生殖支原體Taqman MGB熒光PCR方法的建立及在高危人群流行病學(xué)調(diào)查中的應(yīng)用
發(fā)布時(shí)間：2018-07-26 11:14
【摘要】：生殖支原體(Mycoplasma genitalium, Mg)是近年來(lái)確認(rèn)的性傳播疾病(STD)病原體之一,在男性引起非淋球菌性尿道炎(NGU),在女性導(dǎo)致宮頸炎、子宮內(nèi)膜炎及盆腔炎等,如不治療可致異位妊娠、不孕等不良結(jié)局。 NUG是常見(jiàn)的STD,世界范圍而言,每年有8900萬(wàn)的新發(fā)病例,NGU的發(fā)病率呈逐年上升的趨勢(shì)。在我國(guó),自1988年起,NGU作為重點(diǎn)監(jiān)測(cè)的性病在一些監(jiān)測(cè)點(diǎn)對(duì)其流行情況進(jìn)行監(jiān)測(cè),2002年以來(lái)NGU的病例數(shù)超過(guò)淋病,居所有規(guī)定上報(bào)的STD首位,在隨后幾年中均占全國(guó)STD病例報(bào)告數(shù)構(gòu)成比的35%以上,然而自2008年起NGU的監(jiān)測(cè)被沙眼衣原體(CT)感染所取代,最主要的原因是CT感染已被確認(rèn)為NGU的主要病因之一,可在11%-43%的NGU患者中檢出。 研究表明Mg是NGU的另一個(gè)重要的常見(jiàn)病原之一,在9%--25%NGU患者中可檢出,與CT合并感染少見(jiàn),規(guī)范治療后復(fù)發(fā)性及持續(xù)性NGU患者中Mg陽(yáng)性多見(jiàn),因此在CT陰性的NGU患者中Mg可能發(fā)揮重要作用。采用推薦治療藥物阿奇霉素或強(qiáng)力霉素規(guī)范治療后,對(duì)Mg陽(yáng)性的NGU治療失敗的病例陸續(xù)有報(bào)道,說(shuō)明有耐藥的產(chǎn)生。隨著對(duì)Mg在NGU中致病作用的認(rèn)識(shí),Mg在國(guó)外日益得到重視,2009年的歐洲男性NGU診療指南中提到需要把Mg的檢測(cè)納入臨床診療中,對(duì)慢性NGU患者的治療應(yīng)該覆蓋治療Mg的藥物,2010年?yáng)|歐國(guó)家確立了關(guān)于Mg感染的實(shí)驗(yàn)室診斷指南。 對(duì)Mg在中國(guó)人群中流行情況的研究比較有限,既往研究發(fā)現(xiàn)在NGU患者中Mg的流行率為20.6%-25%,在CT陰性的NGU患者中可達(dá)44.19%,此發(fā)現(xiàn)與其他一些國(guó)家的研究類似,說(shuō)明Mg在中國(guó)的流行應(yīng)引起重視。 女性性工作者(FSWs),性病門診男性就診者(MSP)及男男性行為者(MSM)是STD/HIV感染的高危人群,也是HIV哨點(diǎn)監(jiān)測(cè)的重點(diǎn)人群,隨著近年來(lái)HIV傳播模式的轉(zhuǎn)變,經(jīng)性傳播已成為HIV傳播的主要模式,上述人群在HIV的傳播起著重要作用。近來(lái)研究發(fā)現(xiàn)Mg與HIV密切相關(guān),Mg感染可能促進(jìn)HIV的感染及傳播,一項(xiàng)對(duì)泌尿生殖道Mg感染與HIV陽(yáng)性的相關(guān)性的系統(tǒng)性綜述及Meta分析發(fā)現(xiàn)Mg感染與HIV陽(yáng)性顯著相關(guān),Mg感染者中HIV陽(yáng)性率是Mg未感染者的2倍,此外有研究報(bào)道Mg感染可能通過(guò)促進(jìn)HIVDNA的脫落進(jìn)而促進(jìn)HIV的傳播。因此了解上述高危人群中Mg的流行情況,及時(shí)干預(yù),不僅有助于控制Mg的傳播,預(yù)防不良結(jié)局的發(fā)生,而且可能對(duì)于HIV的防治也起著積極作用。 盡管Mg在國(guó)際社會(huì)越來(lái)越受到重視,然而由于Mg體外培養(yǎng)極其困難,且目前國(guó)內(nèi)沒(méi)有商品化檢測(cè)試劑盒等,因此大大限制了對(duì)Mg的流行病學(xué)研究,缺乏相應(yīng)的流行病學(xué)資料。本研究旨在采用文獻(xiàn)報(bào)道的簡(jiǎn)便快捷,敏感性高,特異性好的TaqmanMGB實(shí)時(shí)定量PCR方法對(duì)MSP中Mg的流行情況進(jìn)行調(diào)查,并對(duì)相關(guān)危險(xiǎn)因素進(jìn)行分析,為高危人群中Mg的流行及監(jiān)測(cè)提供基線資料,為制定防治策略提供參考。全文分為三部分,各部分主要內(nèi)容分述如下： 第一部分：Taqman MGB熒光PCR方法建立 采用文獻(xiàn)中報(bào)道特異性及敏感性較高的以Mg主要黏附素基因(MgPa基因)為靶基因的Taqman MGB熒光PCR方法,用Mg標(biāo)準(zhǔn)菌株G37制備濃度分別為1×101拷貝/gl、1×102拷貝/gl、1×103拷貝/μl、1×104拷貝/μl、1×10�？