不育症精液细菌感染分布特点及其对精液常规质量参数的影响

Distribution characteristics of pathogens and its influence on semen quality parameters in patients with male infertility

目的通过对男性不育症患者精液细菌培养,精液常规分析,了解男性不育症患者精液细菌感染率、菌种分布、细菌的耐药率以及细菌感染对精液常规各主要参数的影响。方法对来浙江中医药大学附属宁波中医院男科门诊就诊的325例不育症患者的精液进行细菌培养、鉴定及药敏分析,并采用北京伟力计算机辅助精子分析系统对精液进行常规分析,以了解精液细菌感染分布以及对精液常规各主要质量参数的影响。结果 325例男性不育症精液分离出127株细菌,感染率为39.1%,其中G^+球菌占59.9%,以葡萄球菌为主。G^-杆菌占22.0%,以大肠埃希菌为主。药敏分析发现,葡萄球菌对头孢菌素类、大环内酯类耐药率较高;大肠埃希菌对氨苄西林和复方新诺明耐药率较高。精液细菌各感染组与正常男性对照组对精子浓度、存活率、前向运动比率以及液化时间这四个质量参数进行比较,淋病奈瑟菌组的精子浓度较其他感染组显著降低(P<0.01);金黄色葡萄球菌组和大肠埃希菌组的精子存活率较其他感染组显著降低(P<0.01);金黄色葡萄球菌组、大肠埃希菌组和淋病奈瑟菌组的精子前向运动比率与其他感染组比较差异有统计学意义(P<0.01);大肠埃希菌组的液化时间较其他感染组延长(P<0.05)。结论男性不育症精液细菌培养以G^+球菌分离率较高,超过大肠埃希菌的分离率;各主要感染组中凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌以及淋病奈瑟菌对精液常规各主要参数的影响各有特点,需加以关注。

Objective To investigate the presence of bacteria in semen, strain distribution, bacterial resistance and the effects of bacterial infection on sperm analysis parameters. Methods The semen analysis, culture, identification and drug sensitivity tests were performed in 325 cases of masculine sterility in our hospital, and their influence on the sperm analy- sis parameters （spgrm concentration, survival rate, and forward movement ratio and liquefaction time ） was evaluated. Results A total of 127 strains of bacteria were isolated among 325 cases of male infertility with an infection rate of 39.1%, including G - cocci （ 59.9%, mainly Staphylococcus aureus ） and G - bacilli （ 22%, mainly Escherichia coli ）. Drug sensitivity analysis showed that cephalosporins and macrolides resistance in staphylococcus was high;Ampicillin and Cotrimoxazole resistance in Escherichia coli was high. The sperm concentration in Neisseria gonorrhoeae group were signif- icantly lower than that in the other infection groups （P 〈 0.01 ） ;The survival rate of sperm in the Staphylococcus aureus and Escherichia coli group was significantly lower than those in the other infection groups（ P 〈 0.01 ） ;The difference in the rate of forward movement were found in Staphylococcus aureus, Escherichia coli and Neisseria gonorrhoeae group when compared with the other infection groups（ P 〈 0.01 ）. The liquefaction time in the Escherichia coli group was longer than that of the other infection groups. Conclusions The positive rate of G^＋ cocci was higher than that of E. coli in bacterial culture of semen in male infertility patients ; the effects of coagulase negative staphylococcus aureus, staphylococcus au- reus,E, coli and gonorrhea neisseria bacteria on the semen analysis parameters has the characteristic respectively, and needed to be concerned.