上海地区893例性病门诊患者淋病奈瑟菌、沙眼衣原体及解脲脲原体的感染特点分析

Prevalence of Neisseria gonorrhoeae,Chlamydia trachomatis and Ureaplasma urealyticum infections in 893 patients at STD clinic in Shanghai

目的了解上海地区性病门诊淋病奈瑟菌、沙眼衣原体和解脲脲原体的感染人群及特征,为性病防治工作提供参考。方法选取2018年7月—2020年11月在上海市皮肤病医院性病门诊就诊且疑似泌尿生殖道感染的患者,统计分析患者泌尿生殖道分泌物中淋病奈瑟菌、沙眼衣原体和解脲脲原体的核酸检测结果。结果893例患者中,男性496例,女性397例,平均年龄(36.2±10.9)岁。PCR荧光探针法检测出淋病奈瑟菌、沙眼衣原体和解脲脲原体的阳性率分别为8.0%、11.2%和42.7%,其中男性淋病奈瑟菌的感染率显著高于女性(11.9%对3.0%,P<0.001),而女性解脲脲原体的检出率显著高于男性(66.2%对23.8%,P<0.001),沙眼衣原体的感染率性别差异无统计学意义;同时检测出两种及三种性病病原体混合感染的阳性率为8.4%(75/893),其中以沙眼衣原体+解脲脲原体混合感染阳性率最高(4.8%),随之是淋病奈瑟菌+解脲脲原体(1.7%),淋病奈瑟菌+沙眼衣原体+解脲脲原体的检出率最低(0.7%);不同年龄组淋病奈瑟菌、沙眼衣原体和解脲脲原体感染情况显示:20~40岁是三种病原菌检测阳性的主要人群,同时0~20岁淋病奈瑟菌和沙眼衣原体感染阳性率较高。结论性病门诊患者淋病奈瑟菌、沙眼衣原体和解脲脲原体检出率较高,并存在多种性病病原体混合感染现象,临床上应重视混合感染的筛查,以防漏诊及延误治疗;同时,人群性传播疾病的防治教育工作需加强。

Objective To investigate the prevalence of Neisseria gonorrhoeae(NG),Chlamydia trachomatis(CT)and Ureaplasma urealyticum(UU)infections among outpatients at STD clinic of Shanghai Skin Disease Hospital.Methods A retrospective analysis was conducted with the nucleic acid testing results of outpatients with high risk sexual behavior or suspected NG,CT,and/or UU infections from July 2018 to November 2020.Results Among the 893 patients,496 were males and 397 were females.The prevalence of NG,CT,and UU was 8.0%,11.2%,and 42.7%,respectively.Males showed significantly higher prevalence of NG infection than females(11.9%vs.3.0%,P<0.001),while females had significantly higher prevalence of UU infection than males(66.2%vs.23.8%,P<0.001).No significant sex difference was found in CT infection.The overall prevalence of co-infection was 8.4%,among which the CT and UU co-infection was the highest(4.8%).Young adults(20 to 40 years of age)were more likely to be infected with these three pathogens compared with other age groups.In the age group of 0-20 years,the prevalence of NG and CT was relatively higher than UU.Conclusion The prevalence of NG,CT,and UU is high in the patients visiting STD clinic.Co-infection of NG,CT,and UU is also frequently identified.Therefore,multiple pathogens should be screened at STD clinic to prevent misdiagnosis and delayed treatment.Furthermore,sexual health education should be strengthened.