Salado-Rasmussen Kirsten, Jensen Jørgen Skov
Microbiology and Infection Control, Sexually Transmitted Infections, Research and Development, Statens Serum Institut, Copenhagen, Denmark.
Clin Infect Dis. 2014 Jul 1;59(1):24-30. doi: 10.1093/cid/ciu217. Epub 2014 Apr 11.
Mycoplasma genitalium is a common cause of nongonococcal urethritis (NGU) and cervicitis. The aim of the study was to analyze the M. genitalium testing pattern and distribution of positive results according to sex and age in a 5-year period where all diagnostic M. genitalium testing in Denmark was centralized at the Statens Serum Institut. A secondary aim was to estimate the occurrence of macrolide resistance in a 3-year period.
The study was performed as a nationwide retrospective survey of specimens submitted from general practice, private specialists, and hospitals to Statens Serum Institut for detection of M. genitalium by polymerase chain reaction between 1 January 2006 and 31 December 2010. Macrolide resistance screening was introduced December 2007.
A total of 31 600 specimens from 28 958 patients were tested for M. genitalium, with an increasing trend from 3858 per year in 2006 to 7361 in 2010. The majority (54%) of the patients were tested in general practice. For both sexes, the positive rate increased significantly, from 2.4% to 3.8% for women and from 7.9% to 10.3% for men (P < .0005). Macrolide resistance was detected in 38% (385/1008) of the M. genitalium-positive patients, and the highest rate was found in patients tested at sexually transmitted disease clinics (43%).
Testing for M. genitalium has become important for clinicians treating sexually transmitted infections. In this nationwide survey, macrolide resistance was found in almost 40% of the specimens, raising concern about single-dose azithromycin treatment of NGU, and emphasizing that NGU treatment should be guided by etiologic diagnosis.
生殖支原体是引起非淋菌性尿道炎（NGU）和宫颈炎的常见病因。本研究旨在分析丹麦5年间生殖支原体检测模式以及根据性别和年龄划分的阳性结果分布情况，在此期间丹麦所有生殖支原体诊断检测均集中在国家血清研究所进行。次要目的是估计3年间大环内酯类耐药的发生率。
本研究为一项全国性回顾性调查，收集了2006年1月1日至2010年12月31日期间从普通诊所、私人专科医生和医院提交至国家血清研究所，用于通过聚合酶链反应检测生殖支原体的标本。2007年12月开始进行大环内酯类耐药性筛查。
共对来自28958例患者的31600份标本进行了生殖支原体检测，检测数量呈上升趋势，从2006年的每年3858份增至2010年的7361份。大多数（54%）患者是在普通诊所接受检测。男女两性的阳性率均显著上升，女性从2.4%升至3.8%，男性从7.9%升至10.3%（P < .0005）。在1008例生殖支原体阳性患者中，38%（385/1008）检测出大环内酯类耐药，其中在性传播疾病诊所接受检测的患者中耐药率最高（43%）。
对于治疗性传播感染的临床医生而言，生殖支原体检测已变得至关重要。在这项全国性调查中，近40%的标本检测出大环内酯类耐药，这引发了对单剂量阿奇霉素治疗非淋菌性尿道炎的担忧，并强调非淋菌性尿道炎的治疗应以病因诊断为指导。
