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目的通过对男性不育症患者精液细菌培养,精液常规分析,了解男性不育症患者精液细菌感染率、菌种分布、细菌的耐药率以及细菌感染对精液常规各主要参数的影响。方法对来浙江中医药大学附属宁波中医院男科门诊就诊的325例不育症患者的精液进行细菌培养、鉴定及药敏分析,并采用北京伟力计算机辅助精子分析系统对精液进行常规分析,以了解精液细菌感染分布以及对精液常规各主要质量参数的影响。结果 325例男性不育症精液分离出127株细菌,感染率为39.1%,其中G~+球菌占59.9%,以葡萄球菌为主。G~-杆菌占22.0%,以大肠埃希菌为主。药敏分析发现,葡萄球菌对头孢菌素类、大环内酯类耐药率较高;大肠埃希菌对氨苄西林和复方新诺明耐药率较高。精液细菌各感染组与正常男性对照组对精子浓度、存活率、前向运动比率以及液化时间这四个质量参数进行比较,淋病奈瑟菌组的精子浓度较其他感染组显著降低(P<0.01);金黄色葡萄球菌组和大肠埃希菌组的精子存活率较其他感染组显著降低(P<0.01);金黄色葡萄球菌组、大肠埃希菌组和淋病奈瑟菌组的精子前向运动比率与其他感染组比较差异有统计学意义(P<0.01);大肠埃希菌组的液化时间较其他感染组延长(P<0.05)。结论男性不育症精液细菌培养以G~+球菌分离率较高,超过大肠埃希菌的分离率;各主要感染组中凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌以及淋病奈瑟菌对精液常规各主要参数的影响各有特点,需加以关注。
OBJECTIVE: To study the effects of bacterial infection in semen of male infertility patients and semen analysis on the prevalence of sepsis, strain distribution, bacterial resistance rate and bacterial infection in semen of male infertility patients. Methods Bacteria culture, identification and drug sensitivity analysis were performed on 325 infertile patients who were admitted to Ningbo TCM Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine. The sperms were routinely analyzed by Beijing Weili computer-assisted sperm analysis system The distribution of semen bacterial infection and its influence on the main quality parameters of semen routine. Results A total of 127 strains of bacteria were isolated from 325 cases of male infertility, the infection rate was 39.1%. Among them, G ~ + bacteria accounted for 59.9%, mainly Staphylococcus. G ~ - accounted for 22.0% of bacteria, mainly to Escherichia coli. Drug susceptibility analysis found that staphylococcus aureus cephalosporins, macrolides resistant rate higher; Escherichia coli ampicillin and cotrimoxazole resistance rate higher. The sperm concentration, survival rate, forward movement ratio and liquefaction time were compared among the four semen groups and the normal male control group. The concentrations of sperm in Neisseria gonorrhoeae group were significantly lower than those in other groups (P <0.01) ). The sperm viability of Staphylococcus aureus and Escherichia coli groups was significantly lower than that of other infected groups (P <0.01). The sperm motility of Staphylococcus aureus, Escherichia coli and Neisseria gonorrhoeae groups (P <0.01). The liquefaction time of Escherichia coli group was longer than that of other infection groups (P <0.05). Conclusion The isolation rate of G + -adococcus is higher than that of Escherichia coli in the seminal fluid of male infertility. The coagulase-negative staphylococci, Staphylococcus aureus, Escherichia coli, The effects of each bacterium on each of the major parameters of the semen have their own characteristics that warrant attention.