Abstract：
BACKGROUND: Chlamydia trachomatis and Mycoplasma infections have been regarded as severe challenges to public health worldwide because their potential risk of leading to serious reproductive complications. C. trachomatis is the most common sexually transmitted bacterial infections and the prevalence has been increasing in recent years. As a newly discovered pathogen, Mycoplasma genitalium has gradually been recognized as important sexually transmitted infection and even been called a \"new chlamydia\". There are no official epidemiological data of M. genitalium in China especially in women with lower reproductive tract infection. This work aims to understand the prevalence and risk factors of M. genitalium and C. trachomatis in women with lower reproductive tract infections and to provide reference for the formulation of health policy in China.
METHODS: This study was conducted in the gynecological clinics of 12 hospitals geographically located in different regions in China. Women with purulent cervical secretions or abnormal vaginal microecology were included as the research group, and those with normal vaginal microecology and cervical secretions were included as the control group. A total of 2190 participants were recruited in this project including 1357 of research group and 833 of control group. All participants were required to complete questionnaires, whose vaginal discharge were collected for vaginal microecology test and cervical discharge for detection of M. genitalium and C. trachomatis.
RESULTS: The prevalence of C. trachomatis and M. genitalium were 7.1% (96/1357) and 3.8% (51/1357), respectively in research group. The prevalence of C. trachomatis and M. genitalium varied in different regions. Infection rates of C. trachomatis and M. genitalium were higher in women with abnormal vaginal microecology (C.t P = 0.038, M.g P = 0.043), especially in women with bacterial vaginosis and mixed vaginitis, of which C. trachomatis showed statistical differences (bacterial vaginosis, P = 0.035; mixed vaginitis, P = 0.0001) and M. genitalium was close to statistical differences (bacterial vaginosis, P = 0.057; mixed vaginitis, P = 0.081). Alcoholism and abnormal vaginal microecology were positively correlated with both C. trachomatis and M. genitalium infection. Increasing age, being married and multi-parity were negatively correlated with C. trachomatis infection. There is a positive correlation between multiple sexual partners, diversed styles of sex and C. trachomatis infection.
CONCLUSIONS: Women with lower genital dysbiosis have an increased risk of C. trachomatis and M. genitalium. The overall prevalence of M. genitalium is lower than that of C. trachomatis, while they have similarities in the characteristics of infection. Although M. genitalium is not routinely screened as C. trachomatis in young women, attention should be paid to M. genitalium infection in young women with abnormal vaginal microecology or having childbearing needs.
METHODS: This study was conducted in the gynecological clinics of 12 hospitals geographically located in different regions in China. Women with purulent cervical secretions or abnormal vaginal microecology were included as the research group, and those with normal vaginal microecology and cervical secretions were included as the control group. A total of 2190 participants were recruited in this project including 1357 of research group and 833 of control group. All participants were required to complete questionnaires, whose vaginal discharge were collected for vaginal microecology test and cervical discharge for detection of M. genitalium and C. trachomatis.
RESULTS: The prevalence of C. trachomatis and M. genitalium were 7.1% (96/1357) and 3.8% (51/1357), respectively in research group. The prevalence of C. trachomatis and M. genitalium varied in different regions. Infection rates of C. trachomatis and M. genitalium were higher in women with abnormal vaginal microecology (C.t P = 0.038, M.g P = 0.043), especially in women with bacterial vaginosis and mixed vaginitis, of which C. trachomatis showed statistical differences (bacterial vaginosis, P = 0.035; mixed vaginitis, P = 0.0001) and M. genitalium was close to statistical differences (bacterial vaginosis, P = 0.057; mixed vaginitis, P = 0.081). Alcoholism and abnormal vaginal microecology were positively correlated with both C. trachomatis and M. genitalium infection. Increasing age, being married and multi-parity were negatively correlated with C. trachomatis infection. There is a positive correlation between multiple sexual partners, diversed styles of sex and C. trachomatis infection.
CONCLUSIONS: Women with lower genital dysbiosis have an increased risk of C. trachomatis and M. genitalium. The overall prevalence of M. genitalium is lower than that of C. trachomatis, while they have similarities in the characteristics of infection. Although M. genitalium is not routinely screened as C. trachomatis in young women, attention should be paid to M. genitalium infection in young women with abnormal vaginal microecology or having childbearing needs.
