CORRELATION OF AUXOTYPE AND PENICILLIN SUSCEPTIBILITY OF NEISSERIA-GONORRHOEAE WITH SEXUAL PREFERENCE AND CLINICAL MANIFESTATIONS OF GONORRHEA
CORRELATION OF AUXOTYPE AND PENICILLIN SUSCEPTIBILITY OF NEISSERIA-GONORRHOEAE WITH SEXUAL PREFERENCE AND CLINICAL MANIFESTATIONS OF GONORRHEA
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DOI：
10.1097/00007435-198001000-00001
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发表时间：
1980-01-01
影响因子：
3.1
通讯作者：
HOLMES, KK
中科院分区：
文献类型：
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作者：
HANDSFIELD, HH;KNAPP, JS;HOLMES, KK
需要精氨酸、次黄嘌呤和尿嘧啶的淋球菌(Arg-Hyx-Ura-)对青霉素G高度敏感，并与无症状的尿路感染和播散性淋球菌感染(DGI)有关。在282名异性恋男性和女性中，48%的人找到了Arg-Hyx-Ura菌株，而在69名同性恋或双性恋男性中，只有9%的人找到了Arg-Hyx-Ura菌株(P<；0.0001)。在一组连续患有尿路淋球菌感染的单独人群中，96名同性恋男性中有0名没有尿液，而在261名异性恋男性中有18名(P<；0.025)。1970年至1973年，41例男性DGI患者中没有同性恋男性，而1978年，患有无并发症淋病的男性比例为35%。无症状的尿路淋球菌感染和DGI在同性恋男性中可能并不常见，可能是因为感染Arg-Hyx-Ura菌株相对较少。在所研究的人群中，对男性同性恋者的尿路标本进行淋病奈瑟菌培养的筛查结果很低。从同性恋者身上找到的淋病奈瑟菌菌株对青霉素的抗药性明显高于从异性恋受试者中分离出来的菌株；即使是非精氨酸氨基尿素菌株也是如此。这种差异可能有助于解释为什么氨苄西林治疗同性恋者直肠淋球菌感染的疗效较差。
Strains of N. gonorrhoeae requiring arginine, hypoxanthine and uracil (Arg-Hyx-Ura-) are highly susceptible to penicillin G and were associated with asymptomatic urethral infection and disseminated gonococcal infection (DGI). Arg-Hyx-Ura- strains were recovered from 48% of 282 heterosexual men and women vs. only 9% of 69 homosexual or bisexual men (P < 0.0001). In a separate population of consecutive men with urethral gonococcal infections, urethral discharge was absent in 0 of 96 homosexual men vs. 18 of 261 heterosexual men (P < 0.025). Homosexual men accounted for none of 41 cases of DGI in men in 1970-1973, compared with 35% of men with uncomplicated gonorrhea in 1978. Asymptomatic urethral gonococcal infection and DGI may be uncommon in homosexual men, perhaps because infection with Arg-Hyx-Ura- strains is relatively uncommon. Screening cultures of urethral specimens for N. gonorrhoeae had a low yield among homosexual men in the population studied. Strains of N. gonorrhoeae recovered from homosexual men were significantly more resistant to penicillin than were isolates from heterosexual subjects; this was true even for non-Arg-Hyx-Ura- strains. This difference may help to explain the lesser efficacy of ampicillin in treatment of rectal gonococcal infection in homosexual men.