Am J Epidemiol. 2013 Oct 15;178(8):1289-95. doi: 10.1093/aje/kwt115. Epub 2013 Sep 18.
We analyzed 265 urethral Neisseria gonorrhoeae specimens collected from symptomatic males at San Francisco's municipal sexually transmitted disease clinic, a participant in the Gonococcal Isolate Surveillance Project, during 2009. We used N. gonorrhoeae multiantigen sequence typing to describe characteristics of patients infected with common sequence type families. Specimens were classified into 6 homology-based families and 1 additional family of all other identified strains. Strain family results were combined with results of culture-based antibiotic sensitivity minimum inhibitory concentration, sociodemographic and behavioral risk data collected at the clinic, and presence or absence of the mosaic penicillin-binding protein 2 (penA) allele. Characteristics of patients were compared across strain families through the use of χ(2) statistics. Among men who have sex with men, strain distribution differed by those reporting receptive oral sex as their only urethral exposure (P = 0.04), by number of sex partners (P = 0.03), and by race/ethnicity (P < 0.001); there were no differences by age or human immunodeficiency virus status. Also, among men who have sex with men, strain family distributions differed for culture specimens with reduced susceptibility to a range of antibiotics, as well as with presence of the mosaic penA allele (all P < 0.001). The combination of molecular, phenotypic, and epidemiologic data on N. gonorrhoeae infection could help develop a more complete epidemiology of gonorrhea in the United States.
我们分析了 2009 年旧金山市立性传播疾病诊所的 265 例淋病奈瑟菌尿道标本,这些标本来自有症状的男性,他们是性传播疾病监测项目的参与者。我们使用淋病奈瑟菌多抗原序列分型来描述感染常见序列型家族的患者的特征。标本分为 6 个同源家族和 1 个其他所有鉴定菌株的家族。将菌株家族结果与培养基于抗生素敏感性最小抑菌浓度的结果、诊所收集的社会人口学和行为风险数据以及是否存在镶嵌青霉素结合蛋白 2(penA)等位基因相结合。通过使用 χ(2)统计数据,比较了不同菌株家族患者的特征。在男男性行为者中,报告仅接受口腔性接触作为唯一尿道暴露的人群(P = 0.04)、性伴侣数量(P = 0.03)和种族/民族(P < 0.001)的菌株分布不同;年龄或人类免疫缺陷病毒状况没有差异。此外,在男男性行为者中,对多种抗生素敏感性降低的培养标本以及存在镶嵌 penA 等位基因的标本的菌株家族分布也不同(均 P < 0.001)。淋病奈瑟菌感染的分子、表型和流行病学数据的组合可以帮助我们更好地了解美国淋病的完整流行病学。