解脲脲原体和生殖支原体与女性黏液脓性宫颈炎相关性的研究
摘要
第一章解脲脲原体和生殖支原体与女性黏液脓性宫颈炎相关性的研究
目的探讨Uu和Mg与女性非衣原体非淋球菌感染的MPC的相关性。方法研究对象包括性病门诊就诊的女性非衣原体非淋球菌感染的MPC患者及健康体检人群两组。采集宫颈拭子标本,运用支原体培养及半定量培养的方法检测Uu,运用PCR技术检测Mg。一般情况、病史和性行为等采用问卷调查。结果Uu在非衣原体非淋球菌感染的MPC患者中的检出率为81.42%(184/226),健康体检人群中的检出率为64.41%(76/118),特别是MPC病例组中Uu半定量培养浓度≥10~4 ccu/mL的阳性率(42.48%)明显高于对照组(16.95%),有高度显著性差异(χ~2=22.61,P＜0.001);Mg在非衣原体非淋球菌感染的MPC患者中的检出率为11.06%(25/226),健康体检人群中的检出率为0.85%(1/118),两组间差异有统计学意义(χ~2=11.58,P＜0.001)。多因素回归分析发现,近3个月非婚性伴数、宫颈口有黏液脓性分泌物及宫颈涂片PMNL≥10个/油镜视野对Mg阳性的影响均有统计学意义(P=0.001、P=0.042和P=0.027)。结论Uu浓度高感染可能在MPC中有一定的致病作用;Mg与性病门诊就诊者中的非衣原体非淋球菌感染的MPC相关。
第二章解脲脲原体生物群及基因型与黏液脓性宫颈炎相关性的研究
目的探讨Uu生物群及基因型与女性非衣原体非淋球菌感染的MPC的相关性。方法研究对象包括性病门诊就诊的女性非衣原体非淋球菌感染的MPC患者及健康体检人群两组,对Uu培养阳性标本应用PCR-SSCP方法检测Uu的生物群及基因型。结果Uu生物一群中的基因3/14型在两组中的检出率均最高,分别为30.98%(57/184)和43.42%(33/76);MPC病例组中生物二群的Uu基因2B型的检出率为16.30%(30/184)明显高于健康体检组的6.58%(5/76),有显著统计学差异(χ~2=4.367,P=0.037);而健康体检组中主要以生物一群中的基因1、3/14、6型的单型别感染为主占81.58%。结论Uu生物二群中的基因2B型可能与性病门诊就诊者中的非衣原体非淋球菌感染的MPC有一定相关性。
ChapterⅠ.Associations of Ureaplasma urealyticum and Mycoplasma genitalium with Mucopurulent cervicitis in Women
Objective To study the association of U.urealyticum and M.genitalium among women with nongonococcal,nonchlamydial mucopurulent cervicitis in women.
Methods The study population consisted of two different groups including STD clinic female patients with nongonococcal,nonchlamydial mucopurulent cervicitis and healthy women.Cervical samples were collected from all subjects.The specimens were tested for the presence of U.urealyticum by culture and M.genitalium by polymerase chain reaction,respectively.Information about socio-demographic characteristics,medical history,sexual behaviour was gathered through a questionnaire.Results The rate of positive culture for U.urealyticum was 81.42% (184/226) in patiens with mucpurulent cervicitis,while 64.41%(76/118 ) in heathy women.The rate of positive culture with Uu≥10~4 ccu/mL was significanthy higher in patients with mucpurulent cervicitis(42.48%),than that in control group(16.95%) (χ~2=22.61,P＜0.001).The prevalence of M.genitaliurn was 11.06%(25/226) in patiens with mucpurulent cervicitis,while 0.85%(1/118) in heathy women.There was a significant difference between the two groups(χ~2=11.58,P＜0.001).By multivariate regression analysis,M.genitalium was strongly associated with multiple sex partners,mucopurulent secretion and≥10 polymorphonuclear leukocytes per high-power field on Gram stained cervical smear(P=0.001,P=0.042 and P=0.027).