截�/μl、1×106拷貝/μl的6個(gè)標(biāo)準(zhǔn)品,制備標(biāo)準(zhǔn)曲線,并對(duì)該方法的重復(fù)性、靈敏度及特異性進(jìn)行檢測(cè),確定該方法的檢測(cè)限(LOD)及定量限(LOQ)。結(jié)果顯示Taqman MGB實(shí)時(shí)定量PCR方法檢測(cè)的線性范圍好(1×101拷貝/μl--l×106拷貝/μl),標(biāo)準(zhǔn)曲線回歸方程y=-3.982x+40.80,R2=0.993,重復(fù)性好(批內(nèi)變異系數(shù)=0.7%,批間變異系數(shù)=1.09%),敏感性高,檢測(cè)限(LOD)為每個(gè)PCR反應(yīng)10拷貝,定量限(LOQ)為10拷貝/μl,用該方法檢測(cè)泌尿生殖道常見(jiàn)10種病原體均為陰性,說(shuō)明該方法靈敏度高,特異性好,且有較好的重復(fù)性。我們認(rèn)為針對(duì)MgPa基因的Taqman MGB實(shí)時(shí)PCR可以快速、靈敏的對(duì)Mg進(jìn)行定性及定量的檢測(cè),為檢測(cè)人群中Mg的感染情況提供了極大的便利。 第二部分：廣西女性性工作者及性病門診男性就診者中生殖支原體的流行病學(xué)調(diào)查及危險(xiǎn)因素分析 采用第一部分建立的Taqman MGB熒光PCR方法對(duì)廣西FSWs及MSP中Mg的流行情況進(jìn)行調(diào)查,采用基于場(chǎng)所的分層抽樣方法,于2009年7月至9月對(duì)廣西梧州、賀州的賓館、酒店、夜總會(huì)、KTV、發(fā)廊、路邊店、站街、公園等娛樂(lè)場(chǎng)所及室外場(chǎng)所的FSWs及賀州性病門診就診的男性進(jìn)行調(diào)查。按工作場(chǎng)所及每次性交易收入將FSWs劃分為3類,路邊店、出租屋、站街及公園工作或每次性交易低于50元者為低檔FSWs, KTV、發(fā)廊、美容美發(fā)等場(chǎng)所工作者為中檔FSWs,賓館、酒店、夜總會(huì)為高檔FSWs,取得知情同意后對(duì)受試者進(jìn)行問(wèn)卷調(diào)查并采集FSWs的宮頸拭子及MSP的尿液標(biāo)本,Taqman MGB熒光PCR檢測(cè)Mg。結(jié)果共納入810名FSWs及423名MSP,收集到810份宮頸拭子及407份尿液標(biāo)本。FSWs中Mg的感染率為13.2%(95%CI=10.87%-15.52%),高中低檔FSWs Mg感染率分別為15.7%(95%CI=13.12%-18.2%),10.8%(95%CI=8.67%-12.93%)及14.6%(95%CI=12.17%-17.03%),不同檔次間無(wú)統(tǒng)計(jì)學(xué)差異,受教育程度低于初中(AOR=2.36,95%CI=1.15-4.87),未婚(AOR=2.27,95%CI=1.42-3.62),非當(dāng)?shù)鼐用?AOR=2.03,95%CI=1.29-3.20),過(guò)去1年無(wú)STIs相關(guān)癥狀(AOR=1.66,95%CI=1.09-2.52)與Mg感染顯著相關(guān)。MSP中Mg感染率為28%(95%CI=25.50%-30.49%),獨(dú)居(AOR=3.84,95%CI=1.58-9.33),過(guò)去1年無(wú)STIs相關(guān)癥狀(AOR=2.21,95%CI=1.35-3.62),最近3個(gè)月與FSWs發(fā)生性行為(AOR=2.27,95%CI=1.41-3.67)與Mg感染相關(guān)。以上研究結(jié)果表明在FSWs及MSP人群中Mg感染率高,且多為無(wú)癥狀感染,提示對(duì)上述高危人群中Mg感染進(jìn)行常規(guī)篩查成為必要。 第三部分：廣州男男性行為者中生殖支原體的流行率調(diào)查及危險(xiǎn)因素分析 于2010年1月至5月采用滾雪球的方法對(duì)廣州市同性戀酒吧、茶吧、桑拿浴池、夜總會(huì)、公園、公廁等場(chǎng)所的MSM進(jìn)行問(wèn)卷調(diào)查并采集尿液標(biāo)本,Taqman MGB熒光PCR檢測(cè)Mg。328名MSM中,97.6%自我認(rèn)同為同性戀,其中41.8%雖自我認(rèn)同為同性戀但也與女性發(fā)生性關(guān)系,87.8%半年內(nèi)與男性發(fā)生過(guò)肛交,63.2%最近一次肛交中使用了安全套,16.8%半年內(nèi)與女性發(fā)生過(guò)性行為,僅27.3%在最近一次與女性發(fā)生性行為時(shí)使用了安全套,4.6%參加過(guò)性交易,尋找性伴的方式以互聯(lián)網(wǎng)為主,占79.0%。323份尿液標(biāo)本中Mg感染率為4.3%(95%CI=3.1%-5.4%),未發(fā)現(xiàn)與Mg感染相關(guān)的因素。研究結(jié)果表明在MSM人群中Mg感染率低,提示Mg感染以異性性行為途徑傳播為主,MSM作為Mg感染的傳染源意義更大。
