Ishihara Satoshi, Yasuda Mitsuru, Ito Shin-ichi, Maeda Shin-ichi, Deguchi Takashi
Department of Urology, Gifu University School of Medicine, Gifu, Japan.
Int J Antimicrob Agents. 2004 Sep;24 Suppl 1:S23-7. doi: 10.1016/j.ijantimicag.2004.02.006.
Mycoplasma genitalium was first isolated from two men with non-gonococcal urethritis (NGU) and thereafter shown to produce urethritis in subhuman primates, inoculated intraurethrally. This mycoplasma has been detected significantly more often in patients with acute NGU, particularly in patients with non-chlamydial NGU, than in subjects without urethritis. The prevalence of M. genitalium-positive non-chlamydial NGU ranges from 18 to 46% of all non-chlamydial NGU cases. In addition, the persistence of M. genitalium in the urethra after antimicrobial chemotherapy is associated with persistence or recurrence of NGU. The various results reported to date tend to support the proposition that M. genitalium is a pathogen of NGU. M. genitalium is highly susceptible to tetracyclines, macrolides, and some new fluoroquinolones, but the clinical data on the chemotherapy in M. genitalium-positive NGU is extremely limited. Because of the possible association between the post-treatment presence of M. genitalium in the urethra and persistent or recurrent NGU, the eradication of this mycoplasma from the urethra is essential in the management of patients with M. genitalium-positive NGU. Further studies are required to establish the optimal chemotherapy for M. genitalium-positive NGU.
生殖支原体最初是从两名患有非淋菌性尿道炎（NGU）的男性中分离出来的，此后证明，将其经尿道内接种到灵长类动物体内可引发尿道炎。与无尿道炎的受试者相比，在急性NGU患者中，尤其是在非衣原体性NGU患者中，检测到这种支原体的频率要高得多。在所有非衣原体性NGU病例中，生殖支原体阳性的非衣原体性NGU患病率在18%至46%之间。此外，抗菌化疗后生殖支原体在尿道中的持续存在与NGU的持续或复发有关。迄今为止报告的各种结果倾向于支持生殖支原体是NGU病原体这一观点。生殖支原体对四环素、大环内酯类药物以及一些新型氟喹诺酮类药物高度敏感，但关于生殖支原体阳性NGU化疗的临床数据极为有限。由于治疗后尿道中存在生殖支原体可能与NGU的持续或复发有关，因此从尿道中根除这种支原体对于治疗生殖支原体阳性NGU患者至关重要。需要进一步研究以确定针对生殖支原体阳性NGU的最佳化疗方案。
