An Intervention Study of Reproductive Tract Infections among Married Women of Reproductive Age in Shanghai

Objective To evaluate the impacts of reproductive tract infections （RTIs） intervention on RTIs-related knowledge, attitudes, practices and prevalence of married women at reproductive age. Methods Four sub-districts from Xuhui district, Shanghai were selected by multistage cluster random sampling and residence committees were randomly assigned to either an intervention group or a control one. RTIs intervention was implemented in intervention group, while routine family planning program was conducted in control group. Results Compared with control group, intervention group have improved the following targets： the increment of RTI knowledge score was higher than that in control group （OR=9. 22, 95%CI： 7.01 - 2.14）; the increment score of individual health behaviors （6. 31） was higher than that in control group （4.50） （OR=1.60, 95%CI： 1.21 -2.10）; the increase of condom use frequency in intervention group was higher than that in control group （4.12% vs 0.69%） （OR=1.84, 95%CI： 1.31-2.57）; the decreased RTIs rate was higher than that in control group （7.45% vs 0.96%） （OR=0.68, 95%CI： 0.49-0.95）. Conclusion It is an effective way to conduct community-based intervention to increase women＇s RTIs knowledge, improve RTIs-related attitudes, promote good individual health behaviors, so as to decrease RTIs prevalence.

Etiopathogenesis of reproductive tract infections and the emerging role of bitter taste receptors:A scoping review

Reproductive tract infections pose an immense public health concern worldwide as over 600 million new cases are recorded annually along with several complications,including infertility,ectopic pregnancy,preterm delivery,and neonatal death.Despite improved understanding of the mechanisms of pathogenic invasion,the etiopathogenesis of reproductive tract infections is yet to be completely understood.Recent data has suggested a critical role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections.Here,we review the literature on current etiopathogenesis of reproductive tract infections and the role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections.Emerging evidence suggests a critical role of microbiota disorder of the reproductive tract in reproductive tract infections.Several bacterial,protozoan parasitic,helminthic parasitic and viral pathogens have been identified as causative agents of reproductive tract infections.These pathogens subvert host defenses and activate specific architectural units of the uroepithelium such as Toll-like receptors,which recognize conserved motifs on the pathogens.The activated Toll-like receptors mediate downstream signaling,stimulating nuclear factor-κB,which in turn activates the production of proinflammatory cytokines.This pathway is also associated with recruitment of immunocytes to the site of aggression and release of proteinases,which drive tissue damage in the reproductive tract.Defects in detection of pathogenic components by the bitter taste receptors of the reproductive tract may play a critical role in the etiopathogenesis of reproductive tract infections.This review provides important information for identification of novel frontiers for the treatment of reproductive tract infections.

Prevalence and risks of reproductive tract infections among women of urban slums in North India: A cross-sectional study

Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.

A Study on Isolation and Antibiotic Sensitivity Testing of Pseudomonas aeruginosa Isolated from Patients with Respiratory Tract Infection with Special Reference to Phenotypic and Genotypic Characterization of Extended Spectrum Beta Lactamases (ESBL)

Backgrounds: Pseudomonas aeruginosa is a classic opportunistic pathogen with innate resistance to many antibiotics and disinfectants. The lung is a main target for colonization and infection by the bacteria either in the context of a chronic, progressively deteriorating infectious and inflammatory pulmonary disease such as cystic fibrosis (CF) or in a more acute setting such as severe pneumonia in immunocompromised patients [1]. Aim and Objectives: To study the prevalence, virulence and the resistance pattern, phenotypic and genotypic characterization of P. aeruginosa from sputum samples. Materials and Methods: The present study was carried out with a total of 500 clinical sputum samples, which were received from patients, admitted to the various departments of Rajah Muthiah Medical College & Hospital, Annamalai University, Chidambaram. Result: Of the 500 samples subjected for isolation and identification of P. aeruginosa, 116 (23.20%) were positive. The isolated strains were tested for antibiotic sensitivity patterns. 93.10% of P. aeruginosa showed a maximum sensitivity to Ofloxacin, Norfloxacin and 86.20% of strains were highly resistant to Cefotaxime. The same isolates were also tested for phenotypic characterization of Extended Spectrum of Beta Lactamases by double disc synergy method against Cefotaxime and Clavulanic acid, according to the criteria of Hi-Media [2]. Of the resistant strains of P. aeruginosa isolated from sputum, 59% were positive for ESBL. The genotype characterization of ESBL P. aeruginosa showed 40% of CTX-M and 46.66% SHV gene. Conclusion: The present study strongly recommends for further checking of the antibiotic resistant strains of P. aeruginosa for phenotypic characterization of ESBL for effective treatment.

