Prevalence of and associated risk factors for fluoroquinolone-resistant Neisseria gonorrhoeae in California, 2000-2003
Prevalence of and associated risk factors for fluoroquinolone-resistant Neisseria gonorrhoeae in California, 2000-2003
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DOI：
10.1086/432801
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发表时间：
2005-09-15
影响因子：
11.8
通讯作者：
Bolan, G
中科院分区：
文献类型：
--
作者：
Bauer, HM;Mark, KE;Bolan, G
背景。全世界和加利福尼亚州的耐氟喹诺酮类淋病奈瑟菌 (QRNG) 比例正在增加。方法。作为对已建立监测的补充，加利福尼亚州 QRNG 的调查包括在南加利福尼亚州的扩大监测，对患者（2001 年 1 月至 2002 年 6 月期间接受 QRNG）进行深入访谈，并对 4 个性传播疾病诊所接受淋球菌分离株并接受药敏试验的患者进行横断面研究（2001 年 7 月至 2002 年 6 月期间）。结果。 QRNG 发生率从 1999 年的 < 1% 上升到 2003 年下半年的 20.2%。 2001 年至 2002 年的扩大监测表明，1355 株分离株中有 66 株（4.9%）对氟喹诺酮类药物耐药；这些感染大多数发生在 2001 年 8 月之后。对 952 名淋病患者的横断面分析显示，2001 年至 2002 年间，QRNG 的患病率存在地域差异，发病率最高的是南加州（8.9%），最低的是旧金山（3.6%）。 QRNG 的患病率在男男性行为者 (MSM) 中为 8.6%，在异性恋男性中为 5.1%，在女性中为 4.3%。尽管 QRNG 的危险因素因诊所而异，但多变量分析表明与种族/民族、近期抗生素使用和 MSM 独立相关。结论。 QRNG 在加利福尼亚州的出现和传播似乎从零星输入演变为 MSM 和异性恋者中的地方性传播。监测 QRNG 感染的流行率和危险因素对于提出治疗建议和制定阻断传播的干预措施至关重要。
Background. Rates of fluoroquinolone-resistant Neisseria gonorrhoeae (QRNG) are increasing worldwide and in California.Methods. As a supplement to established surveillance, the investigation of QRNG in California included expanded surveillance in southern California, with in-depth interviews of patients (who had QRNG during the period of January 2001 - June 2002) and a cross-sectional study of patients at 4 sexually transmitted diseases clinics with gonococcal isolates that underwent susceptibility testing (for the period of July 2001 - June 2002).Results. The rate of QRNG increased from < 1% in 1999 to 20.2% in the second half of 2003. The 2001 - 2002 expanded surveillance demonstrated that 66 (4.9%) of 1355 isolates were resistant to fluoroquinolones; the majority of these infections occurred after August 2001. Cross-sectional analysis of 952 patients with gonorrhea revealed that the prevalence of QRNG varied geographically during 2001 - 2002, with the highest rate being in southern California (8.9%) and the lowest being in San Francisco (3.6%). The QRNG prevalence was 8.6% among men who have sex with men (MSM), 5.1% among heterosexual men, and 4.3% among women. Although risk factors for QRNG varied by clinic, multivariate analysis demonstrated independent associations with race/ethnicity, recent antibiotic use, and MSM.Conclusions. The emergence and spread of QRNG in California appeared to evolve from sporadic importation to endemic transmission among both MSM and heterosexuals. Monitoring of both the prevalence of and risk factors for QRNG infections is critical for making treatment recommendations and for developing interventions to interrupt transmission.