Handsfield H H, Rice R J, Roberts M C, Holmes K K
Seattle-King County Department of Public Health, Harborview Medical Center, Seattle, WA 98104.
JAMA. 1989 Apr 28;261(16):2357-61.
In King County, Washington, penicillinase-producing Neisseria gonorrhoeae infections increased from 0.8% of reported cases of gonorrhea in 1986 to 6.8% of cases in the third quarter of 1987, then stabilized at 2.7% to 3.6% of cases. Of 268 penicillinase-producing N gonorrhoeae isolates tested, 159 (59%) belonged to a single clone, as evidenced by auxotyping, protein-I serotyping, plasmid analysis, and antimicrobial susceptibility testing. As this strain spread, the predominance of cases shifted from whites to blacks and from men to equal numbers of men and women. The proportion of cases associated with illicit drug use rose steadily from 19% in the first quarter of 1987 to 82% in the fourth quarter. Sixty percent of cases occurred in prostitutes or recent sexual contacts of prostitutes. These results suggest that core gonorrhea transmitters in King County are predominantly black illicit drug users, prostitutes, and their sexual partners. These are priority target populations for behavioral intervention and other measures to control the spread of all sexually transmitted diseases, including human immunodeficiency virus infection.
在华盛顿州金县，产青霉素酶的淋病奈瑟菌感染在报告的淋病病例中所占比例从1986年的0.8%增至1987年第三季度的6.8%，随后稳定在病例的2.7%至3.6%。在检测的268株产青霉素酶的淋病奈瑟菌分离株中，159株（59%）属于单一克隆，这通过菌型分类、蛋白-I血清分型、质粒分析和药敏试验得以证实。随着该菌株的传播，病例的优势群体从白人转向黑人，从男性转向男女数量相等。与非法药物使用相关的病例比例从1987年第一季度的19%稳步升至第四季度的82%。60%的病例发生在妓女或妓女的近期性伴侣中。这些结果表明，金县淋病的核心传播者主要是黑人非法药物使用者、妓女及其性伴侣。这些是行为干预和其他控制包括人类免疫缺陷病毒感染在内的所有性传播疾病传播措施的优先目标人群。
