Wiesenfeld Harold C, Manhart Lisa E
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, and Magee-Womens Research Institute, Pittsburgh, Pennsylvania.
Departments of Epidemiology and Global Health, Center for AIDS and STD, University of Washington, Seattle.
J Infect Dis. 2017 Jul 15;216(suppl_2):S389-S395. doi: 10.1093/infdis/jix198.
Health consequences of sexually transmitted diseases disproportionately affect women, making it important to determine whether newly emerged pathogens cause sequelae. Although the pathogenic role of Mycoplasma genitalium in male urethritis is clear, fewer studies have been conducted among women to determine its pathogenic role in the female reproductive tract. Pelvic inflammatory disease (PID) is an important cause of infertility and ectopic pregnancy, and Chlamydia trachomatis and Neisseria gonorrhoeae are recognized microbial causes. Emerging data demonstrate an association between M. genitalium and PID, and limited data suggest associations with infertility and preterm birth, yet the attributable risk for female genital tract infections remains to be defined. Further investigations are needed to better define the impact of M. genitalium on women's reproductive health. Importantly, prospective studies evaluating whether screening programs and targeted treatment of M. genitalium improve reproductive outcomes in women are necessary to guide public health policy for this emerging pathogen.
性传播疾病对健康的影响在女性中更为严重，因此确定新出现的病原体是否会导致后遗症非常重要。虽然生殖支原体在男性尿道炎中的致病作用已很明确，但针对女性进行的研究较少，以确定其在女性生殖道中的致病作用。盆腔炎（PID）是不孕症和异位妊娠的重要原因，沙眼衣原体和淋病奈瑟菌是公认的微生物病因。新出现的数据表明生殖支原体与盆腔炎之间存在关联，有限的数据表明与不孕症和早产有关，但女性生殖道感染的归因风险仍有待确定。需要进一步调查，以更好地确定生殖支原体对女性生殖健康的影响。重要的是，需要进行前瞻性研究，评估针对生殖支原体的筛查计划和靶向治疗是否能改善女性的生殖结局，以指导针对这种新出现病原体的公共卫生政策。
