Kolader Marion-Eliëtte, Dukers Nicole H T M, van der Bij Akke K, Dierdorp Mirjam, Fennema Johan S A, Coutinho Roel A, Bruisten Sylvia M
STI Clinic, Cluster of Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands.
J Clin Microbiol. 2006 Aug;44(8):2689-97. doi: 10.1128/JCM.02311-05.
Molecular typing, added to epidemiological data, can better identify transmission patterns of gonorrhea in Western countries, where the incidence has recently been rising. From September 2002 to September 2003, patients with a laboratory-confirmed diagnosis of gonorrhea at the Clinic for Sexually Transmitted Infections in Amsterdam, The Netherlands, were subjected to a questionnaire pertaining to sexual risk behavior and sexual partners in the 6 months prior to the diagnosis. The Neisseria gonorrhoeae isolates were all genotyped using PCR-restriction fragment length polymorphism of the porin and opacity genes. All patients with a completed questionnaire and genotyped isolates were included in the study. We obtained 885 N. gonorrhoeae isolates from 696 patients that revealed 88 clusters and 46 unique genotypes. Patients infected at multiple anatomical sites with one or more strains and patients infected several times during the study period were shown to pursue high-risk sexual behavior and were considered core groups. There were 11 clusters of > or =20 patients; in seven clusters, 81% to 100% of patients were men who have sex with men (MSM), three clusters contained 87 to 100% heterosexual men and women, and one cluster was formed by equal proportions of MSM and heterosexual male and female patients. However, the various clusters differed in characteristics such as types of coinfections, numbers of sexual partners, Internet use to seek sexual partners, and locations of sexual encounters. Molecular epidemiology of gonococcal isolates in Amsterdam revealed core groups and clusters of MSM and heterosexual patients that probably indicate distinct transmission networks.
分子分型结合流行病学数据，能够更好地识别西方国家淋病的传播模式，这些国家淋病发病率最近呈上升趋势。2002年9月至2003年9月，荷兰阿姆斯特丹性传播感染诊所确诊为淋病的患者接受了一份关于诊断前6个月内性风险行为和性伴侣的问卷调查。所有淋病奈瑟菌分离株均采用孔蛋白和不透明蛋白基因的PCR-限制性片段长度多态性进行基因分型。所有完成问卷调查且分离株已进行基因分型的患者均纳入研究。我们从696名患者中获得了885株淋病奈瑟菌分离株，发现了88个聚类和46种独特基因型。在多个解剖部位感染一种或多种菌株的患者以及在研究期间多次感染的患者表现出高危性行为，被视为核心群体。有11个聚类包含≥20名患者；在7个聚类中，81%至100%的患者为男男性行为者（MSM），3个聚类包含87%至100%的异性恋男性和女性，1个聚类由同等比例的MSM以及异性恋男性和女性患者组成。然而，不同聚类在合并感染类型、性伴侣数量、通过互联网寻找性伴侣以及性接触地点等特征方面存在差异。阿姆斯特丹淋病奈瑟菌分离株的分子流行病学揭示了MSM和异性恋患者的核心群体和聚类，这可能表明存在不同的传播网络。