[Abstract]:Mycoplasma genitalium (Mg) is one of the pathogens of sexually transmitted disease (STD) identified in recent years. It causes non gonococcal urethritis (NGU) in men, causes cervicitis, endometritis and pelvic inflammation in women, such as untreated undesirable outcomes, such as ectopic pregnancy and infertility.
NUG is a common STD. In the world, there are 89 million new cases each year, and the incidence of NGU is increasing year by year. In China, since 1988, NGU has been monitored as a key monitoring venereal disease at some monitoring points. Since 2002, the number of cases of NGU exceeds the gonorrhea, and there is a set of STD first reported in the residence, and then in the following. For a few years, more than 35% of the national STD case reports were accounted for. However, since 2008, NGU monitoring was replaced by Chlamydia trachomatis (CT) infection. The most important reason is that CT infection has been identified as one of the main causes of NGU, and can be detected in NGU patients in 11%-43%.
The study shows that Mg is one of the other important common pathogens of NGU, which can be detected in 9%--25%NGU patients. It is rare to merge with CT, and Mg positive in recurrent and persistent NGU patients after standard treatment. Therefore, Mg may play an important role in the CT negative NGU patients. The recommended treatment for azithromycin or doxycycline is a standard treatment. After treatment, the cases of Mg positive NGU failure have been reported in succession, indicating the emergence of drug resistance. With the understanding of the pathogenicity of Mg in NGU, Mg is becoming more and more important abroad. In 2009, the European male NGU guide to diagnosis of Mg should be included in the clinical diagnosis of Mg, and the treatment of chronic NGU patients should be covered with the drugs for the treatment of Mg. In 2010, Eastern European countries established guidelines for laboratory diagnosis of Mg infection.
Research on the prevalence of Mg in Chinese population is limited. Previous studies have found that the prevalence of Mg in NGU patients is 20.6%-25% and is up to 44.19% in CT negative NGU patients. This discovery is similar to that in other countries, indicating that the prevalence of Mg in China should be paid more attention.
