Gnanadurai Roshina, Fifer Helen
National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Microbiology (Reading). 2020 Jan;166(1):21-29. doi: 10.1099/mic.0.000830.
is a fastidious organism of the class the smallest prokaryote capable of independent replication. First isolated in 1981, much is still unknown regarding its natural history in untreated infection. It is recognized as a sexually transmitted pathogen causing acute and chronic non-gonococcal urethritis (NGU) in men, with a growing body of evidence to suggest it also causes cervicitis and pelvic inflammatory disease in women. Its role in several other clinical syndromes is uncertain. The majority of people infected remain asymptomatic and clear infection without developing disease; asymptomatic screening is therefore not recommended. Prevalence rates are higher in patients attending sexual health clinics and in men with NGU. Limited availability of diagnostics has encouraged syndromic management, resulting in widespread antimicrobial resistance and given that few antimicrobial classes have activity against , there is significant concern regarding the emergence of untreatable strains. There is a need for wider availability of testing, which should include detection of macrolide resistance mediating mutations. Expertise in interpretation of microbiological results with clinical correlation ensures targeted treatment avoiding unnecessary antibiotic exposure. Public health surveillance nationally and internationally is vital in monitoring and responding to changing epidemiology trends. In this review, we summarize current knowledge of , including epidemiology, clinical and microbiological data, and discuss treatment challenges in the era of rising multidrug resistance.
是一类苛求营养的微生物，是能够独立复制的最小原核生物。它于1981年首次分离出来，关于其在未经治疗的感染中的自然史仍有很多未知之处。它被公认为一种性传播病原体，可导致男性急性和慢性非淋菌性尿道炎（NGU），越来越多的证据表明它也会导致女性宫颈炎和盆腔炎。它在其他几种临床综合征中的作用尚不确定。大多数感染者没有症状，可清除感染而不发病；因此不建议进行无症状筛查。在性健康诊所就诊的患者和患有NGU的男性中患病率较高。诊断方法有限促使采用综合征管理方法，导致广泛的抗菌药物耐药性，而且鉴于很少有抗菌药物类别对其有活性，人们对出现无法治疗的菌株深感担忧。需要更广泛地提供检测，其中应包括检测介导大环内酯类耐药性的突变。将微生物学结果与临床相关性进行解读的专业知识可确保进行有针对性的治疗，避免不必要的抗生素暴露。国家和国际层面的公共卫生监测对于监测和应对不断变化的流行病学趋势至关重要。在本综述中，我们总结了关于[病原体名称未给出]的当前知识，包括流行病学、临床和微生物学数据，并讨论了在多重耐药性不断上升的时代的治疗挑战。
