Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Lancet Infect Dis. 2023 Dec;23(12):e558-e566. doi: 10.1016/S1473-3099(23)00356-0. Epub 2023 Jul 26.
There is increasing debate regarding the harms and benefits of frequent asymptomatic screening for Chlamydia trachomatis and Neisseria gonorrhoeae in men who have sex with men (MSM). One concern is that frequent asymptomatic screening could result in increased antimicrobial resistance in an array of sexually acquired infections and other pathogens, due to selection pressure exerted by frequent broad-spectrum antimicrobial usage within some sexual networks. Here, we outline the harms and benefits of frequent C trachomatis and N gonorrhoeae screening in MSM in high-income settings and propose that screening frequency be reduced. We describe the evidence gaps that should be further explored to better understand the implications of reducing the frequency of asymptomatic C trachomatis and N gonorrhoeae screening in MSM and the surveillance systems that should be in place to prepare for such changes.
目前，人们对于男性性工作者（MSM）进行频繁无症状的沙眼衣原体（Chlamydia trachomatis）和淋病奈瑟菌（Neisseria gonorrhoeae）筛查的危害和益处存在越来越多的争议。一个担忧是，由于在某些性网络中频繁使用广谱抗生素，导致选择压力增加，频繁无症状筛查可能会导致一系列性传播感染和其他病原体的抗微生物药物耐药性增加。在这里，我们概述了在高收入环境中对 MSM 进行频繁的 C 型沙眼衣原体和 N 型淋病奈瑟菌筛查的危害和益处，并提出应减少筛查的频率。我们描述了应该进一步探索的证据空白，以更好地了解减少 MSM 中无症状的 C 型沙眼衣原体和 N 型淋病奈瑟菌筛查频率的影响，以及应该建立哪些监测系统来为这些变化做好准备。
