北京地区285例女童外阴阴道炎性传播疾病相关病原体监测

Study on the pathogens correlated to sexually transmitted diseases in 285 pre-pubertal girls with vulvovaginitis in Beijing

目的探讨人生殖道易感支原体和沙眼衣原体、淋球菌等病原体与女童外阴阴道炎的关系,了解与性传播疾病(STD)相关病原体在女童外阴阴道炎感染病原中所占的比例。方法采集285例外阴阴道炎及128例健康对照组女童外阴拭子标本,采用nPCR技术对所有标本进行淋球菌(Ng)、沙眼衣原体(Ct)、解脲脲原体(Uu)、人型支原体(Mh)、生殖支原体(Mg)、发酵支原体(Mf)、穿透支原体(Mpe)检测。结果病例组的285例标本中,STD相关病原体阳性检出率为59.65%。单一病原体感染阳性检出率为37.54%;两种病原体混合感染阳性检出率为16.84%;三种病原体混合感染阳性检出率为5.26%。对照组128例标本中,7例为阳性检出标本.总检出率为6.25%,其中Uu 5例、Mh 2例。与对照组相比,Ng(P<0.01)、Ct(P<0.01)、Uu(P<0.01)、Mg(P<0.01)、Mf(P<0.05)、Mpe(P<0.01)在外生殖道的定植与女童外阴阴道炎的发生有相关性。结论一些与性传播疾病相关病原体是引起女童外阴阴道炎的主要病原体,并存在多病原体协同感染的情况。Mg、Mf、Ng在外生殖道的定植与季节有相关性。大环内酸类抗生素对儿童泌尿生殖道支原体、Ct感染的治疗有很好的临床疗效。

Objective To study the relationship between vulvovaginitis in pre-pubertal girls and pathogens as Chlamydi trachomatis （ Ct ）, N. gonorrhoeae （ Ng ）, Mycoplasrna , Ureaplasrna urealyticum （ Uu ）, Mycoplasma horninis （ Mh ） , M. genitalium （ Mg ）, M. fermentans （Mf） and M. penetrans （Mpe）, as well as to find out the proportion of mycoplasma which is correlated to sexually transmitted diseases （STD） and AIDS. Methods Vulvae swab specimens from 285 pre-pubertal girls with vulvovaglnitis （case group） and 128 healthy girls （control group） were collected and detected by nested polymerase chain reaction （nPCR） to identify the existence of pathogens as Ct, Ng, Uu , Mh , Mg, Mf and Mpe. nPCR with both high specificity and sensitivity, would not be influenced by the amount of pathogens in specimens or inactivated during the process of storage or transportation. Results The rate of detection on pathogens was 59.65 % in the 285 specimens from case group including ‘one kind of pathogen in one specimen＇ as 37.54% and ‘two kinds＇ as 16.84% and ‘three kinds＇ as 5.26%. However, in the 128 specimens from control group, the detectable rate of pathogen was 6.25 %. Relationships were found between Ng（P〈0.01）,Ct（P〈 0.01）, Uu（ P〈 0.01）,Mg（P〈 0.01）,Mf（P〈0.05）, Mpe（P〈 0.01） and vulvovaginitis in pre-pubertal girls. In control group the pathogens were detected from 7 specimens including 5 Uu and 2 Mh. Conclusion Some of the pathogens were correlated to STD and were important in causing vulvovaginitis in pre-pubertal girls. Vulvovaginltis might have been caused by more than one kind of pathogen in pre-pubertal girls. The locations of Mg, Mf and Ng in outer genital tracts were correlated to seasonal change. Macrolide seemed to be quite effective clinically in treating urogenital tract infection caused by mycoplasma and Ct.