Musil Kate, Currie Marian, Sherley Miranda, Martin Sarah
Australian National University, ANU Medical School, Canberra, ACT, Australia.
University of Canberra/ Australian National University/ Canberra Hospital, Canberra, ACT, Australia.
Int J STD AIDS. 2016 Jun;27(7):526-30. doi: 10.1177/0956462415586317. Epub 2015 May 7.
Chlamydia is the most commonly notified sexually transmitted infection in Australia. Australian guidelines recommend urogenital screening in asymptomatic men and women, and rectal screening in men who have sex with men or women reporting anal sex/symptoms. International studies describe a rectal chlamydia prevalence in women of 5% to 21%. We found that in women at high risk of chlamydia, 57% (32/56) tested positive for rectal chlamydia. Of these, 97% (31/32) had concurrent urogenital chlamydia. Women with urogenital chlamydia were significantly more likely to have a positive rectal result (χ(2), p = 0.000). Neither anal symptoms nor reported anal sex were associated with a positive rectal chlamydia test. The recommended treatment of rectal chlamydia differs substantially from that of urogenital chlamydia, raising the possibility that Australian women are being regularly undertreated due to a lack of rectal testing. Untreated rectal chlamydia may increase the risk of persistent infection, reproductive tract reinfection, complications and transmission. Further work is needed to determine the optimal management of chlamydia in women.
衣原体感染是澳大利亚报告最多的性传播感染疾病。澳大利亚的指导方针建议，对无症状的男性和女性进行泌尿生殖系统筛查，对有男男性行为或有肛交/肛门症状报告的女性进行直肠筛查。国际研究表明，女性直肠衣原体感染率为5%至21%。我们发现，在衣原体感染高危女性中，57%（32/56）的直肠衣原体检测呈阳性。其中，97%（31/32）同时患有泌尿生殖系统衣原体感染。患有泌尿生殖系统衣原体感染的女性直肠检测结果呈阳性的可能性显著更高（χ(2)，p = 0.000）。肛门症状和肛交报告均与直肠衣原体检测呈阳性无关。直肠衣原体感染的推荐治疗方法与泌尿生殖系统衣原体感染的治疗方法有很大不同，这增加了澳大利亚女性因缺乏直肠检测而经常接受不充分治疗的可能性。未经治疗的直肠衣原体感染可能会增加持续感染、生殖道再次感染、并发症和传播的风险。需要进一步开展工作，以确定女性衣原体感染的最佳管理方法。
