Effect of Fluoropyrimidines on the Growth of Ureaplasma urealyticum

In the present study, we investigated the effect of fluoropyrimidines on the growth of Ureaplasma urealyticum. Addition of fluoropyrimidines strongly inhibited bacterial growth. Growth inhibition by these analogues could be reversed by addition of either thymidine or deoxyuridine, suggesting inhibition of thymidylate biosynthesis as the mechanism in operation.     

泌尿生殖道支原体培养及耐药性差异分析

目的检测本地区人群泌尿生殖道溶脲脲原体（Uu）和人型支原体（Mh）感染的发生率;分析其对9种抗生素的药物敏感性差异,用以指导临床的抗生素治疗。方法采用法国生物梅里埃Mycoplasma IST2试剂盒对支原体进行分离培养鉴定和药物敏感性试验;分析2008—2013年本地区支原体感染患者耐药性的差异。结果在本地区8168例疑似NGU的患者中检出支原体2564例,阳性检出率为31．39％,其中仅uu感染的患者1833例（22．44％）,Uu和Mh混合感染的患者623例（7．63％）,仅Mh感染的患者108例（1．32％）。仅uu感染的患者对PRI、JOS、DOT、TET、CLA、AZI、ERY、OFL和CIP九种抗生素的敏感率分别为99．8％、99．4％、96．3％、91．9％、90．O％、89．7％、69．7％、4．O％和0．5％;Uu和Mh混合感染的患者对9种抗生素的敏感率分别为96．3％、96．1％、94．8％、79．5％、12．0％、11．7％、1．4％、1．0％和0．3％;仅Mh感染的患者对9种抗生素的敏感率分别为100％、100％、100％、90．7％、0％、0％、O％、14．8％和13．9％。结论本地区泌尿生殖道支原体感染以Uu感染最为常见,Uu和Mh混合感染次之,Mh感染最为少见;对支原体的抗生素治疗首选PRI、JOS、DOT;TET、AZI、CLA可适当使用,而ERY、OFL、CIP则不宜选用。     

Polymerase chain reaction–hybridization method using urease gene sequences for high-throughput Ureaplasma urealyticum and Ureaplasma parvum detection and differentiation

In this article, we discuss the polymerase chain reaction (PCR)–hybridization assay that we developed for high-throughput simultaneous detection and differentiation of Ureaplasma urealyticum and Ureaplasma parvum using one set of primers and two specific DNA probes based on urease gene nucleotide sequence differences. First, U. urealyticum and U. parvum DNA samples were specifically amplified using one set of biotin-labeled primers. Furthermore, amine-modified DNA probes, which can specifically react with U. urealyticum or U. parvum DNA, were covalently immobilized to a DNA–BIND plate surface. The plate was then incubated with the PCR products to facilitate sequence-specific DNA binding. Horseradish peroxidase–streptavidin conjugation and a colorimetric assay were used. Based on the results, the PCR–hybridization assay we developed can specifically differentiate U. urealyticum and U. parvum with high sensitivity (95%) compared with cultivation (72.5%). Hence, this study demonstrates a new method for high-throughput simultaneous differentiation and detection of U. urealyticum and U. parvum with high sensitivity. Based on these observations, the PCR–hybridization assay developed in this study is ideal for detecting and discriminating U. urealyticum and U. parvum in clinical applications.     

Emerging role for Ureaplasma parvum serovar 3: Active infection in women with silent high-risk human papillomavirus and in women with idiopathic infertility

Recently, there are controversial opinions on the presence of Mycoplasmas/Ureaplasmas as colonizers or pathogens, and on the use of a targeted therapy. This study aimed to characterize Mycoplasmas/Ureaplasmas infections in reproductive age women, including the acquisition of sexually transmitted (ST) pathogens and poor birth outcomes. A total of 646 healthy Italian women fulfilled the inclusion criteria including 521 infertile women, 65 pregnant women, and 60 fertile women with identified risk factors and symptomatic for vaginitis/cervicitis. Multiplex and quantitative molecular techniques and direct automatic DNA sequencing were performed to assess the genome structure of Mycoplasma/Ureaplasma species and ST infected pathogens. Ureaplasma parvum serovar 3 represented the predominant colonizer of the urogenital tract of this series and the unique species significantly associated with ST pathogens coinfection (p < 0.01). U. parvum load >10⁴ bacteria/ml, suggestive of active infection, has been measured only in asymptomatic high-risk human papillomavirus infected women (24.3%) and in 40% of women with idiopathic infertility. To note, 16% of the follicular fluid from these idiopathic women resulted infected with U. parvum. In conclusion, the present study focused the attention on U. parvum serovar 3 as emerging microorganism in sexually active women that may have the benefit of targeted therapy.     

