Increasing trends of gonorrhoea and syphilis and the threat of drug-resistant gonorrhoea in Europe.
Increasing trends of gonorrhoea and syphilis and the threat of drug-resistant gonorrhoea in Europe.
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欧洲淋病和梅毒的增长趋势以及耐药淋病的威胁。
DOI：
10.2807/ese.17.29.20225-en
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
G. Spiteri
中科院分区：
文献类型：
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作者：
M. J. W. Laar;G. Spiteri
自21世纪初以来，性传播感染（STI）通报在几个欧洲国家呈上升趋势，很可能是由于多种因素，如筛查增加、使用更敏感的诊断方法、报告得到改善，以及某些亚人群中不安全的性行为水平很高。2010年，整个欧洲报告了3.2万例淋病病例、1.8万例梅毒病例和34.5万多例衣原体病例。某些亚群似乎比其他亚群受影响更大：男男性行为者（MSM）受淋病和梅毒的影响不成比例，15至24岁的年轻人主要受衣原体和淋病的影响。本版欧洲监测报告淋病和梅毒的增加令人担忧，因为它们在男男性接触者和年轻人中被发现，似乎与高水平的不安全性行为和人类免疫缺陷病毒（HIV）的合并感染有关。淋病的增加尤其令人担忧，因为它们与淋病奈瑟菌对英国和整个欧洲目前使用的抗菌药物的敏感性下降相吻合。本版报告的增加可以部分解释为增加了对危险群体的检测。Bremer等人报道，德国梅毒诊断的增加可能与艾滋病毒阴性男男性行为者筛查的增加以及将梅毒检测纳入艾滋病毒阳性男男性行为者的临床监测有关。在瑞典，过去五年中淋病的增加，特别是在年轻妇女（她们往往比男性更无症状）中，同样与青年诊所越来越多地使用核酸扩增试验有关，这种试验更敏感，可以在同一样本中同时检测衣原体和淋病。同样，由于最近性病性淋巴肉芽肿（LGV）的增加，英国增加了对男男性接触者的检测，新的检测指南被认为是导致英国淋病通报增加的原因。
Sexually transmitted infections (STI) notifications have been on the rise in several European countries since the early 2000s, most likely due to multiple factors like increased screening, use of more sensitive diagnostics, improved reporting and also due to high levels of unsafe sexual behaviour among certain subpopulations. Across Europe, 32,000 cases of gonorrhoea, 18,000 cases of syphilis and over 345,000 cases of chlamydia were reported in 2010 [1]. Certain subpopulations appear to be more affected than others: Men who have sex with men (MSM) are disproportionately affected by gonorrhoea and syphilis, and young people between 15 and 24 years of age are affected mainly by chlamydia and gonorrhoea. The increases in gonorrhoea and syphilis reported in this edition of Eurosurveillance are worrying as they are identified in MSM and young adults and seem to be associated with high levels of unsafe sexual behaviour and coinfection with human immunodeficiency virus (HIV). The increases in gonorrhoea are of particular concern as they coincide with decreasing susceptibility of Neisseria gonorrhoeae to currently used antimicrobial drugs in England [2] and across Europe [3]. The increases reported in this edition can be partly explained by increased testing of risk groups. Bremer et al. [4] report that the increase in syphilis diagnoses in Germany could be linked to increased uptake of screening by HIV-negative MSM and incorporation of syphilis testing in the clinical monitoring of HIVpositive MSM. In Sweden, the increase in gonorrhoea seen over the last five years, particularly among young women (who are more often asymptomatic than men) is similarly linked to the increasing use by youth clinics of nucleic acid amplification tests which are more sensitive and test for both chlamydia and gonorrhoea in the same sample [5]. Similarly, increased testing of MSM in the United Kingdom (UK) due to the recent increases in lymphogranuloma venereum (LGV), and new testing guidance is thought to have contributed to the increase in gonorrhoea notification there [6].