Björnelius Eva
med dr, överläkare, hudkliniken, Karolinska universitetssjukhuset Huddinge, Stockholm.
Lakartidningen. 2021 Nov 1;118:21062.
Mycoplasma genitalium is a common sexually transmitted infection, probably as common in Swedish STI clinics as Chlamydia trachomatis. M. genitalium may cause urethritis in men and and urethritis, cervicitis, pelvic inflammatory disease (PID) and infertility in women. The proportion of PID and its implications need further studies. The prevalence of M. genitalium infection in a general population and in asymptomatic patients is estimated to be low and general screening is not recommended. Antimicrobial resistance is a growing problem. Nucleic acid amplification tests (NAATs) including resistance testing for macrolides are available in Sweden. The first-line treatment in the absence of macrolide resistance is with azithromycin, but not as a single dose. Pretreatment with doxycycline to lower bacterial load and reduce risk of macrolide resistance during treatment is under discussion.
生殖支原体是一种常见的性传播感染,在瑞典性传播感染诊所中可能与沙眼衣原体一样常见。生殖支原体可导致男性尿道炎以及女性尿道炎、宫颈炎、盆腔炎(PID)和不孕症。盆腔炎的比例及其影响需要进一步研究。据估计,普通人群和无症状患者中生殖支原体感染的患病率较低,不建议进行普遍筛查。抗菌药物耐药性是一个日益严重的问题。瑞典有包括大环内酯类耐药性检测在内的核酸扩增检测(NAATs)。在不存在大环内酯类耐药性的情况下,一线治疗药物是阿奇霉素,但不是单剂量使用。目前正在讨论使用多西环素进行预处理以降低细菌载量并减少治疗期间大环内酯类耐药性的风险。