Pediatric Infectious Diseases, Dalhousie University, Canadian Center for Vaccinology, IWK Health Center, Halifax, Canada.
Adv Exp Med Biol. 2013;764:219-39. doi: 10.1007/978-1-4614-4726-9_19.
Gonorrhea remains as a significant public health concern with an estimated 88 million new cases per year globally. Gonorrhea is a disease of sexual networks and is most prevalent in youth, men who have sex with men, and the socioeconomically disadvantaged. Highly adaptive through years of co-evolution, gonorrhea has developed multiple ways of evading the human immune system. Although new molecular-based strategies have opened avenues for less invasive testing, education and accessibility issues persist. Novel strategies, including use of the internet and social media, are required to better target high risk groups for education, testing, and treatment. Increasing the availability of youth-friendly health services will also help foster earlier gonorrhea diagnosis and management. The inappropriate and overuse of antibiotics and propensity of gonococcus for mutation has led to growing microbe resistance. Treatment failures now include both oral and intravenous formulations of third generation cephalosporins; key front line recommended gonococcal treatment in many countries. With treatment options dwindling, the need for better preventative strategies has never been more important. This overview highlights some of the major aspects of gonococcal infection, including the epidemiology of the disease with an emphasis on sexual networks, new diagnostic techniques, treatment options in the face of evolving gonococcal resistance, and notes potential new preventative strategies.
淋病仍然是一个重大的公共卫生问题，全球每年估计有 8800 万例新发病例。淋病是一种性网络传播的疾病，在年轻人、男男性行为者和社会经济地位较低的人群中最为普遍。经过多年的共同进化，淋病具有很强的适应性，已经发展出多种逃避人体免疫系统的方法。尽管新的基于分子的策略为非侵入性检测开辟了途径，但教育和可及性问题仍然存在。需要新的策略，包括利用互联网和社交媒体，以便更好地针对高风险群体进行教育、检测和治疗。增加青年友好型卫生服务的可及性也将有助于促进淋病的早期诊断和管理。抗生素的不适当和过度使用以及淋球菌的突变倾向导致了微生物耐药性的增加。治疗失败现在包括第三代头孢菌素的口服和静脉制剂；这是许多国家推荐的淋病治疗的关键一线药物。随着治疗选择的减少，更好的预防策略的需求从未如此重要。本综述重点介绍了淋球菌感染的一些主要方面，包括疾病的流行病学，重点是性网络，新的诊断技术，面对不断演变的淋球菌耐药性的治疗选择，并指出了潜在的新的预防策略。
