性传播感染引起异性男性尿道炎和相关尿液炎症反应的特征：流式细胞术研究。
Profile of sexually transmitted infections causing urethritis and a related inflammatory reaction in urine among heterosexual males: A flow-cytometry study.
机构信息
Andrology Centre, Tartu University Hospital, Tartu, Estonia.
Faculty of Medicine, University of Tartu, Tartu, Estonia.
出版信息
PLoS One. 2020 Dec 2;15(12):e0242227. doi: 10.1371/journal.pone.0242227. eCollection 2020.
BACKGROUND
Information about the use of flow cytometry in the diagnosis of male urethritis is scarce. The current study aims to evaluate the performance of flow cytometry on first-voided urine in males with infectious urethritis (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis).
METHODS
Male patients of the Andrology Centre (Tartu University Hospital, Estonia) were recruited during the period March 2015 -January 2018. Cases included 306 patients with infectious urethritis caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and/or Trichomonas vaginalis. The control group consisted of 192 patients without uro-genital complaints, negative tests for C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis from first-voided urine and no inflammation in first-voided urine, mid-stream urine and urine after prostate massage. C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis were detected from first-voided urine using polymerase chain reaction (PCR) method. First-voided urine was analysed using urine particle analyzer Sysmex UF-500i.
RESULTS
The most prevalent infection was chlamydia (64.1%), followed by Mycoplasma genitalium (20.9%), gonorrhoea (7.8%) and trichomoniasis (1.6%). Gonorrhoea caused the highest flow-cytometric leucocyte/bacteria count, followed by chlamydia and Mycoplasma genitalium. Trichomonas vaginalis showed nearly absent inflammation in first-voided urine. Using an empiric flow-cytometry diagnostic threshold for urethritis in first-voided urine (leucocytes ≥ 15/μl and bacteria ≥ 20/μl) the total calculated sensitivity was over 90%. However, when applying such criteria for deciding whether to perform first-voided urine PCR for C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis or not, we could miss 23 cases with infectious urethritis that makes up 7,5% of all proven cases.
CONCLUSIONS
Flow cytometry of first-voided urine can be considered as a rapid and objective screening method in case of suspected male infectious urethritis.
背景
关于流式细胞术在男性尿道炎症诊断中的应用信息较少。本研究旨在评估流式细胞术在由沙眼衣原体、淋病奈瑟菌、生殖支原体和阴道毛滴虫引起的男性传染性尿道炎患者首段尿中的应用价值。
方法
2015 年 3 月至 2018 年 1 月期间，在爱沙尼亚塔尔图大学医院男科中心招募男性患者。病例组包括 306 例由沙眼衣原体、淋病奈瑟菌、生殖支原体和/或阴道毛滴虫引起的传染性尿道炎患者。对照组包括 192 例无泌尿生殖系统症状、首段尿沙眼衣原体、淋病奈瑟菌、生殖支原体和阴道毛滴虫检测阴性、首段尿、中段尿和前列腺按摩后尿无炎症的患者。采用聚合酶链反应（PCR）方法检测沙眼衣原体、淋病奈瑟菌、生殖支原体和阴道毛滴虫。采用 Sysmex UF-500i 尿粒子分析仪分析首段尿。
结果
最常见的感染是衣原体（64.1%），其次是生殖支原体（20.9%）、淋病（7.8%）和滴虫病（1.6%）。淋病引起的流式细胞术白细胞/细菌计数最高，其次是衣原体和生殖支原体。阴道毛滴虫在首段尿中几乎没有炎症表现。使用首段尿尿道炎的经验性流式细胞术诊断阈值（白细胞≥15/μl，细菌≥20/μl），总计算敏感性超过 90%。然而，当应用这些标准来决定是否进行首段尿 PCR 检测沙眼衣原体、淋病奈瑟菌、生殖支原体和阴道毛滴虫时，我们可能会错过 23 例传染性尿道炎患者，占所有确诊病例的 7.5%。
结论
流式细胞术检测首段尿可作为疑似男性传染性尿道炎的快速、客观的筛查方法。
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