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性虐待儿童中的性传播感染:在土耳其的一个儿童倡导中心实施 PCR 检测的审计项目。

Sexually transmitted infections in sexually abused children: an audit project to implement PCR tests in a child advocacy center in Türkiye.

机构信息

Department of Forensic Medicine, Faculty of Medicine, Marmara University, İstanbul, Türkiye.

Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Marmara University, İstanbul, Türkiye.

出版信息

Turk J Pediatr. 2024 Nov 16;66(5):618-624. doi: 10.24953/turkjpediatr.2024.5188.

Abstract

BACKGROUND

Sexual abuse in children can sometimes result in sexually transmitted infections (STIs), which can serve as crucial forensic evidence. Although PCR methods are now accepted as the gold standard for STI screening, they have not yet widely replaced traditional culture methods in Türkiye. This study aims to assess the necessity of implementing PCR-based STI testing at Child Advocacy Centers in Türkiye, where such testing is not routinely available.

METHODS

Conducted between February and November 2023, this study included children who presented to the Child Advocacy Center of Marmara University Pendik Training and Research Hospital. High-risk victims were identified based on criteria including a history of penetrative sexual abuse and factors such as multiple perpetrators or significant age disparity. Serological tests and genital swabs were collected and analyzed using both bacterial culture methods and a comprehensive STI PCR panel.

RESULTS

The study included 20 victims, with a median age of 16 years. STI PCR testing detected pathogens in 19 out of 21 samples, including Chlamydia trachomatis (20%) and Neisseria gonorrhoeae (5%). In contrast, culture methods identified no sexually transmitted pathogens.

CONCLUSION

PCR testing demonstrated significantly higher sensitivity for detecting STIs compared to traditional bacterial culture methods, as expected. Implementing PCR-based STI testing in Child Advocacy Centers is an urgent and essential need for providing an accurate diagnosis and robust forensic evidence, enhancing the care and legal protection of sexually abused children.

摘要

背景

儿童性虐待有时会导致性传播感染(STIs),这些感染可以作为重要的法医证据。尽管聚合酶链反应(PCR)方法现在被认为是 STI 筛查的金标准,但在土耳其,它们尚未广泛取代传统的培养方法。本研究旨在评估在土耳其的儿童保护中心实施基于 PCR 的 STI 检测的必要性,因为这些中心目前并未常规进行此类检测。

方法

本研究于 2023 年 2 月至 11 月在马尔马拉大学潘迪克培训和研究医院的儿童倡导中心进行,纳入了前来就诊的儿童。根据包括有穿透性性虐待史以及多个施害者或显著年龄差异等标准,确定高风险受害者。采集血清学检测和生殖器拭子,并使用细菌培养方法和全面的 STI PCR 检测面板进行分析。

结果

研究纳入了 20 名受害者,中位年龄为 16 岁。STI PCR 检测在 21 个样本中的 19 个样本中检测到病原体,包括沙眼衣原体(20%)和淋病奈瑟菌(5%)。相比之下,培养方法未鉴定出任何性传播病原体。

结论

PCR 检测在检测 STIs 方面的敏感性明显高于传统的细菌培养方法,这是预期的结果。在儿童保护中心实施基于 PCR 的 STI 检测是提供准确诊断和有力法医证据、加强对受性虐待儿童的护理和法律保护的迫切和必要需求。

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