Female sex workers (FSWs), STD clinic male doctor (MSP) and male male actor (MSM) are high risk population of STD/HIV infection, and also the key population of HIV sentinel monitoring. With the change of HIV transmission pattern in recent years, sexual transmission has become the main mode of HIV transmission. The spread of the above population plays an important role in the transmission of HIV. Recently, the research has been studied. Mg is closely related to HIV. Mg infection may promote infection and transmission of HIV. A systematic review of the correlation between Mg infection and HIV positive in genitourinary tract and Meta analysis found that Mg infection is significantly related to HIV positive. The HIV positive rate in Mg infected persons is 2 times that of those who are not infected with Mg. Falling off further promotes the spread of HIV. Therefore, understanding the prevalence of Mg in these high-risk groups and intervening in time will not only help to control the spread of Mg, prevent the occurrence of bad outcome, but also play an active role in the prevention and control of HIV.
Although Mg is being paid more and more attention in the international community, however, it is very difficult to cultivate Mg in vitro, and there is no commercial detection kit in China at present. Therefore, the epidemiological study of Mg is greatly restricted and the corresponding epidemiological data are lacking. This study aims to adopt the simple, fast, sensitive and specific TaqmanM of the literature report. GB real-time quantitative PCR method was used to investigate the prevalence of Mg in MSP, and the related risk factors were analyzed to provide baseline data for the epidemic and monitoring of Mg in high-risk groups, and to provide reference for the development of prevention and control strategies. The full text is divided into three parts, the main contents of each part are as follows:
The first part: the establishment of Taqman MGB fluorescence PCR method
The Taqman MGB fluorescent PCR method, which was reported in the literature, was specific and sensitive to Mg major adhesion gene (MgPa gene) as the target gene. The Mg standard strain G37 was used to prepare 1 x 101 copies /gl, 1 x 102 copies /gl, 1 x 103 copies / mu L, 1 * 104 copy / mu L, 1 x 10. copy / muon, 1 106 copy / micron standard, preparation standard, preparation standard Curves, and detection of the repeatability, sensitivity and specificity of the method, determine the detection limit (LOD) and quantitative limit (LOQ) of the method. The results show that the linear range of the Taqman MGB real-time quantitative PCR method is good (1 x 101 copies / mu l--l x 106 copies / L), the standard curve regression equation y=-3.982x+40.80, R2=0.993, and good reproducibility (intra variation) The coefficient =0.7%, the inter group variation coefficient =1.09%), the sensitivity high, the detection limit (LOD) for each PCR reaction 10 copies, the quantitative limit (LOQ) is 10 copies / mu L, using this method to detect the genitourinary tract common 10 pathogens are negative, indicating that the method is high sensitivity, good specificity, and has good repeatability. We think of the MgPa gene Taqman MGB real. PCR can quickly and sensitively detect the Mg qualitatively and quantitatively. It provides a great convenience for detecting the infection of Mg in the population.
The second part: epidemiological investigation and risk factors analysis of Mycoplasma genital mycoplasma in male sex workers and sexually transmitted diseases outpatients in Guangxi.
The Taqman MGB fluorescence PCR method established in the first part was used to investigate the epidemic situation of Mg in Guangxi FSWs and MSP. By using the place based stratified sampling method, the FSWs and Hezhou sex of the hotels, hotels, nightclubs, KTV, hairdresser, roadside, park, park and other places of entertainment and outdoor places in Wuzhou, Wuzhou, Hezhou, Hezhou, Guangxi, from July 2009 to September. FSWs is divided into 3 categories according to the workplace and the income of each sex transaction. Roadside stores, rental houses, station street and park work or lower FSWs, KTV, hairdresser, beauty hairdresser and other place workers are low file FSWs, KTV, hairdresser, and beauty hairdresser for the middle grade FSWs, hotel, hotel and night club for the high-end FSWs, after obtaining informed consent The subjects were investigated with a questionnaire and collected FSWs's cervix swabs and MSP urine specimens. The results of Taqman MGB fluorescence PCR were included in 810 FSWs and 423 MSP. The infection rate of Mg in 810 cervix swabs and 407 urine specimens was 13.2% (95%CI=10.87%-15.52%) and 15.7% (15.7%) 2%-18.2%), 10.8% (95%CI=8.67%-12.93%) and 14.6% (95%CI=12.17%-17.03%), there was no statistical difference between different grades, the degree of education was lower than that of junior middle school (AOR=2.36,95%CI=1.15-4.87), unmarried (AOR=2.27,95%CI=1.42-3.62), non local residents (AOR=2.03,95%CI= 1.29-3.20), and no STIs related symptoms (AOR=1.66,95%CI=1.09-2.52) and Mg infection had been found in the past 1 years. The incidence of Mg infection in the associated.MSP was 28% (95%CI=25.50%-30.49%), solitary (AOR=3.84,95%CI=1.58-9.33), without STIs related symptoms (AOR=2.21,95%CI=1.35-3.62) in the last 1 years, and the recent 3 months with FSWs sexual behavior (AOR=2.27,95%CI=1.41-3.67) associated with Mg infection. The above study results showed that the Mg rate was high in FSWs and MSP population, and most of them were asymptomatic. It is suggested that routine screening for Mg infection in these high-risk groups is necessary.
