德国鲁尔地区无症状队列人群中的性行为、性传播感染（STI）知识及沙眼衣原体（CT）和淋病奈瑟菌（NG）流行情况：PreYoungGo 研究。
Sexual behaviour, STI knowledge and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence in an asymptomatic cohort in Ruhr-area, Germany: PreYoungGo study.
机构信息
Walk In Ruhr (WIR), Center for Sexual Health and Medicine, Bochum, Germany.
Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany.
出版信息
J Eur Acad Dermatol Venereol. 2021 Jan;35(1):241-246. doi: 10.1111/jdv.16913. Epub 2020 Oct 29.
BACKGROUND AND OBJECTIVES
STIs present a significant threat to individual and public health, disproportionately affecting youth. The study aimed to evaluate (a) the prevalence of asymptomatic Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among youth using a rapid assay platform, (b) the participants' sexual behaviour and STI knowledge, (c) the utility of the rapid assay in reducing diagnosis-to-treatment time.
METHODS
In this study, 272 subjects (14-31 years) were included between 12/2016 and 7/2018. A questionnaire was used to collect sociodemographic data, sexual behaviour and STI knowledge. Prevalence of CT and NG infections were tested from oral, vaginal and anal swabs for women and oral, anal swabs and urine for men, using the Cepheid Xpert CT/NG assay. Time intervals between (i) test to the time the patient were informed of the result (turn around time - TAT) and (ii) test to therapy initiation was documented.
RESULTS
Of the 272 subjects (48.9% female, 48.9% male, undisclosed 2.2%), 56.6 % reported university education. 46.6% were men who have sex with men (MSM), and 47.4% of women and 63.1% of men had anal intercourse. 59.9% had previously been tested for HIV, while only 39.7% had for CT, 20.6% for NG. Among these asymptomatic youth 7.7% were positive for CT and 5.5% for NG. The localization of CT were 3.7% genital, 5.5% anal and 2.2% oral, while the corresponding localization of NG were 0.4%, 2.9%, 4.4% respectively. 91.8% of the participants were informed of a positive result within 24 h with a median TAT of 03:09 h. 73.3% initiated therapy within 24 h, with a median time from testing to therapy initiation being 06:50 h.
CONCLUSION
Asypmtomatic CT and NG infections are common and often not tested in persons at risk. The Cepheid Xpert CT/NG assay is an effective strategy as it reduces STI diagnosis-to-treatment time to less than a day.
背景与目的
性传播感染（STIs）对个人和公共健康构成重大威胁，对年轻人的影响尤为严重。本研究旨在评估：（a）使用快速检测平台检测青年人群中无症状沙眼衣原体（CT）和淋病奈瑟菌（NG）感染的流行率；（b）参与者的性行为和 STI 知识；（c）快速检测在缩短诊断到治疗时间方面的效用。
方法
本研究纳入了 2016 年 12 月至 2018 年 7 月间的 272 名（14-31 岁）受试者。使用问卷收集社会人口统计学数据、性行为和 STI 知识。对女性进行口腔、阴道和肛门拭子检测，对男性进行口腔、肛门拭子和尿液检测，使用 Cepheid Xpert CT/NG 检测试剂盒检测 CT 和 NG 感染的流行率。记录从检测到告知患者检测结果的时间间隔（周转时间-TAT）和从检测到开始治疗的时间间隔。
结果
272 名受试者中（48.9%为女性，48.9%为男性，2.2%未披露），56.6%的人接受过大学教育。46.6%为男男性行为者（MSM），47.4%的女性和 63.1%的男性有肛交行为。59.9%的人曾接受过 HIV 检测，而只有 39.7%的人曾接受过 CT 检测，20.6%的人曾接受过 NG 检测。在这些无症状的年轻人中，有 7.7%的人 CT 检测呈阳性，5.5%的人 NG 检测呈阳性。CT 的定位为 3.7%为生殖器，5.5%为肛门，2.2%为口腔，而 NG 的相应定位分别为 0.4%、2.9%和 4.4%。91.8%的参与者在 24 小时内获知阳性结果，中位 TAT 为 03:09 小时。73.3%的人在 24 小时内开始治疗，从检测到开始治疗的中位时间为 06:50 小时。
结论
无症状 CT 和 NG 感染很常见，且往往不会对高危人群进行检测。Cepheid Xpert CT/NG 检测试剂盒是一种有效的策略，因为它将 STI 的诊断到治疗时间缩短至不到一天。
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