陕西省眉县和华阴县农村已婚育龄妇女RTI/STD患病现状及影响因素分析

目的了解陕西省眉县和华阴县农村已婚育龄妇女生殖道感染及性传播疾病(RTI/STD)患病现状及影响因素。方法采用分层整群抽样方法抽取陕西省眉县和华阴县共4304例已婚育龄妇女进行RTI/STD的患病现状、相关知识和行为现况调查。结果RTI/STD总患病率为63.80%,慢性宫颈炎的患病率为60.84%,霉菌、滴虫、尖锐湿疣总患病率为8.20%。RTI/STD患病的影响因素有年龄、宗教信仰、家庭经济水平、丈夫外出打工时间、生育活产数、自然流产史、避孕方式、夏天洗澡地点、冬天洗澡周期、夫妻性生活周期。结论陕西省眉县和华阴县农村已婚育龄妇女RTI/STD患病率处于全国较高水平,家庭经济水平、个体婚育特征和卫生习惯是RTI/STD患病的主要影响因素。

社区健康促进对农村妇女RTI防治的影响

目的：探讨针对性强、妇女乐意接受的RTI防治社区健康促进干预措施,降低妇女生殖道感染的发生率,提高目标人群和社区的健康水平及生活质量。方法：运用小组讨论和问卷调查方法将弥勒、陇川两县6个样本村的18-49岁2 020名农村育龄妇女作为研究对象,进行了健康教育需求评估;开发出了农村妇女喜看易懂的健康教育及教学材料;采用逐级参与式培训的方法,培训出本土的健教人员,提供持续性的服务;开展了以促进农村社区群众健康为目标,社区及群众共同参与、灵活生动、新颖有效、形式多样、参与性强的健康促进活动。结果：样本村在项目实施后,社区妇女对生殖道感染疾病防治知识知晓率、健康行为形成率均发生了明显变化,生殖道感染患病率有所下降。结论：多部门合作、形式多样、参与性强、综合干预的健康促进活动,及为本地留下一支不走的健康教育队伍,既可提高健康教育效果,又能提高社区及妇女控制疾病、增进健康的能力,有利于整合当地的各种资源,不断提高社区居民的健康水平,不失为一种较有效的干预方式。

Current Situations of the Integration of RTIs Prevention and Treatment into Routine FP Program

Objective To understand the current situation of the integration of reproductive tract infections （RTIs） prevention and treatment into routine Family planning （FP） program. Methods Literature review, in depth interview and focus group discussion were employed to collect the related information. Questionnaire survey was conducted in 59 county level FP facilities. Results Both central and local governments provide policy supports to RTIs prevention and treatment. Nearly 98.3% of local FP facilities had integrated this work into their routine FP program. A comprehensive network system of family planning has been established in China and there were plenty of FP human resources. The existing FP resource should be effectively used, which could produce great social benefit if RTIs prevention and treatment be integrated into routine FP program. However, some problems still need to be solved in the integrated program, such as insufficient finance support, low quality of service, lack of co-operations between different sectors, etc. Conclusion It is possible and feasible to develop RTIs controlling projects in the family planning system. However, intensive training and close cooperation need to be applied respectively into FP staffs and relative departments.

Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India

Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itching/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915];p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424];p < 0.001) for secondary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733];p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887];p = 0.018) were associated with lesser odds of presenting with an STD symptom. Belonging to a minority religious community (AOR: 7.20 [CI: 1.866 - 48.251];p < 0.012) or backward castes (AOR: 3.753 [CI: 1.587 - 10.144];p < 0.001), having similar illness (AOR: 4.205 [CI: 2.795 - 6.439];p < 0.001) or having an invasive gynecological procedure done in the past one year (AOR: 1.953 [CI: 1.184 - 3.295];p = 0.010) and washing the reusable sanitary material only with water (AOR: 4.900 [CI: 2.701 - 9.116];p < 0.001) as compared to washing it with water and soap, had a higher association with presenting with STD symptoms. Stratified analysis also showed that women presenting discharge (AOR: 2.049 [CI: 1.343 - 3.146] for vaginal and cervical;AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 - 1.180];p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose interventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower socio-economic sections of the society.

Analysis of Vagina Microecology and Investigation of Common Infection in Border Area of Chongzuo City

Objective: To investigate the microecology and common infection of the female vagina in border area of Chongzuo City. Methods: Female patients in the outpatient department and inpatient department of gynecology of our hospital from April 1, 2018 to August 23, 2021 were selected as the research objects. The reproductive tract secretions of all patients were examined by microecological examination, morphological examination, chemical analysis and microscopic examination, and the results of various indicators were statistically analyzed to draw relevant conclusions. Results: Among the 1498 women with vaginal micro- ecological imbalances, cleanliness was determined to be 534 cases of degree II, 868 cases of degree III, and 96 cases of degree IV;Nugent scores were 9 - 10 in 9 cases, 8 in 122 cases, 7 in 30 cases, 6 in 18 cases, 5 in 8 cases, 4 in 717 cases, 3 in 248 cases, 2 in 209 cases, 1 in 118 cases, and 0 in 19 cases. AV scores were 8 in 1 case, 7 in 1 case, 6 in 2 cases, 5 in 9 cases, 4 in 84 cases, 3 in 207 cases, 2 in 850 cases, 1 in 284 cases, and 0 in 60 cases. Among the pathogen infections, 99 cases were mycoplasma, 361 cases were candida, 199 cases were bacterial and 8 cases were trichomonas;In chemical analysis, there were 138 cases with pH 5.1, 326 cases with pH 4.8, 775 cases with pH 4.6, 217 cases with pH 4.4, and 42 cases with pH 4.1;meanwhile, 1390 cases were positive for hydrogen peroxide, 505 cases were positive for glucosidase, 487 cases were positive for acetylglucosaminidase, 184 cases were positive for sialidase, 290 cases were positive for proline amino-peptidase, 501 cases were positive for coagulase, and 1064 cases were positive for leukocyte esterase. Conclusion: Female reproductive tract microecology is more complex, and the pathogens of infection are also diverse. A systematic examination can clarify the occurrence and development of the disease, and then provide reliable laboratory data for clinical treatment and guide clinical medication.

Analysis on the reproductive health situation of unmarried floating young women in cities

Objective: To understand the prevalence of RTIs/STIs, the incidence of sex violence and the KAP of the sex and reproductive health among unmarried floating young women.Methods: During Ocb.2002 to Feb.2003, in the maternal and child health hospital of Beijing, Shenzhen, Nanning and Zhengzhou, 1,219 unmarried floating young women who wanted termination of pregnancy and was under 24 years old before induced abortion received gynecological and laboratory examination. At the same time, they also answered a self-questionnaire. Results: The mean age of all respondents was (22.0±1.6) years old. The respondents' average age of having first sexual activity was (20.3±1.8) years old. The rate of induced abortion history was 38.7%. 17.5% of young women had never used contraception. The incidence of sex violence was 15.6%. The prevalence of RTIs and STIs was 56.1% and 9.7%, respectively. Young women were lack of the knowledge about reproductive health care. Conclusions: The reproductive health situation of unmarried floating young women was serious, especially on sex violence and RTIs/STIs and higher rate of induced abortion.

