论文部分内容阅读
淋病是淋菌引起的主要由于性行为感染的性传染病(Sexually transmitted diseases STD)。二十年来欧美各国淋病的发病率持续上升,尤其是耐青霉素性淋菌发病骤增。日本最近五年,淋病的患者也有所增加,1981年以来并发现耐青霉素性淋菌。一、淋菌的检查1.染色镜检:必须找到淋菌才能确诊。先用吕弗硫单染法或革兰氏染色而后镜检。分泌物呈脓性时,镜下可见大量白细胞且细胞内外均有淋菌,即使吕弗硫单染法也能做出诊断。但感染初期,由于淋菌较少而且混有大量杂菌,则必须用革兰氏染色。女性因生殖道存在其它双球菌,单用镜检诊断较困难,必须并用培养法或酶抗体法(gonzyme)检查。2.分离培养:用淋菌培养基,添加抗生素以抑制混合菌生长。淋菌在粘膜生活力强,在体外则很弱。虽属嗜氧性菌.但发育过程必须有适量的二氧化碳。标本采取后可直接涂抹在培养基上开始培养。除来院之前用过抗生素者外,培养几乎都能成功。所采的标本不宜放置过久,远道送来的标本因耽搁过久,培养成功的可能性很小。3.耐青霉素淋菌的检出:耐青霉素淋菌破坏青霉素,产生β-乳肽酶(β-Lactamase)。分离培养后可用头孢菌素滤纸发色法、碘法检查。作者在门诊将脓汁涂抹培养基上后,在培养基一端放置30μg 氨苄青霉素圆盘,直接开始培养,如果第二天培养基上出现15～30mm 的阻止带,则表明是青霉素敏感菌,反之则为耐青霉素淋菌。
Gonorrhea is caused by gonococcal sexually transmitted diseases (Sexually transmitted diseases STD). In the past two decades, the incidence of gonorrhea in Europe and the United States has been on the rise, especially the sudden increase in the incidence of penicillin-resistant gonococcus. In Japan the number of patients with gonorrhea has also increased in the last five years, and penicillin-resistant gonococcal bacteria have been found since 1981. First, the gonococcus check 1. Dyeing microscopy: gonococcus must be found to confirm. The first use of LV Sulfur single dye method or Gram stain and microscopic examination. Secretion was purulent, the microscope shows a large number of white blood cells and cells are gonorrhea inside and outside, even if Lu Fu sulfur single dye method can make a diagnosis. However, early stage of infection, due to less gonococcal mixed with a large number of bacteria, you must use Gram stain. Female reproductive tract existence of other meningitis, single microscopic diagnosis is more difficult and must be used culture or enzyme antibody method (gonzyme) examination. 2. Isolation and culture: use gonococcus culture medium, add antibiotics to inhibit the growth of mixed bacteria. Gonococcus in the mucosal vitality, in vitro is very weak. Although oxygen bacteria, but the development process must have the right amount of carbon dioxide. After taking the specimen can be directly coated on the medium to start culturing. In addition to the hospital before the antibiotics used, the training can be successful almost. The specimens taken should not be placed too long, far from the specimen sent too long delay, the possibility of successful cultivation is small. 3. Detection of penicillin-resistant gonococcus: penicillin-resistant penicillin penicillin, producing β-lactopeptidase (β-Lactamase). Separation and culture available cephalosporin filter paper color method, iodine method. The author in the clinic pus smear on the medium, the end of the medium placed 30μg ampicillin disc, the direct start of culture, if the next day appeared on the medium 15 ~ 30mm stop band, it is sensitive to penicillin, and vice versa For penicillin-resistant bacteria.