男性生殖道感染标本采集和细菌定位培养改良法  

Improved sample collection methods and bacteriologic localization patterns for male genital tract infection

作　　者：王丹霓[1] 王和[2] 

机构地区：[1]上海交通大学基础医学院病原生物学教研室,上海200025 [2]贵阳医学院微生物学教研室,贵州贵阳550004

出　　处：《中华男科学杂志》2014年第5期423-429,共7页National Journal of Andrology

基　　金：贵州科技基金(SY[2001]3045);贵州省卫生厅基金(gzwkj2009-1-028);传染病预防控制国家重点实验室自主研究开放课题基金(2011SKLID302)~~

摘　　要：目的:改良男性生殖道感染标本采集和细菌定位培养法,探讨标本采集和病原体分离对前列腺炎诊断与治疗的影响。方法:分别采集200例前列腺炎样症状患者的分段尿液、前列腺按摩液(EPS)和精液标本,定量接种培养液分离培养,根据分离物的菌落数及分布规律评估其实验室诊断意义。结果:从200例前列腺炎样症状患者检出病原体468株,包括细菌414株(占88.5%)、真菌12株(占2.6%)、支原体40株(占8.5%)、衣原体2株(占0.4%)。其中仅从EPS分离到病原体的患者为66例(占33.0%),仅从精液分离到病原体的患者为34例(占17.0%),EPS和精液均分离到病原体的患者为100例(占50.0%)。在这些标本中仅分离到1种病原体的分别为EPS 36例(占18.0%),精液20例(占10.0%),EPS和精液39例(占19.5%);分离到2种病原体的分别为EPS 30例(占15.0%),精液14例(占7.0%),EPS和精液60例(占30.0%);1例从EPS和精液分离到3种病原体(占0.5%)。结论:复数菌感染(MMI)、多器官感染(MOI)和耐药性菌株感染在前列腺炎样症状患者常见,是造成临床及实验室诊断漏诊和误诊的常见因素以及影响治疗效果的重要机制,MMI和MOI可通过标本采集和细菌定位培养改良法进行诊断与鉴别诊断。Objective： To improve the sample collection methods and bacteriologic localization patterns in male genital tract in- fection, and to investigate the influence of specimen collection and pathogen isolation on the diagnosis and treatment of prostatitis. Methods ： We collected the samples of the initial urinary stream, the third portion of the urinary stream, expressed prostatic secretion （ ESP）, and semen from 200 adult males with chronic prostatitis-like symptoms, inoculated them quantitatively in culture media for iso- lation of microorganisms, and evaluated their laboratory diagnostic significance according to the count of colonies and distribution of the isolates. Results： A total of 468 strains of microorganisms were isolated from the samples, including 414 strains of bacteria spp （88.5%） , 12 strains of fungi spp （2.6%） , 40 strains of mycoplasma spp （8.5%） , and 2 strains of chlamydia spp （0.4%）. Pathogens were isolated from the ESP in 66 cases （33.0%） , from the semen in 34 cases （ 17.0% ） , and from both the ESP and semen in 100 cases （50.0%）. Only 1 species of pathogen was found in the ESP samples of 36 cases （ 18.0% ） , in the semen samples of 20 cases （10%）, and in both the ESP and semen samples of 39 cases （19.5%）; 2 species in the ESP samples of 30 cases （ 15.0% ）, in the semen samples of 14 cases （7.0%）, and in both the ESP and semen samples of 60 cases （30.0%） ; and 3 species in both the ESP and semen samples of 1 case （ 0.5 % ）. Conclusion ： Multiple microbial infection （ MMI）, multi-organ infection （MOI） and drug-resistance strains infection are common in patients with prostatitis-like symptoms, frequently leading to missed diagnosis and misdiagnosis in clinic and laboratory, and affecting the effect of antimicrobial therapy. MMI and MOI can be diagnosed and differentially diagnosed with the improved sample collection methods and bacteriologic localization patterns. Natl J Androl, 2014, 20 （5） ： 423 -429

关 键 词：前列腺炎 男性生殖道感染 实验室诊断 标本采集 细菌定位培养 

分 类 号：R691.3[医药卫生—泌尿科学] R378[医药卫生—外科学]