with Gardnerella vaginalis, Candida albicans, Trichomonas vaginalis or a bacterial cause of urinary tract infection in 15 patients. C. trachomatis was isolated alone from 15 symptomatic women. The source of the positive culture was not always the site of symptoms. C. trachomatis was isolated from both the cervix and the urine of 9 patients, either simultaneously or sequentially. The probability of finding a chlamydial infection was 30% in young women with vaginal discharge alone, 33% in those with dysuria and frequency alone and 53% in those with abdominal or pelvic pain in addition to lower urogenital tract symptoms.     

Relationship between the morphology of Candida cells and vaginal discharge

The aim of this study was to detect whether there is a correlation between the dimorphic pattern of Candida cells and various types of vaginal discharge. For this purpose, 2861 Papanicolaoustained cervicovaginal smears were examined cytologically and 265 of 2861 (9.26%) were diagnosed as having Candida cells. The 88 of 295 (29.83%) were identified as having blastospores only, 135 of 295 (45.76%) as having "hyphae only", and 47 of 295 (15.93%) as having both blastospores and hyphae of candida cells. There was a significant correlation between the type of candida cells and vaginal discharge (p < 0.05). The white-cheesy type vaginal discharge was the most prominent symptom for the observation the "hyphae only" following "blastospores only" and both blastospores and hyphae of Candida cells. It was suggested that hyphael form of Candida cells is the most pathogenic pattern and white-cheesy vaginal discharge is a marker for the presence of hyphael form in the vaginal mucosa.     

Adherence of Candida to mucosal epithelial cells

Adherence abilities of 45 Candida strains to human buccal and vaginal epithelial cells in vitro were tested in two media: 0.9% saline and phosphate buffer. Candida albicans cells adhered more strongly to epithelial cells than fungal cells of other Candida species. These findings were statistically significant according to Mann-Whitney's "U" test with buccal epothelial cells in both of the test media and with vaginal cells in saline only.     

女性体检人群生殖道病原体的分布

目的了解体检妇女人群生殖道感染情况,为女性生殖道感染的防治提供进一步的资料。方法对1157例参加健康体检的妇女的阴道后穹窿及宫颈分泌物标本进行显微镜镜检以检测阴道清洁度、真菌、滴虫等,同时采用培养法对淋球菌、解脲支原体、人型支原体、真菌等进行检测,沙眼衣原体则采用免疫层析法;检测结果进行统计学分析。结果女性生殖道感染的感染率为54.0%,其中混合感染率为9.3%,而清洁度异常率仅为23.8%;前3位病原体依次为解脲支原体(35.3%)、衣原体(22.2%)、真菌(5.5%);年轻妇女组与年老组支原体的检出率差异有显著性(P<0.05)。结论女性生殖道感染情况严重,支原体、衣原体等感染隐匿,加强对育龄妇女的监测尤为重要。     

多次人工流产后妊娠期阴道病患者致病微生物检测及药敏分析

目的检测多次人工流产后妊娠期阴道病患者的致病微生物,并提出治疗建议。方法选取102例多次人工流产后妊娠期阴道病患者作为研究对象,所有患者均采用无菌棉拭子收集2份阴道分泌物样本,其中1份采用高倍镜检查阴道清洁度和滴虫感染情况,另1份检测病原微生物感染情况,统计病原微生物分布情况并检测常见病原微生物药敏情况。结果阴道清洁度检测显示,清洁度4度者构成比最高,为60.78%,其次为3度,1度者构成比最低。共12例患者存在滴虫感染,构成比为11.76%。人乳头瘤病毒(HPV)感染12例,感染率为11.76%。支原体感染率、衣原体感染率分别为38.24%、33.33%。92例患者阴道分泌物共检出225株病原菌,其中革兰阳性菌占60.44%,以棒状杆菌、金黄色葡萄球菌、表皮葡萄球菌为主;革兰阴性菌占25.78%,以肺炎克雷伯菌、阴道加德纳菌、大肠埃希菌为主;真菌占13.78%,以白假丝酵母、光滑假丝酵母、克柔假丝酵母为主。药敏试验显示,棒状杆菌、金黄色葡萄球菌、表皮葡萄球菌、乳杆菌和肠球菌属对青霉素的耐药率均较低,分别为0.00%、0.00%、5.00%、5.88%、6.67%;肺炎克雷伯菌、阴道加德纳菌、大肠埃希菌对亚胺培南的耐药率均较低,分别为4.55%、12.50%、9.09%;白假丝酵母、光滑假丝酵菌、克柔假丝酵母对两性霉素B、5-氟胞嘧啶的耐药率均为0.00%,且光滑假丝酵母菌对酮康唑、克霉唑的耐药率也均为0.00%。结论多次人工流产后妊娠期阴道病患者常见的致病微生物有滴虫、支原体、衣原体、细菌、真菌等,需要根据检测结果选择安全、合理的药物进行治疗。     

