Ureaplasma infection
Introduction
Introduction to Ureaplasma Urealyticum Infection M. urealyticum is the only species in the genus Ureaplasma and is named for its need for urea for growth. The colony is tiny, only 15 ~ 25um in diameter, must be observed under a low magnification microscope, so the old known as the T strain (tinystrain). The surface of the colony has coarse particles and can be converted into typical poached egg-like colonies under suitable conditions. Growth requires cholesterol and urea, decomposes urea as its metabolic characteristic, produces ammonia nitrogen, raises the pH of the medium, and the patient often has astringent urination. Mainly through sexual life, most of the initial patients have no obvious symptoms, which can cause inflammation of the reproductive system in the later stage, which is an important reason for female infertility. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of transmission: blood transmission, sexual transmission Complications: genitourinary mycoplasma infection infertility
Cause
Ureaplasma urealyticum infection
Mainly through sexual life, more common in the period of youthfulness, especially after unclean sexual intercourse. When inflammation occurs in the genitourinary tract and the mucosal surface is damaged, Ureaplasma urealyticum easily invades from the damaged mouth, causing genitourinary tract infection. After Ureaplasma urealyticum infection, most of the patients have no obvious symptoms, so it is difficult for the patient to be aware of it, and it is easy to cause doctors to miss the diagnosis. Ureaplasma urealyticum can invade the urethra, cervix and vestibular glands, causing urethritis, cervicitis and vestibular gland inflammation; when infected, it can cause endometritis, pelvic inflammatory disease, salpingitis, especially salpingitis. Pathological changes in female genital organs caused by Ureaplasma urealyticum infection are important causes of infertility. Domestic and foreign data suggest that the positive rate of Ureaplasma urealyticum culture in cervical mucus and semen of infertile couples is as high as 50%. It can be seen that Ureaplasma urealyticum infection is associated with the occurrence of infertility. Another cause of malnutrition caused by Ureaplasma urealyticum infection is abortion. Some people have detected a positive rate of Ureaplasma urealyticum from aborted tissues of more than 40%. Therefore, for unexplained abortions, especially those with multiple abortions, the possibility of Ureaplasma urealyticum infection should be considered. Inflammatory tubal inflammatory adhesion caused by incomplete obstruction caused by Ureaplasma urealyticum infection can make the lumen narrow and unobstructed, or an important cause of ectopic pregnancy.
After pregnancy, women's immunity is inhibited by the increase of progesterone, the body's resistance is reduced, and the infection of Ureaplasma urealyticum is more susceptible. The perinatal infection caused by Ureaplasma urealyticum is a new problem faced by modern obstetrics. Ureaplasma urealyticum can be transmitted vertically through the placenta or spread by the lower genital tract infection of pregnant women, causing intrauterine infection, both of which can lead to miscarriage, premature delivery, intrauterine growth retardation, low birth weight, premature rupture of membranes, and even fetal A series of adverse consequences such as death in the palace.
During childbirth, the fetus is also susceptible to infection when it is delivered through the birth canal. Commonly, there are neonatal ophthalmia, followed by neonatal respiratory infections, and other otitis media, pharyngitis and so on.
Prevention
Ureaplasma urealyticum infection prevention
Both couples should be tested for Ureaplasma urealyticum before preparation for pregnancy. If there is Ureaplasma urealyticum infection, they should be pregnant after curing. Secondly, early detection of pregnancy, if the test is positive, should be treated in time to avoid damage to the fetus. Pregnant women can take minocycline, erythromycin and other drugs, pregnant women can only be treated with erythromycin. The side effect of erythromycin is small, Ureaplasma urealyticum is a disease transmitted through sexual contact, and there are also indirect infections. Therefore, both couples pay attention to sexual hygiene, daily cleaning of women's care solution with Ph4 weak acid formula, to prevent unclean sex life. It is of great significance for the prevention of Ureaplasma urealyticum infection.
Complication
Ureaplasma urealyticum infection complications Complications, genitourinary mycoplasma infection, infertility
1, non-gonococcal urethritis: urethritis caused by chlamydia or mycoplasma is called non-gonococcal urethritis, Ureaplasma urealyticum is one of the important pathogens. The disease is more common in young people. Symptoms include urgency, dysuria, urinary tract itching or dysuria. The urethral orifice has sticky secretions or molting. It is similar to gonorrhea and is lighter than gonorrhea, but it cannot be identified from clinical symptoms. Laboratory inspection.
2, acute epididymitis: epididymis suddenly pain, increase, pain to the ipsilateral groin or lower abdomen radiation, often due to urinary tract infections and repeated attacks, can be converted to a chronic process, scrotum fall sense, epididymis pain.
