De Francesco Maria Antonia, Negrini Riccardo, Ravizzola Giuseppe, Galli Paola, Manca Nino
Institute of Microbiology and Virology, Spedali Civili-Brescia, Brescia, Italy.
Eur J Contracept Reprod Health Care. 2011 Feb;16(1):47-53. doi: 10.3109/13625187.2010.533219. Epub 2010 Nov 23.
To identify bacterial species present in the lower genital tract of males and to investigate the relationship with semen quality.
The microscopic analyses and cultures of 696 semen specimens, collected over five years from males investigated for subfertility, were retrospectively assessed.
Semen cultures were sterile in 48%; they showed a polymicrobial flora (more than two bacterial species) in 30%, and were positive (>1 × 10(3) colony forming units/ml) in 22% of the cases. Gardnerella vaginalis was the most frequently isolated bacterium, followed by Escherichia coli and Enterococcus sp. Ureaplasma urealyticum was recovered from 13 of 147 samples (9%). Of patients with bacteriospermia 42% had leukospermia (>10(6) leukocytes/ml of semen). Bacteriospermia and leukospermia did not correlate with each other although a positive correlation was found between the presence of leukocytes and G. vaginalis isolation. Semen parameters were correlated with the bacterial species isolated most frequently. In comparison with controls, sperm concentration, motility and morphology were mostly deteriorated in the presence of G. vaginalis and U. urealyticum.
Positive seminal fluid cultures must be interpreted with caution, taking into account both raised colony counts of single isolates and leukocyte concentration in the semen. Thus the common misdiagnosis of genital tract infection, based on the presence of seminal bacteria, and unnecessary treatment with antibiotics may be avoided.
鉴定男性下生殖道中的细菌种类，并研究其与精液质量的关系。
回顾性评估了从因生育力低下接受调查的男性中在五年内收集的696份精液标本的显微镜分析和培养结果。
48%的精液培养无菌；30%显示为多微生物菌群（超过两种细菌种类），22%的病例培养阳性（>1×10³菌落形成单位/毫升）。阴道加德纳菌是最常分离出的细菌，其次是大肠杆菌和肠球菌属。从147份样本中的13份（9%）中检出解脲脲原体。在有菌精症的患者中，42%有白细胞精子症（精液中白细胞>10⁶/ml）。菌精症和白细胞精子症之间没有相关性，尽管白细胞的存在与阴道加德纳菌的分离之间存在正相关。精液参数与最常分离出的细菌种类相关。与对照组相比，在存在阴道加德纳菌和解脲脲原体的情况下，精子浓度、活力和形态大多变差。
对于阳性精液培养结果必须谨慎解读，要同时考虑单一分离菌的菌落计数增加和精液中的白细胞浓度。因此，可以避免基于精液中细菌存在而对生殖道感染的常见误诊以及不必要的抗生素治疗。