解脲脲原体诱导脐静脉血管内皮细胞凋亡的研究

目的通过探讨解脲脲原体(Ureaplasma urealyticum,UU)诱导人脐静脉内皮细胞(human umbilicalvein endothelial cells;HUVEC)凋亡的情况,揭示妊娠期间UU垂直传播影响胚胎发育的可能机制。方法不同剂量血清4型UU标准菌株刺激体外培养的HUVEC,通过Annexin-V.FITC/PI双染流式细胞术和DNA Ladder实验观察细胞凋亡情况。结果对照组细胞凋亡率小于各实验组(P<0.01~0.05),其凋亡率和刺激剂量、时间之间呈现一定的剂量-时间-效应关系(P>0.05)。结论UU可诱导人脐静脉内皮细胞凋亡,提示妊娠期间UU感染可能通过诱导脐静脉内皮细胞凋亡破坏胎盘屏障而影响胚胎发育。     

UU1、UU3和UU4致昆明小鼠下生殖道致病性的研究

目的:研究解脲脲原体(Ureaplasma Urealyticum,UU)的第1血清型(UU1)、第3血清型(UU3)和第4血清型(UU4)对昆明小鼠下生殖道的致病性。方法:将100只昆明小鼠随机分为5组:空白组、雌二醇组、UU1组、UU3组和UU4组,每组20只;空白组和雌二醇组为对照组,UU1组、UU3组和UU4组为实验组;雌二醇组和实验组雌二醇化后1周,将UU1、UU3和UU4分别接种至UU1、UU3和UU4组小鼠泌尿生殖道,将液体培养基接种至空白组和雌激素组。2周后检测各组小鼠泌尿生殖道的IL-8、SIgA、TNF-α并取小鼠子宫组织行病理检查。结果:实验组小鼠UU接种都获得成功。IL-8、SIgA、TNF-α检测结果显示:实验组和对照组比较有显著性差异;UU4组和UU1组及UU3组比较有显著性差异;空白组和雌二醇组比较无显著性差异;UU1组和UU3组比较无显著性差异。病理显示:UU1、UU3和UU4组昆明小鼠子宫组织有炎细胞浸润,UU4组小鼠宫颈病变更明显。对照组小鼠子宫未见明显改变。结论:UU1、UU3和UU4可能导致昆明小鼠下生殖道产生病理反应;UU4可能短期致病力更强。     

女性泌尿生殖道支原体感染及耐药性分析

目的通过分析深圳市人民医院2009年9月至2010年4月女性泌尿生殖道支原体感染状况及耐药性变迁,指导临床合理用药。方法采用法国生物梅里埃公司MyeoplasmaIST2支原体鉴定及药敏试剂盒,进行支原体检测及药敏分析。结果2135例患者总检出率为54．6％（1166／2135）,其中解脲脲支原体（Uu）阳性1017例（47．6％）;人型支原体（Mh）阳性32例（1．5％）;Uu＋Mh阳性117例（5．5％）。1166例患者支原体对9种抗生素够感性依次为原始霉素（99．8％）、交沙霉素（99．6％）、强力霉素（96．3％）、四环素（94．4％）、克拉霉素（85．6％）、阿奇霉素（77．6％）、红霉素（75．6％）、氧氟沙星（28．4％）和环丙沙星（22．8％）。结论支原体（尤其是Uu）感染已成为女性泌尿生殖系统炎症的主要病原体之一,治疗支原体感染应选择原始霉素、交沙霉素、强力霉素等敏感率高的药物及药敏试验显示敏感的药物,喹诺酮类药物耐药率较高,应引起临床重视。     

Trends in the rates of resistance of Ureaplasma urealyticum to antibiotics and identification of the mutation site in the quinolone resistance-determining region in Chinese patients

The resistance of Ureaplasma urealyticum to antibacterials, isolated from 804 patients from the outpatient clinic of the Sir Run Run Shaw Hospital Hangzhou, China, from March to June over six consecutive years (1999-2004) was reviewed. The quinolone resistance-determining region of six strains of U. urealyticum was analyzed. The level of resistance to doxycycline, josamycin, tetracycline, azithromycin, clarithromycin and pristinamycin was below 20% and did not change during the study period. The rate of resistance to fluoroquinolones (ofloxacin, ciprofloxacin) was much greater than these (>50%) and has increased since 1999. The rate of resistance to Erythromycin decreased from 63.9% in 1999 to about 20% from 2000 onwards. The widespread use of fluoroquinolones had led to high resistance rates in U. urealyticum and the emergence of quinolone resistance. Analysis of the gene sequence of topoisomerase IV and DNA gyrase suggested a role for the topoisomerase IV ParE subunit in fluoroquinolone-resistant U. urealyticum.     

女性生殖道炎症支原体多重耐药性分析

了解本地区在采用常规抗生素治疗支原体后多重耐药株的产生情况,为临床针对性用药提供科学依据。采用培养法对女性生殖道炎患者分泌物进行支原体培养、体外药敏试验及分析。结果可见,感染数量≥10~4 cfu/mL的支原体阳性率为52.9%(82/155);13种抗生素中,耐药种数构成比为6R>2R、4R、5R>3R>1R>8R>7R、10R>0R>9R、12R、13R;耐药率为林可霉素>壮观霉素>环丙沙星>诺氟沙星>司帕沙星>罗红霉素>氧氟沙星>克拉霉素>左氧氟沙星>阿齐霉素>强力霉素,美满霉素>交沙霉素。体外药敏试验对临床治疗支原体感染及减少多重耐药株的产生具有重要指导意义。