Mycoplasma infection

Introduction to mycoplasma infection Mycoplasma is the smallest microorganism that survives extracellularly. It is a kind of prokaryotic cell type microorganism lacking cell wall, generally ranging in size from 0.3 to 0.5 um. It is highly pleomorphic and has various forms such as spherical, rod-shaped, filamentous, and branched. Of the 16 mycoplasmas isolated from humans, 5 are pathogenic to humans, namely M. pneumoniae, Ureaplasmaurealyticum, M. homins, M. genitalium. And fermented mycoplasma (M. fermentans). Urea mycoplasma (ureaplasma) containing urea-mycoplasma, etc., Ureaplasma urealyticum and human mycoplasma are pathogenic to humans. Mycoplasma pneumoniae is the main cause of respiratory infections and pneumonia. Ureaplasma mycoplasma and Mycoplasma hominis cause genitourinary tract infections. Mycoplasmal pneumonia, also known as primary atypical pneumonia, mycoplasma pneumonia can occur throughout the year, more common in winter, there may be a small epidemic, mycoplasmal encephalitis is a common type of pneumonia in preschool children and young people, mycoplasma pneumonia mainly through flying Foam spread, the incubation period is longer, up to 2 to 3 weeks. Although mycoplasma pneumonia has a longer course, lung lesions are heavier and inflammation absorption is slower, but most of the prognosis is good, comorbidities are less, genital mycoplasma infection It is a new sexually transmitted disease in recent years. Adults mainly transmit through sexual contact. Newborns are infected by the mother's reproductive tract. Adult males are infected in the urethra mucosa, female infected sites are in the cervix, and neonates mainly cause conjunctiva. Inflammation and pneumonia. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of transmission: blood transmission, sexual transmission Complications: meningitis, myocarditis, hepatitis, pelvic inflammatory disease

Cause of mycoplasma infection

Sexual contact factors (50%):

Mycoplasma infection is a sexually transmitted disease. Mycoplasma can exist in healthy carriers, and the detection rate is higher in people with sexual disorder, homosexuality, excessive sexual partners, and gonorrhea. The more sexual partners, the greater the sexual activity index and the higher the infection rate. Adult female mycoplasma infection is mainly transmitted through sexual contact.

Infection factor (20%):

Newborns are infected by the mother's reproductive tract during childbirth.

Mycoplasma infection prevention

(1) Actively exercise, plan to exercise regularly on weekdays, keep fresh air indoors during sleep, and have appropriate temperature. You should open the window to sleep at an early age, at least indirect ventilation, make full use of sunbathing, air bath and water bath to enhance physical fitness. The first important factor in disease prevention.

(2) Speaking of hygiene, avoiding cross-infection, not crowded, poorly ventilated theaters, department stores, supermarkets, etc., try to avoid contact with patients, get close to the doctor if you are sick, run a large hospital, shorten the waiting time, in the past Respiratory diseases are transmitted only by breathing. In recent years, it has been confirmed that exposure to infection is an important mode of transmission. It should be noted that not to let children passively smoke, smoking is an important reason for increasing respiratory diseases in children.

(3) Drug prevention, some Chinese and Western medicines can improve the body's cellular and humoral immune function, preferably under the guidance of a doctor.

(4) Injecting vaccines. At present, attenuated virus vaccines are used in some places, but they are still not widely used. Vaccines have been designed for prevention, but the protection rate is only 50%, and there is no systematic report on antibiotic prevention.

Mycoplasma infection complications Complications meningitis myocarditis hepatitis pelvic inflammatory disease

Mycoplasma pneumoniae can infect extrapulmonary tissues, so other extrapulmonary symptoms such as skin damage, nervous system damage, cardiovascular damage, digestive system damage, pleural lesions, etc. can occur during pneumonia. Very few cases can be associated with central nervous system. Symptoms, such as meningitis, meningoencephalitis, radiculitis, and even mental disorders, hemorrhagic tympanitis, gastroenteritis, arthritis, thrombocytopenic purpura, hemolytic anemia, pericarditis, myocarditis, hepatitis also Find.

The common complication of urinary mycoplasma infection is salpingitis, and a small number of patients may have endometritis and pelvic inflammatory disease.