3, prostatitis: prostatitis caused by Ureaplasma urealytic infection is a non-bacterial prostatitis, mostly for acute onset, the typical symptoms are white urine at the end of the urine, after the urine is not exhausted, the outer urethra is secreted by secretions.
4, male infertility: the relationship between male infertility and ureaplasma urealyticum has attracted people's attention. Some scholars have investigated 921 cases of U. urealyticum culture in infertile men, 511 cases were positive, accounting for 55.48%, while 132 cases were positive in normal fertility group. 25 cases, only 18.93%. The mechanism by which Ureaplasma urealyticum infection causes male infertility has not been fully clarified, and generally includes the following aspects:
(1) its mycoplasma invades spermatogenic cells, resulting in reduced sperm cell production,
(2) adsorption on the surface of the sperm, so that the sperm deformity rate increases,
(3) Interfering with sperm egg recognition fusion,
(4) The presence of common antigens between mycoplasma and sperm may cause immune infertility.
5, female infertility: male urogenital system of Ureaplasma urealyticum can enter the female reproductive tract with the sperm "hitch", causing endometritis, salpingitis, ovarian inflammation, membranous inflammation, spontaneous abortion and intrauterine stillbirth, etc. Fertility is affected.
Symptom
Ureaplasma urealyticum infection symptoms common symptoms leucorrhea abnormal backache urinary frequency cervical edema
The incubation period is 1-3 weeks. The typical acute phase symptoms are similar to other non-gonococcal genitourinary infections. It is characterized by urethral tingling, varying degrees of urgency and frequent urination, urination and tingling, especially when the urine is more concentrated. obvious. The urethra is slightly red and swollen, the secretion is thin, the amount is small, and it is serous or purulent. It is necessary to squeeze the urethra to see the secretion overflow. It often has a small amount of mucous secretion or only the diaphragm seal in the morning urethra. Or see dirty pants.
Subacute period often combined with prostate infection, patients often have perineal pain, backache, double internal discomfort or tingling from the perineum to the inside of the femoral sinus.
Female patients often have germline inflammation that spreads around the cervix. Most of them have no obvious symptoms. A few critically ill patients have vaginal sensation. When the infection spreads to the urethra, frequent urination and urgency are the main symptoms that cause the patient to pay attention. The infection is limited to the cervix, which is characterized by increased vaginal discharge, opacity, cervical edema, congestion or surface erosion. Infection and urethra are characterized by flushing of the urethra, congestion, and squeezing of the urethra. There is a small amount of secretion spillover, but there is little tenderness.
Ureaplasma urealyticum (M.urealyticum)
It is the only species in the genus Ureaplasma and is named for its need for urea for growth.
It requires cholesterol and urea for growth. Decomposition of urea as its metabolic characteristic produces ammonia nitrogen, which causes the pH of the medium to rise, leading to its own death.
In 1954, Shepard first isolated tiny colony mycoplasma or microtubules from patients with non-gonococcal urethritis.
By 1974, the International Mycoplasma Society (IOM) was named Ureaplasma urealyticum (Uu) because it has urease and can decompose urea. It has at least 16 serotypes.
In 1977, Talyor was isolated from the urine of male urethritis patients and inoculated into his own urethra, with frequent urination, urgency and pyuria.
Thus, it was first confirmed that Uu is one of the common causes of non-gonococcal urethritis in men.
The Uu of the lower genital tract of women is usually only a carrier, and it is only possible to transmit to a sexual partner and is not pathogenic.
Because women have almost no cholesterol and urea in their vagina, it usually does not cause vaginal diseases.
Ureaplasma urealyticum was not found in the female reproductive tract of infants or non-sexual contacts.
Uu causes chronic cervicitis when the body's resistance is low, and its degree of inflammation is positively correlated with the degree of infection.
Only a very small number of women in the vagina Uu can go up to the uterus, causing infection to cause endometritis. Or pregnant women invade the amniotic sac, causing chorioamnionitis, causing spontaneous abortion.
