Historical perspective of syphilis in the past 60 years in China: eliminated, forgotten, on the return

Syphilis (historically called lues) is a sexually transmitted disease (STD) caused by the spirochete bacterium Treponema pallidum subspecies pallidum.Syphilis had many alternate names,such as the "great pox" in order to distinguish it from smallpox,and was given many national attributions,such as the French pox,the English pox,and the Italian pox,due to the disease often being spread by foreign sailors and soldiers during their frequent,unprotected sexual contact with local prostitutes.1 The French pox was widely used before it was named syphilis by the Italian physician and poet Girolamo Fracastoro in 1530.2 Syphilis first reached Canton (Guangzhou) of China through the sea in 1505 and was called "Canton sores" or "Canton rash" (kuang chuang).However,"plum-blossom sores" (yangmei chuang) was more widely used in medical records in China because they had a shape resembling plum-blossoms.Syphilis is almost transmitted through unprotected sexual contact with an infected person although it is possible to contract the infection by coming into contact with the broken skin of an infected person.Syphilis can also be passed from an infected mother to her unborn child.     

社会网络理论和方法在研究MSM HIV感染者中的应用进展

男男性行为人群(MSM)中艾滋病病毒(HIV)感染率高、风险行为普遍,一部分人同时与女性保持性关系,性关系网络复杂,是HIV向一般人群传播的重要桥梁。与传统流行病学研究主要关注个体风险行为不同,社会网络理论从网络视角研究人际关系及其对个体行为和疾病传播的影响。近年来,越来越多的研究关注社会网络在HIV传播中发挥的作用。该文综述了社会网络分析的主要方法和国内外男男性行为人群的社会网络分析和干预研究进展。研究发现:1)性网络结构特征影响MSM感染和传播HIV的风险;2)社会网络可通过网络成员间的同伴压力、行为准则和社会支持影响MSM的行为和健康状况;3)以社会网络为基础的干预方法在MSM中可行且可减少风险行为。     

淋球菌耐药监测15年

目的:了解我国1987～2001年淋病流行中的淋球菌对抗生素的敏感性,为修改淋病治疗方案和制订防治策略提供依据.方法:用琼脂稀释法检测淋球菌对WHO规定的5种核心抗生素的敏感性,用纸片酸度法测定淋球菌产青霉素酶(PPNG)菌株.结果:15年来用琼脂稀释法共检测了7583株菌,青霉素耐药株5399株,占71.20%;PPNG株占17.71%(1056/5964).四环素的耐药株占92.61%(1090/1177);由质粒介导的高度耐四环素淋球茵茵株(TRNG)占14.03%(811/5779).对环丙沙星的耐药性迅速增高,占61.12%(3311/5417).对大观霉素和头孢曲松的耐药菌百分率较低,分别为0.41%(26/6342)和0.39%(23/5853).对南京地区1993～1995年和1999～2001年大观霉素和头孢曲松对淋球菌的MIC50作了比较,结果显示MIC50值并无明显变化.结论:我国近15年流行的淋球菌对青霉素、四环素和环丙沙星的耐药性相当高,而对大观霉素和头孢曲松仍较敏感.为了防止淋球菌耐药菌株的进一步传播应强调对淋病病人进行范围治疗.     

Surveillance of antimicrobial susceptibilities in Neisseria gonorrhoeae in Nanjing, China, 1999-2006

OBJECTIVE: To monitor the frequency and types of antibiotic resistance of Neisseria gonorrhoeae in Nanjing, China, between 1999 and 2006. METHODS: beta-Lactamase production was determined by paper acidometric testing. Minimum inhibitory concentrations (MICs) to penicillin, ceftriaxone, tetracycline, ciprofloxacin, and spectinomycin were determined by agar plate dilution. Plasmid types were determined for TRNG and PPNG isolates by PCR. RESULTS: One-thousand two-hundred and eight N. gonorrhoeae isolates were examined. The rate of PPNG rose from 8.0% (9 of 112) in 1999 to 57.36% (113 of 197) in 2004, and declined to 44.44% (88 of 198) in 2006. Prevalence of TRNG increased from 1.8% (2 of 112) in 1999 to 32.82% (65 of 198) in 2006. 99.23% (258 of 260) of TRNG contained the Dutch-type tetM gene and 2 strains contained the American-type tetM gene. All PPNG examined contained the Asian type plasmid. Among non-PPNG, chromosomally mediated resistance to penicillin varied from 57.84% (59 of 102) to 87.80% (72 of 82). Chromosomal resistance to ciprofloxacin (QRNG) was detected in 83.93% (94 of 112) of the strains in 1999 and 98.99% (196 of 198) in 2006. Eight spectinomycin-resistant N. gonorrhoeae strains were detected between 2001 and 2006. None of the gonococcal isolates tested was resistant to ceftriaxone but decreased susceptibility was observed in some strains. CONCLUSIONS: Among N. gonorrhoeae strains isolated in Nanjing, China, plasmid mediated resistance including PPNG and TRNG increased significantly between 1999 and 2006. Chromosomally mediated resistance to both penicillin and ciprofloxacin was also high during this period. Spectinomycin resistance of N. gonorrhoeae was sporadic. Ceftriaxone and spectinomycin can be considered effective antimicrobial agents for the treatment of gonorrhea in Nanjing at the present time.     

Validation of syndromic algorithm for the management of genital ulcer diseases in China

OBJECTIVES: 1. To determine the aetiologies of genital ulcers in China. 2. To evaluate a modified WHO syndromic management algorithm for genital ulcer disease (GUD). METHODS: Patients with genital ulcers were enrolled at their first visit to STD clinics in the cities of Shanghai and Chengdu. They were managed according to a modified WHO algorithm for GUD, in which no treatment was given for chancroid. A multiplex polymerase chain reaction was used to detect Treponema pallidum, Herpes simplex and Haemophilus ducreyi. Dark field examination and serology (rapid plasma reagin and Treponema pallidum particle agglutination assay (TPPA) were also used to diagnose syphilis. RESULTS: A total of 227 male and female patients were enrolled. Syphilis alone was diagnosed in 78 (35%), genital herpes alone in 43 (19%), and both infections were present in 28 (12%). No diagnosis was made in 76 (34%). No case of chancroid was identified. The sensitivity of the algorithm for syphilis and herpes was 88.7% and 69.0% respectively, the specificity 95.0% and 50.0%. 12/106 cases of syphilis were incorrectly classified as herpes (11%), and did not receive treatment. More than 97% of patients followed up responded clinically to treatment. CONCLUSION: Further validation and revision of the WHO flowchart for GUD are needed.     

沙眼衣原体耐药性的分子机制研究的新进展

沙眼衣原体(Ct)感染如果未得到及时治疗,会引起严重及复杂的并发症。目前大环内酯类和喹诺酮类药物是治疗Ct感染的一线药物,但Ct对这几种药物产生耐药的报道越来越多,给临床治疗带来了挑战。众多研究表明,Ct产生耐药的机制比较复杂,与多种基因突变有关。     

2014—2019年中国梅毒流行趋势与特征分析

目的:分析2014—2019年中国梅毒流行趋势和特征,为制定防治对策提供依据。方法:应用描述性流行病学方法对2014—2019年中国梅毒报告病例数据进行"三间分布"分析。结果:2014—2019年,梅毒报告发病率由30.93/10万增长至38.37/10万,年均增长4.41%;其中一期与二期梅毒、胎传梅毒报告发病率年均...