性感染症 の 診断 と 治療: レビュー
Susan Tuddenham1, Matthew M Hamill1, Khalil G Ghanem1
1Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA
|January 11, 2022
まとめ
米国では性感染症 (性感染症) が増加し,ヘルペスの発生率は減少しています. 有効な治療法がありますが,抗菌剤耐性やヘルペス治療法がないことが課題となっています.
科学分野:
- 公衆衛生
- 感染症
- 流行病学について
背景:
- 性感染症 (STD) は,米国の成人の約5人に1人に感染し,2015年から2019年の間に淋病,クラミジア,梅毒が著しく増加しました.
- 若者,性的およびジェンダーのマイノリティー,人種/民族のマイノリティーを含む特定の集団は,不釣り合いの高いSTI率を経験しています.
- ヘルペスやトリホモナシスなどの多くの性感染症はしばしば無症状であり,診断を複雑にし,感染リスクを高め,同時にHIVと不妊症に関連しています.
研究 の 目的:
- 一般的な性感染症の流行病学,診断,治療に関する最新のレビューを提供すること.
- バクテリア性性感染症の増加率と特定のウイルス性感染症の減少率を含むSTIの流行傾向を強調する.
- 抗菌剤耐性や性器ヘルペスの治癒方法の欠如などのSTI管理における課題について議論する.
主な方法:
- 1999年から2019年の米国におけるSTI発生率に関する疫学データのレビュー.
- 核酸増強検査と梅毒の血清検査を含む診断方法の分析
- 様々な性感染症に対する現在の薬理学的治療法と推奨される治療法の検討
主要な成果:
- ゴノレア,クラミジア,梅毒の発生率は上昇し,ヘルペス・シンプレックスウイルス1型と2型 (HSV-1とHSV-2) の流行率は減少しています.
- 核酸増幅検査は,最も一般的な性感染症の診断に高い感度と特異性を示しています.
- 抗菌剤耐性はますます懸念され,性麻疹とMycoplasma genitaliumの治療選択肢が制限され,性器ヘルペスの治療法は存在しない.
結論:
- 治療法があるにも関わらず,性感染症の発生率と抗菌剤耐性が増加しているため,公衆衛生上の取り組みを継続する必要があります.
- 効果的な予防策には,スクリーニング,パートナーへの通知,そしてバリア避妊の一貫した使用が含まれます.
- 継続的な研究と監視は,変化する性感染症の管理に不可欠です.
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