Symptoms of mycoplasma infection Common symptoms Backache, vaginal discharge, urinary urgency, frequent cervical edema

The incubation period is 1-3 weeks. The typical acute phase symptoms are similar to other non-gonococcal genitourinary infections. It is characterized by urethral tingling, varying degrees of urgency and frequent urination, urination and tingling, especially when the urine is more concentrated. obvious. The urethra is slightly red and swollen, the secretion is thin, the amount is small, and it is serous or purulent. It is necessary to squeeze the urethra to see the secretion overflow. It often has a small amount of mucous secretion or only the diaphragm seal in the morning urethra. Or see dirty pants.

Subacute period often combined with prostate infection, patients often have perineal pain, backache, double internal discomfort or tingling from the perineum to the inside of the femoral sinus.

Female patients often have germline inflammation that spreads around the cervix. Most of them have no obvious symptoms. A few critically ill patients have vaginal sensation. When the infection spreads to the urethra, frequent urination and urgency are the main symptoms that cause the patient to pay attention. The infection is limited to the cervix, which is characterized by increased vaginal discharge, opacity, cervical edema, congestion or surface erosion. Infection and urethra are characterized by flushing of the urethra, congestion, and squeezing of the urethra. There is a small amount of secretion spillover, but there is little tenderness.

Examination of mycoplasma infection

1. Blood routine: The peripheral white blood cell count is generally normal, and eosinophils increase.

2. X-ray examination: Chlamydia pneumonia pneumonia is non-specific, mostly unilateral inferior lobe infiltration, showing segmental pneumonia, severe bilateral pneumonia, Chlamydia trachomatis pneumonia showing bilateral extensive interstitial and alveolar Infiltration, excessive inflation is more common, occasionally large leaf consolidation.

3. Direct smear microscopy: take pharyngeal secretions, sputum, respiratory mask or other parts of the specimen for smear, GZmesa staining, the original stained red, the initial body dyed dark blue, Chlamydia trachomatis inclusion body contains sugar Originally, 801 stained and dyed brown.

4. Rapid antigen detection: Direct detection of chlamydia in specimens by monoclonal antibody direct immunofluorescence, and addition of anti-Chlamydia antibody, enzyme-labeled antibody 18G and substrate for colorimetric quantitative detection by 2I-IsA method. Simple and sensitive.

5. Chlamydia isolation: Chlamydia pneumoniae culture is best to use Hela cells or Hep-2 cells, generally take tracheal or nasopharyngeal as a clinical specimen, timely inoculation, the current identification of Chlamydia using Hela cells or Hep-2 cells culture through the specific The monoclonal monoclonal fluorescent antibody method (MFA), which has high sensitivity and specificity, can obtain positive results within 48 hours if the specimen can be collected early.

6. Serological examination: using the complement fixation test, the serum antibody titer in the recovery period is 4 times or more than the acute phase serum titer, which is diagnostic, but no early diagnostic significance, micro immunofluorescence (MrF ) Suitable for Chlamydia trachomatis.

7.PcR technology: Common PcR technology detects Chlamydia pneumoniae-specific DNA, which has the advantages of rapid, simple and specific. The sensitivity is higher than that of cell separation technology, but the effect of detecting throat swab in specimens is not ideal, and the nested PcR (nPcR) is used. Detection can significantly increase its sensitivity.

Diagnosis and diagnosis of mycoplasma infection

diagnosis

(1) Culture and biochemical reaction: Mycoplasma facultative anaerobic growth is better under the conditions of 5% to 10% CO2 and 80% to 90% humidity. The main components of mycoplasma cells are cholesterol and protein from the culture medium. The latter needs to contain serum, egg yolk, etc., the colony looks like fried poached eggs, generally large colonies, 100 ~ 300nm, growth needs 7 ~ 14d, another, colonies 10 ~ 25nm, fast growth, only 24 ~ 48h, called T Strain, Ureaplasma urealyticum.

(B) detection of antibodies and antigens: 2 weeks after infection with Mycoplasma pneumoniae, about 50% of antibodies are produced, the red blood cell condensation test is positive, the titer is 1:32 or more, and the recovery period titer of 4 times is significant, 40% to 50%. S. streptococci MG agglutination test is positive, and can be detected by complement fixation test, indirect hemagglutination, enzyme-linked adsorption, etc. In addition, the lesion lavage fluid is detected by PCR, and in addition, the gene probe rapid detection system is used, and isotope-labeled DNA is used. The RNA in Mycoplasma pneumoniae can be determined, and the coincidence rate is 89% compared with the culture.

Differential diagnosis

It needs to be differentiated from infections caused by other microorganisms. The status of mycoplasma and other microorganisms in the biological classification is as follows, and the identification of mycoplasma and other microorganisms.

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