Examine
Examination of Ureaplasma urealyticum infection
Laboratory tests for Ureaplasma urealyticum include: morphological examination, mycoplasma culture, antigen detection, serological methods, and molecular biology methods. Studies on Ureaplasma urealyticum MB antigen showed that MB antigen is the major outer membrane antigen recognized when Ureaplasma urealyticum is infected, and has species specificity, including serum-specific and cross-reactive antigenic determinants. The gene encoding the MB antigen is more than 1200 bases in length and the N-terminal 1/3 is a conserved region, and contains a group-specific antigenic determinant: C-terminal 2/3 is a variable region consisting of a repeat sequence, and contains a specific antigen. Clusters, the study of this antigen and plays an important role in the study of the pathogenesis and immune mechanisms of the disease. The MB antigen is located on the surface of the Ureaplasma urealyticum membrane, and the N-terminus is immobilized on the membrane to expose the C-terminal repeating region to the microenvironment surrounding the microorganism. The N-terminus can serve as the basis for its clustering. The C-terminus is most likely to first encounter the host's defense system to cause major antibody responses, which is the basis for understanding its pathogenesis and immune mechanisms. The relationship between MB antigen and disease, and its role in the disease remains to be further explored.
In the serological test method for the determination of mycoplasma antibodies, there are mycoplasma-specific serological tests and non-specific serological tests: among the methods of mycoplasma-specific serological tests, the most commonly used complement fixation test, and indirect immunofluorescence staining test, Growth inhibition test, metabolic inhibition test, indirect hemagglutination test, enzyme immunoassay, and enzyme-linked immunosorbent assay (ELISA). The non-specific serological methods of mycoplasma include the Mycoplasma pneumoniae condensation test and the MG streptococcal agglutination test, which can play a role in the auxiliary diagnosis of mycoplasmal pneumonia. The method of detecting specific antibody IgG has not been able to achieve the purpose of early rapid diagnosis, and the detection of antigen is the development direction of future research. At present, there are reports of direct detection of mycoplasma antigens in secretions and body fluids by enzyme-linked immunosorbent assay, fluorescently labeled antibody, monoclonal antibody against Mycoplasma pneumoniae membrane and reverse indirect hemagglutination, which has high specificity and sensitivity. When the human body is infected with Mycoplasma pneumoniae, it can produce specific IgM and IgG antibodies. IgM antibodies appear early, usually appear 1 week after infection, peak at 3 to 4 weeks, and then gradually decrease. Since the incubation period of Mycoplasma pneumoniae infection is 2 to 3 weeks, IgM antibody has reached a fairly high level when the patient has symptoms, so IgM antibody positive can be used as a diagnostic indicator for acute infection. If the IgM antibody is negative, the Mycoplasma pneumoniae infection cannot be denied, and the IgG antibody needs to be detected. IgG is later than IgM and needs to be observed dynamically. If the elevation is significantly increased, it indicates a recent infection, and a significant decrease indicates that it is in the late stage of infection. PCR technology testing provides the possibility of further early diagnosis of MP infection. The sensitivity of PCR and the specificity of probe hybridization are one of the best assays for current accuracy and reproducibility.
Diagnosis
Diagnosis and diagnosis of Ureaplasma urealyticum infection
In nature and in our bodies, there are a lot of microbes, many of which are pathogenic microorganisms. But many people are healthy, normal, and do not cause disease, which is related to the immunity of the person's own immunity. It is also related to the "quantity" of microorganisms that are parasitic in the human body and the "bacterial balance" formed. Our bodies have a strong immune system that protects the body from all kinds of microbes and maintains our health.
Even a small number of pathogenic microorganisms (such as strong infectious diseases), not all people will be infected and cause disease. This is why under normal circumstances, living in the same environment, only a few people will get sick, because they have a decline in physical fitness, and the resistance is low. The various microorganisms parasitic in the human body can be said to be accompanied by human life. Mycoplasma and chlamydia are microorganisms that are "parasitic" in normal human bodies. They interact with many other "parasitic microorganisms" to achieve a dynamic balance, so that the number of each other is controlled and does not affect the human body. This is what medically calls "bacterial balance." If the abuse of antibiotics, or the body's resistance and immunity decline, it will destroy the original "bacterial balance", there will be a "quantity increase" of certain microorganisms, and even cause the corresponding "infection" and disease. In some hospitals, due to factors such as the level of interest or professional knowledge, doctors exaggerate their words and deceive people's money. In particular, some hospitals for treating infertility and sexually transmitted diseases use mycoplasma or chlamydia as a routine examination and treatment program. It is not necessary for patients to spend more money. Some people are not "sick" at all, but there are some local inflammations. However, some hospitals grasp the current situation of patients who do not understand the disease and arbitrarily exaggerate the harm and consequences of their "illness". ; caused great harm to the patient's psychology. Some hospitals have tested positive for you. If you use it, it will turn "yin" very quickly. But if you test it again after a while, it will be positive. It will tell you that this is a "relapse". You can treat it again and let the patient spend a lot of money. Many people are scared by the infection of chlamydia and mycoplasma, which causes the patient to suffer great economic losses, psychologically suffered severe trauma, and the patient suffers from physical and mental pain.
