Burillo A, Fernández-Pérez C, Rivera M, Alonso R, Catalán P, Bouza E
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón and Universidad Complutense, Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 2008 Nov;27(11):1037-43. doi: 10.1007/s10096-008-0540-4. Epub 2008 May 28.
Syphilis re-emergence is a cause of concern. Our objective was to quantify the laboratory workload, incident cases and patient follow-up that syphilis has generated for 11 years in a large teaching hospital. An ecologic study including all samples submitted for syphilis serodiagnosis at our hospital from January 1994 to December 2004 was undertaken. Our laboratory processed 58,832 samples for syphilis serodiagnosis. From 1994 to 2004, the number of samples submitted for syphilis testing dropped by 11% (95% confidence interval [CI] 10-12, p<0.001). Syphilis was diagnosed in 443 patients. The incidences were 11, 3 and 8 per 100,000 inhabitants/year in 1994, 2000 and 2004, respectively. Only 42% (185) of patients had repeat tests and in 79% (146) of cases, the 1-year follow-up data were missing. The median follow-up was 9 months (interquartile range [IQR] 3-26). We detected a reduction in the effort to detect syphilis, despite an increase in its incidence and the low cost of syphilis screening. Efforts should be intensified to improve physician compliance with syphilis screening and follow-up guidelines.
梅毒再度出现令人担忧。我们的目标是量化一家大型教学医院11年来梅毒检测产生的实验室工作量、新发病例及患者随访情况。我们开展了一项生态学研究，纳入了1994年1月至2004年12月期间我院提交进行梅毒血清学诊断的所有样本。我们的实验室处理了58832份用于梅毒血清学诊断的样本。1994年至2004年，提交进行梅毒检测的样本数量下降了11%（95%置信区间[CI]为10%-12%，p<0.001）。共诊断出443例梅毒患者。1994年、2000年和2004年的发病率分别为每10万居民每年11例、3例和8例。只有42%（185例）的患者进行了复查，79%（146例）的病例缺少1年的随访数据。随访时间中位数为9个月（四分位间距[IQR]为3-26个月）。尽管梅毒发病率上升且梅毒筛查成本较低，但我们发现检测梅毒的工作力度有所下降。应加大力度提高医生对梅毒筛查和随访指南的依从性。