The third part: prevalence and risk factors of Mycoplasma reproductive tract among men who have sex with men in Guangzhou.
From January 2010 to May, the method of snowball was used to investigate and collect urine samples from MSM gay bar, tea bar, sauna bath pool, night club, park, public toilet and other places. Taqman MGB fluorescence PCR was used to detect Mg.328 name MSM, 97.6% self identity was homosexual, of which 41.8% were homosexual but also female hair. Sexual relationship, 87.8% half a year had anal sex with men, 63.2% in the last time in the use of condoms in the anal intercourse, 16.8% months with women in sexual behavior, only 27.3% in the last time with women in the use of condoms, 4.6% sex trade, the way to find sex with the Internet, accounting for 79.0%.323 urine specimens. The infection rate of Mg was 4.3% (95%CI=3.1%-5.4%), and the factors associated with Mg infection were not found. The results showed that the rate of Mg infection was low in the MSM population, suggesting that Mg infection was mainly transmitted by heterosexual behavioral pathways, and MSM was more significant as the source of Mg infection.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2012
【分類號(hào)】：R759
本文編號(hào)：2145830
[Abstract]:Mycoplasma genitalium (Mg) is one of the pathogens of sexually transmitted disease (STD) identified in recent years. It causes non gonococcal urethritis (NGU) in men, causes cervicitis, endometritis and pelvic inflammation in women, such as untreated undesirable outcomes, such as ectopic pregnancy and infertility.
NUG is a common STD. In the world, there are 89 million new cases each year, and the incidence of NGU is increasing year by year. In China, since 1988, NGU has been monitored as a key monitoring venereal disease at some monitoring points. Since 2002, the number of cases of NGU exceeds the gonorrhea, and there is a set of STD first reported in the residence, and then in the following. For a few years, more than 35% of the national STD case reports were accounted for. However, since 2008, NGU monitoring was replaced by Chlamydia trachomatis (CT) infection. The most important reason is that CT infection has been identified as one of the main causes of NGU, and can be detected in NGU patients in 11%-43%.
The study shows that Mg is one of the other important common pathogens of NGU, which can be detected in 9%--25%NGU patients. It is rare to merge with CT, and Mg positive in recurrent and persistent NGU patients after standard treatment. Therefore, Mg may play an important role in the CT negative NGU patients. The recommended treatment for azithromycin or doxycycline is a standard treatment. After treatment, the cases of Mg positive NGU failure have been reported in succession, indicating the emergence of drug resistance. With the understanding of the pathogenicity of Mg in NGU, Mg is becoming more and more important abroad. In 2009, the European male NGU guide to diagnosis of Mg should be included in the clinical diagnosis of Mg, and the treatment of chronic NGU patients should be covered with the drugs for the treatment of Mg. In 2010, Eastern European countries established guidelines for laboratory diagnosis of Mg infection.
Research on the prevalence of Mg in Chinese population is limited. Previous studies have found that the prevalence of Mg in NGU patients is 20.6%-25% and is up to 44.19% in CT negative NGU patients. This discovery is similar to that in other countries, indicating that the prevalence of Mg in China should be paid more attention.
