Slifirski Josephine B, Vodstrcil Lenka A, Fairley Christopher K, Ong Jason J, Chow Eric P F, Chen Marcus Y, Read Timothy R H, Bradshaw Catriona S
Emerg Infect Dis. 2017 Nov;23(11):1826-1833. doi: 10.3201/eid2311.170998.
Data on the likelihood of Mycoplasma genitalium infection in sexual contacts, particularly for men who have sex with men (MSM), are needed to form an evidence base for guidelines. We conducted a cross-sectional analysis of patients attending a sexual health clinic in Melbourne, Victoria, Australia, during 2008-2016. We calculated the proportion of contacts with M. genitalium infection and determined factors associated with infection. Among those patients reporting sexual contact with an M. genitalium-infected person, 48.2% of women, 31.0% of heterosexual men, and 41.7% of MSM were infected. Among heterosexual contacts, women were twice as likely to be infected; among MSM, rectal infection was more common than urethral infection; and among persons within heterosexual partnerships, concordance of infection was high. High positivity among female and MSM contacts and high concordance in heterosexual partnerships provide some justification for presumptive treatment; however, clinicians should consider antimicrobial drug resistance and toxicity of quinolones.
为制定指南建立证据基础,需要了解性接触中生殖支原体感染的可能性数据,尤其是男男性行为者(MSM)的数据。我们对2008年至2016年期间在澳大利亚维多利亚州墨尔本一家性健康诊所就诊的患者进行了横断面分析。我们计算了生殖支原体感染接触者的比例,并确定了与感染相关的因素。在报告与生殖支原体感染者有性接触的患者中,48.2%的女性、31.0%的异性恋男性和41.7%的男男性行为者被感染。在异性接触中,女性感染的可能性是男性的两倍;在男男性行为者中,直肠感染比尿道感染更常见;在异性伴侣关系中,感染的一致性很高。女性和男男性行为者接触者中的高阳性率以及异性伴侣关系中的高一致性为推定治疗提供了一些依据;然而,临床医生应考虑抗菌药物耐药性和喹诺酮类药物的毒性。