2004-2010年广西凤山县梅毒、淋病、AIDS/HIV疫情分析

目的了解边远山区凤山县近7年法定传染病中的梅毒、淋病、AIDS和HIV阳性病例情况,分析其流行特征和规律,为制定防治策略和措施提供科学依据。方法收集该县2004-2010年的法定传染病梅毒、淋病、AIDS/HIV阳性病例疫情资料采用Excel软件进行统计分析。结果全县近7年报告梅毒、淋病、AIDS和HIV阳性病例共594例,人群发病率为43.48/10万,男性高于女性,为2.58：1。其中梅毒111例,人群发病率为8.12/10万。淋病454例,人群发病率为33.23/10万。AIDS患者10例（死亡4例）、HIV阳性患者19例（死亡5例）,AIDS/HIV人群发病率为2.12/10万。以上4种疾病高发年龄在25～54岁年龄组,占总病例的86.70%。农民发病人数占总病例的23.74%,而公职人员也占有22.73%。4种疾病病例数近几年呈逐年上升趋势,特别是AIDS/HIV阳性病例上升较明显。结论该县梅毒、淋病、AIDS/HIV阳性总病例近几年在不断增多,中青年龄组的农民及公职人员应为防治重点,该县性病的防治任务仍然严峻。     

山东省1998～2004年淋病流行特征分析

[目的]分析淋病流行特征,为做好淋病防治工作提供依据。[方法]对山东省1998~2004年淋病疫情数据进行分析。[结果]7年中,全省淋病年均发病率为8.57/10万;男性发病高于女性,男女之比为3.02∶1;20~45岁为主要发病年龄组,农民和工人为主要发病人群。[结论]今后应针对重点人群加强健康宣教和监测工作,同时大力推广安全套使用。     

红细胞、内毒素对淋病患者粒细胞吞噬功能影响的实验研究

检测红细胞和内毒素对30例淋球菌感染（GI）患者变形核粒细胞（PMN）吞噬功能的影响。实验结果显示：GI患者PMN吞噬活性,红细胞促粒细胞吞噬活性（ERPN）均明显低于正常人（P＜0．05）。提示淋病发病机制可能与红细胞免疫功能降低有关。     

细胞培养法检测淋病患者泌尿生殖道沙眼衣原体的研究

用衣原体细胞培养法和淋球菌培养法，对我中心脏病门诊的４５例初步诊断为淋病（涂片检查）的患者进行了泌尿生殖道标本检测。结果显示：４５份标本淋球菌培养均为阳性，其中衣原体细胞培养检测阳性的７份，阳性检出率为１５．６％。对资料的分析还提示，与淋病患者合并衣原体感染发病率显著相关的危险因素是性伴数和既往性病史。     

Disseminated gonococcal infection during pregnancy

Background: Disseminated gonococcal infection in pregnancy is rare with the incidence of 0.04–0.09% in pregnant women. Its most common manifestation is arthritis. Case: A 38-year-old woman, G₁P₀, 36⁺ weeks pregnancy came to hospital with decreased fetal movement. She had purulent vaginal discharge and history of self treatment 1 month earlier. She had a fever with arthritis for 3 days. Purulent joint fluid from arthrocentesis of her right wrist demonstrated intracellular Gram negative diplococcal bacteria. The diagnosis was disseminated gonococcal infection. She was successfully treated with parenteral ceftriaxone followed by oral cefixime. Cesarean section was performed due to preterm premature rupture of the membranes. The maternal and neonatal outcomes were uneventful. Conclusion: Disseminated gonococcal infections are not rare, however, disseminated gonococcal infection in pregnancy is a rare condition. Clinicians should be suspicious of the disease when a pregnant patient presents with arthritic symptoms.     

Emergence of a predominant sequence type ST7363 and the increasing trend of resistance to cefixime and ceftriaxone in Neisseria gonorrhoeae in Southern Taiwan, 2019–2021

Background/purposeMulti-drug resistance and the presence of epidemic lineages of Neisseria gonorrhoeae locally and globally were important clinical and public health issues. We aimed to investigate the molecular epidemiology and the antimicrobial susceptibility profiles of N. gonorrhoeae in Southern Taiwan.MethodsBetween 2019 and 2021, adult patients who had suspected gonorrhea and attended a urology clinic in southern Taiwan were recruited to participate in this study. Clinical data from medical records and a questionnaire, antimicrobial susceptibility testing using a disk diffusion test in accordance with the guidelines by the Clinical and Laboratory Standards Institute, and Multi-locus sequence typing (MLST) were analyzed.ResultsA total of 500 patients participated in the surveillance study. Among them, 232 N. gonorrhoeae isolates were identified, but only 164 isolates were recovered for further research. ST7363 (n = 83, 50.61%) was found to be the predominant sequence type, followed by ST1583 (n = 24, 14.63%), ST1588 (n = 13, 7.93%), and ST7827 (n = 12, 7.32%). 100% resistance to penicillin and 99.4% non-susceptible rate of ciprofloxacin were observed. The azithromycin resistant rate being 15.24% and the cefixime non-susceptible rate being 17.07% were alarming, both with decreasing trends in susceptibilities during 2019–2021. The 25 azithromycin resistant isolates were mainly belonged to ST7363 (n = 12) and ST7827 (n = 3). Seven (4.2%) isolates were ceftriaxone non-susceptible. Among them, four were assigned to be ST 7827 and three belonged to ST7363.ConclusionWe observed the emergence of a predominant sequence type ST7363 in southern Taiwan. Compared with previous Taiwan studies, the increasing trend of resistance to cefixime and ceftriaxone necessitates clinicians’ alertness for clinical treatment response of the extended spectrum cephalosporins and the further surveillance monitor.     

