Influence of sexual intercourse on genital tract microbiota in infertile couples

Several studies have suggested the association of disturbed genital tract microbiota with infertility. Our aim was to clarify the influence of sexual intercourse on partner’s genital tract microbiota in infertile couples. Seventeen couples were studied, and in 5 men inflammatory prostatitis (IP) was diagnosed. Semen samples were collected during menstruation of the female counterpart, two self-collected vaginal samples were taken 3–5 days later – before intercourse and 8–12 h after intercourse. Ureaplasma parvum was found in 59% of women, its prevalence was higher in women whose partner had IP, as well as in half of their male partners. Sexual intercourse caused significant shifts in vaginal microbiota – increase of Nugent score and shifts in cultured microbiota (emergence and disappearance of several species). These changes were less expressed in the presence of normal vaginal microbiota but more prominent in the partners of IP men. These changes may interfere with fertilization.     

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.     

Investigation on silent bacterial infections in specimens from pregnant women affected by spontaneous miscarriage

Miscarriage is one of the main complications occurring in pregnancy. The association between adverse pregnancy outcomes and silent bacterial infections has been poorly investigated. Ureaplasma parvum and urealiticum, Mycoplasma genitalium and hominis and Chlamydia trachomatis DNA sequences have been investigated by polymerase chain reaction (PCR) methods in chorionic villi tissues and peripheral blood mononuclear cells (PBMCs) from females with spontaneous abortion (SA, n = 100) and females who underwent voluntary interruption of pregnancy (VI, n = 100). U. parvum DNA was detected in 14% and 15% of SA and VI, respectively, with a mean of bacterial DNA load of 1.3 × 10⁻¹ copy/cell in SA and 2.8 × 10 ⁻³ copy/cell in VI; U. urealiticum DNA was detected in 3% and 2% of SA and VI specimens, respectively, with a mean DNA load of 3.3 × 10⁻³ copy/cell in SA and 1.6 × 10⁻³ copy/cell in VI; M. hominis DNA was detected in 5% of SA specimens with a DNA load of 1.3 × 10⁻⁴ copy/cell and in 6% of VI specimens with a DNA load of 1.4 × 10⁻⁴ copy/cell; C. trachomatis DNA was detected in 3% of SA specimens with a DNA load of 1.5 × 10⁻⁴ copy/cell and in 4% of VI specimens with a mean DNA load of 1.4 × 10⁻⁴ copy/cell. In PBMCs from the SA and VI groups, Ureaplasma spp, Mycoplasma spp and C. trachomatis DNAs were detected with a prevalence of 1%–3%. Bacteria were investigated, for the first time, by quantitative real-time PCR (qPCR) in chorionic villi tissues and PBMCs from women affected by SA and VI. These data may help to understand the role and our knowledge of the silent infections in SA.     

产后子宫内膜炎与围生期解脲脲原体感染有关

为了探讨围生期支原体感染与产后子宫内膜炎的关系及治疗,本研究选取产后子宫内膜炎患者73例作为观察组,同时选取正常产妇80例作为对照组。通过检测两组解脲脲原体(Uu)和人型支原体(Mh)感染情况,同时给予观察组常规治疗,本研究发现观察组Uu阳性比例为32.88%,明显高于对照组(p<0.05);观察组和对照组Mh阳性差异比较无统计学意义(p>0.05);观察组Uu阳性和Mh阳性产妇发生早产或胎膜早破的比例分别为62.50%和25.00%,明显高于支原体感染阴性产妇(p<0.05);观察组Uu阳性、Mh阳性和阴性患者治疗效果比较差异无统计学意义(p>0.05);观察组治疗后Uu阳性率为10.96%,明显较治疗前降低(p<0.05);观察组治疗前后Mh阳性率比较差异不显著(p>0.05)。本研究表明,Uu感染与产后子宫内膜炎发生有一定关系,围生期应加强Uu感染筛查,并及时进行治疗。     

Vaginal infection with Ureaplasma urealyticum accounts for preterm delivery via induction of inflammatory responses

