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。     

性病患者泌尿生殖系病原体感染分析

目的 结合临床分析医院性病门诊具有泌尿生殖道刺激症状及异常分泌物患者的淋球菌(NG)、沙眼衣原体(CT)和解脲脲原体(UU)的感染状况,为临床治疗提供依据.方法 对门诊283例患者标本作NG、CT、UU检测,其中UU、CT采用新型快速试剂盒检测;NG检测采用分泌物涂片、染色、镜检,可疑者再用培养法确证.结果 三种病原体总感染率为62.19％(176/283),单一感染占39.22％(111/283),混合感染占22.97％(65/283),混合感染中以CT+ UU感染(13.07％)为主;男、女感染率分别为59.65％和66.07％,患者年龄集中在21 ～40岁,以31 ～40岁组阳性病例数最多(35.34％);职业分布:病例数最多的是无业人员(45.58％),其次为工人、干部.非淋菌性尿道(宫颈)炎(NGU)和淋病(GU)的阳性检出率分别为46.64％和15.54％.结论 NGU和GU的的感染以性成熟期患者为主,NGU发病率高,应引起高度重视.     

妇科千金片联合抗生素治疗慢性盆腔炎的临床疗效观察

目的:评价妇科千金片联合抗生素治疗慢性盆腔炎的疗效。方法:对照组选用抗生素治疗,观察组在此基础上加用妇科千金片治疗。同时对两组患者治疗前后血液流变学、血清C-反应蛋白检测及局部体征进行评价。结果:对照组、治疗组总有效率分别为71.43%、92.86%;治疗组疗效优于对照组(P<0.05)。两组均可使异常升高的血液流变学、血清C-反应蛋白指标降低,但治疗组明显优于对照组,两组间比较有显著性差异(P<0.05)。结论:运用妇科千金片联合抗生素治疗慢性盆腔炎疗效显著,能改善全身及盆腔的血液循环,改善组织营养,提高机体的新陈代谢,有利于盆腔炎性分泌物的消散和吸收,从而达到治疗的目的。     

泌尿生殖道支原体感染及其药物抗性频度研究

目的了解本地区支原体引起泌尿生道感染的状况及其药物抗性频度,为临床治疗支原体感染提供参考依据.方法取男性尿道分泌物或前列腺液和女性宫颈分泌物,应用Mycoplasma IST综合试剂盒进行支原体定量培养鉴定和药物抗性频度试验,同时检测沙眼衣原体(CT)、白色念珠菌和淋球菌(NG).结果2 023例泌尿生殖道感染患者中,747例支原体培养阳性,阳性率36.93%; 其中女性为40.16%,男性为23.04%,两者差异有非常显著性(P＜0.01);解脲支原体 (UU)感染(410例,20.27%)显著高于人型支原体(MH)感染(29例,1.43%)和UU+MH混合感染( 308例,15.22%)(P＜0.01).各年龄组支原体感染率,以18～37岁年龄段最高,年龄组间差异有非常显著性 (P＜0.01).747例支原体感染患者中,合并CT感染59例,占7 .90%,合并白色念珠菌感染 81例,占10.84%;合并NG感染39例,占5.22%.药物抗性频度研究结果显示对红霉素的抗药频率最高,占65.21%,对氧氟沙星和四环素的抗药频率次之,分别为28.53%和11.09%,对强力霉素、原始霉素和交沙霉素的抗药频较低,分别为 4.74%、4.17%和1.52%.比较MH 和UU对6种抗生素的药物抗性频度,MH均显著高于UU(P ＜0.01).结论支原体是引起泌尿生殖道感染的主要病原体之一,交沙霉素和强力霉素应作为本地区目前临床治疗泌尿生殖道支原体感染的首选抗生素.在诊断疾病时,要注意混合感染的可能性.     