细菌性阴道病的治疗进展

细菌性阴道病(bacterial vaginosis,BV)是育龄期妇女最常见的下生殖道感染性疾病,会导致盆腔炎、不良妊娠结局和多种性传播疾病感染风险增加。目前临床用于治疗BV的药物主要为甲硝唑、克林霉素等抗生素,但难以解决部分患者治疗失败以及复发率高等问题。其原因可能在于抗生素的抑菌机制较为单一,且作用强度不足,无法重建以乳杆菌为主的阴道微生态,也无法抑制阴道加德纳菌主导的致病性生物被膜产生。因此,亟需开发新的替代药物或采用联合疗法用于BV治疗。基于BV的微生物学基础,综述近期BV治疗方式的研究进展,包括乳杆菌制剂、生物被膜抑制剂等。这些疗法大多安全性好、有效性高,极具研究价值,部分已初步应用于临床。

Innate and adaptive immune responses in male and female reproductive tracts in homeostasis and following HIV infection

The male and female reproductive tracts are complex microenvironments that have diverse functional demands. The immune system in the reproductive tract has the demanding task of providing a protective environment for a fetal allograft while simultaneously conferring protection against potential pathogens. As such, it has evolved a unique set of adaptations, primarily under the influence of sex hormones, which make it distinct from other mucosal sites. Here, we discuss the various components of the immune system that are present in both the male and female reproductive tracts, including innate soluble factors and cells and humoral and cell-mediated adaptive immunity under homeostatic conditions. We review the evidence showing unique phenotypic and functional characteristics of immune cells and responses in the male and female reproductive tracts that exhibit compartmentalization from systemic immunity and discuss how these features are influenced by sex hormones. We also examine the interactions among the reproductive tract, sex hormones and immune responses following HIV-1 infection. An improved understanding of the unique characteristics of the male and female reproductive tracts will provide insights into improving clinical treatments of the immunological causes of infertility and the design of prophylactic interventions for the prevention of sexually transmitted infections.

早产及未足月胎膜早破与妊娠期生殖道感染的关系研究

目的明确早产及未足月胎膜早破(PPROM)与妊娠期生殖道感染(RTI)的相关性。方法选择2021年1月至2022年12月在北京市通州区妇幼保健院规律产前检查及分娩的早产或PPROM孕妇416例作为研究对象进行回顾性分析。根据分娩期间(分娩当次入院)检查有无明确的RTI病原学证据分为观察组(171例,有证据)和对照组(245例,无证据)。对孕妇相关资料进行分析,比较2组孕早期患阴道炎症情况、PPROM发生率、分娩孕周、分娩方式、胎儿宫内窘迫发生情况及不同年龄孕妇妊娠结局、相同孕周分娩新生儿出生体重。结果观察组171例孕妇阴道分泌物常规检查前3位病原菌为解脲支原体感染14例(8.2%)、细菌性阴道病13例(7.6%)、霉菌性阴道炎10例(5.8%);细菌学培养RTI的常见病原体为无乳链球菌9例(5.3%)、白色念珠菌8例(4.7%)、大肠埃希菌6例(3.5%)。观察组孕早期患阴道炎症比例高于对照组[18.7%(32/171)比11.4%(28/245)],差异有统计学意义(P=0.042)。观察组与对照组PPROM发生率、分娩孕周、分娩方式、胎儿宫内窘迫发生率比较差异均有统计学意义(均P<0.05)。不同年龄组孕妇PPROM、RTI、胎儿宫内窘迫发生率差异均无统计学意义(均P>0.05)。观察组和对照组相同孕周分娩新生儿出生体重比较差异均无统计学意义(均P>0.05)。结论解脲支原体、无乳链球菌、白色念珠菌是RTI的主要致病菌;妊娠期RTI有增加早产或PPROM发病风险的可能,同时妊娠期RTI增加妊娠期母儿的不良结局。

