Overview of mycoplasma infection Mycoplasma is the smallest known free-living organism and the smallest prokaryotic cell. It is a prokaryotic microorganism larger than a virus and smaller than a bacterium, which is distinguished by the absence of a cell wall. As a result, the cells are soft, variable and highly polymorphic. Mycoplasma is widely found in soil, sewage, insects, vertebrates and humans, and is one of the pathogenic bacteria of plants, animals and humans. There are more than 80 species of mycoplasma genera, including Mycoplasma pneumoniae (MP), Mycoplasma humanum (MH), Mycoplasma urealyticum (UU) and Mycoplasma genitalium (MG), the former causing pneumonia and the latter three causing genitourinary tract infections. Mycoplasma genitalium infections in the genitourinary tract cause diseases such as non-gonococcal urethritis in men and mainly non-gonococcal genitourinary tract infection in women. Men present with urethral tingling, burning sensation and difficulty in urination, and in a few cases, frequent urination. The urethral opening is mildly red and swollen, and the discharge is thin, and some patients are asymptomatic. In women, the symptoms are increased leucorrhea, burning in the urethra or infertility, miscarriage and ectopic pregnancy caused by pelvic inflammatory disease, tubal inflammatory disease, etc. When Mycoplasma and Chlamydia infect the human body, they first invade the columnar epithelial cells and grow and multiply inside the cells, and then enter the cells of the mononuclear macrophage system to proliferate. As mycoplasma and chlamydia multiply within the cells, they lead to the death of the infected cells, while still evading the host immune defenses and receiving intermittent protection. The pathogenic mechanism of mycoplasma and chlamydia is the inhibition of infected cell metabolism, lysis and destruction of cells and leads to the release of lysozyme, cytotoxic effects of metabolites, causing metamorphic reactions and autoimmunity. When the body is infected with mycoplasma and chlamydia, specific immunity is produced, but this immunity is weak and short-lived; therefore, mycoplasma and chlamydia infections tend to cause persistent, recurrent infections, and occult infections. In terms of cellular immunity, most patients with active cured chlamydia often cause a delayed metaplasia when the corresponding antigen is given intradermally. This metaplasia can be passively transferred by lymphocytes. This immunity is likely to be mediated by T cells. In terms of humoral immunity, neutralizing antibodies appear in the serum and local secretions after mycoplasma and chlamydia infections. Neutralizing antibodies prevent the adsorption of chlamydia to host cells and also enhance phagocytic uptake through conditioning. The most common site of invasion of mycoplasma and chlamydia in the female reproductive tract is the cervix, and the resulting upward spread can cause endometritis, tubitis, pelvic inflammatory disease, and also acute urethritis and vestibular adenitis. Mycoplasma and chlamydia infections in pregnant women can cause neonatal ophthalmia and pneumonia if the fetus passes through the birth canal during delivery. Mycoplasma and chlamydia infections in women do not always cause symptoms, and even if they do, they vary depending on the site of infection. For example, cervical infections can cause cervical erosion, cervical mucous membrane edema, increased leucorrhea (purulent), contact bleeding, etc. Fallopian tube infections can cause lower abdominal pain, back pain and infertility. In general, none of these symptoms are specific. Mycoplasma and Chlamydia can be transmitted through sexual contact, but also through hands, eyes, towels, clothing, baths, stools, and swimming pools. Sexual relations with more than one person, the male partner has a UTI, poor hygiene habits, etc. are prone to infection. Therefore, the key to preventing infection is to be clean and take good care of your personal hygiene. The causes of mycoplasma infection are mainly transmitted through sexual contact in adults, while newborns are infected by the mother’s reproductive tract during delivery. In adult males, the site of infection is in the mucous membrane of the urethra, and in females, the site of infection is in the cervix. In newborns, it mainly causes conjunctivitis and pneumonia. Mycoplasma can only adhere to receptors on the surface of epithelial cells in the respiratory or genitourinary tract and does not enter the tissues or bloodstream. Mycoplasma causes cell damage because: mycoplasma adhering to the surface of host cells absorbs nutrients from cells and obtains lipids and cholesterol from cell membranes, causing cell damage; mycoplasma metabolizes toxic substances, such as mycoplasma lyticum, which can produce neurotoxins and cause cell membrane damage; ureaplasma contains urease, which can hydrolyze urea to produce large amounts of ammonia, which has a toxic effect on cells. In addition to adhering to the surface of cells and macrophages, mycoplasma can also adhere to the surface of sperm, thus preventing sperm movement, and its production of neuraminidase-like substances can interfere with the union of sperm and egg. This is one of the reasons why mycoplasma infections cause infertility and infertility. Symptoms of mycoplasma infection The incubation period is 1-3 weeks, and the typical acute phase symptoms are similar to other non-gonorrheal genitourinary infections, manifesting as urethral tingling, varying degrees of urinary urgency and frequency, and stinging pain in urination, especially when the urine is more concentrated. The