Conclusion This study indicates that infection with U.urealyticum at a high concentration may be related to mucopurulent cervicitis,and M.genitalium is associated with nongonococcal,nonchlamydial mucopurulent cervicitis among female patients attending STD clinic.
ChapterⅡ.Association of Ureaplasma urealyticum biovar and genotype with Mucopurulent cervicitis
Objective To study the association of U.urealyticum biovar and genotype with nongonococcal,nonchlamydial mucopurulent cervicitis.Methods The study population consisted of two different groups including STD clinic female patients with nongonococcal,nonchlamydial mucopurulent cervicitis and healthy women(as controls).U.urealyticum biovar and genotype were differentiated from U. urealyticum positive cultures by polymerase chain reaction and single-strand conformation polymorphism analysis.Results The rate of mba genotype 3/14 from biovars 1 was the highest in both groups,30.98%(57/184) in patients with mucopurulent cervicitis and 43.42%(33/76) in controls.The rate of genotype 2B from biovars 2 was 16.30%(30/184) in patient group,while 6.58%(5/76) in controls,and there was a significant difference between the two groups(χ~2 = 4.367,P=0.037). Genotype 1,3/14 and 6 from biovar 1 was dominant in healthy population(81.58%).
Conclusion This study indicates that genotype 2B of U.urealyticum biovars 2 may be associated with nongonococcal,nonchlamydial mucopurulent cervicitis among female patients attending STD clinic.
目的探讨Uu和Mg与女性非衣原体非淋球菌感染的MPC的相关性。方法研究对象包括性病门诊就诊的女性非衣原体非淋球菌感染的MPC患者及健康体检人群两组。采集宫颈拭子标本,运用支原体培养及半定量培养的方法检测Uu,运用PCR技术检测Mg。一般情况、病史和性行为等采用问卷调查。结果Uu在非衣原体非淋球菌感染的MPC患者中的检出率为81.42%(184/226),健康体检人群中的检出率为64.41%(76/118),特别是MPC病例组中Uu半定量培养浓度≥10~4 ccu/mL的阳性率(42.48%)明显高于对照组(16.95%),有高度显著性差异(χ~2=22.61,P＜0.001);Mg在非衣原体非淋球菌感染的MPC患者中的检出率为11.06%(25/226),健康体检人群中的检出率为0.85%(1/118),两组间差异有统计学意义(χ~2=11.58,P＜0.001)。多因素回归分析发现,近3个月非婚性伴数、宫颈口有黏液脓性分泌物及宫颈涂片PMNL≥10个/油镜视野对Mg阳性的影响均有统计学意义(P=0.001、P=0.042和P=0.027)。结论Uu浓度高感染可能在MPC中有一定的致病作用;Mg与性病门诊就诊者中的非衣原体非淋球菌感染的MPC相关。
第二章解脲脲原体生物群及基因型与黏液脓性宫颈炎相关性的研究
目的探讨Uu生物群及基因型与女性非衣原体非淋球菌感染的MPC的相关性。方法研究对象包括性病门诊就诊的女性非衣原体非淋球菌感染的MPC患者及健康体检人群两组,对Uu培养阳性标本应用PCR-SSCP方法检测Uu的生物群及基因型。结果Uu生物一群中的基因3/14型在两组中的检出率均最高,分别为30.98%(57/184)和43.42%(33/76);MPC病例组中生物二群的Uu基因2B型的检出率为16.30%(30/184)明显高于健康体检组的6.58%(5/76),有显著统计学差异(χ~2=4.367,P=0.037);而健康体检组中主要以生物一群中的基因1、3/14、6型的单型别感染为主占81.58%。结论Uu生物二群中的基因2B型可能与性病门诊就诊者中的非衣原体非淋球菌感染的MPC有一定相关性。
ChapterⅠ.Associations of Ureaplasma urealyticum and Mycoplasma genitalium with Mucopurulent cervicitis in Women
Objective To study the association of U.urealyticum and M.genitalium among women with nongonococcal,nonchlamydial mucopurulent cervicitis in women.
