生殖道支原体感染诊治专家共识

Consensus on the diagnosis and treatment of mycoplasma infection in genital tract

生殖道支原体感染是临床关注的热点问题,涉及多个学科。中国性学会性医学专业委员会生殖道感染学组组织多学科讨论,对临床支原体相关问题形成了共识。泌尿生殖道支原体存在无症状携带,以解脲支原体(U.urealyticum,Uu)为主,解脲支原体可分为微小脲原体和解脲支原体两种亚型,其中微小脲原体特别容易见于无症状携带。Uu和生殖支原体(M.genitalium,Mg)是导致尿道炎的重要致病微生物,Mg还是宫颈炎、盆腔炎的重要致病微生物。采用核酸分析的方法进行支原体检测更有利于支原体的诊治。如果男女双方均无泌尿生殖道感染的相关症状,仅Uu阳性,考虑为携带者,不必治疗。男性为Uu性尿道炎,建议同时治疗性伴。孕期下生殖道检出Uu的患者不需要进行干预和治疗。男性精液质量异常且有生育需求时,男女双方建议同时治疗一疗程。男女双方生殖道Uu培养阳性对IVF无明显影响。

Mycoplasma infection in genital tract is a hot issue,which involves many subjects. China Institute of Medical Professional Committee of the Reproductive Tract Infection Group forms a consensus on the diagnosis and treatment of mycoplasma. Urogenital mycoplasma has a state of asymptomatic carry,especially in Ureaplasma urealyticum（ Uu）. Uu can be divided into two subtypes of Ureaplasma parvum and Ureaplasma urealyticum,and Ureaplasma parvum can be easily found in asymptomatic carriers. Uu and M. genitalium（ Mg） is the important pathogen causing urethritis; Mg is an important pathogen of cervicitis and pelvic inflammatory disease. Nucleic acid analysis is a more favorable method for the diagnosis and treatment of mycoplasma. If there are no symptoms of urinary tract infection in both genders with Uu positive,it should be considered as a carrier and do not need treatment.If male is of Uu sex urethritis,the proposal is that sex partner should be treated at the same time. Patients with vaginal Uu during pregnancy do not need intervene and treatment. If male with abnormal semen quality have fertility requirements,both male and female need to be treated for a course of antibiotic. The positive of Uu has not significant effect either in women or in men during IVF- ET.