U. urealyticum, a member of the family Mycoplasmataceae, is often detected in the vagina of pregnant women. In this study, the possible association of ureaplasmal infection with preterm delivery was examined, as was the capacity of ureaplasmal LP to stimulate monocytes in vitro to produce pro-inflammatory cytokines relevant to preterm delivery. A hundred cases of normal delivery and 45 cases of preterm delivery were randomly selected. A mAb against U. urealyticum urease, that selectively and positively stained it in vaginal secretions of infected women but not in those of uninfected women, was generated. The preterm delivery group showed a significantly higher incidence of vaginal infection with this bacteria than the normal delivery group. Since the LP of Mycoplasma has potent biological activity, ureaplasmal LP was extracted. THP-1 cells, and human monocytic cells, produced IL-8, a potent pro-inflammatory cytokine associated with preterm delivery, and showed apoptotic cell death in response to the LP in vitro. These results suggest that U. urealyticum infection might play a causative role in preterm delivery via LP-induced IL-8 production and apoptosis.     

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.     

550例支原体药敏结果分析

目的：了解本地区感染泌尿生殖系的解脲、人型支原体耐药情况。方法：对性病科和妇科门诊近3年来550例支原体感染者用支原体药敏试剂盒进行司巴沙星（SPA）、克拉霉素（CLA）、可乐必妥（CRA）、交沙霉素（JOS）、阿奇霉素（AZI）、罗红霉素（ROX）、强力霉素（DOX）、美满霉素（MIN）、氧氟沙星（ODL）、乙酰螺旋霉素（ASP）、四环素（TET）、红霉素（ERY）12种抗生素的药敏试验。结果：统计近3年耐药率,总计依次是4.2%、8.4%、10.4%、23.2%、23.8%、29.6%、29.6%、33.0%、43.1%、55.3%、61.9%、82.7%。结论：耐药率司巴沙星、克拉霉素、可乐必妥较稳定,基本低于10%,其余均较高且大部分呈逐年增长趋势,且解脲和人型支原体耐药性有较大差异。     

酶联免疫吸附试验夹心法检测解脲脲原体方法的建立

目的为了提高解脲脲原体(Ureaplasma urealyticum,UU)检测的快速性。方法用酶联免疫吸附试验(ELISA)夹心法检测UU抗原并与传统的培养法相比较。结果ELISA夹心法敏感度为92.6%,特异度为97.4%,最低能够检测出蛋白含量为5～10ng/ml的UU抗原。结论ELISA夹心法是一种敏感、方便、快捷、适合大规模标本检测解脲脲原体的方法。     

Vaginal Secretion Epithelium Count As a Prognostic Indicator of High Abundance of Ureaplasmas in Women with a Normal Nugent Score

Genital tract ureaplasma infections are associated with numerous complications, ranging from inflammation, through infertility, to problematic pregnancy. In the course of ureaplasma infection, the risk of human papillomavirus infection increases. Diagnostic tests for urea-plasma infections are not always carried out, especially in women with the normal Nugent test results. The study attempts to check whether it is possible to find a prognostic indicator that could suggest a high abundance of ureaplasmas (≥ 10⁴ CFU/ml) at the stage of the initial examination of vaginal discharge. Such a prognostic factor could qualify women for further tests to detect infections with these atypical bacteria. Six hundred twenty-seven white women with a score of 0–3 on the Nugent scale were tested, including 322 patients with a high abundance of ureaplasmas (≥ 10⁴ CFU/ml) and 305 who tested negative for these bacteria. Ureaplasma infections were detected statistically significant in women who had few or no epithelial cells in the genital swab specimens compared to the results obtained for women with numerous or very numerous epithelial cells (p < 0.001). The risk of the high density of ureaplasmas was 38.7% higher with fewer or no epithelial cells than with high numbers. In patients aged 18–40 years with few or no epithelial cells, a high density of ureaplasmas (≥ 10⁴ CFU/ml) was observed significantly more frequently (p = 0.003). Determining the number of epithelial cells in Gram-stained slides may be the prognostic indicator of ureaplasma infection. Testing for genital ureaplasma infection should be considered, especially in women of childbearing age (18–40 years), even if the Nugent test value is normal and pH ≤ 4.6.