Methods The study population consisted of two different groups including STD clinic female patients with nongonococcal,nonchlamydial mucopurulent cervicitis and healthy women.Cervical samples were collected from all subjects.The specimens were tested for the presence of U.urealyticum by culture and M.genitalium by polymerase chain reaction,respectively.Information about socio-demographic characteristics,medical history,sexual behaviour was gathered through a questionnaire.Results The rate of positive culture for U.urealyticum was 81.42% (184/226) in patiens with mucpurulent cervicitis,while 64.41%(76/118 ) in heathy women.The rate of positive culture with Uu≥10~4 ccu/mL was significanthy higher in patients with mucpurulent cervicitis(42.48%),than that in control group(16.95%) (χ~2=22.61,P＜0.001).The prevalence of M.genitaliurn was 11.06%(25/226) in patiens with mucpurulent cervicitis,while 0.85%(1/118) in heathy women.There was a significant difference between the two groups(χ~2=11.58,P＜0.001).By multivariate regression analysis,M.genitalium was strongly associated with multiple sex partners,mucopurulent secretion and≥10 polymorphonuclear leukocytes per high-power field on Gram stained cervical smear(P=0.001,P=0.042 and P=0.027).
Conclusion This study indicates that infection with U.urealyticum at a high concentration may be related to mucopurulent cervicitis,and M.genitalium is associated with nongonococcal,nonchlamydial mucopurulent cervicitis among female patients attending STD clinic.
ChapterⅡ.Association of Ureaplasma urealyticum biovar and genotype with Mucopurulent cervicitis
Objective To study the association of U.urealyticum biovar and genotype with nongonococcal,nonchlamydial mucopurulent cervicitis.Methods The study population consisted of two different groups including STD clinic female patients with nongonococcal,nonchlamydial mucopurulent cervicitis and healthy women(as controls).U.urealyticum biovar and genotype were differentiated from U. urealyticum positive cultures by polymerase chain reaction and single-strand conformation polymorphism analysis.Results The rate of mba genotype 3/14 from biovars 1 was the highest in both groups,30.98%(57/184) in patients with mucopurulent cervicitis and 43.42%(33/76) in controls.The rate of genotype 2B from biovars 2 was 16.30%(30/184) in patient group,while 6.58%(5/76) in controls,and there was a significant difference between the two groups(χ~2 = 4.367,P=0.037). Genotype 1,3/14 and 6 from biovar 1 was dominant in healthy population(81.58%).
Conclusion This study indicates that genotype 2B of U.urealyticum biovars 2 may be associated with nongonococcal,nonchlamydial mucopurulent cervicitis among female patients attending STD clinic.
引文
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21. Clausen HF, Fedder J, Drasbek M, et al. Serological investigation of Mycoplasma genitalium in infertile women. Human Reproduction, 2001,16(9): 1866-1874.
22. Baczynska A, Friis Svenstrup H, Fedder J, et al. The use of enzyme-linked immunosorbent assay for detection of Mycoplasma hominis antibodies in infertile women serum samples. Hum Reprod, 2005, 20(5): 1277-1285.
23. Martinelli F, Garrafa E, Turano A, et al. Increased frequency of detection of Ureaplasma urealyticum and Mycoplasma genitalium in AIDS patients without urethral symptoms. J Clin Microbiol, 1999, 37(6): 2042-2044.
24、 I M Linhares, S S Witkin,P Giraldo, et al. Ureaplasma urealyticum colonization in the vaginal introitus and cervix of human immunodeficiency virus-infected women. Int J STD AIDS, 2000, 11:176-179.
1.Marrazzo JM,Martin D.Management of women with cervicitis.Clin Infect Dis.2007,44(3):102-110.
2.Romoren M,Sundby J,Velauthapillai M,et al.Chlamydia and gonorrhoea in pregnant Batswana women:time to discard the syndromic approach? BMC Infect Dis.2007,16(7):27.
3.Marrazzo JM.Mucopurulent cervicitis:no longer ignored,but still misunderstood.Infect Dis Clin North Am 2005,19(2):333-349.
