German Reference Laboratory for Gonococci, Department of Dermatology and Venerology, Vivantes Hospital, Berlin, Germany.
Department of Dermatology, Venereology and Allergology, University Medical Center, Frankfurt am Main, Germany.
J Dtsch Dermatol Ges. 2019 Mar;17(3):287-315. doi: 10.1111/ddg.13804.
Worldwide, the incidence of bacterial sexually transmitted infections (STIs) has shown a significant increase in recent years. In Germany, this circumstance is reflected by a rise in the number of reported syphilis cases. There has also been an uptick in the incidence of non-notifiable STIs such as gonorrhea and infections caused by Chlamydia trachomatis and Mycoplasma genitalium. A key factor in the spread of these infections is their varied clinical presentation, which includes urogenital, pharyngeal and rectal involvement as well as a large number of asymptomatic cases. New real-time multiplex PCR methods allow for rapid and targeted detection of STI pathogens. The most common bacterial STI is urogenital chlamydial infection caused by serovars D-K, which affects young adults in particular. Lymphogranuloma venereum (LGV) caused by L serovars often presents as chlamydial proctitis. In recent years, Neisseria (N.) gonorrhoeae has shown a significant development of resistance, with high-level monoresistance and multiresistance to antibiotics commonly used for treatment. It is therefore imperative that sensitivity testing of N. gonorrhoeae be performed in addition to nucleic acid amplification tests (NAATs). Increased drug resistance has also been observed for Mycoplasma genitalium, a fact that complicates treatment.
全球范围内，近年来细菌性性传播感染（STI）的发病率显著上升。在德国，梅毒报告病例的增加反映了这一情况。淋病和衣原体及支原体引起的非报告 STI 的发病率也有所上升。这些感染传播的一个关键因素是其多样的临床表现，包括泌尿生殖、咽和直肠感染以及大量无症状病例。新的实时多重 PCR 方法可实现 STI 病原体的快速靶向检测。最常见的细菌性 STI 是由血清型 D-K 引起的泌尿生殖道衣原体感染，尤其影响年轻人。由 L 血清型引起的淋球菌肉芽肿病（LGV）常表现为衣原体直肠炎。近年来，淋病奈瑟菌（N. gonorrhoeae）对常用治疗抗生素的高水平单药耐药和多药耐药性显著发展。因此，除了核酸扩增试验（NAAT）外，还必须对淋病奈瑟菌进行药敏试验。生殖道支原体的耐药性也有所增加，这使得治疗变得复杂。
