男性疑似泌尿生殖道感染患者支原体感染检出情况及与精液质量的关系

Association between Mycoplasma infection and semen quality of male patients with suspected urogenital tract infection

目的探究男性疑似泌尿生殖道感染患者支原体(MP)感染检出情况及与精液质量的关系。方法收集2021年1月-2023年12月在南阳市第一人民医院就诊,疑似泌尿生殖道感染的975例男性患者的临床资料,根据MP检测结果,分为阳性组298例和阴性组677例。采集患者尿道分泌物、精液、前列腺液或中段尿液,聚合酶链反应(PCR)检测MP,并对MP进行常规分离培养,行药敏试验;检测精液量、液化时间、精子活力、精子浓度、前向和非前向运动精子百分率。结果PCR检测共298例MP感染(30.56%)。2021年感染率为36.22%,2022年为32.28%,2023年为27.62%。其中218份样本分离培养,主要为解脲支原体(UU)感染(48.62%)、人型支原体(MH)感染(23.85%)和UU+MH感染(19.27%)。尿道分泌物样本分离率为83.77%,前列腺液样本分离率49.25%,精液样本分离率62.96%,中段尿液样本分离率61.54%。医院MP感染患者对环丙沙星、阿奇霉素和罗红霉素的耐药率较高,对多西环素、交沙霉素和米诺环素的敏感性较高。与阴性组比较,阳性组精液量、精子活力、精子浓度和前向运动精子百分率较低,液化时间较长(P<0.05)。两组非前向运动精子百分率比较,无统计学差异。结论医院泌尿生殖道MP感染以UU、MH和UU+MH为主,MP感染阳性者除控制感染外,也应关注其可能存在的不育问题。

OBJECTIVE To explore the relationship between the Mycoplasma(MP)infection and the semen quality of the male patients with suspected urogenital tract infection.METHODS The clinical data were collected from 975 male patients with suspected urogenital tract infection who were treated in Nanyang First People′s Hospital from Jan.2021 to Dec.2023.The patients were divided into the positive group with 298 cases and the negative group with 677 cases according to the result of MP test.The urinary tract secretions,semen,prostatic fluid or midstream urine specimens were collected from the patients,the MP was detected by means of polymerase chain reaction(PCR).Conventional isolation and culture were carried out for the MP,the drug susceptibility testing was performed.The volume of semen,liquefaction time,sperm motility,sperm concentration and percentages of forward and non-forward movement sperm were detected.RESULTS A total of 298(30.56%)cases of MP infection were detected by PCR.The infection rate was 36.22%in 2021,32.88%in 2022,27.62%in 2023.Totally 218 samples were cultered,48.62%of which were Ureaplasma urealyticum(UU),23.85%were Mycoplasma hominis(MH),and 19.27%were UU plus MH.The isolation rate of the urinary tract secretion specimens was 83.77%,the isolation rate of the prostatic fluid specimens was 49.25%,the isolation rate of the semen specimens was 62.96%,and the isolation rate of midstream urine specimens was 61.54%.The drug resistance rates of the patients with MP infection to erythromycin,azithromycin and erythromycin were high,while the drug susceptibility rates to doxycycline,josamycin and minocycline were high.The volume of semen,sperm motility,sperm concentration and percentage of forward movement sperm were lower in the positive group than in the negative group,and the liquefaction time of the positive group was longer than that of the negative group(P<0.05);there was no significant difference in the percentage of non-forward movement sperm between the two groups.CONCLUSIONS The patients with UU,MH and UU plus MH infections are dominant among the patients with urogenital tract MP infection.Apart from the control of infection,it is necessary to pay attention to the infertility that may happen to the MP-positive patients.