Taylor-Robinson D, Furr P M
Department of Genitourinary Medicine, Imperial College School of Medicine at St Mary's Paddington, London, United Kingdom.
Wien Klin Wochenschr. 1997 Aug 8;109(14-15):578-83.
Since 1937, 13 Mycoplasma species, two Acholeplasma species, and one Ureaplasma species have been isolated from humans. Six of these have the urogenital tract as the primary site of colonisation but others, which have the oropharynx and respiratory tract as the primary site, are found occasionally in the urogenital tract because of orogenital contact. Mycoplasma hominis was the first to be isolated and is most strongly associated with bacterial vaginosis (BV), together with a variety of other bacteria. Its involvement in pelvic inflammatory disease (PID) and other conditions may be as part of BV, although when isolated in pure culture from the blood of women who have postpartum or postabortal fever there is no reason to suspect its aetiological role. There is evidence for an aetiological role for Ureaplasma urealyticum organisms (ureaplasmas) in acute non-gonococcal urethritis (NGU) and particularly chronic NGU in men, but they rank third to Chlamydia trachomatis and M. genitalium. Whether the association of ureaplasmas with miscarriage and preterm labour is in the context of BV is not clear. Of no doubt, however, is the ability of ureaplasmas to cause septic arthritis in hypogammaglobulinaemic patients and there is evidence that they may cause some cases of sexually acquired reactive arthritis. The advent of polymerase chain reaction technology has seen an advance in the understanding of the role of M. genitalium; there is strong evidence that it is one of the causes of both acute and chronic NGU independent of C. trachomatis. There is some support for the role of M. genitalium in PID, but this needs to be substantiated. Other mycoplasmas, for example M. fermentans, M. pivum, M. primatum, M. penetrans, M. spermatophilum and even M. pneumoniae have the capacity to cause urogenital tract disease but there is no evidence to indicate that they do so.
自1937年以来，已从人类身上分离出13种支原体、2种无胆甾原体和1种脲原体。其中6种以泌尿生殖道为主要定植部位，但其他以口咽部和呼吸道为主要部位的支原体，由于口生殖器接触，偶尔也会在泌尿生殖道中发现。人型支原体是最早被分离出来的，与细菌性阴道病（BV）以及多种其他细菌密切相关。它参与盆腔炎性疾病（PID）和其他病症，可能是作为BV的一部分，不过，当从产后或流产后发热的女性血液中纯培养分离出该菌时，没有理由怀疑其病因作用。有证据表明解脲脲原体（脲原体）在急性非淋菌性尿道炎（NGU）尤其是男性慢性NGU中具有病因作用，但它们在病因方面排在沙眼衣原体和生殖支原体之后。脲原体与流产和早产之间的关联是否与BV有关尚不清楚。然而，毫无疑问的是，脲原体能够在低丙种球蛋白血症患者中引起败血症性关节炎，并且有证据表明它们可能导致一些性传播反应性关节炎病例。聚合酶链反应技术的出现推动了对生殖支原体作用的认识；有强有力的证据表明，它是急性和慢性NGU的病因之一，独立于沙眼衣原体。有一些证据支持生殖支原体在PID中的作用，但这需要得到证实。其他支原体，例如发酵支原体、猪鼻支原体、灵长类支原体、穿透支原体、嗜精支原体，甚至肺炎支原体都有能力引起泌尿生殖道疾病，但没有证据表明它们确实如此。
