Management of Mycoplasma genitalium infections - can we hit a moving target?
Management of Mycoplasma genitalium infections - can we hit a moving target?
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支原体生殖器感染的管理 - 我们可以达到移动的目标吗？
DOI：
10.1186/s12879-015-1041-6
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发表时间：
2015-08-19
影响因子：
3.7
通讯作者：
Bradshaw C
中科院分区：
文献类型：
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作者：
Jensen JS;Bradshaw C
生殖支原体是性传播感染的病原体，但由于其苛刻的生长要求，只有少数M。生殖器菌株可用于测定当前使用的和新的抗微生物剂的活性。最近的临床试验表明，由于大环内酯类耐药的流行率增加，阿奇霉素治疗的疗效下降，这可能是由于1 g单剂量阿奇霉素的广泛使用。同样，使用阿托沙星的二线治疗也面临着新出现的耐药性的压力。单一剂量单药治疗无并发症的STI（如M）的时代。genitalium和N.淋病虽然对病人和医生都很方便，但它与不断升级的耐药性和治疗失败有关，现在正接近尾声。目前迫切需要对现有注册药物和新抗菌化合物的组合进行试验，实施诊断检测与耐药性分子检测相结合，以及抗菌素监测。
Mycoplasma genitalium is an etiological agent of sexually transmitted infections, but due to its fastidious growth requirements, only a few M. genitalium strains are available for determination of the activity of currently used and new antimicrobial agents. Recent clinical trials have demonstrated that treatment with azithromycin has decreasing efficacy due to an increasing prevalence of macrolide resistance, which is likely to be attributed to the widespread use of 1 g single dose azithromycin. Second line treatment with moxifloxacin is similarly under pressure from emerging resistance. The era of single dose monotherapy for uncomplicated STIs such as M. genitalium and N. gonorrhoeae, while convenient for patients and physicians, has been associated with escalating resistance and treatment failure and is now drawing to a close. There is a critical need for trials of combinations of existing registered drugs and new antimicrobial compounds, implementation of diagnostic testing combined with molecular detection of resistance, and antimicrobial surveillance.