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中国在理解和治疗由生殖支原体、人型支原体和脲原体引起的泌尿生殖道感染方面的进展。

Chinese advances in understanding and managing genitourinary tract infections caused by Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma urealyticum.

机构信息

Institute of Pathogenic Biology, Basic Medical School, Hengyang Medical School, University of South China, Hengyang Central Hospital, Hengyang, 421001, China.

出版信息

Arch Microbiol. 2024 Nov 28;207(1):5. doi: 10.1007/s00203-024-04204-z.

Abstract

Mycoplasma genitalium, Ureaplasma urealyticum and Mycoplasma hominis are bacterial pathogens found in the genitourinary tract, implicated in a range of infections. In women, these infections including pelvic inflammatory disease, vaginitis, infertility, and cervical cancer, while in men, they can cause non-gonococcal urethritis, prostate cancer, among other conditions. These infections are a global health concern, with China identified as a country with a high prevalence. This review provides a comprehensive overview of the epidemiology, causative factors, and diagnostic methods for these three Mycoplasma species with in China. The rise of multi-drug resistance, driven by antibiotics overuse, poses a significant challenge to treatment, complicating patient management. These Mycoplasma species employ unique adhesion mechanisms that trigger a cascade of signal transduction, culminating to inflammatory responses, tissue damage, and the release of toxic metabolites. Here, we delineate the mechanisms of underlying Mycoplasma resistance and propose key therapeutic strategies for these three mycoplasmas in China. This includes a summary of effective antibiotic treatment strategies, and potential combinations of therapeutic to improve cure rates, and a discussion of potential therapeutic approaches using traditional Chinese medicine.

摘要

生殖支原体、解脲脲原体和人型支原体是存在于泌尿生殖道的细菌病原体,与多种感染有关。在女性中,这些感染包括盆腔炎、阴道炎、不孕和宫颈癌,而在男性中,它们可引起非淋球菌性尿道炎、前列腺癌等疾病。这些感染是一个全球性的健康问题,中国被确定为高发国家。本综述全面概述了这三种支原体在中国的流行病学、病因和诊断方法。抗生素的过度使用导致多药耐药性的上升,对治疗构成了重大挑战,使患者的管理变得复杂。这些支原体采用独特的粘附机制,引发信号转导级联反应,最终导致炎症反应、组织损伤和有毒代谢物的释放。在这里,我们阐述了支原体耐药的潜在机制,并针对中国的这三种支原体提出了关键的治疗策略。这包括对有效抗生素治疗策略的总结,以及提高治愈率的治疗联合方案的潜在讨论,以及使用中药的潜在治疗方法的讨论。

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