摘要：
背景：沙眼衣原体和支原体感染被认为是全球公共卫生面临的严峻挑战，因为它们具有导致严重生殖并发症的潜在风险。沙眼衣原体是最常见的性传播细菌感染，近年来患病率呈上升趋势。作为一种新发现的病原体，生殖支原体已逐渐被认为是重要的性传播感染，甚至被称为“新衣原体”。中国尚无生殖支原体的官方流行病学数据，尤其是下生殖道感染的女性。目的了解女性下生殖道感染生殖道和沙眼衣原体的患病率及危险因素,为我国卫生政策的制定提供参考。
方法：本研究在地理上位于中国不同地区的12家医院的妇科诊所进行。将宫颈脓性分泌物或阴道微生态异常的女性作为研究组。以阴道微生态和宫颈分泌物正常者为对照组。该项目共招募2190名参与者，包括1357名研究组和833名对照组。所有参与者都被要求填写问卷，收集阴道分泌物进行阴道微生态试验，宫颈分泌物检测生殖支原体和沙眼衣原体。
结果：沙眼衣原体和生殖分枝杆菌的患病率分别为7.1％（96/1357）和3.8％（51/1357），分别在研究组。沙眼衣原体和生殖分枝杆菌的患病率在不同地区有所不同。阴道微生态异常的女性沙眼衣原体和生殖分枝杆菌的感染率较高（C.tP=0.038，M.gP=0.043），尤其是患有细菌性阴道炎和混合性阴道炎的女性，其中沙眼衣原体表现出统计学差异(细菌性阴道病，P=0.035；混合性阴道炎，P=0.0001）和生殖支原体接近统计学差异（细菌性阴道病，P=0.057；混合性阴道炎，P=0.081)。酒精中毒和阴道微生态异常与沙眼衣原体和生殖支原体感染呈正相关。年龄增长,已婚和多胎与沙眼衣原体感染呈负相关。多个性伴侣之间存在正相关,不同的性别和沙眼衣原体感染方式。
结论：患有下生殖器菌群失调的女性患沙眼衣原体和生殖分枝杆菌的风险增加。生殖器分枝杆菌的总体患病率低于沙眼衣原体，虽然它们在感染特征上有相似之处。尽管在年轻女性中，生殖器分枝杆菌通常不被筛查为沙眼衣原体，阴道微生态异常或有生育需求的年轻女性应注意生殖器支原体感染。
方法：本研究在地理上位于中国不同地区的12家医院的妇科诊所进行。将宫颈脓性分泌物或阴道微生态异常的女性作为研究组。以阴道微生态和宫颈分泌物正常者为对照组。该项目共招募2190名参与者，包括1357名研究组和833名对照组。所有参与者都被要求填写问卷，收集阴道分泌物进行阴道微生态试验，宫颈分泌物检测生殖支原体和沙眼衣原体。
结果：沙眼衣原体和生殖分枝杆菌的患病率分别为7.1％（96/1357）和3.8％（51/1357），分别在研究组。沙眼衣原体和生殖分枝杆菌的患病率在不同地区有所不同。阴道微生态异常的女性沙眼衣原体和生殖分枝杆菌的感染率较高（C.tP=0.038，M.gP=0.043），尤其是患有细菌性阴道炎和混合性阴道炎的女性，其中沙眼衣原体表现出统计学差异(细菌性阴道病，P=0.035；混合性阴道炎，P=0.0001）和生殖支原体接近统计学差异（细菌性阴道病，P=0.057；混合性阴道炎，P=0.081)。酒精中毒和阴道微生态异常与沙眼衣原体和生殖支原体感染呈正相关。年龄增长,已婚和多胎与沙眼衣原体感染呈负相关。多个性伴侣之间存在正相关,不同的性别和沙眼衣原体感染方式。
结论：患有下生殖器菌群失调的女性患沙眼衣原体和生殖分枝杆菌的风险增加。生殖器分枝杆菌的总体患病率低于沙眼衣原体，虽然它们在感染特征上有相似之处。尽管在年轻女性中，生殖器分枝杆菌通常不被筛查为沙眼衣原体，阴道微生态异常或有生育需求的年轻女性应注意生殖器支原体感染。
