Little James W
University of Minnesota, Naples, FL, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Feb;101(2):137-43. doi: 10.1016/j.tripleo.2005.05.077.
Gonorrhea is a worldwide sexually transmitted disease (STD) caused by Neisseria gonorrhoeae. Gonorrhea is the second most often reported STD in the United States behind chlamydia. An estimated 600,000 people each year in the United States are infected. Only about half this number of cases are reported. From 1975 through 1997, the national gonorrhea rate declined 74.3%. After a small increase in 1998, the gonorrhea rate has decreased each year since 1999. In 2003 the South had the highest gonorrhea rate among the four regions of the country. Antimicrobial resistance remains an important consideration in the treatment of gonorrhea. In 2003 the Gonococcal Isolate Surveillance Project found about 16% of collected isolates were resistant to penicillin and/or tetracycline. Since 1998 the number of ciprofloxacin-resistant isolates has been increasing with 270 (4.1%) being reported in 2003. Oral gonorrhea is rare, nonspecific, and varied and may range from slight erythema to severe ulceration with a pseudomembranous coating. The patient with gonorrhea poses little threat of disease transmission to the dentist. However, patients who have or have had gonorrhea should be approached with a measure of caution because they are in a high-risk group for additional STDs. The CDC has published recommendations for standard precautions to be followed in controlling infection in dentistry that have become the standard for preventing cross-infection. Strict adherence to these recommendations will, for all practical purposes, eliminate the danger of disease transmission between dentist and patient. Dentists should be aware of local statutory requirements regarding reporting STDs to state health officials. Syphilis, gonorrhea, and AIDS are reportable diseases in every state. Local health departments or state STD programs are sources of information regarding this matter.
淋病是一种由淋病奈瑟菌引起的全球性性传播疾病（STD）。淋病是美国报告率仅次于衣原体感染的第二常见性传播疾病。据估计，美国每年有60万人感染淋病。而报告的病例数仅约为这一数字的一半。从1975年到1997年，全国淋病发病率下降了74.3%。1998年略有上升后，自1999年以来淋病发病率逐年下降。2003年，美国南部地区的淋病发病率在全国四个地区中最高。抗菌药物耐药性仍是淋病治疗中的一个重要考虑因素。2003年，淋病分离株监测项目发现，约16%的收集分离株对青霉素和/或四环素耐药。自1998年以来，对环丙沙星耐药的分离株数量一直在增加，2003年报告了270株（4.1%）。口腔淋病罕见、无特异性且表现多样，可能从轻微红斑到伴有假膜覆盖的严重溃疡不等。淋病患者对牙医造成疾病传播的威胁很小。然而，患有或曾患淋病的患者应谨慎对待，因为他们属于其他性传播疾病的高危人群。美国疾病控制与预防中心（CDC）发布了牙科控制感染应遵循的标准预防措施建议，这些建议已成为预防交叉感染的标准。实际上，严格遵守这些建议将消除牙医与患者之间疾病传播的危险。牙医应了解向州卫生官员报告性传播疾病的当地法定要求。梅毒、淋病和艾滋病在每个州都是应报告的疾病。当地卫生部门或州性传播疾病项目是关于此事的信息来源。