宫颈癌合并生殖道感染患者临床特征及放化疗预后影响因素分析

目的总结宫颈癌合并生殖道感染患者的临床特征,并分析放化疗预后及其影响因素。方法本研究为单中心回顾性队列研究,收集2018年1月至2020年8月福建省肿瘤医院行放化疗的宫颈癌合并生殖道感染的患者,归纳总结患者的临床特征,采用Kaplan-Meier法计算并比较2组患者的无进展生存(PFS)时间、总生存(OS)时间,对预后的相关因素进行单因素及多因素logistic回归分析。结果共80例患者纳入本研究,患者的中位诊断年龄为55.5岁,最常见的症状为阴道不规则出血。病理类型最常见的是鳞状细胞癌(74/80,92.5%)。96.3%(77/80)来自农村。13例(16.3%)有糖尿病。依据国际妇产科联盟(FIGO)2018分期对所有患者进行重新分期,其中Ⅱa期1例(1.3%),Ⅱb期26例(32.5%),Ⅲb期12例(15.0%),Ⅲc期32例(40%),Ⅳa期5例(6.2%),Ⅳb期4例(5.0%)。39例(48.7%)患者无淋巴结转移,41例(51.3%)盆腔淋巴结转移,8例(10.0%)腹膜后淋巴结转移,2例(2.5%)腹股沟、左锁骨上淋巴结转移。肿瘤形态呈结节型50例(62.5%),菜花型28例(35.0%),空洞型2例(2.5%)。肿瘤最大径≤4 cm的患者13例(16.3%),>4 cm 67例(83.7%)。有52例(65.0%)行宫颈或阴道分泌物病原检查,病原学检测阴性18例(34.6%),阳性34例(65.4%)。病原学排名前3位的常见细菌为大肠埃希菌18例(53.0%)、粪肠球菌11例(32.4%)、肺炎克雷伯6例(17.7%)。病原学阳性的患者中单纯感染占61.8%(2/34),混合感染占38.2%(13/34)。35例患者有C反应蛋白(CRP)、降钙素原(PCT)实验室检查结果,CRP中位数30(3.7~174.0)mg/ml,PCT中位数0.05(0.02,0.66)ng/ml。80例患者的3年生存率为75.0%,5年生存率43.8%。3年无进展生存率68.8%,5年无进展生存率为42.5%。在单因素COX回归模型中,分期、贫血情况、肿瘤形态、淋巴结转移情况、治疗前鳞状细胞癌抗原(SCC)和肿瘤最大径均为患者生存情况的显著影响因素。将单因素模型中显著的变量纳入多因素Cox回归模型中,发现分期、肿瘤形态、治疗前SCC、肿瘤最大径是OS的独立危险因素。结论宫颈癌合并生殖道感染的常见病原微生物为革兰阴性菌,其中大肠埃希菌及肺炎克雷伯菌多见,感染患者CRP显著升高,PCT正常或仅轻微升高。宫颈癌合并感染患者预后相对较差。较晚的分期、结节形态肿瘤、治疗前较高的SCC和肿瘤最大径>4 cm是宫颈癌合并生殖道感染患者放化疗预后危险因素。

生殖道感染对足月和未足月胎膜早破孕妇宫颈分泌液MMP-2、MMP-9表达及不良母婴结局的影响

目的分析生殖道感染对足月和未足月胎膜早破(PROM)孕妇基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)表达及不良母婴结局的影响。方法招募2021年6月至2023年6月就诊于湖北医药学院附属十堰市太和医院的110例PROM孕妇作为研究对象。根据生殖道感染情况和孕周将其分为未足月胎膜早破(pPROM)感染组(34例)、pPROM非感染组(26例)、足月胎膜早破(tPROM)感染组(34例)、tPROM非感染组(16例)。比较四组一般资料、宫颈分泌液MMP-2和MMP-9表达水平以及不良母婴结局发生情况,采用多因素logistic回归分析PROM孕妇发生不良母婴结局的影响因素。结果四组年龄、孕次、体质量指数、吸烟史、饮酒史比较差异无统计学意义(P>0.05)。四组宫颈分泌液MMP-2、MMP-9表达水平比较差异有统计学意义(P<0.05),其中pPROM感染组宫颈分泌液MMP-2、MMP-9表达水平高于pPROM非感染组和tPROM非感染组,tPROM感染组宫颈分泌液MMP-2、MMP-9表达水平高于tPROM非感染组,差异有统计学意义(P<0.05)。四组绒毛膜羊膜炎及不良母婴结局总发生率比较差异有统计学意义(P<0.05),其中pPROM感染组绒毛膜羊膜炎发生率高于tPROM感染组和tPROM非感染组,不良母婴结局总发生率高于pPROM非感染组和tPROM非感染组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,生殖道感染及较高的宫颈分泌液MMP-2、MMP-9表达水平是PROM孕妇发生不良母婴结局的独立危险因素(P<0.05)。结论生殖道感染可增加足月和未足月PROM孕妇宫颈分泌液MMP-2、MMP-9表达水平,生殖道感染及较高的宫颈分泌液MMP-2、MMP-9表达水平是PROM孕妇发生不良母婴结局的独立危险因素。