4.B Andrsen,I Sokolowski,L Φstergaard,et al.Mycoplasma genitalium:prevalence and behavioural risk factors in the general population.Sex Transm Infect.2007,83:237-241.
5.L E.Manhart,K.K.Holmes,James P.Hughes.Mycoplasma genitalium Among Young Adults in the United States:An Emerging Sexually Transmitted Infection.American Public Health Association.2007,97(6):1118-1125.
6.LE Manhart,CW Critchlow,KK Holmes,et al.Mucopurulent cervicitis and Mycoplasma genitalium.J infect Dis.2003,187:650-657.
7.Uno M,Deguchi T,Komeda H,et al.Mycoplasma genitalium in the cervices of Japanese women. Sex Transm Dis.1997,24: 284-286.
8. Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect.2005, 81(1): 67-72.
9. Haggerty CL, Totten PA, Astete SG, et al. Mycoplasma Genitalium Among Women With Nongonococcal, Nonchlamydial Pelvic Inflammatory Disease. Infect Dis Obstet Gynecol.2006, 5:1-5.
10. Falk L, Fredlund H, Jensen JS. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection. Sex Transm Infect, 2005, 81(1): 73-78.
11. Cohen CR, Nosek M, Meier A, et al. Mycoplasma genitalium infection and persistence in a Cohort of female sex workers in Nairobi,Kenya. Sex Transm Dis.2007,34(5):274-279.
12. Nyirjesy P. Nongonococcal and nonchlamydial cervicitis. Curr Infect Dis Rep, 2001, 3(6): 540-545.
13. Ness RB, Hillier SL, Kip KE, et al. Bacterial vaginosis and risk of pelvic inflammatory disease. Obstet Gynecol.2004,104(4):761-769.
14. Schwebke JR, Weiss HL. Interrelationships of bacterial vaginosis and cervical inflammation. Sex Transm Dis.2002,29(1):59-64.
15. Ness RB, Kip KE, Soper DE,et al. Variability of bacterial vaginosis over 6- to 12-month intervals. Sex Transm Dis.2006,33(6):381-385.
16. Marrazzo JM, Wiesenfeld HC, Murray PJ, et al. Risk factors for cervicitis among women with bacterial vaginosis. J Infect Dis.2006,193(5):617-624.
17. Uuskiila A, Raukas E. Atypical genital herpes: report of five cases. Scand J Infect Dis.2004,36(1):37-39.
18. Critchlow CW, Wolner-Hanssen P, Eschenbach DA, et al. Determinants of cervical ectopia and of cervicitis: age, oral contraception, specific cervical infection, smoking, and douching. Am J Obstet Gynecol. 1995,173(2):534—543.
19. Nugent RP, Hillier SL. Mucopurulent cervicitis as a predictor of Chlamydial infection and adverse pregnancy outcome. Sex Transm Dis. 1992,19(4): 198-202.
20. Peipert JF, Ness RB, Soper DE, et al. Association of lower genital tract inflammation with objective evidence of endometritis.Infect Dis Obstet Gynecol.2000,8(2):83-87.
21. Kreiss J, Willerford DM, Hensel M, et al. Association between cervical inflammation and cervical shedding of human immunodeficieny virus DNA.J Infect Dis. 1994,170(6):1597-1601.
22. Mcclelland RS, Wang CC, Mandaliya K, et al. Treatment of cervicitis is associated with decreased cervical shedding of HIV-1. AIDS.2001,15(1):105-110.
23. Castle PE, Hillier SL, Rabe LK, et al. An association of cervical inflammation with high grade cervical neoplasia in women infected with oncogenic human papillomavirus(HPV).CancerEpidemiol Biomarkers Prev,2001,10(10): 1021-1027.
2.Marrazzo JM,Martin D.Management of women with cervicitis.Clin Infect Dis.2007,44 (3):102-110.
3. Romoren M, Sundby J, Velauthapillai M,et al. Chlamydia and gonorrhoea in pregnant Batswana women: time to discard the syndromic approach? BMC Infect Dis. 2007,16(7): 27.
