Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009-2011
Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009-2011
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DOI：
10.1136/sextrans-2013-051119
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发表时间：
2013-12-01
影响因子：
3.6
通讯作者：
Patey, Olivier
中科院分区：
文献类型：
--
作者：
Belkacem, Anna;Caumes, Eric;Patey, Olivier
目的 播散性淋球菌感染 (DGI) 很少见。我们描述了法国 DGI 的特征。方法这是对 2009 年至 2011 年间通过法国微生物学家和传染病专家的两个网络收集的 DGI 病例进行的 3 年回顾性分析。DGI 的定义是从血液和滑液中分离出淋病奈瑟菌，或者通过存在与 DGI 一致的临床综合征以及从任何部位分离出淋病奈瑟菌来定义。我们描述了 DGI 的流行病学、临床和微生物学特征以及结果。结果 21 名患者（9 名女性，12 名男性；18-62 岁）被诊断为 DGI。 2009年至2011年间，DGI病例数量有所增加。两名男男性行为者同时感染了艾滋病毒。我们发现了28个生殖器外部位，包括关节炎（14例）、腱鞘炎（7例）、皮肤病变（4例）、心内膜炎（1例）、前列腺炎（1例）和盆腔炎（1例）。五名患者出现生殖器症状。该诊断通过 20 名患者的血液培养（4 例）、滑液（11 例）、生殖器（3 例）、喉咙（1 例）、尿液（1 例）的培养以及 1 例患者咽拭子的分子生物学检测得到证实。 7例对氟喹诺酮类药物耐药。患者接受头孢曲松治疗，并联合皮质类固醇（2 例）和手术（6 例）。 4例患者出现关节后遗症。结论DGIs呈增加趋势。男性似乎比女性面临更高的风险。共同参与很常见。微生物学诊断基于培养，但当培养呈阴性时，使用咽拭子的分子生物学很有帮助。
Objectives Disseminated gonococcal infections (DGIs) are rare. We describe the characteristics of DGIs in France.Methods This is a 3-year retrospective analysis of DGI cases collected through two networks of microbiologists and infectious disease specialists in France between 2009 and 2011. DGI was defined either by the isolation of Neisseria gonorrhoeae from blood and synovial fluid or by the existence of a clinical syndrome consistent with DGI and the isolation of N gonorrhoeae from any site. We describe the epidemiological, clinical and microbiological characteristics and outcomes of DGIs.Results 21 patients (9 women, 12 men; 18-62 years old) were diagnosed with DGI. The number of DGI cases increased between 2009 and 2011. Two men who had sex with men were coinfected with HIV. We found 28 extragenital locations, including arthritis (14 cases), tenosynovitis (7), skin lesions (4), endocarditis (1), prostatitis (1) and pelvic inflammatory disease (1). Genital signs were present in five patients. The diagnosis was confirmed by cultures in 20 patients-blood (4), synovial fluid (11), genital (3), throat (1), urine (1)-and by molecular biology on a pharyngeal swab in 1 patient. Seven cases were resistant to fluoroquinolones. The patients were treated with ceftriaxone, associated with corticosteroids (two cases) and surgery (six cases). Four patients had joint sequelae.Conclusions DGIs are increasing. Men seem to be at higher risk than women. Joint involvement was common. Microbiological diagnosis was based on culture, however molecular biology using pharyngeal swabs was helpful when cultures were negative.