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。     

育龄期女性解脲支原体感染后阴道微生态和Th17细胞及相关炎性因子的变化

目的研究育龄期女性解脲支原体(UU)感染后阴道微生态变化及其宫颈Th17细胞免疫及其炎性因子的关系。方法研究对象来源自我院进行检测的育龄期女性,年龄为(24~45)岁。取女性宫颈分泌物进行微生物培养检测并阴道微生态分析,流式细胞术检测Th17细胞数量,ELISA检测炎性相关细胞因子的浓度。结果对照组中检测到76例UU阳性患者,阳性率38.0%;观察组155例UU阳性患者,阳性率77.5%(χ~2=63.946,P0.001)。血清型分析发现UU血清型1、血清型2、血清型6、血清型9和混合型在观察组的患者数量明显高于和对照组,未能分型则没有明显差异。Th17细胞及分泌的相关细胞因子比较发现UU检测阳性患者IL-4、IL-17以及TGF-β的浓度明显高于阴性患者(P0.001),IL-10和IL-6未发现明显差别。最后,阴道微生态分析发现UU阳性患者的菌群多样性、菌群密度和阴道酸性正常的比例明显低于阴性患者,而微生态失调分析发现UU阳性患者比例明显高于阴性患者(P0.05)。结论育龄期女性UU感染会使阴道微生态发生变化,其宫颈Th17细胞及其炎性因子明显上升。说明育龄期女性UU感染会出现炎性反应。导致宫颈疾病的发生,应该密切关注。     

生殖道感染与宫颈癌及宫颈癌前病变的相关性研究

目的:探讨生殖道感染与宫颈癌、宫颈癌前病变的相关性及危险因素分析。方法:选取我院收治的185例宫颈癌及宫颈癌前病变患者和同期206例健康体检者分为两组,对人乳头瘤病毒(HPV)、沙眼衣原体(CT)、细菌性阴道病(BV)、阴道滴虫进行检测,观察分析相应病原微生物导致的生殖道感染与宫颈癌及宫颈癌前病变的关系,同时根据HPV不同基因型在宫颈癌及宫颈癌前病变中的致癌作用和程度,判定危险程度。结果:宫颈癌及宫颈癌前病变患者上述指标感染检出率明显高于对照组,差异具有统计学意义(P=0.000、0.001、0.000、0.037),其中高危HPV感染率随宫颈上皮内瘤变级别的升高而呈明显上升趋势,CINⅠ～Ⅲ级感染率分别为57.1%、78.6%和82.9%,宫颈癌感染率最高达91.1%,高危HPV为高危因素。结论:生殖道HPV、CT、BV、滴虫感染与宫颈癌及CIN存在必然或一定相关性,加强对妇女生殖道病原体感染的重视和检测对防治宫颈癌及CIN具有积极意义。     

合肥市孕期妇女阴道分泌物湿片镜检与五项生化检验结果分析

目的探查合肥地区孕期妇女生殖道感染特点,为临床诊断提供参考。方法选取2017年11月-2018年9月来我院行孕期检查的孕妇969例,采集阴道分泌物分别进行镜检和五联检法联合检测,分析孕妇分泌物清洁度及病原结果。结果 969例孕妇阴道分泌物中,正常清洁度(Ⅰ～Ⅱ)占标本总数36.22%,病原体检出率6.84%,异常清洁度(Ⅲ～Ⅳ)占标本总数63.78%,病原体检出率44.66%,不同清洁度病原体检出率差异有统计学意义(Ps0.05)。病原体阳性者300例,其中真菌感染158例(16.31%),细菌感染157例(16.20%),毛滴虫感染5例(0.52%),混合感染20例(2.06%)。清洁度Ⅰ～Ⅱ度白细胞酯酶、唾液酸苷酶、脯氨酸氨基肽酶阳性率分别为17.23%、0.52%、0.93%,清洁度Ⅲ～Ⅳ度白细胞酯酶、唾液酸苷酶、脯氨酸氨基肽酶阳性率分别为61.40%、8.36%、17.34%,检测结果差异有统计学意义(Ps0.05)。结论合肥地区孕妇阴道分泌物病原体检出率较高,湿片镜检和五联检法联合检测可提高阴道炎诊断的准确性,在临床工作中应加强对孕期妇女的健康指导及生殖道感染的监测,做到早发现、早诊断、早治疗。     

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。     

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.     

