Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences.
State Autonomous Institution of Health of the Sverdlovsk Region "Clinical and Diagnostic Center of the city of Yekaterinburg".
Klin Lab Diagn. 2022 Aug 15;67(8):463-470. doi: 10.51620/0869-2084-2022-67-8-463-470.
Infectious etiology is the cause of about 15% of cases of male infertility. And if sexually transmitted infections are easily diagnosed, the role of asymptomatic bacteriospermia in the formation of infertility in men, and especially in adolescents against the background of the existing pathology of the reproductive sphere (varicocele), remains insufficiently studied. A microbiological study in the ejaculate of adolescents revealed the following types of bacteria: Escherichia coli, Enterococcus faecalis, Corynebacterium glucuronolyticum, Corynebacterium minitissimum, Streptococcus anginosus, Staphylococcus epidermidis, Staphylococcus haemolyticus. Bacteria in the ejaculate were also detected during semen analysis and electron microscopic examination of spermatozoa. With abundant growth of microorganisms in a monoculture or an association of two microorganisms present in a moderate amount, in all cases, violations of sperm motility, an increase in the viscosity of the ejaculate, the presence of leukocytes in the seminal fluid were detected, and damage to the chromatin, acrosome and mitochondria was recorded at the ultrastructural level, which may indicate active infection. When bacterial flora was detected in a small and moderate amount (<10 CFU/ml), no pathological changes in the ejaculate were observed. The microflora of the ejaculate of the examined adolescents is represented by gram-positive microflora. Simultaneous study of the ejaculate sample by bacteriological seeding, the performance of spermogram and EMIS allowed to increase the detection of bacteriospermia. Opportunistic pathogens with abundant growth or their various combinations can serve as a factor in the development of pathospermia. It is possible to distinguish an active infection from commensal microflora or sample contamination not only by the presence of bacteria in the ejaculate and their quantitative accounting, but also by the degree of damage to the function of spermatozoa and pathological changes in the parameters of the ejaculate, by combining diagnostic methods. Most often, in the presence of bacteria in the ejaculate, asthenozoospermia is diagnosed.
感染病因约占男性不育症的 15%。如果性传播感染很容易诊断，那么无症状菌精症在男性不育症形成中的作用，尤其是在青少年生殖领域现有病理学的背景下（精索静脉曲张），其作用仍未得到充分研究。对青少年精液进行微生物学研究发现了以下类型的细菌：大肠杆菌、粪肠球菌、解糖胨 Corynebacterium、微小棒状杆菌、咽峡炎链球菌、表皮葡萄球菌、溶血性葡萄球菌。在精液分析和精子电子显微镜检查中也检测到精液中的细菌。在单一培养物中微生物大量生长或两种微生物以中等数量存在的联合体中，在所有情况下，均检测到精子运动能力受损、精液粘度增加、精液中白细胞存在，以及超微结构水平上记录到染色质、顶体和线粒体损伤，这可能表明存在活动性感染。当检测到细菌菌群数量较少且中等量时（<10 CFU/ml），精液中未观察到病理性变化。所检查青少年的精液微生物区系由革兰氏阳性微生物组成。通过细菌培养、精液常规分析和 EMIS 同时研究精液样本，可以提高菌精症的检出率。大量生长的机会性病原体或其各种组合都可能成为病态精子症的发展因素。不仅可以通过精液中存在细菌及其定量计数来区分活性感染与共生微生物区系或样本污染，还可以通过精子功能损伤和精液参数的病理变化程度，结合诊断方法来区分。大多数情况下，在精液中存在细菌时，会诊断为弱精子症。
