Nylander Elisabet, Unemo Magnus
överläkare, professor, hud- och STD-kliniken, Norrlands universitetssjukhus; Umeå universitet.
PhD, docent, WHO Collaborating Centre for Gonorrhoea and other STIs, Universitetssjukhuset Örebro; Örebro universitet, Örebro.
Lakartidningen. 2021 Nov 2;118:21063.
Neisseria gonorrhoeae causes the sexually transmitted infection gonorrhoea, which can result in serious complications, e.g. infertility and ectopic pregnancy. The incidence of gonorrhoea is high internationally and has dramatically increased in Sweden during the last 10 years. Gonorrhoea mostly manifests as urethritis, cervicitis, and/or extragenital infections (in pharynx, rectum and eye). Urogenital infections in women and particularly pharyngeal and rectal gonorrhoea are frequently asymptomatic. Nucleic acid amplification tests (NAATs) are recommended for diagnostics, but culture remains imperative for antimicrobial susceptibility testing. Antimicrobial resistance in N. gonorrhoeae is a major concern, which compromises management and control of gonorrhoea globally. Diagnosed gonorrhoea should always be treated and the recommended first-line treatment is an injection with a high dose of ceftriaxone. Test-of-cure is recommended for all cases approximately two weeks after treatment.
淋病奈瑟菌可引发性传播感染淋病,淋病可能导致严重并发症,如不孕和异位妊娠。淋病在国际上发病率很高,在瑞典过去10年中急剧上升。淋病主要表现为尿道炎、宫颈炎和/或生殖器外感染(咽部、直肠和眼部)。女性的泌尿生殖系统感染,尤其是咽部和直肠淋病,通常没有症状。诊断推荐使用核酸扩增试验(NAATs),但培养对于抗菌药物敏感性测试仍然至关重要。淋病奈瑟菌的抗菌药物耐药性是一个主要问题,这在全球范围内影响了淋病的管理和控制。确诊的淋病应始终进行治疗,推荐的一线治疗是注射高剂量的头孢曲松。治疗后约两周,建议对所有病例进行治愈检测。