Female sex workers (FSWs), STD clinic male doctor (MSP) and male male actor (MSM) are high risk population of STD/HIV infection, and also the key population of HIV sentinel monitoring. With the change of HIV transmission pattern in recent years, sexual transmission has become the main mode of HIV transmission. The spread of the above population plays an important role in the transmission of HIV. Recently, the research has been studied. Mg is closely related to HIV. Mg infection may promote infection and transmission of HIV. A systematic review of the correlation between Mg infection and HIV positive in genitourinary tract and Meta analysis found that Mg infection is significantly related to HIV positive. The HIV positive rate in Mg infected persons is 2 times that of those who are not infected with Mg. Falling off further promotes the spread of HIV. Therefore, understanding the prevalence of Mg in these high-risk groups and intervening in time will not only help to control the spread of Mg, prevent the occurrence of bad outcome, but also play an active role in the prevention and control of HIV.
Although Mg is being paid more and more attention in the international community, however, it is very difficult to cultivate Mg in vitro, and there is no commercial detection kit in China at present. Therefore, the epidemiological study of Mg is greatly restricted and the corresponding epidemiological data are lacking. This study aims to adopt the simple, fast, sensitive and specific TaqmanM of the literature report. GB real-time quantitative PCR method was used to investigate the prevalence of Mg in MSP, and the related risk factors were analyzed to provide baseline data for the epidemic and monitoring of Mg in high-risk groups, and to provide reference for the development of prevention and control strategies. The full text is divided into three parts, the main contents of each part are as follows:
The first part: the establishment of Taqman MGB fluorescence PCR method
The Taqman MGB fluorescent PCR method, which was reported in the literature, was specific and sensitive to Mg major adhesion gene (MgPa gene) as the target gene. The Mg standard strain G37 was used to prepare 1 x 101 copies /gl, 1 x 102 copies /gl, 1 x 103 copies / mu L, 1 * 104 copy / mu L, 1 x 10. copy / muon, 1 106 copy / micron standard, preparation standard, preparation standard Curves, and detection of the repeatability, sensitivity and specificity of the method, determine the detection limit (LOD) and quantitative limit (LOQ) of the method. The results show that the linear range of the Taqman MGB real-time quantitative PCR method is good (1 x 101 copies / mu l--l x 106 copies / L), the standard curve regression equation y=-3.982x+40.80, R2=0.993, and good reproducibility (intra variation) The coefficient =0.7%, the inter group variation coefficient =1.09%), the sensitivity high, the detection limit (LOD) for each PCR reaction 10 copies, the quantitative limit (LOQ) is 10 copies / mu L, using this method to detect the genitourinary tract common 10 pathogens are negative, indicating that the method is high sensitivity, good specificity, and has good repeatability. We think of the MgPa gene Taqman MGB real. PCR can quickly and sensitively detect the Mg qualitatively and quantitatively. It provides a great convenience for detecting the infection of Mg in the population.
The second part: epidemiological investigation and risk factors analysis of Mycoplasma genital mycoplasma in male sex workers and sexually transmitted diseases outpatients in Guangxi.
The Taqman MGB fluorescence PCR method established in the first part was used to investigate the epidemic situation of Mg in Guangxi FSWs and MSP. By using the place based stratified sampling method, the FSWs and Hezhou sex of the hotels, hotels, nightclubs, KTV, hairdresser, roadside, park, park and other places of entertainment and outdoor places in Wuzhou, Wuzhou, Hezhou, Hezhou, Guangxi, from July 2009 to September. FSWs is divided into 3 categories according to the workplace and the income of each sex transaction. Roadside stores, rental houses, station street and park work or lower FSWs, KTV, hairdresser, beauty hairdresser and other place workers are low file FSWs, KTV, hairdresser, and beauty hairdresser for the middle grade FSWs, hotel, hotel and night club for the high-end FSWs, after obtaining informed consent The subjects were investigated with a questionnaire and collected FSWs's cervix swabs and MSP urine specimens. The results of Taqman MGB fluorescence PCR were included in 810 FSWs and 423 MSP. The infection rate of Mg in 810 cervix swabs and 407 urine specimens was 13.2% (95%CI=10.87%-15.52%) and 15.7% (15.7%) 2%-18.2%), 10.8% (95%CI=8.67%-12.93%) and 14.6% (95%CI=12.17%-17.03%), there was no statistical difference between different grades, the degree of education was lower than that of junior middle school (AOR=2.36,95%CI=1.15-4.87), unmarried (AOR=2.27,95%CI=1.42-3.62), non local residents (AOR=2.03,95%CI= 1.29-3.20), and no STIs related symptoms (AOR=1.66,95%CI=1.09-2.52) and Mg infection had been found in the past 1 years. The incidence of Mg infection in the associated.MSP was 28% (95%CI=25.50%-30.49%), solitary (AOR=3.84,95%CI=1.58-9.33), without STIs related symptoms (AOR=2.21,95%CI=1.35-3.62) in the last 1 years, and the recent 3 months with FSWs sexual behavior (AOR=2.27,95%CI=1.41-3.67) associated with Mg infection. The above study results showed that the Mg rate was high in FSWs and MSP population, and most of them were asymptomatic. It is suggested that routine screening for Mg infection in these high-risk groups is necessary.