Characteristics of Vaginal Microbiome in Women with Pelvic Inflammatory Disease in Korea

Human vaginal microorganisms play an important role in maintaining good health throughout the human life cycle. An imbalance in the vaginal microbiota is associated with an increased risk of pelvic inflammatory disease (PID). This study aimed to characterize and compare vaginal microbial profiles of premenopausal Korean women with and without PID. 74 Korean premenopausal female vaginal samples were obtained; 33 were from healthy women (a control group) and 41 from PID patients. Vaginal fluid samples were collected from the vaginal wall and posterior cervix and then analyzed by 16S ribosomal ribonucleic acid (rRNA) gene-based amplicon sequencing. Results showed a significant difference between the vaginal microbial communities of the two groups (Jensen-Shannon, p = 0.014; Bray-Curtis, p = 0.009; Generalized UniFrac, p = 0.007; UniFrac, p = 0.008). Lactobacillus accounted for the highest percentage (61.0%) of the control group but was significantly decreased (34.9%) in PID patients; this was the most significant difference among all bacterial communities (p = 0.028, LDA effect size = 5.129). In addition, in the PID patient group, species diversity significantly increased (Simpson, p = 0.07) as the proportion of various pathogens increased evenly, resulting in a polymicrobial infection. Similarly, lactate, which constituted the highest percentage of the organic acids in the control group, was significantly decreased in the PID patient group (p = 0.04). The present study’s findings will help understand PID from the microbiome perspective and are expected to contribute to the development of more efficient PID diagnosis and treatment modalities.     

Local adaptation in the Linum marginale-Melampsora lini host-pathogen interaction

The potential for local adaptation between pathogens and their hosts has generated strong theoretical and empirical interest with evidence both for and against local adaptation reported for a range of systems. We use the Linum marginale-Melampsora lini plant-pathogen system and a hierarchical spatial structure to investigate patterns of local adaptation within a metapopulation characterised by epidemic dynamics and frequent extinction of pathogen populations. Based on large sample sizes and comprehensive cross-inoculation trials, our analyses demonstrate strong local adaptation by Melampsora to its host populations, with this effect being greatest at regional scales, as predicted from the broader spatial scales at which M. lini disperses relative to L. marginale. However, there was no consistent trend for more distant pathogen populations to perform more poorly. Our results further show how the coevolutionary interaction between hosts and pathogens can be influenced by local structure such that resistant hosts select for generally virulent pathogens, while susceptible hosts select for more avirulent pathogens. Empirically, local adaptation has generally been tested in two contrasting ways: (1) pathogen performance on sympatric versus allopatric hosts; and (2) sympatric versus allopatric pathogens on a given host population. In situations where no host population is more resistant or susceptible than others when averaged across pathogen populations (and likewise, no pathogen population is more virulent or avirulent than others), results from these tests should generally be congruent. We argue that this is unlikely to be the case in the metapopulation situations that predominate in natural host-pathogen interactions, thus requiring tests that control simultaneously for variation in plant and pathogen populations.     

Mycoplasmal PID: a review of natural and experimental infections

The present report is a review of data assuming an etiological relationship between pelvic inflammatory disease (PID) and Mycoplasma hominis. Thus the organism can be isolated from the vagina/cervix more frequently in PID patients than in any other clinical group, i.e., in half to three-fourths of all such cases. One-fourth of PID patients develop a significant antibody response to M. hominis during the course of the disease. The antibody response can be detected by indirect hemagglutination tests. Grivet monkeys infected experimentally with M. hominis develop PID, predominantly parametritis; the infection seems to spread via lymphatics to the parametria. These animals develop a significant antibody response. The animals, like naturally infected women, develop a marked increase in the serum level of IgM. In tissue cell cultures of human fallopian tubes experimentally infected with M. hominis, a decrease of the mucociliary wave activity occurs. So far, few clinical data support an etiological role for Ureaplasma urealyticum in PID. In grivet monkeys, the organism does not produce PID.     