4. Marrazzo JM. Mucopurulent cervicitis: no longer ignored, but still misunderstood. Infect Dis Clin North Am 2005,19(2):333-349.
5. Kong FR, James G, Ma ZF, et al. Phylogenetic analysis of Ureaplasma urealyticum-support for the establishment of a new species, Ureaplasma parvum. Int J Syst Bacteriol, 1999,49:1979-1889.
6. Robertson JA, Stemke GW, Davis JW Jr, et al. Proposal of Ureaplasma parvum sp. nov.and emended description of Ureaplasma urealyticum(Shepard et al.1974) Robertson et al.2001.Int J Syst Evol Microbiol,2002,52(2):587-597.
7. Nyirjesy P. Nongonococcal and nonchlamydial cervicitis. Curr Infect Dis Rep, 2001, 3(6): 540-545.
8. Rar VA, Maksimova TG, Trukhina AV, et al. Level of colonization by Ureaplasma urealyticum of definite biovars in a group of women with different clinical symptoms.Zh Mikrobiol Epidemiol Immunobiol., 2004 (4): 12-17.
9. Abele-Horn M, Wolff C, Dressel P, et al. Association of Ureaplasma urealyticum biovars with clinical outcome for neonates, obstetric patients, and gynecological patients with pelvic inflammatory disease. J Clin Microbiol,1997, 35(5):1199-1202.
10. Domingues D, Tavira LT, Duarte A, et al. Ureaplasma urealyticum biovar determination in women attending a family planning clinic in Guine-Bissau, using polymerase chain reaction of the multiple-banded antigen gene.J Clin Lab Anal, 2002,16(2):71-75.
11. Jensen JS, Borre MB, Dohn Birthe, et al. Detection of Mycoplasma genitalium by PCR Amplification of the 16S rRNA Gene. J Clin Microbiol,2003,41(1):261-266.
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13. Totten PA, Schwartz MA, Sjostrom KE, et al. Association of Mycoplasma genitalium with Nongonococcal Urethrits in Heterosexual Men. J Infect Dis, 2001,183(2):269-276.
14. Mena L, Wang X, Mroczkowski TF, et al. Mycoplasma genitalium Infections in Asymptomatic Men and Men with Urethritis Attending a Sexually Transmitted Diseases Clinic in New Orleans. Clin Infect Dis,2002,35(21): 1167-1173.
15. B Andrsen, I Sokolowski, L 0stergaard, et al. Mycoplasma genitalium: prevalence and behavioural risk factors in the general population. Sex Transm Infect,2007,83:237-241.
16. L E. Manhart, K. K. Holmes, James P. Hughes. Mycoplasma genitalium Among Young Adults in the United States: An Emerging Sexually Transmitted Infection. American Public Health Association,2007, 97(6): 1118-1125.
17. LE Manhart, CW Critchlow , KK Holmes, et al. Mucopurulent cervicitis and Mycoplasma genitalium. J infect Dis,2003,187:650-657.
18. Uno M, Deguchi T, Komeda H, et al. Mycoplasma genitalium in the cervices of Japanese women. Sex Transm Dis,1997, 24: 284-286.
19. Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect,2005, 81(1): 67-72.
20. Cohen CR, Nosek M, Meier A, et al. Mycoplasma genitalium infection and persistence in a Cohort of female sex workers in Nairobi,Kenya. Sex Transm Dis,2007,34(5):274-279.
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16.Uno M,Deguchi T,Komeda H,et al.Mycoplasma genitalium in the cervices of Japanese women.Sex Transm Dis,1997,24:284-286.
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1.Yokoi,S Maeda,Y Kubota,et al.The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis.Clin Infect Dis,2007,45:866-871.
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1. Dallo SF, Baseman JB. Intracellular DNA replication and long-term survival of pathogenic mycoplasmas. Microb Pathog, 2000, 29: 301-309.
2. Ishihara S, Yasuda M,Ito S, et al. Mycoplasma genitalium urethritis in men. Int J Antimicrob Agents,2004,24(11):23-27.
3. Uno M, Deguchi T, Komeda H, et al. Mycoplasma genitalium in the cervices of Japanese women. Sex Transm Dis,1997, 24: 284-286.