Study on the Correlation between Human Papillomavirus and Mycoplasma genitalium Combined with TCT Detection

Objective: This study aims to explore the correlation between human papillomavirus (HPV) and Mycoplasma genitalium (CT) combined with TCT detection in cervical cancer screening. Method: A cross-sectional study design was adopted, and a total of 609 women who came to seek medical treatment were recruited as the study subjects. Combination testing was evaluated on cervical cancer screening by testing the women for HPV, CT with TCT detection and analyzing the relationship of cervical lesions with HPV and CT infection. Results: The study results showed that 21.57% of the subjects were infected with both HPV and CT, and 48.42% of the cases had abnormal TCT results at the same time. Further data analysis showed that HPV infection was significantly associated with abnormal TCT outcomes (p < 0.05), suggesting a possible synergistic effect of the two infections in cervical lesions. The combined sensitivity and specificity of HPV, CT and TCT detection were 21.57% and 48.42%, respectively, which were significantly higher than that of single detection. Conclusion: In summary, the results of this study support the importance of combined HPV, CT, and TCT testing in cervical cancer screening, and propose the hypothesis that combined testing may improve screening effectiveness. However, further large sample studies are needed to confirm this conclusion and explore the prospects of combined testing in clinical practice.

生殖免疫抗体检测在女性不孕不育生殖道感染中的应用价值

目的 检测血清生殖免疫抗体,分析其在不孕不育女性生殖道感染中的应用价值。方法 回顾性分析136例不孕不育症育龄期女性临床资料,其中合并生殖道感染74例(感染组),无生殖道感染62例(未感染组)。比较2组血清抗精子抗体(ASAb)、抗子宫内膜抗体(EMAb)、抗卵巢抗体(AOAb)、抗心磷脂抗体(ACAb)水平差异,使用受试者工作特征(ROC)曲线评估血清ASAb、EMAb、AOAb、ACAb对不孕不育症合并生殖道感染的诊断效能,并记录不同病原感染者血清ASAb、EMAb、AOAb、ACAb检测结果。结果 感染组血清ASAb、EMAb、AOAb、ACAb阳性率及血清含量明显高于未感染组(P<0.05)。ROC曲线分析显示,血清ASAb、EMAb、AOAb、ACAb诊断不孕不育症合并生殖道感染的AUC值分别为0.972、0.945、0.968、0.862(P<0.05)。感染组中,不同病原感染者血清ASAb、EMAb、AOAb、ACAb阳性率比较差异无统计学意义(P>0.05)。结论 ASAb、EMAb、AOAb、ACAb对女性不孕不育症合并生殖道感染具有较高诊断效能,临床应用价值较高。

孕妇下生殖道感染状态下微生物紊乱情况及对妊娠结局的影响

【目的】探讨孕妇下生殖道感染状态下微生物紊乱情况及对妊娠结局的影响。【方法】选取2019年1月至2022年1月在西安高新医院就诊的96例孕妇,根据生殖道病原微生物培养结果将患者分为观察组(结果阳性,n=44)和对照组(结果阴性,n=52),比较两组孕妇白细胞计数、中性粒细胞、C反应蛋白水平、不良妊娠结局及新生儿不良并发症总发生率。【结果】96例孕妇中下生殖道感染44例(45.83%),感染病原体包括细菌、真菌、衣原体、支原体、解脲脲原体、滴虫。细菌感染率为38.64%,真菌感染率为13.64%,衣原体感染率为15.91%,支原体感染率为18.18%,解脲脲原体感染率为2.27%,滴虫感染率为11.36%。观察组孕妇白细胞计数、中性粒细胞、C反应蛋白显著高于对照组,差异有统计学意义(P<0.05);观察组孕妇胎膜早破、宫内感染、产褥期感染等不良妊娠结局总发生率为22.73%,显著高于对照组的3.85%,差异有统计学意义(P<0.05);观察组新生儿败血症、病理性黄疸、新生儿肺炎等不良并发症总发生率为25.00%,显著高于对照组的3.85%,差异有统计学意义(P<0.05)。【结论】孕妇下生殖道感染病原体主要包括细菌、真菌、衣原体、支原体、解脲脲原体、滴虫,孕妇下生殖道感染会增加不良妊娠结局、新生儿不良并发症总发生率,发现感染后应及时进行治疗。