Transection of the pelvic or vagus nerve forestalls ripening of the cervix and delays birth in rats

Innervation of the cervix is important for normal timing of birth because transection of the pelvic nerve forestalls birth and causes dystocia. To discover whether transection of the parasympathetic innervation of the cervix affects cervical ripening in the process of parturition was the objective of the present study. Rats on Day 16 of pregnancy had the pelvic nerve (PnX) or the vagus nerve (VnX) or both pathways (PnX+VnX) transected, sham-operated (Sham) or nonpregnant rats served as controls. Sections of fixed peripartum cervix were stained for collagen or processed by immunohistochemistry to identify macrophages and nerve fibers. All Sham controls delivered by the morning of Day 22 postbreeding, while births were delayed in more than 75% of neurectomized rats by more than 12 h. Dystocia was evident in more than 25% of the PnX and PnX+VnX rats. Moreover, on prepartum Day 21, serum progesterone was increased severalfold in neurectomized versus Sham rats. Assessments of cell nuclei counts indicated that the cervix of neurectomized rats and Sham controls had become equally hypertrophied compared to the unripe cervix in nonpregnant rats. Collagen content and structure were reduced in the cervix of all pregnant rats, whether neurectomized or Shams, versus that in nonpregnant rats. Stereological analysis of cervix sections found reduced numbers of resident macrophages in prepartum PnX and PnX+VnX rats on Day 21 postbreeding, as well as in VnX rats on Day 22 postbreeding compared to that in Sham controls. Finally, nerve transections blocked the prepartum increase in innervation that occurred in Sham rats on Day 21 postbreeding. These findings indicate that parasympathetic innervation of the cervix mediates local inflammatory processes, withdrawal of progesterone in circulation, and the normal timing of birth. Therefore, pelvic and vagal nerves regulate macrophage immigration and nerve fiber density but may not be involved in final remodeling of the extracellular matrix in the prepartum cervix. These findings support the contention that immigration of immune cells and enhanced innervation are involved in processes that remodel the cervix and time parturition.     

临时多性伴接触者病原体感染分析

目的了解临时多性伴接触者病原体的感染情况。方法对2005年5月至2008年5月于我科门诊就诊的临时多性伴接触者进行病原体检测并分析病种特点。结果临时多性伴接触者病原体感染的阳性率为65．3％,2种以上病原体混合感染阳性率为31．4％,病原体以解脲脲原体为最高,人型支原体阳性率最低;病种以非淋菌性尿道炎、尖锐湿疣及梅毒为主。结论临时多性伴接触者容易感染病原体,混合性感染增多,病种以非淋菌性尿道炎、尖锐湿疣及梅毒为主。     

Amplification of DNA of Xanthomonas axonopodis pv. citri from historic citrus canker herbarium specimens

Herbaria are important resources for the study of the origins and dispersal of plant pathogens, particularly bacterial plant pathogens that incite local lesions in which large numbers of pathogen genomes are concentrated. Xanthomonas axonopodis pv. citri (Xac), the causal agent of citrus bacterial canker disease, is a notable example of such a pathogen. The appearance of novel strains of the pathogen in Florida and elsewhere make it increasingly important to understand the relationships among strains of this pathogen. USDA-ARS at Beltsville, Maryland maintains approximately 700 herbarium specimens with citrus canker disease lesions up to 90 years old, originally collected from all over the world, and so is an important resource for phytogeographic studies of this bacterium. Unfortunately, DNA in herbarium specimens is degraded and may contain high levels of inhibitors of PCR. In this study, we compared a total of 23 DNA isolation techniques in combination with 31 novel primer pairs in order to develop an efficient protocol for the analysis of Xac DNA in herbarium specimens. We identified the most reliable extraction method, identified in terms of successful amplification by our panel of 31 primer pairs. We also identified the most robust primer pairs, identified as successful in the largest number of extracts prepared by different methods. We amplified Xac genomic sequences up to 542 bp long from herbarium samples up to 89 years old. Primers varied in effectiveness, with some primer pairs amplifying Xac DNA from a 1/10,000 dilution of extract from a single lesion from a citrus canker herbarium specimen. Our methodology will be useful to identify pathogens and perform molecular analyses of bacterial and possibly fungal genomes from herbarium specimens.     