Population-based genetic epidemiologic analysis of Chlamydia trachomatis serotypes and lack of association between ompA polymorphisms and clinical phenotypes

Chlamydia trachomatis is the leading cause of bacterial sexually transmitted diseases worldwide. Urogenital strains are classified into serotypes and genotypes based on the major outer membrane protein and its gene, ompA, respectively. Studies of the association of serotypes with clinical signs and symptoms have produced conflicting results while no studies have evaluated associations with ompA polymorphisms. We designed a population-based cross-sectional study of 344 men and women with urogenital chlamydial infections (excluding co-pathogen infections) presenting to clinics serving five U.S. cities from 1995 to 1997. Signs, symptoms and sequelae of chlamydial infection (mucopurulent cervicitis, vaginal or urethral discharge; dysuria; lower abdominal pain; abnormal vaginal bleeding; and pelvic inflammatory disease) were analyzed for associations with serotype and ompA polymorphisms. One hundred and fifty-three (44.5%) of 344 patients had symptoms consistent with urogenital chlamydial infection. Gender, reason for visit and city were significant independent predictors of symptom status. Men were 2.2 times more likely than women to report any symptoms (P=0.03) and 2.8 times more likely to report a urethral discharge than women were to report a vaginal discharge in adjusted analyses (P=0.007). Differences in serotype or ompA were not predictive except for an association between serotype F and pelvic inflammatory disease (P=0.046); however, the number of these cases was small. While there was no clinically prognostic value associated with serotype or ompA polymorphism for urogenital chlamydial infections except for serotype F, future studies might utilize multilocus genomic typing to identify chlamydial strains associated with clinical phenotypes.     

Vaginal microbial flora in normal young women.

Vaginal swabs were taken from 1498 women attending a family planning clinic. The flora was assessed in the absence of any information about the women to whom the swabs related. Yeasts and fungi were present in 311 women (21%) and were no more prevalent among "pill" users than others. Candida albicans was significantly associated with vulval itching and with a vaginal discharge described as heavier than normal or curdy on clinical examination, though these abnormalities were present in only a minority of women with the organism. Trichomonas vaginalis was found in 14 women (1%) and was associated with abnormalities of vaginal discharge in all but one. Gram-negative anaerobic bacilli were significantly more common in women with a troublesome vaginal discharge and those who used an intrauterine device than others. No associations were found between fungi other than C albicans or the other bacteria sought and either symptoms or clinical abnormalities of vaginal discharge.     

Diffuse peritonitis and chronic ascites due to infection with Chlamydia trachomatis in patients without liver disease: new presentation of the Fitz-Hugh-Curtis syndrome.

Two women were admitted for increasing abdominal pain, vaginal discharge, and severe or moderate chronic ascites. Diffuse peritonitis without evidence of liver disease was found in both cases, and in one the ascites and vaginal discharge contained Chlamydia trachomatis. Both patients responded to doxycycline, and this and the laboratory findings pointed strongly to C trachomatis as the aetiological agent. C trachomatis may cause severe peritoneal infections with chronic ascites formation in the absence of liver disease in women with the Fitz-Hugh-Curtis syndrome. Prompt diagnosis and antibiotics lead to rapid cure.     

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.