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淋菌感染的流行病学与治疗研究——壮观霉素单次注射疗法——[札幌性传播疾病临床研究组]

[Epidemiological and therapeutic studies on gonococcal infections--one shot therapy by spectinomycin--[Sapporo Clinical Research Group for STD]].

作者信息

Sakai S, Kumamoto Y, Tsunekawa T, Hirose T, Tabata S, Goro T, Inoke T, Igawa K, Henmi I, Tanda H

出版信息

Hinyokika Kiyo. 1987 Jan;33(1):157-68.

PMID:2953180
Abstract

From January through March of 1985, the Sapporo Clinical Research Group for STD treated 69 cases of gonococcal infections (61 cases of male gonococcal urethritis and 8 cases of female gonococcal cervicitis) at its facilities in Sapporo City. The therapeutic efficacy of one shot therapy of Spectinomycin (SPCM) was investigated, and an epidemiological study on the cases and bacteriological studies on the isolated strains of Neisseria gonorrhoeae were made. The male patients were between 19 and 55 years old, with a peak age distribution in the younger half of the twenties. The female patients were between 18 and 40 years old. The major source of infections was a so-called special massage parlor which accounted for 36.1% of male cases. The isolation rate of PPNG were 16.7% (11/66). The MIC (inoculum size; 10(6) CFU/ml) of SPCM ranged from 3.13 to 25 micrograms/ml regardless of beta-lactamase production. In male patients, the eradication rate (efficacy rate) of N. gonorrhoeae by SPCM was 94.7% on the first day, 93.6% on the third day and 100% on the seventh day after 2 g one shot therapy. In female patients, the rate was 100% on the third and seventh day after 2 g one shot therapy, and 75% on the first day, 66.7% on third day and 100% on seventh day after 4 g one shot therapy. We considered that one shot therapy of SPCM was effective for gonococcal infection also in the present time. Especially SPCM was effective for infections by PPNG, since it was not resolved by beta-lactamase of N. gonorrhoeae. Positive rate of Chlamydia trachomatis was 16.3% in male gonococcal urethritis, and the serous discharge tended to remain longer in the positive patients than in the negative patients. There was only one side effect (1.4%), therefore SPCM was recognized to be a safely administrated antimicrobial agent.

摘要

1985年1月至3月,札幌市性传播疾病临床研究小组在其位于札幌市的医疗机构中治疗了69例淋病感染病例(61例男性淋菌性尿道炎和8例女性淋菌性宫颈炎)。对壮观霉素(SPCM)单次注射疗法的治疗效果进行了研究,并对病例进行了流行病学研究,对分离出的淋病奈瑟菌菌株进行了细菌学研究。男性患者年龄在19至55岁之间,年龄分布高峰在二十多岁的下半段。女性患者年龄在18至40岁之间。主要感染源是一家所谓的特殊按摩院,占男性病例的36.1%。产青霉素酶淋病奈瑟菌(PPNG)的分离率为16.7%(11/66)。无论是否产生β-内酰胺酶,SPCM的最低抑菌浓度(接种量;10(6) CFU/ml)范围为3.13至25微克/毫升。在男性患者中,单次注射2克SPCM后,淋病奈瑟菌的根除率(有效率)在第一天为94.7%,第三天为93.6%,第七天为100%。在女性患者中,单次注射2克后第三天和第七天的根除率为100%,单次注射4克后第一天为75%,第三天为66.7%,第七天为100%。我们认为SPCM单次注射疗法目前对淋病感染也有效。特别是SPCM对PPNG感染有效,因为它不会被淋病奈瑟菌的β-内酰胺酶分解。男性淋菌性尿道炎中沙眼衣原体的阳性率为16.3%,阳性患者的浆液性分泌物持续时间往往比阴性患者更长。只有一例副作用(1.4%),因此SPCM被认为是一种安全给药的抗菌剂。

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