疾病的时间性分布研究

目的：分析淋病发病的时间分布。方法：采用时序图法，Poisson分布法及周期性检验方差分析法，结果：（1）时序图显示淋病发病存在长期上升趋势及周期性波动情况；（2）Poisson分布拟合结果，1994、1995、1996、1997各年X^2值分别为394．97、91．74、39．14、391．56，其对应的P值都＜0．01；（3）周期性方差分析结果为F＝12．8，P＜0．01。结论：（1）淋病的发病率在每年的2－4月和9－12月是发病的高峰季节，且发病存在长期升高的趋势，（2）序列图法，Poisson分布法及周期性方差分析法可以作为研究疾病时间分布的基本方法。     

Sexual networks and sexually transmitted infections: A tale of two cities

Research on risk behaviors for sexually transmitted infections (STIs) has revealed that they seldom correspond with actual risk of infection. Core groups of people with high-risk behavior who form networks of people linked by sexual contact are essential for STI transmission, but have been overlooked in epidemiological studies. Social network analysis, a subdiscipline of sociology, provides both the methods and analytical techniques to describe and illustrate the effects of sexual networks on STI transmission. Sexual networks of people from Colorado Springs, Colorado, and from Winnipeg, Manitoba, Canada, infected with chlamydia during a 6-month period were compared. In Winnipeg, 442 networks were identified, comprising 571 cases and 663 contacts, ranging in size from 2 to 20 individuals; Colorado Springs data yielded 401 networks, comprising 468 cases and 700 contacts, ranging in size from 2 to 12 individuals. Taking differing partner notification methods and the slightly smaller population size in Colorado Springs into account, the networks from both places were similar in both size and structure. These smaller, sparsely linked networks, peripheral to the core, may form the mechanism by which chlamydia can remain endemic, in contrast with larger, more densely connected networks, closer to the core, which are associated with steep rises in incidence.     

Screening for Gonorrhea and Chlamydia in Pregnancy: Room for Improvement

ObjectiveThis study sought to determine the proportion of pregnant women who are tested for gonorrhea and chlamydia as part of their prenatal care and to examine patient and provider factors affecting testing rates.MethodsThe study investigators conducted a retrospective chart review of all patients who delivered at St. Michael's Hospital, an urban tertiary care centre in Toronto, Ontario, between November 2015 and April 2016. Rates of testing and the prevalence of positive test results for gonorrhea and chlamydia were calculated. Chi-square tests were used to compare rates of testing among different types of prenatal care providers (obstetricians, maternal-fetal medicine specialists, family practitioners, midwives) and to determine whether testing rates were affected by patient demographics or characteristics. This study was a Canadian Task Force Classification II-2 retrospective cohort study.ResultsOf the 1315 women who delivered at St. Michael's Hospital during the study period, 1220 met inclusion criteria for the study. Of these women, 186 (15.3%) were not tested for gonorrhea and chlamydia during their pregnancy. There were 11 cases of chlamydia (1.1%) and no cases of gonorrhea. Testing rates were not affected by patient demographic variables or obstetrical history. Midwives and family physicians had the highest testing rates among the provider groups: 93.8% and 91.4%, respectively. Generalist obstetricians tested 88.5% of their patients. Maternal-fetal medicine specialists had a significantly lower rate of testing than the other provider groups, at 64.8% (P < 0.0001).ConclusionsFifteen percent of women were not tested for gonorrhea and chlamydia during the study period even though testing was recommended as part of routine prenatal care. Testing rates varied among providers, and strategies to improve these rates need to be explored.     

不同剂量头孢哌酮舒巴坦治疗单纯性淋病疗效比较研究

目的：探讨不同剂量头孢哌酮舒巴坦治疗单纯性淋病的疗效,以期探索最佳治疗剂量。方法：选择84例单纯性淋病患者,随机分为三组：头孢哌酮舒巴坦1.50g治疗组（简称Ⅰ组）、头孢哌酮舒巴坦2.25g治疗组（简称Ⅱ组）及头孢哌酮舒巴坦3.0g治疗组（简称Ⅲ组）,观察三组患者不同时间点的疗效、不良反应发生率以及评定生活质量。结果：用药第1 d、2d、3d,与Ⅰ组比较,Ⅱ组、Ⅲ增加明显,差异均具有统计学意义（P＜0.05）;Ⅱ组、Ⅲ组比较,均未见明显差异（P＞0.05）。用药第5d、7d,与Ⅰ组的有效率比较,Ⅱ组、Ⅲ组虽有所增加,但差异不具有统计学意义;Ⅱ组、Ⅲ组比较,未见明显差异（P＞0.05）。三组的不良反应发生率比较,差异无统计学意义（P＞0.05）。结论：临床使用2.25 g头孢哌酮舒巴坦治疗单纯性淋病疗效较佳,且安全性较好。