Azariah Sunita, Perkins Nicky
Auckland Sexual Health Service, Auckland.
N Z Med J. 2007 Apr 13;120(1252):U2491.
A case-control study of patients with gonorrhoea presenting to Auckland Sexual Health Service was carried out to determine specific risk factors and to look more closely at the transmission of ciprofloxacin-resistant Neisseria gonorrhoeae in the Auckland region.
Patients who tested positive for gonorrhoea during a 6-month time period from September 2003 till March 2004 were included in the study. A control group was selected from patients who presented during the same time period but who had negative sexually transmitted infection (STI) screens. A selection of N. gonorrhoeae isolates were sent to ESR for typing by pulsed-field gel electrophoresis (PFGE).
204 cases of gonorrhoea were identified during the study period; 50% of the diagnosed cases were in people aged less than 26 years. Gonococcal infection was strongly associated with being of either Māori or Pacific ethnicity (p<0.001). A history of consistent condom use was found to lower the risk of acquisition of gonorrhoea (p=0.009). Thirty-three percent of cases had ciprofloxacin-resistant gonococcal infection and the majority of these acquired their infection in New Zealand (88%). Comparison of PFGE genotyping data with results from an audit in 2001 indicated that genetic diversity amongst ciprofloxacin-resistant isolates has increased significantly.
The incidence of gonorrhoea in the Auckland population is steadily rising, with the main risk factors being age under 25 and being of Māori or Pacific ethnicity. Genetic diversity amongst ciprofloxacin-resistant isolates is increasing, thus indicating high levels of endemic infection. Urgent action needs to be taken to control the current gonorrhoea epidemic in Auckland and more research is required to investigate reasons for ethnic differences in disease incidence.
对前往奥克兰性健康服务中心就诊的淋病患者进行病例对照研究，以确定具体的风险因素，并更深入地研究奥克兰地区耐环丙沙星淋病奈瑟菌的传播情况。
纳入2003年9月至2004年3月这6个月期间淋病检测呈阳性的患者。对照组从同一时期就诊但性传播感染（STI）筛查呈阴性的患者中选取。挑选出的淋病奈瑟菌分离株被送往环境科学与研究中心，通过脉冲场凝胶电泳（PFGE）进行分型。
研究期间共确诊204例淋病病例；50%的确诊病例年龄小于26岁。淋球菌感染与毛利族或太平洋岛民族裔密切相关（p<0.001）。发现持续使用避孕套的病史可降低感染淋病的风险（p=0.009）。33%的病例感染了耐环丙沙星的淋球菌，其中大多数在新西兰感染（88%）。将PFGE基因分型数据与2001年的一项审计结果进行比较表明，耐环丙沙星分离株之间的遗传多样性显著增加。
奥克兰人群中淋病的发病率在稳步上升，主要风险因素是25岁以下以及毛利族或太平洋岛民族裔。耐环丙沙星分离株之间的遗传多样性正在增加，这表明地方性感染水平较高。需要立即采取行动控制奥克兰目前的淋病疫情，还需要更多研究来调查疾病发病率存在种族差异的原因。