urethral orifice is mildly red and swollen, and the discharge is thin, small, plagioid or purulent, and it requires forceful squeezing of the urethra to see the discharge overflow. In the subacute stage, prostate infection is often combined with perineal swelling and pain, lumbago, discomfort in the inner part of both femurs, or a tingling sensation from the perineum to the inner part of the femur when doing anal lifting. In women, inflammation of the genital tract centered on the cervix is common. When the infection spreads to the urethra, frequent and urgent urination is the main symptom that draws 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. The impact of mycoplasma infection on male infertility Mycoplasma is a class of prokaryotic microorganisms that are between bacteria and viruses in size. There are three species of mycoplasma that are pathogenic to humans, including Mycoplasma solium, which is a common pathogen of the human genitourinary tract and is associated with many genitourinary tract infections, perinatal infections and infertility, and is one of the pathogens of sexually transmitted diseases. Mycoplasma infection via the urethra patients can develop symptoms of urethritis and can be secondary to chronic prostatitis. During examination of prostate fluid, a lively, swimming community of microorganisms is visible. Mycoplasma also continues to infect the seminal tract, seminal vesicles and testes, affecting the quality of sperm and semen and causing infertility. Mycoplasma has been observed to cause infertility through the following links. 1, interference with sperm movement: sperm movement is an important function of healthy sperm, is an important indicator of whether sperm can be conceived, and sperm movement must have a certain speed and frequency. Mycoplasma infected sperm, often attached to the head and tail of the sperm, so that the entire sperm hung with attachments of varying sizes, resulting in sperm swimming weak, entangled with each other, leading to infertility. 2, sperm deformation rate increases: mycoplasma infection leads to an increase in sperm deformation rate is another feature that causes infertility. According to clinical observation, the sperm deformity rate can sometimes be as high as 80% in such infertility patients. 3, destruction of spermatogenic cells: the testis has a large number of spermatogenic cells in the varicocele, which develop and reproduce to form sperm. When mycoplasma enters the testicular varicose duct from the urethra and prostate, it will destroy the sperm cells and make the “sperm factory” produce shoddy products, leading to infertility. Therefore, patients with infertility should be checked for mycoplasma infections in order to identify the cause and treat the disease. Treatment of mycoplasma infection Strongylin 100mg orally, twice daily for 7-14 days or Azithromycin 1g, single dose orally, with a half-life of up to 60 hours, once orally, to maintain effective concentration for 5 days; Fluozinil 0.2, orally, twice daily for 7-14 days. Symptoms of prostate due to Chlamydia infection Chronic prostatitis due to Mycoplasma decidua and Chlamydia trachomatis infection is often the result of upward spread of sexual urethritis. The diagnostic criteria are as follows: (1) clinical symptoms frequent urination, urgent urination, painful urination, residual urination, milky white urethra, pain and discomfort on the pubic bone or around the perineum and anus, or sexual dysfunction, etc. (2) rectal examination The prostate gland is normal in size or has enlargement, the surface is not flat, or not to what slightly hard, there is pressure pain, irregular inflammatory nodules can be found. (3) Prostate fluid examination microscopic examination leukocytes ≥ 10 / HP or pile phenomenon, small body reduction or disappearance, pH>6.8. (4) Detection of mycoplasma using the culture method, mycoplasma solium medium contains phenol red, mycoplasma solium in the process of growth can decompose urea ammonia production, so that the pH of the medium, phenol red indicator by the influence of pH changes in the medium from light yellow, this is positive, indicating This is positive, indicating the growth of Mycoplasma solani. Prevention of mycoplasma infection (1) active physical exercise weekdays to exercise systematically when sleeping to keep the air fresh indoor temperature appropriate since childhood should open the window sleep should be at least indirect ventilation to make full use of sunbathing air bath and water bath to enhance physical fitness is the first important factor in the prevention of disease. (2) hygiene to avoid cross-infection not to crowded poorly ventilated theaters department stores supermarkets and other places to try to avoid contact with patients with illnesses to seek medical care near less run big hospitals to shorten the waiting time previously believed that respiratory diseases are transmitted only by breathing in recent years has been confirmed that contact transmission is an important mode of transmission should be particularly reminded of the attention is not to allow children to smoke passively being smoked is an important reason to increase the number of children suffering from respiratory diseases. (3) Drug prevention certain Chinese and Western drugs can improve the body’s cellular and humoral immune function is best to use drugs under the guidance of a doctor. (4) vaccination at present some places with attenuated virus vaccine but not yet universal application had designed vaccine for prevention but the protection rate is only 50% antibiotic prevention also no systematic report.