4. Manhart LE, Critchlow CW, Holmes KK, et al. Mucopurulent Cervicitis and Mycoplasma genitalium. J Infect Dis, 2003,187(4): 650-657.
5. Falk L, Fredlund H, Jensen JS. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection. Sex Transm Infect, 2005, 81(1): 73-78.
6. Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect, 2005, 81(1): 67-72.
7. Casin I, Vexiau-Robert D, Salmoniere P, et al. High Prevalence of Mycoplasma genitalium in the Lower Genitourinary Tract of Women Attending a Sexually Transmitted Disease Clinic in Paris, France. Sex Transm Dis, 2002, 29(6): 353-359.
8. Nyirjesy P. Nongonococcal and nonchlamydial cervicitis. Curr Infect Dis Rep, 2001, 3(6): 540-545.
9. Simms I, Eastick K, Mallinson H, et al. Associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease. Sex Transm Infect, 2003, 79: 154-156.
10. Cohen CR, Manhart LE, Bukusi EA, et al. Association between Mycoplasma genitalium and acute endometritis. Lancet ,2002, 359:765-766.
11. Cohen CR, Mugo NR,Astete SG, et al.Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis.Sex Transm Infect 2005,81:463-466
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14. Keane FEA, Thomas BJ, Gilroy CB, et al. The Association of Mycoplasma hominis, Ureaplasma urealyticum and Mycoplasma genitalium with bacterial vaginosis: observations on heterosexual women and their male partner. Int J STD AIDS, 2000, 11(6): 356-360.
15. OP Arya, CYW Tong, CA Hart, et al. Is Mycoplasma hominis a vaginal pathogen? Sex Transm Inf, 2001, 77: 58-62.
16. Witt A, Berger A, Gruber CJ, et al. Increased intrauterine frequency of Ureaplasma urealyticum in women with preterm labor and preterm premature rupture of the membranes and subsequent cesarean delivery. Am J Obstet Gynecol, 2005,193(5): 1663-1669.
17. Stefan Gerber,Yvan vial,Patrick Hohlfeld, et al. Detection of Ureaplasma urealyticum in second-trimester amniotic fluid by polymerase chain reaction correlates with subsequent preterm labor and delivery. J Infect Dis, 2003, 187: 518-521.
18. Naessens A, Foulon W, Breynaert J, et al. Serotypes of ureaplasma urealyticum isolated from normal pregnant women and patients with pregnancy complications. J Clin Microbiol, 1988, 26(2): 319-322
19. Lu GC, Schwebke JR, Duffy B, et al. Midtrimester vaginal Mycoplasma genitalium in women with subsequent spontaneous preterm birth. Am J Obstet Gynecol, 2001,185(1): 163-165.
20. Labbe AC, Frost E, Deslandes S, et al. Mycoplasma genitalium is not associated with adverse outcomes of pregnancy in Guinea-Bissau. Sex Transm Infect, 2002, 78(4): 289-291.
21. Clausen HF, Fedder J, Drasbek M, et al. Serological investigation of Mycoplasma genitalium in infertile women. Human Reproduction, 2001,16(9): 1866-1874.
22. Baczynska A, Friis Svenstrup H, Fedder J, et al. The use of enzyme-linked immunosorbent assay for detection of Mycoplasma hominis antibodies in infertile women serum samples. Hum Reprod, 2005, 20(5): 1277-1285.
23. Martinelli F, Garrafa E, Turano A, et al. Increased frequency of detection of Ureaplasma urealyticum and Mycoplasma genitalium in AIDS patients without urethral symptoms. J Clin Microbiol, 1999, 37(6): 2042-2044.
24、 I M Linhares, S S Witkin,P Giraldo, et al. Ureaplasma urealyticum colonization in the vaginal introitus and cervix of human immunodeficiency virus-infected women. Int J STD AIDS, 2000, 11:176-179.
1.Marrazzo JM,Martin D.Management of women with cervicitis.Clin Infect Dis.2007,44(3):102-110.
