沙眼衣原体在巴黎性传播感染诊所就诊无症状男性中的尿液筛查：一项横断面研究。
Chlamydia trachomatis screening in urine among asymptomatic men attending an STI clinic in Paris: a cross-sectional study.
机构信息
Department of Infectious Diseases, University Hospital Saint-Antoine, APHP, 75012, Paris, France.
Department of Bacteriology, University Hospital Saint-Antoine, APHP, 75012, Paris, France.
出版信息
BMC Infect Dis. 2019 Jan 8;19(1):31. doi: 10.1186/s12879-018-3595-6.
BACKGROUND
The incidence of Chlamydia trachomatis (Ct) urethritis has been increasing for the past 10 years. There is little data regarding the screening of Ct infection in asymptomatic men in France, despite the national recommendation to screen at-risk asymptomatic men under 30 attending Sexually Transmitted Infections (STI) clinics. Recent data from the French surveillance network Rénachla show indeed that systematic screening is still focused on women. The objective of our study was to determine the prevalence and risk factors for Ct infection in asymptomatic men under 30 attending an STI clinic located in Paris, France.
METHODS
We performed a cross-sectional study between April 4, and December 31, 2016 in the database of the software DIAMM Client V8 used in our STI clinic. We extracted the demographic characteristics, sexual behavior and result of STI screening of all asymptomatic men who had consulted and given their consent for the use of their personal data. Those data were collected in usual care through a standardized questionnaire filled in during an appointment with a trained physician. STI screening was performed using PCR kit CT/NG Abbott Realtime® on first void urines. For MSM, a rectal swab was also collected. Risk factors for Ct infection were analyzed by univariate and multivariate modeling using STATA software 8.2.
RESULTS
Among 872 men who had attended the clinic, 647 were included and 37 (5.7, 95% CI 4.2 to 7.8) were positive for Ct in urine. In univariate analysis, men who had unprotected sex in the last 6 weeks (OR 2.40 (95%CI 1.16 to 4.94), p = 0.02), and those who had an infected partner (OR 7.6 (95%CI 3.03 to 20), p = 0.0001) were more likely to be infected. In the multivariate analysis having an infected partner was the only risk factor (OR 11.1(95% CI 3.7 to 33.3), p = 0.0001) that remained significant.
CONCLUSION
Prevalence of Ct infection is high among asymptomatic men of 30 years or less attending our urban STI clinic especially among those with an infected partner. The Ct screening among this population associated with partner notification, as recommended by the French national guidelines, should be more widely implemented.
背景
过去 10 年来，沙眼衣原体（Ct）尿道炎的发病率一直在上升。尽管法国国家建议对 30 岁以下有风险的无症状男性进行筛查，但有关法国无症状男性 Ct 感染筛查的数据很少。法国 Rénachla 监测网络的最新数据确实表明，系统筛查仍然集中在女性身上。我们研究的目的是确定在法国巴黎一家性传播感染（STI）诊所就诊的 30 岁以下无症状男性中 Ct 感染的患病率和危险因素。
方法
我们于 2016 年 4 月 4 日至 12 月 31 日在我们的 STI 诊所使用的 DIAMM Client V8 软件数据库中进行了一项横断面研究。我们提取了所有咨询并同意使用其个人数据的无症状男性的人口统计学特征、性行为和 STI 筛查结果。这些数据是通过培训医生在预约期间填写的标准化问卷，在常规护理中收集的。STI 筛查使用 PCR 试剂盒 CT/NG Abbott Realtime®对首次排尿进行检测。对于男男性行为者（MSM），还采集了直肠拭子。使用 STATA 软件 8.2 进行单变量和多变量建模分析 Ct 感染的危险因素。
结果
在 872 名就诊男性中，有 647 名男性纳入研究，其中 37 名（5.7%，95%CI 4.2 至 7.8）尿液 Ct 检测呈阳性。在单变量分析中，过去 6 周内无保护性行为的男性（OR 2.40（95%CI 1.16 至 4.94），p=0.02）和有感染伴侣的男性（OR 7.6（95%CI 3.03 至 20），p=0.0001）更有可能感染。在多变量分析中，有感染伴侣是唯一具有统计学意义的危险因素（OR 11.1（95%CI 3.7 至 33.3），p=0.0001）。
结论
在我们的城市 STI 诊所就诊的 30 岁或以下无症状男性中，Ct 感染的患病率很高，尤其是那些有感染伴侣的男性。根据法国国家指南，建议对这一人群进行 Ct 筛查，并进行伴侣通知，应更广泛地实施。
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