The third part: prevalence and risk factors of Mycoplasma reproductive tract among men who have sex with men in Guangzhou.
From January 2010 to May, the method of snowball was used to investigate and collect urine samples from MSM gay bar, tea bar, sauna bath pool, night club, park, public toilet and other places. Taqman MGB fluorescence PCR was used to detect Mg.328 name MSM, 97.6% self identity was homosexual, of which 41.8% were homosexual but also female hair. Sexual relationship, 87.8% half a year had anal sex with men, 63.2% in the last time in the use of condoms in the anal intercourse, 16.8% months with women in sexual behavior, only 27.3% in the last time with women in the use of condoms, 4.6% sex trade, the way to find sex with the Internet, accounting for 79.0%.323 urine specimens. The infection rate of Mg was 4.3% (95%CI=3.1%-5.4%), and the factors associated with Mg infection were not found. The results showed that the rate of Mg infection was low in the MSM population, suggesting that Mg infection was mainly transmitted by heterosexual behavioral pathways, and MSM was more significant as the source of Mg infection.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2012
【分類號(hào)】：R759
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 金岳龍;姚應(yīng)水;葉冬青;何建剛;豆正東;齊少波;安洲;;女性商業(yè)性工作者STD/AIDS檢測(cè)及安全套使用現(xiàn)狀的調(diào)查與分析[J];中華疾病控制雜志;2009年01期
2 王荷英,施美琴,葉順章,賴偉紅,張傳福,姜文華,薛華忠,王紅春;451例STD患者的生殖支原體感染[J];臨床皮膚科雜志;2002年09期
3 張北川,李秀芳,史同新,胡鐵中,劉殿昌;對(duì)男性同性愛(ài)人群性病艾滋病高危行為的調(diào)查及其干預(yù)模式探索[J];中國(guó)麻風(fēng)皮膚病雜志;2002年01期
4 蔣娟,葉順章,王荷英,韓國(guó)柱,施美琴,王紅春,薛華忠,張樹(shù)文,柏立琴,潘繼紅;生殖支原體和解脲脲原體與非淋菌性尿道炎相關(guān)性的研究[J];中國(guó)麻風(fēng)皮膚病雜志;2005年02期
5 趙季文,王婉云,范寶劍,張獻(xiàn)哲,徐萃瑜,仉慶文,汪寧;生殖支原體分離培養(yǎng)及流行病學(xué)意義的研究[J];南京鐵道醫(yī)學(xué)院學(xué)報(bào);1997年04期
6 曹寧校;張津萍;夏強(qiáng);龔向東;王學(xué)武;薛華忠;羊海濤;張國(guó)成;邵長(zhǎng)庚;蔣娟;;江蘇省部分城市男男性行為者HIV/STD感染情況研究[J];中國(guó)艾滋病性病;2006年02期
7 李東民;袁飛;胡紹源;呂繁;;不同場(chǎng)所暗娼的高危行為和HIV/STI感染狀況調(diào)查[J];中國(guó)艾滋病性病;2007年03期
8 王蓓,崔玉明,趙季文,徐萃瑜,張瑩;細(xì)胞培養(yǎng)法分離培養(yǎng)生殖支原體的研究[J];預(yù)防醫(yī)學(xué)情報(bào)雜志;2000年01期
9 朱柳賓;黃建平;俸衛(wèi)東;;1996～2004年非淋球菌性尿道炎流行病學(xué)分析[J];中國(guó)現(xiàn)代醫(yī)生;2008年22期
10 張岱;魏宏;廖秦平;馬京梅;;女性生殖道支原體及其他病原體在急性盆腔炎中的檢出率[J];中國(guó)婦幼保健;2010年03期
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