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在表现出下生殖尿路症状的门诊患者中,潜在的延迟和/或错过的性传播疾病诊断:现实世界的数据库研究研究
Louis Kuritzky1,2, Zune Huynh3, Rodney Arcenas3
1Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA.
Postgraduate medicine
|November 14, 2023
概括
性传播感染 (STIs) 的延迟诊断在患有下生殖尿路症状 (LGUTS) 的患者中很常见. 这项研究发现检测率低,治疗延迟,表明需要改进性传播疾病诊断策略.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 性传播感染 (STIs) 经常伴有下生殖尿路症状 (LGUTS),模仿其他疾病,如尿路感染 (UTIs).
- 准确及时诊断性传播感染对于预防并发症和限制传播至关重要.
- 在临床实践中,重叠的症状可能导致STI诊断延迟或错过.
研究的目的:
- 确定在美国出现下生殖尿路症状 (LGUTS) 的患者中可能错过的性传播感染 (STI) 诊断的比例.
- 为了分析治疗模式和诊断性感染的诊断测试在一个大队列的LGUTS.
- 识别导致性病诊断和治疗延迟的因素.
主要方法:
- 使用了来自IBM® MarketScan®研究数据库 (2010年1月至2019年12月) 的非识别保险索赔数据.
- 创建了一个"GAP"队列的LGUTS情节与潜在的延迟治疗 * 克拉米迪亚瘤 * (CT) 或 * 尼塞利亚淋病 * (NG).
- 根据接受的抗生素治疗和检查的索引诊断以及索引后的性传播疾病检测率,分析了子组.
主要成果:
- GAP队列包括833,574次LGUTS发作;索引后CT/NG测试仅发生在4.6% (男性) 和5.4% (女性) 的人群中.
- 显著比例的发作最初被诊断为尿路感染 (52.1%的男性,68.3%的女性) 或其他疾病,如失尿症,耳炎或阴道炎.
- 复诊率高表明诊断挑战和适当的STI管理的潜在延误.
结论:
- 结果表明,性传播感染的抗生素治疗延迟,CT/NG检测率低,这表明对性传播感染的考虑迟到了.
- 在LGUTS患者中,性传播感染的低最佳诊断可能导致抗生素滥用和治疗并发症.
- 在患有LGUTS的患者中,准确及及时的性传播感染诊断和治疗对于改善患者结果和公共健康至关重要.
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