Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia
Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia.
Sex Transm Infect. 2021 Aug;97(5):363-367. doi: 10.1136/sextrans-2020-054529. Epub 2020 Sep 10.
International guidelines recommend testing, preferably using an assay to detect macrolide resistance-associated mutations, for men presenting with non-gonococcal urethritis, but there is no specific guidance on such testing for men with gonococcal urethritis.
This study aimed to estimate the proportion of men with gonococcal urethritis who have coinfection with through a retrospective analysis of cases of symptomatic urethral gonorrhoea at Western Sydney Sexual Health Centre in 2017 and 2018.
Fourteen of 184 (7.6%, 95% CI 3.7 to 11.5) men with gonococcal urethritis had detected in the urine at the time of presentation. No demographic or behavioural factors predicted coinfection. Coinfection with urethral was detected in 29 of 184 (15.8%, 95% CI 10.5 to 21.1). All five men with macrolide-resistant detected returned for treatment with moxifloxacin at a median of 8 days (range 5-16 days) after presentation and treatment of gonorrhoea; three of five were documented to remain symptomatic at this visit.
Although coinfection is less common than chlamydia among men with symptomatic gonococcal urethritis, testing, using an assay to detect macrolide resistance, will potentially reduce symptom duration particularly for men with macrolide-resistant infections, but may not be justifiable on cost-benefit analysis.
国际指南建议对出现非淋球菌性尿道炎的男性进行检测，最好使用检测大环内酯类耐药相关突变的方法，但对于出现淋球菌性尿道炎的男性，尚无此类检测的具体指导。
本研究旨在通过对 2017 年和 2018 年西悉尼性健康中心有症状尿道淋病病例的回顾性分析，估计患有淋球菌性尿道炎的男性合并感染的比例。
在出现淋病的 184 名男性中，有 14 名（7.6%，95%CI3.7 至 11.5）尿液中检测到 。没有发现人口统计学或行为因素可以预测合并感染。在 184 名男性中，有 29 名（15.8%，95%CI10.5 至 21.1）合并感染了尿道 。在出现淋病后 8 天（5-16 天）中位数时，所有 5 名检测到耐大环内酯类的 男性均返回接受莫西沙星治疗，并且治疗淋病；在此次就诊中，有 3 人记录仍有症状。
尽管在出现症状性淋球菌性尿道炎的男性中，合并感染比衣原体感染少见，但使用检测大环内酯类耐药的方法进行 检测，特别是对耐大环内酯类感染的男性，可能会缩短症状持续时间，但从成本效益分析来看，可能并不合理。
