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目的:改良男性生殖道感染标本采集和细菌定位培养法,探讨标本采集和病原体分离对前列腺炎诊断与治疗的影响。方法:分别采集200例前列腺炎样症状患者的分段尿液、前列腺按摩液(EPS)和精液标本,定量接种培养液分离培养,根据分离物的菌落数及分布规律评估其实验室诊断意义。结果:从200例前列腺炎样症状患者检出病原体468株,包括细菌414株(占88.5%)、真菌12株(占2.6%)、支原体40株(占8.5%)、衣原体2株(占0.4%)。其中仅从EPS分离到病原体的患者为66例(占33.0%),仅从精液分离到病原体的患者为34例(占17.0%),EPS和精液均分离到病原体的患者为100例(占50.0%)。在这些标本中仅分离到1种病原体的分别为EPS 36例(占18.0%),精液20例(占10.0%),EPS和精液39例(占19.5%);分离到2种病原体的分别为EPS 30例(占15.0%),精液14例(占7.0%),EPS和精液60例(占30.0%);1例从EPS和精液分离到3种病原体(占0.5%)。结论:复数菌感染(MMI)、多器官感染(MOI)和耐药性菌株感染在前列腺炎样症状患者常见,是造成临床及实验室诊断漏诊和误诊的常见因素以及影响治疗效果的重要机制,MMI和MOI可通过标本采集和细菌定位培养改良法进行诊断与鉴别诊断。
Objective: To improve the collection of male genital tract infection specimens and bacterial localization culture method to explore the impact of specimen collection and pathogen isolation on the diagnosis and treatment of prostatitis. Methods: Segmental urine, prostate massage fluid (EPS) and semen samples were collected from 200 patients with prostatitis-like symptoms, and the culture medium was isolated and cultured quantitatively. The diagnostic significance of laboratory was evaluated according to the number and distribution of colonies. Results: 468 pathogens were detected in 200 cases of prostatitis-like symptoms, including 414 bacteria (88.5%), 12 fungi (2.6%), 40 mycoplasmas (8.5%), 2 chlamydia %). Among them, 66 cases (33.0%) were isolated from EPS alone, 34 cases (17.0%) only isolated from semen, and 100 cases were isolated from EPS and semen %). There were 36 cases (18.0%) of EPS, 20 cases of semen (10.0%), 39 cases of EPS and semen (19.5%), and only 2 strains of pathogens isolated from one of these pathogens 30 cases of EPS (15.0%), 14 cases of semen (7.0%), 60 cases of EPS and semen (30.0%), 1 case of EPS and semen (0.5%). CONCLUSIONS: MMI, MOI and drug-resistant bacterial infections are common in patients with prostatitis-like symptoms. They are common causes of missed diagnosis and misdiagnosis of clinical and laboratory diagnosis, as well as important mechanisms affecting the therapeutic effect. MMI and MOI can be diagnosed and differential diagnosis by specimen collection and modified method of bacterial localization culture.