2.Romoren M,Sundby J,Velauthapillai M,et al.Chlamydia and gonorrhoea in pregnant Batswana women:time to discard the syndromic approach? BMC Infect Dis.2007,16(7):27.
3.Marrazzo JM.Mucopurulent cervicitis:no longer ignored,but still misunderstood.Infect Dis Clin North Am 2005,19(2):333-349.
4.B Andrsen,I Sokolowski,L Φstergaard,et al.Mycoplasma genitalium:prevalence and behavioural risk factors in the general population.Sex Transm Infect.2007,83:237-241.
5.L E.Manhart,K.K.Holmes,James P.Hughes.Mycoplasma genitalium Among Young Adults in the United States:An Emerging Sexually Transmitted Infection.American Public Health Association.2007,97(6):1118-1125.
6.LE Manhart,CW Critchlow,KK Holmes,et al.Mucopurulent cervicitis and Mycoplasma genitalium.J infect Dis.2003,187:650-657.
7.Uno M,Deguchi T,Komeda H,et al.Mycoplasma genitalium in the cervices of Japanese women. Sex Transm Dis.1997,24: 284-286.
8. Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect.2005, 81(1): 67-72.
9. Haggerty CL, Totten PA, Astete SG, et al. Mycoplasma Genitalium Among Women With Nongonococcal, Nonchlamydial Pelvic Inflammatory Disease. Infect Dis Obstet Gynecol.2006, 5:1-5.
10. Falk L, Fredlund H, Jensen JS. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection. Sex Transm Infect, 2005, 81(1): 73-78.
11. Cohen CR, Nosek M, Meier A, et al. Mycoplasma genitalium infection and persistence in a Cohort of female sex workers in Nairobi,Kenya. Sex Transm Dis.2007,34(5):274-279.
12. Nyirjesy P. Nongonococcal and nonchlamydial cervicitis. Curr Infect Dis Rep, 2001, 3(6): 540-545.
13. Ness RB, Hillier SL, Kip KE, et al. Bacterial vaginosis and risk of pelvic inflammatory disease. Obstet Gynecol.2004,104(4):761-769.
14. Schwebke JR, Weiss HL. Interrelationships of bacterial vaginosis and cervical inflammation. Sex Transm Dis.2002,29(1):59-64.
15. Ness RB, Kip KE, Soper DE,et al. Variability of bacterial vaginosis over 6- to 12-month intervals. Sex Transm Dis.2006,33(6):381-385.
16. Marrazzo JM, Wiesenfeld HC, Murray PJ, et al. Risk factors for cervicitis among women with bacterial vaginosis. J Infect Dis.2006,193(5):617-624.
17. Uuskiila A, Raukas E. Atypical genital herpes: report of five cases. Scand J Infect Dis.2004,36(1):37-39.
18. Critchlow CW, Wolner-Hanssen P, Eschenbach DA, et al. Determinants of cervical ectopia and of cervicitis: age, oral contraception, specific cervical infection, smoking, and douching. Am J Obstet Gynecol. 1995,173(2):534—543.
19. Nugent RP, Hillier SL. Mucopurulent cervicitis as a predictor of Chlamydial infection and adverse pregnancy outcome. Sex Transm Dis. 1992,19(4): 198-202.
20. Peipert JF, Ness RB, Soper DE, et al. Association of lower genital tract inflammation with objective evidence of endometritis.Infect Dis Obstet Gynecol.2000,8(2):83-87.
21. Kreiss J, Willerford DM, Hensel M, et al. Association between cervical inflammation and cervical shedding of human immunodeficieny virus DNA.J Infect Dis. 1994,170(6):1597-1601.
22. Mcclelland RS, Wang CC, Mandaliya K, et al. Treatment of cervicitis is associated with decreased cervical shedding of HIV-1. AIDS.2001,15(1):105-110.
23. Castle PE, Hillier SL, Rabe LK, et al. An association of cervical inflammation with high grade cervical neoplasia in women infected with oncogenic human papillomavirus(HPV).CancerEpidemiol Biomarkers Prev,2001,10(10): 1021-1027.