Brosh-Nissimov Tal, Kedem Ron, Ophir Nimrod, Shental Omri, Keller Nathan, Amit Sharon
The Infectious Disease Unit, Assuta Ashdod University Hospital, Harefua 7, Ashdod 7747629, Israel.
Israel Defense Forces Medical Corps, Tel Hashomer, MilPOB 02149, Israel.
Sex Health. 2018 Jul;15(4):298-303. doi: 10.1071/SH17190.
Background Data regarding sexually transmissible infections (STI) often originate from STI clinics, screening programs or laboratory-based studies, thus are biased for specific risk groups or lack clinical details. This real-life observational study presents sample data of most young adult Israeli population by exploiting the centralised diagnostic and documentation platforms resulting from a mandatory military service at the age of 18 years for both genders.
All STI diagnoses of Israeli Defence Forces soldiers during a 6-month period were reviewed. Patients with Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) (major-STI) and Ureaplasma urealyticum (UU), Ureaplasma parvum (UP) and Mycoplasma hominis (MH) (equivocal STI) were compared with STI-negative controls.
Sexually transmissible infection positivity rates (n=2816) were as follows: CT 6.6%; MG 1.9%; NG 0.7%; TV 0.5%; UU 15.7%; UP 28.2%; and MH 6.2%. The CT+MG coinfection rate was 4.1%, yet CT+NG coinfections were rare (≈0.5%). More than half of the patients with ureaplasmas and/or MH were treated; 40% of them were recommended partner treatment. Most antibiotics were prescribed to patients with equivocal infections. Classic STI symptoms in males were linked to major-STI and UU, while females were asymptomatic or presented non-specific symptoms.
The judicious use of antibiotics in the era of antimicrobial resistance necessitates re-evaluating the significance of equivocal pathogen detection and reporting (MH, UU, UP). Likewise, universal empiric treatment for NG should be reconsidered in light of its low rates in non-high-risk groups. Conversely, a high MG rate, a pathogen with potential resistance to common STI protocols, requires evaluation of guidelines adequacy.
关于性传播感染（STI）的数据通常来自性传播感染诊所、筛查项目或基于实验室的研究，因此对特定风险群体存在偏差或缺乏临床细节。这项现实生活中的观察性研究通过利用18岁男女义务兵役产生的集中诊断和记录平台，展示了大多数以色列年轻成年人的样本数据。
回顾了以色列国防军士兵在6个月期间的所有性传播感染诊断。将沙眼衣原体（CT）、生殖支原体（MG）、淋病奈瑟菌（NG）和阴道毛滴虫（TV）（主要性传播感染）以及解脲脲原体（UU）、微小脲原体（UP）和人型支原体（MH）（疑似性传播感染）患者与性传播感染阴性对照组进行比较。
性传播感染阳性率（n = 2816）如下：CT 6.6%；MG 1.9%；NG 0.7%；TV 0.5%；UU 15.7%；UP 28.2%；MH 6.2%。CT + MG合并感染率为4.1%，但CT + NG合并感染很少见（约0.5%）。超过一半的脲原体和/或MH患者接受了治疗；其中40%被建议对性伴侣进行治疗。大多数抗生素开给了疑似感染患者。男性的典型性传播感染症状与主要性传播感染和UU有关，而女性无症状或表现为非特异性症状。
在抗菌药物耐药时代，明智地使用抗生素需要重新评估疑似病原体检测和报告（MH、UU、UP）的意义。同样，鉴于非高危群体中NG发病率较低，应重新考虑对其进行普遍经验性治疗。相反，MG发病率较高，这种病原体对常见性传播感染治疗方案可能耐药，需要评估指南的充分性。
