Hosenfeld Christina B, Workowski Kimberly A, Berman Stuart, Zaidi Akbar, Dyson Jeri, Mosure Debra, Bolan Gail, Bauer Heidi M
California Department of Public Health, STD Control Branch, Richmond, California 94804, USA.
Sex Transm Dis. 2009 Aug;36(8):478-89. doi: 10.1097/OLQ.0b013e3181a2a933.
Determining the magnitude of chlamydia and gonorrhea reinfection is critical to inform evidence-based clinical practice guidelines related to retesting after treatment. PubMed was used to identify peer-reviewed English language studies published in the past 30 years that estimated reinfection rates among females treated for chlamydia or gonorrhea. Included in this analysis were original studies conducted in the United States and other industrialized countries that reported data on chlamydia or gonorrhea reinfection in females. Studies were stratified into 3 tiers based on study design. Reinfection rates were examined in relation to the organism, study design, length of follow-up, and population characteristics. Of the 47 studies included, 16 were active cohort (Tier 1), 15 passive cohort (Tier 2), and 16 disease registry (Tier 3) studies. The overall median proportion of females reinfected with chlamydia was 13.9% (n = 38 studies). Modeled chlamydia reinfection within 12 months demonstrated peak rates of 19% to 20% at 8 to 10 months. The overall median proportion of females reinfected with gonorrhea was 11.7% (n = 17 studies). Younger age was associated with higher rates of both chlamydia and gonorrhea reinfection. High rates of reinfection with chlamydia and gonorrhea among females, along with practical considerations, warrant retesting 3 to 6 months after treatment of the initial infection. Further research should investigate effective interventions to reduce reinfection and to increase retesting.
确定衣原体和淋病再感染的程度对于制定基于证据的治疗后重新检测的临床实践指南至关重要。利用PubMed检索过去30年发表的经同行评审的英文研究，这些研究估计了接受衣原体或淋病治疗的女性的再感染率。纳入该分析的是在美国和其他工业化国家进行的原始研究，这些研究报告了女性衣原体或淋病再感染的数据。根据研究设计将研究分为3个层级。根据病原体、研究设计、随访时间和人群特征对再感染率进行了研究。在纳入的47项研究中，16项为主动队列研究（第1层级），15项为被动队列研究（第2层级），16项为疾病登记研究（第3层级）。衣原体再感染女性的总体中位比例为13.9%（n = 38项研究）。12个月内模拟的衣原体再感染在8至10个月时显示出19%至20%的峰值率。淋病再感染女性的总体中位比例为11.7%（n = 17项研究）。年龄较小与衣原体和淋病再感染率较高相关。女性衣原体和淋病的高再感染率以及实际考虑因素，使得在初始感染治疗后3至6个月进行重新检测是必要的。进一步的研究应调查有效的干预措施以减少再感染并增加重新检测。
