Three items of urogenital tract pathogens

Urinary health is very important, and this is also the area most prone to disease. The three items of urogenital tract pathogens generally focus on the examination of mycoplasma, chlamydia and gonorrhea. These three conditions are very harmful. Once you are sick, you must receive treatment in time, otherwise there will be very serious consequences. Let’s take a closer look at the specific examinations for mycoplasma, chlamydia and gonorrhea.

Mycoplasma test

1. Blood routine test

The total number of peripheral blood leukocytes is normal or slightly increased, mainly neutrophils.

2. X-ray examination

Chest X-rays of mycoplasma pneumonia are nonspecific, mostly showing unilateral lower lobe infiltration, manifesting as segmental pneumonia, and in severe cases, extensive bilateral pneumonia.

3. Etiological examination

Sputum, nose, and throat swabs were cultured for Mycoplasma pneumoniae.

4. Serological examination

Serum pathogen antibody titer >1:32, streptococcal MG agglutination test, titer ≥1:40 is positive, and two consecutive increases of 4 times or more have diagnostic value.

Two weeks after onset, about two-thirds of patients have a positive cold agglutination test, with a titer greater than 1:32, which is of diagnostic value, especially when the titer gradually increases. About half of the patients had a positive agglutination test for Streptococcus MG. Further confirmation of the diagnosis depends on the determination of mycoplasma IgM antibodies in the serum (enzyme-linked immunosorbent assay is the most sensitive, immunofluorescence assay is highly specific, and indirect hemagglutination assay is more practical). Antigen detection can be performed using the PCR method, but the reagent kit needs to be improved to increase sensitivity and specificity.

5. PCR technology

Conventional PCR technology is used to detect Chlamydia pneumoniae-specific DNA, which is rapid, simple, and specific. Its sensitivity is higher than that of cell separation technology, and its sensitivity can be significantly improved by using nested PCR (nPCR) detection.

Chlamydia test

1. Antigen detection

(1) Smear microscopy can be performed by taking conjunctival or cervical swabs or scrapings for smears. For lower respiratory tract infection, secretions or lavage fluid can be brushed with a fiberoptic bronchoscope to detect Chlamydia trachomatis inclusion bodies in the cytoplasm of epithelial cells. The method is simple, but the detection rate is less than 30%.

(2) Enzyme-linked immunosorbent assay (ELISA) is used to detect chlamydia antigens in clinical specimens. This method is sensitive, simple and rapid, but it has cross-reactions with bacteria and may result in false positives, especially in nasopharyngeal specimens.

2. Nucleic acid testing

Polymerase chain reaction (PCR) is used to detect Chlamydia DNA and can directly identify the species and type of Chlamydia from the specimen. Nucleic acid probes detect Chlamydia DNA in biopsy specimens.

3. Antibody detection

People with uncomplicated genital tract infections may produce low titers of antibodies; about 20% of patients with acute chlamydial urethritis do not produce antibodies. Commonly used ones are:

(1) The complement fixation test is suitable for the diagnosis of lymphogranuloma venereum, psittacosis and Chlamydia pneumoniae infection, but has low sensitivity.

(2) Micro-indirect immunofluorescence test This experiment is one of the most sensitive methods for diagnosing Chlamydia pneumoniae infection. If the titer of the double serum increases by 4 times, or the IgM antibody titer of a single serum is ≥1:16, or the IgG antibody titer is ≥1:512, it can be diagnosed as acute infection.

(3) Direct fluorescent antibody assay can detect various types of Chlamydia specimens. This method is sensitive, specific, and rapid, and is a diagnostic technology with strong operability and practicality.

Gonorrhea test

1. History of contact

The patient has a history of extramarital sex or prostitution, the spouse has a history of infection, there is a history of sharing items with gonorrhea patients (especially gonorrhea patients at home), and the newborn's mother has a history of gonorrhea.

2. Clinical manifestations

The main symptoms of gonorrhea include frequent and urgent urination, painful urination, pus discharge from the urethra, or purulent secretions from the cervix and vagina. Or there may be symptoms of gonococcal conjunctivitis, proctitis, pharyngitis, or symptoms of disseminated gonorrhea.

3. Laboratory examination

In men, a smear test is diagnostic for acute gonococcal urethritis, but a gonococcal culture should be done in women. Where conditions permit, genetic diagnosis (polymerase chain reaction) can be used to confirm the diagnosis.