性传播感染的诊断和治疗:一篇综述
Susan Tuddenham1, Matthew M Hamill1, Khalil G Ghanem1
1Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA
|January 11, 2022
概括
美国的性传播感染 (STI) 如淋病,淋病和梅毒正在增加, 而疹的发病率正在下降. 有效的治疗方法存在, 但抗菌药物耐药性和缺少疹治愈的方法带来了挑战.
科学领域:
- 公共卫生
- 传染性疾病
- 流行病学
背景情况:
- 性传播感染 (STIs) 影响了大约五分之一的美国成年人,在2015-2019年期间,淋病,克拉米迪亚和梅毒的病例显著增加.
- 某些群体,包括年轻人,性和性别少数群体以及种族/民族少数群体的性病发病率不成比例.
- 许多性传播疾病,如疹和三毛病,往往无症状,使诊断复杂,传播风险增加,同时也与艾滋病毒和不孕症有关.
研究的目的:
- 提供常见性病的流行病学,诊断和治疗的最新评估.
- 突出性传播疾病的流行趋势,包括细菌性传播疾病的增长率和某些病毒性传播疾病的下降率.
- 讨论性感染管理的挑战,例如抗菌素耐药性和生殖器疹的缺乏治疗方法.
主要方法:
- 对1999年至2019年美国性病发病率的流行病学数据的审查.
- 分析诊断方法,包括核酸放大测试和梅毒血清学.
- 对各种性病的现有和推药物治疗方法的检查.
主要成果:
- 淋病,克拉米迪亚和梅毒的发病率有所上升,与单纯疹病毒1型和2型 (HSV-1和HSV-2) 发病率的下降形成鲜明对比.
- 核酸放大试验对于诊断最常见的性病具有很高的敏感性和特异性.
- 抗菌药物耐药性是一个越来越大的问题,限制了淋病和Mycoplasma genitalium的治疗选择,并且没有治愈生殖器疹.
结论:
- 尽管有治疗方法,但性传播感染率和抗菌素耐药性不断上升,需要持续开展公共卫生工作.
- 有效的预防策略包括查,通知伴侣和持续使用屏障避孕.
- 持续的研究和监测对于管理不断变化的性病环境至关重要.
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