Matsumoto T
Department of Urology, School of Medicine, University of Occupational and Environmental Health, Japan.
Int J Antimicrob Agents. 2008 Feb;31 Suppl 1:S35-9. doi: 10.1016/j.ijantimicag.2007.08.029.
Sexually transmitted diseases (STDs), especially HIV infection, gonococcal infection and genital chlamydial infections are increasing all over the world. UNAIDS recently reported that the number of HIV/AIDS patients had been increasing and the highest prevalence was found in African countries, followed by Caribbean, Asian and Eastern European countries. HIV infection has also been gradually increasing in Japan. In non-HIV STDs, genital chlamydial infections are increasing worldwide also. On the contrary, gonococcal infections have been decreasing in many countries except Asian countries. N. gonorrhoeae has been changing in its infecting sites. The pharynx is the most important infecting site, because gonococcal infection in the pharynx may be one of the causes of the wide spread of N. gonorrhoeae. Antimicrobial-resistant N. gonorrhoeae has wide distribution throughout the world. For example, penicillin-resistant N. gonorrhoeae is prevalent in various part of the world, and fluoroquinolone-resistant N. gonorrhoeae is prevalent mainly in Asia. In addition to penicillin, tetracycline and fluoroquinolone resistance, N. gonorrhoeae acquired resistance to almost all of the cephalosporins except for ceftriaxone and cefodizime in Japan. Although there is no resistant strain to ceftriaxone, cefodizime and spectinomycin, 1.0 g single dose of ceftriaxone is considered to be the most suitable regimen for the treatment of gonococcal infection including the pharyngeal infection, because of the 100% elimination rate of N. gonorrhoeae from the urethra, cervix and pharynx obtained in a recent study.
性传播疾病(STDs),尤其是艾滋病毒感染、淋球菌感染和生殖系统衣原体感染在全球范围内呈上升趋势。联合国艾滋病规划署最近报告称,艾滋病毒/艾滋病患者数量一直在增加,非洲国家的患病率最高,其次是加勒比地区、亚洲和东欧国家。日本的艾滋病毒感染率也在逐渐上升。在非艾滋病毒引起的性传播疾病中,生殖系统衣原体感染在全球范围内也在增加。相反,除亚洲国家外,许多国家的淋球菌感染率一直在下降。淋病奈瑟菌的感染部位一直在发生变化。咽部是最重要的感染部位,因为咽部的淋球菌感染可能是淋病奈瑟菌广泛传播的原因之一。耐抗菌药物的淋病奈瑟菌在全球广泛分布。例如,耐青霉素的淋病奈瑟菌在世界各地区都很普遍,耐氟喹诺酮的淋病奈瑟菌主要在亚洲流行。除了对青霉素、四环素和氟喹诺酮耐药外,在日本,淋病奈瑟菌对除头孢曲松和头孢地嗪之外的几乎所有头孢菌素都产生了耐药性。虽然没有对头孢曲松、头孢地嗪和大观霉素耐药的菌株,但由于最近一项研究显示,1.0克单剂量的头孢曲松能使淋病奈瑟菌从尿道、宫颈和咽部的清除率达到100%,因此它被认为是治疗包括咽部感染在内的淋球菌感染的最合适方案。