泌尿生殖道分泌物支原体培养与药敏分析

目的探究泌尿生殖道支原体感染及耐药情况。方法选取3050例2022年7月至2023年6月在阿克苏地区第一人民医院妇科、产科、皮肤科和泌尿外科等各个科室就诊的患者作为研究对象,对所有患者开展泌尿生殖道的分泌物检测。结果3050例标本中,反应孔颜色变混浊红色12例,属于细菌污染,3038例合格样本以女性居多,女性支原体培养阳性率56.87%,其中解脲支原体(Ureaplasma Urealyticum,UU)组阳性率81.23%,占比最高。男女性的人型支原体(Mycoplasma hominis,MH)组、UU组及UU+MH组间的阳性率对比差异无统计学意义(P>0.05)。合格标本多源于妇科,占比74.62%(2267/3038),UU组抗菌药物敏感率超过50%的从高到低分别为多西环素、米诺环素、壮观霉素、交沙霉素,敏感率最高的是多西环素与米诺环素,而耐药率超过40%的抗菌药物从高到低分别为阿奇霉素、克拉霉素、环丙沙星、司帕沙星、罗红霉素,耐药率最高的为阿奇霉素、克拉霉素以及环丙沙星。结论泌尿生殖道支原体培养结果为阳性的患者,应与其临床症状、病史、检查指征和支原体浓度等信息相结合,综合判断,通过药代药效动力学、体外药敏试验的方式确定抗菌药物的用法和用量。

GDM孕妇孕中期下生殖道感染、糖代谢指标水平变化及增重速率的临床意义

目的探讨妊娠期糖尿病(GDM)孕妇孕中期下生殖道感染、糖代谢指标及增重速率的临床意义。方法采用前瞻性研究方法,选取2022年1月至12月在山东第一医科大学附属济南妇幼保健院产检并分娩的GDM孕妇210例作为研究对象。观察GDM孕妇的母婴不良妊娠结局发生情况,分析发生和未发生母婴不良妊娠结局GDM孕妇的年龄、学历、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(LDL-C)和低密度脂蛋白胆固醇(HDL-C)、孕中期空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、Log胰岛素抵抗指数(HOMA-IR)、Log胰岛β细胞功能(HOMA-β)等糖代谢指标及下生殖道感染情况、增重速率的差异,总结GDM孕妇发生母婴不良妊娠结局的影响因素。结果210例GDM孕妇中发生母婴不良妊娠结局58例,纳入发生母婴不良妊娠结局组,未发生母婴不良妊娠结局的152例GDM孕妇纳入未发生母婴不良妊娠结局组。发生母婴不良妊娠结局组的FBG、HbA1c、FINS、Log HOMA-IR和增重速率分别为(6.12±0.82)mmol/L、(6.23±0.69)%、(14.43±2.28)μU/L、0.60±0.20和(0.51±0.20)kg/周,均明显高于未发生母婴不良妊娠结局组[(4.40±0.67)mmol/L、(5.42±0.80)%、(11.43±2.03)μU/L、0.37±0.15和(0.34±0.18)kg/周],而Log HOMA-β为2.06±0.73,明显低于未发生母婴不良妊娠结局组(2.41±0.89),差异均有统计学意义(P<0.05);发生母婴不良妊娠结局组伴有下生殖道感染比率为55.17%,明显高于未发生母婴不良妊娠结局组(13.16%),差异有统计学意义(P<0.05);两组下生殖道感染类型比较差异无统计学意义(P>0.05);行Logistic回归分析显示:FBG、Log HOMA-IR、增重速率和下生殖道感染是GDM孕妇发生母婴不良妊娠结局的影响因素(P<0.05)。结论下生殖道感染、增重速率、FBG以及Log HOMA-IR是GDM孕妇发生母婴不良妊娠结局的影响因素,临床应加以重视,及早干预以确保母婴健康。