| 1954 Shepard provided the first description of T-strain mycoplasmas, later known as ureaplasmas, when he was able to cultivate them in vitro from the urethras of men with nongonococcal urethritis。Ureaplasma has two biovars and 14 serotypes: Ureaplasma urealyticum parvo biovar (biovar 1 or B) includes the serotypes 1, 3, 6, and 14, Ureaplasma urealyticum biovar T960 (biovar 2 or A) includes the serotypes 2, 4, 5, as well as 7–13 .The two biovars seem to be independent species, Ureaplasma parvum (former biovar 1) and Ureaplasma urealyticum (former biovar 2)..Many questions remain unanswered about the role of these organisms as human pathogens for a variety of reasons. These include the high prevalence of mycoplasmas in healthy persons . Numerous and often contradictory articles have been published on the clinical importance of Ureaplasma urealyticum in disturbances of human reproduction, pregnancy, intrauterine development, and neonatal outcome. ureaplasmas may be of clinical significance in a variety of urogenital infections affecting pregnant women and neonates, which are the focus of this review . The relevant literature is surveyed and the apparent contradictions are discussed. The question is whether or not to treat the infection.The lack of conclusive knowledge regarding the pathogenic potential of Ureaplasma . Results were varied and inconsistent due to a great extent to the inefficient and imprecise methods available for serotype differentiation at the time, occurrence of multiple cross-reactions, and the fact that many persons may harbor more than one serotype in their urogenital tract in the presence or absence of disease. Development of monoclonal antibodies enabled identification of multiple-banded antigens responsible for serotype specificity on the cell surface .Considerable attention has been given in recent years to the application of the PCR assay in primary detection of mycoplasmal and ureaplasmal perinatal infections.Objective To study the relationship between colonization and pathopoiesis of Ureaplasma urealyticm( UU ) in cervix in gynecologic out-patient clinic population and its biovars and serotypes.Methods 319 gynecologic out-patient clinic cases were colleted from Jilin province Women and Children Health Hospital .Swabs taken from cervix were cultured by commercial UU selective liquid medium. The positive cases were extracted DNA and were classified into biovars by PCR method and different serotypes were identified by PCR and restriction edonuclease digestion on the basis of DNA sequence of N terminal of multiple-banded antigen gene.Results 1. 319 cases were screened and 112 cases were found to be UU positive by commercial UU selective liquid medium. Among 112 cases ,106 cases were found to be UU positive by PCR. The concordance rate was 94.6% between the two kinds of methods. 2. The isolation rates of UU were 34.6% versus 29.5% in study groups ( the groups of women with different clinical symptoms of genitourinary tract)and control groups, respectively. No significant disparity between both the groups was found in the prevalence of UU(χ2=0.743,P=0.389>0.05). UU biovar showed statistically significant difference between study subjects and control subjects. (χ2=4.821 ,P=0.028<0.05). The isolation rates of urealyticum biovar in study subjects were significantly higher than that in control subject(sχ2=4.19,P<0.05). No statistical significance of genotype 1, 3 , 6 and 14of biovar 1 was found between study subjects and control subjects . The isolation rates of UU serotype 1 was higher in study subjects than that in control subjects.3. There was no difference between the prevalence of U. urealyticum in the cervical swabs of both first Trimester and control groups(χ2=2.322,P=0.128>0.05), however, the biovar distribution, showed a significant difference between first Trimester and control group(sχ2=5.892,P=0.015<0.05).U. urealyticum was more frequently isolated in first Trimester groups than in control group(sχ2=7.87,P<0.01). No difference in distribution of genotype 1, 3 and 6 of biovar 1 was found between first Trimester and control groups.The isolation rates of UU serotype 1 was higher in first Trimester than that in control subjects.4. UU biovar showed statistically significant difference between with and without cervical erosion and cervicitis (P=0.01). The isolation rates of parvo biovar(72.3%)in without cervical erosion and cervicitis were significantly higher than that in with cervical erosion and cervicitis (47.5 %)(χ2=4.82,P<0.05). No statistical significance in distribution of genotype 1, 3 , 6 and 14of biovar 1 and in positive rate(χ2=0.457,P=0.499 >0.05) of UU was found between with and without cervical erosion and cervicitis. The isolation rates of UU serotype 1 was higher in with cervical erosion than that in control subjects.5. There were no significant differences in the prevalence of UU(χ2 =0.152,P=0.697 >0.05), the biovar distribution(χ2=0.057,P=0.812 >0.05)and distribution of genotype 1, 3 ,14and 6 of biovar 1 in with and without bacterial vaginitis.6. There were no significant differences in the prevalence of UU(χ2=0.955,P=0.328 >0.05), the biovar distribution(χ2=1.519,P=0.218 >0.05)and distribution of genotype 1, 3 ,14and 6 of biovar 1 in with and without vulvovaginal candidiasis .Conclusions 1. The concordance rate was 94.6% between the UU positive by commercial UU selective liquid medium and by PCR. The positive cases were extracted DNA and were classified into biovars by PCR method and different serotypes were identified by PCR and restriction edonuclease digestion on the basis of DNA sequence of N terminal of multiple-banded antigen gene. the method described here was relatively simple, rapid and specific for the biotyping between biovar 1 and 2 and genotyping of genotypes 1, 3, 6, and 14 in biovar1. 2. No significant disparity between both the groups(with and without cervical erosion and cervicitis, first Trimester, bacterial vaginitis, vulvovaginal candidiasis, clinical symptoms of genitourinary tract)was found in the prevalence of UU.3. UU biovar showed statistically significant difference between study subjects and control subjects. (χ2=4.821,P=0.028<0.05). The isolation rates of urealyticum biovar in study subjects were significantly higher than that in control subjects(χ2 =4.19,P<0.05). 4. UU biovar showed statistically significant difference between with and without cervical erosion and cervicitis, (P=0.01). The isolation rates of parvo biovar(72.3%)in without cervical erosion and cervicitis, were significantly higher than that in with cervical erosion and cervicitis(47.5 %) (χ2=4.82,P<0.05).5. The biovar distribution, showed a significant difference between first Trimester and control groups (χ2=5.892 ,P=0.015<0.05). U. urealyticum was more frequently isolated in first Trimester groups than in control groups(χ2=7.87,P<0.01).6. The finding of UU in cervix hasn't pathogenicity .It need to be ascertain differential pathogenicity of ureaplasmas at the serotype level.7. The main colonization biovar of UU was parvo biovar in without complaint,which was though conditioned pathogen.There was relationship beween urealyticum biovar and pathogenicity. In the first Trimester all pregnancies was easy to infect the urealyticum biovar because of the loss of immunity probably. In the second and third trimester there was or not correlation between genital colonisation of UU and pathological pregnancy, and perinatal morbidity need to be confirmed.8. The distribution of genotype 3 , 6 and 14of biovar 1 in the groups of women with different clinical symptoms was approximately similar. The isolation rates of UU serotype 1 was higher in study groups than that in control groups.
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