Mycoplasma and chlamydia vaginitis Reproductive tract infection (RTI) is an infection caused by microorganisms normally present in the reproductive tract or by external microorganisms that enter the reproductive tract during medical procedures or during sexual contact. Chlamydia and mycoplasma infections are common sexually transmitted infections in women and are also a difficult problem to manage clinically. Mycoplasma vaginalis 1. Pathogens: The pathogens of mycoplasma infections include Mycoplasma humanum (MH), Mycoplasma urealyticum (UU) and Mycoplasma genitalium (MG). Mycoplasma urealyticum has the highest rate of infection, which not only causes inflammation of the urinary tract and reproductive tract, such as non-gonococcal urethritis, vaginitis, cervicitis, endometritis, pelvic inflammatory disease, and in severe cases can cause infection in pregnant women, infertility, intrauterine growth retardation of the fetus, and a high recurrence rate, and difficult to treat. 2, the transmission route: mycoplasma exists in the vagina, around the urethra, the ectocervix and urine, mainly through sexual contact transmission. When a pregnant woman is infected, it can be transmitted vertically through the placenta. In the process of delivery, the fetus can also be infected through the contaminated birth canal. The clinical manifestations of the infection in women are often in the cervix, which then invades the vagina and leads to mycoplasma vaginitis. Mycoplasma vaginalis is an inflammatory disease of the reproductive system that spreads around the cervix. When the infection spreads to the urethra, urinary frequency and urgency are the main symptoms that attract the patient’s attention. When the infection is confined to the cervix, the symptoms are increased leucorrhea, cloudiness, edema, congestion or surface erosion of the cervix. If the infection spreads to the urethra, the urethral orifice is flushed and congested, and a small amount of discharge can be spilled by squeezing the urethra, but pressure pain is rarely present. The common comorbidity of mycoplasma infection is tubal inflammation, and a few patients may develop endometritis and pelvic inflammatory disease. 4, diagnosis of mycoplasma culture: remove vaginal and cervical orifice discharge with sterile cotton balls, insert a sterile cotton swab 1 to 2 cm into the cervix and gently rotate to remove the columnar epithelial cell-containing secretion. 5, treatment due to mycoplasma lack of cell wall, β-lactam antibacterial drugs that inhibit cell wall synthesis is ineffective, while mycoplasma infection is often slow and long, for whether it can be cured, the correct choice of drugs is crucial. Erythromycin and tetracycline were once considered to be the first choice of antibiotics with certain efficacy, and the course of treatment was generally 7-10 days. However, with the widespread use of antibiotics, drug resistance has inevitably emerged. Generally speaking, the sensitivity rate of cross-spectin, doxycycline and memantine to mycoplasma is above 90%, and they are the main antibiotics for the treatment of mycoplasma. If necessary, antibiotics can be selected according to the results of the drug sensitivity test. 6, pregnancy combined with mycoplasma infection preferred treatment drug for azithromycin 1g tonics, alternative therapy for erythromycin 0.5g/bid oral, for 14 days. Sexual partners should be examined and treated at the same time during treatment. Mycoplasma should be retested in January after treatment. Chlamydia vaginitis 1. Pathogenic Chlamydia vaginitis is a common sexually transmitted disease and the main pathogen is Chlamydia trachomatis. Chlamydia trachomatis infection accounts for the first place in sexually transmitted diseases in developed countries, and the rate of Chlamydia trachomatis infection is also increasing in China. Chlamydia trachomatis mainly infects the columnar epithelium and migratory epithelium without invading to the deeper layers, which can cause cervical mucositis, endometritis, tubal inflammation and eventually lead to infertility. The transmission of Chlamydia is mainly through sexual transmission, but rarely indirectly through contact with the patient’s secretions contaminated items. 3, clinical manifestations occur mostly in sexually active people, incubation period of 13 weeks. The cervical canal is the most common site of infection for chlamydia, and 70% to 90% of chlamydial mucositis has no clinical symptoms. If symptomatic, it is manifested by increased vaginal discharge, mucopurulent, post-coital bleeding or intermenstrual bleeding. If accompanied by urethritis there may be difficulty in urination, urgency and frequency of urination. Examination reveals purulent discharge from the cervical canal, redness and swelling of the cervix, and increased mucosal fragility. 4, diagnosis Chlamydia trachomatis culture is the gold standard for the diagnosis of Chlamydia trachomatis infection, with high sensitivity and specificity. 5.Treatment Doxycycline 100mg/bid times for 7 days, or Azithromycin 1g in a single dose. Alternative regimens: erythromycin 500mg 4 times daily for 7 days; erythromycin 800mg successively 4 times daily for 7 days; ofloxacin 300mg/bid for 7 days; or levofloxacin 500mg/qd for 7 days. Sexual partners should be examined and treated at the same time during treatment. 6, pregnancy combined with Chlamydia infection Chlamydia infection can cause premature birth, stillbirth, low birth weight babies, neonatal meningitis, etc.. For pregnancy combined with Chlamydia trachomatis infection of high-risk pregnant women should be screened, if the infection is found should be treated, the preferred drug for treatment is azithromycin 1g tonics, or amoxicillin 500mg/tid orally for 7 days, erythromycin is not recommended. Doxycycline, quinolones and tetracycline are contraindicated in pregnant women. Retest for chlamydia after 3 to 4 weeks of treatment.