Peel Joanne, Aung Ei, Bond Stephanie, Bradshaw Catriona
Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Fac Rev. 2020 Oct 30;9:3. doi: 10.12703/b/9-3. eCollection 2020.
has emerged over the last 30 years as a sexually transmitted infection (STI). As data have accumulated, our understanding of this pathogen and its role in disease continues to evolve. This in turn creates new challenges and complexities. Questions remain regarding the natural history of , its contribution to disease and long-term sequelae. A decline in cure rates for first-line anti-microbials has been observed. This is likely in part due to high usage of single-dose azithromycin in the sexual health field but also due to the intrinsic ability of to rapidly acquire anti-microbial resistance. Consequently, the term 'the new STI superbug' is not infrequently used by the media to describe this pathogen. Currently available antibiotics have side effects that, though rare, are potentially serious. This leads to inherent questions regarding the benefit of testing for and treating , particularly in asymptomatic individuals or in genital syndromes where the benefit of treatment is not well established. In this review, we summarize the most recent evidence and literature regarding and explore areas of research where disparities exist. We discuss the contribution of to genital syndromes, particularly those where data are conflicting, in order to inform indications for testing and treatment. Avoidance of increasing anti-microbial resistance with astute anti-microbial stewardship is paramount if we are to successfully manage infection. We examine the state of play regarding anti-microbial resistance and how to combat this, including currently available anti-microbials, resistance-guided therapy and novel therapeutic approaches. We aim to provide an overview of the current understanding of and the implications for current clinical practise and suggestions for future research.
在过去30年里已成为一种性传播感染（STI）。随着数据的积累，我们对这种病原体及其在疾病中的作用的理解不断演变。这反过来又带来了新的挑战和复杂性。关于其自然史、对疾病的贡献以及长期后遗症仍存在疑问。已观察到一线抗菌药物的治愈率有所下降。这可能部分归因于性健康领域单剂量阿奇霉素的大量使用，但也归因于其迅速获得抗菌耐药性的内在能力。因此，媒体经常使用“新的性传播感染超级病菌”这一术语来描述这种病原体。目前可用的抗生素有副作用，虽然罕见，但可能很严重。这就引发了关于检测和治疗的益处的内在问题，特别是在无症状个体或治疗益处尚未明确的生殖器综合征中。在本综述中，我们总结了关于该病原体的最新证据和文献，并探讨存在差异的研究领域。我们讨论该病原体对生殖器综合征的贡献，特别是那些数据相互矛盾的情况，以便为检测和治疗的指征提供依据。如果我们要成功管理该病原体感染，通过精明的抗菌药物管理避免抗菌耐药性增加至关重要。我们研究了抗菌耐药性的现状以及如何应对这一问题，包括目前可用的抗菌药物、耐药性指导治疗和新的治疗方法。我们旨在概述目前对该病原体的理解以及对当前临床实践的影响，并为未来研究提供建议。
