Choudhry Shilpee, Ramachandran V G, Das Shukla, Bhattacharya S N, Mogha Narendra Singh
Department of Microbiology, UCMS & GTB Hospital, Dilshad Garden, Delhi, India.
Indian J Sex Transm Dis AIDS. 2010 Jul;31(2):87-91. doi: 10.4103/0253-7184.74978.
Many studies have examined the inter-relationship between different STI. There are, however, a few data on patients presenting with more than one concurrent sexually transmitted infection (STI). The aim of the study was to determine the burden of patients with more than one concurrent STI and to characterize factors associated with such infections.
Two hundred seventy five patients with one or more of the complaints, as enunciated by the World Health Organization (WHO) in its syndromic approach for the diagnosis of STI, were included as subjects. Detailed history, demographical data, and clinical features were recorded. All the patients were screened for common STIs. Multivariate analysis was performed taking all significant risk factor obtained from univariate analysis.
A total of 102 (37%) patients were identified as having multiple STIs amongst whom 72% (73/102) were male, 70% were married, and except one none reported regular use of condom The age of first sexual exposure was 13-17 years, 31.3% had more than three sexual partners in the past 6 months, and 76.4% had contact with commercial sex workers (CSWs). Multivariate analysis revealed statistical significance in relation to marital status, number of sexual partners exposed in the past 6 months, age of first sexual exposure, and age of patient at the time of presentation. Syphilis (48%) was the most common infection associated with multiple STI followed by HIV (45%) and HSV-2 (39.2%). None of the patients with multiple infections were detected and managed accurately by syndromic approach.
Pattern of concurrent multiple STIs and the clinical severity of such multiple infections may serve as an indicator of the type of host-pathogen interaction determining the outcome of infection. When patient had multiple STIs, syndromic approach was not axiomatic and thus underscores the need for laboratory diagnosis.
许多研究探讨了不同性传播感染（STI）之间的相互关系。然而，关于同时患有多种性传播感染的患者的数据却很少。本研究的目的是确定同时患有多种性传播感染的患者负担，并描述与此类感染相关的因素。
纳入275例有世界卫生组织（WHO）在其性传播感染综合征诊断方法中所阐述的一种或多种症状的患者作为研究对象。记录详细病史、人口统计学数据和临床特征。对所有患者进行常见性传播感染筛查。采用单因素分析得出的所有显著危险因素进行多因素分析。
共有102例（37%）患者被确定患有多种性传播感染，其中72%（73/102）为男性，70%已婚，除1例患者外，均未报告经常使用避孕套。首次性接触年龄为13 - 17岁，31.3%的患者在过去6个月内有3个以上性伴侣，76.4%的患者与商业性工作者（CSW）有接触。多因素分析显示，婚姻状况、过去6个月内接触的性伴侣数量、首次性接触年龄以及就诊时患者年龄具有统计学意义。梅毒（48%）是与多种性传播感染相关的最常见感染，其次是艾滋病毒（45%）和单纯疱疹病毒2型（39.2%）。综合征诊断方法未能准确检测和管理任何一例患有多种感染的患者。
同时发生多种性传播感染的模式以及此类多重感染的临床严重程度可能作为宿主 - 病原体相互作用类型的指标，决定感染的结果。当患者患有多种性传播感染时，综合征诊断方法并非必然有效，因此强调了实验室诊断的必要性。