Herbivore and pathogen effects on tree growth are additive,but mediated by tree diversity and plant traits

Herbivores and fungal pathogens are key drivers of plant community composition and functioning. The effects of herbivores and pathogens are mediated by the diversity and functional characteristics of their host plants. However, the combined effects of herbivory and pathogen damage, and their consequences for plant performance, have not yet been addressed in the context of biodiversity–ecosystem functioning research. We analyzed the relationships between herbivory, fungal pathogen damage and their effects on tree growth in a large‐scale forest‐biodiversity experiment. Moreover, we tested whether variation in leaf trait and climatic niche characteristics among tree species influenced these relationships. We found significant positive effects of herbivory on pathogen damage, and vice versa. These effects were attenuated by tree species richness—because herbivory increased and pathogen damage decreased with increasing richness—and were most pronounced for species with soft leaves and narrow climatic niches. However, herbivory and pathogens had contrasting, independent effects on tree growth, with pathogens decreasing and herbivory increasing growth. The positive herbivory effects indicate that trees might be able to (over‐)compensate for local damage at the level of the whole tree. Nevertheless, we found a dependence of these effects on richness, leaf traits and climatic niche characteristics of the tree species. This could mean that the ability for compensation is influenced by both biodiversity loss and tree species identity—including effects of larger‐scale climatic adaptations that have been rarely considered in this context. Our results suggest that herbivory and pathogens have additive but contrasting effects on tree growth. Considering effects of both herbivory and pathogens may thus help to better understand the net effects of damage on tree performance in communities differing in diversity. Moreover, our study shows how species richness and species characteristics (leaf traits and climatic niches) can modify tree growth responses to leaf damage under real‐world conditions.     

Evolution of acuteness in pathogen metapopulations: conflicts between “classical” and invasion-persistence trade-offs

Classical life-history theory predicts that acute, immunizing pathogens should maximize between-host transmission. When such pathogens induce violent epidemic outbreaks, however, a pathogen’s short-term advantage at invasion may come at the expense of its ability to persist in the population over the long term. Here, we seek to understand how the classical and invasion-persistence trade-offs interact to shape pathogen life-history evolution as a function of the size and structure of the host population. We develop an individual-based infection model at three distinct levels of organization: within an individual host, among hosts within a local population, and among local populations within a metapopulation. We find a continuum of evolutionarily stable pathogen strategies. At one end of the spectrum—in large well-mixed populations—pathogens evolve to greater acuteness to maximize between-host transmission: the classical trade-off theory applies in this regime. At the other end of the spectrum—when the host population is broken into many small patches—selection favors less acute pathogens, which persist longer within a patch and thereby achieve enhanced between-patch transmission: the invasion-persistence trade-off dominates in this regime. Between these extremes, we explore the effects of the size and structure of the host population in determining pathogen strategy. In general, pathogen strategies respond to evolutionary pressures arising at both scales.     

性传播疾病性尿道炎后慢性前列腺炎病原学分析

目的：了解性传播疾病(sexually transmitted disease,STD)性尿道炎后慢性前列腺炎患者前列腺液(expressed prostatic secretion,EPS)标本中病原体的感染状况及对常用抗菌药物的敏感性。方法：对性传播疾病后慢性前列腺患者的EPS进行病原体检测和药敏试验。结果：126例患者中96例分离出病原体115株,阳性率为76．2％。主要病原体为金黄色葡萄球菌(20．0％)、解脲支原体(18．3％)、表皮葡萄球菌(14．8％)和淋球菌(13．9％),混合感染率达15．1％。药敏试验显示解脲支原体对四环素、红霉素和氧氟沙星耐药,而对原始霉素、强力霉素和交沙霉素敏感。葡萄球菌属对万古霉素、呋喃妥因和头孢唑啉最为敏感。结论,提示EPS的病原体检测对临床诊断和治疗性传播疾病后慢性前列腺炎具有重要意义。     

457株尿路感染的病原菌及其耐药性研究

目的了解尿路感染的病原菌分布及耐药情况,为临床合理用药提供依据。方法用VITEK-AMS微生物自动分析仪鉴定菌种和药敏试验,同时对大肠埃希菌和肺炎克雷伯菌进行ESBLs检测,对肠球菌进行氨基糖苷类高水平耐药（HLAR）的筛选。结果尿路感染以大肠埃希菌检出率最高（50．5％）其余依次为肠球菌属（10．5％）,克雷伯菌属（8．6％）,真菌（7．9％）等,大肠埃希菌和肺炎克雷伯菌ESBLs检出率分别为24．2％和17．9％,HLAR肠球菌检出率为60．4％．尿路感染病原菌对喹诺酮类等常用药物的耐药性较高。结论明确尿路感染的病原菌及其耐药性对合理使用抗生素具有重要意义。