Rudén A K
Department of Dermatovenereology, Södersjukhuset, Stockholm, Sweden.
Genitourin Med. 1994 Aug;70(4):256-61.
To analyse temporal changes in gonococcal serovar patterns in Stockholm during a two year study period (1987-1989) to elucidate the dynamics of gonorrhoea epidemiology.
The study population comprised 857 patients with culture proven gonorrhoea and with serotyped gonococcal isolates. The probable geographical origin of the infection was determined in 690 of the patients.
A total of 108 Ph/GS-serovars were identified. Most (73%) of the serovars were recognised only during one or two quarters of the study period and comprised 16% of the isolates. Seven serovars were encountered during all eight quarters. Three of these serovars i.e. Arost/Aedgkih (IA-1, IA-2), Bropt/Bajk (IB-3, IB-6), Brpyust/Bacejk (IB-1, IB-2) were the most prevalent in the overall study, accounting for 60% of the isolates during the first quarter of the study and 36% of the isolates during the last quarter. Fifty-seven percent of the patients were infected in Stockholm (endemic infection). The proportion of endemic isolates among the three most common serovars declined throughout the study period (77% during the first quarter; 47% during the last quarter). A total of 32 Ph/GS-serovars were recognised among 80 PPNG strains. Only four of these 32 serovars were encountered during more than two quarters. Of 57 patients with PPNG strains and with geographical origin of the infection known, only seven (12%), all infected in Sweden, might have transmitted their infection further into the society.
The decline in the total number of gonorrhoea cases seen in Stockholm during the study period, was due mainly to a decline of endemic isolates of the three most prevalent serovars. Results from contact tracing and serotyping indicated that PPNG infections acquired abroad seldom become established in the community. Serovar determination seems valuable mainly as a tool for surveillance whereby the introduction and circulation of gonococcal strains in the community can be pursued.
分析在两年研究期（1987 - 1989年）内斯德哥尔摩淋病菌血清型模式的时间变化，以阐明淋病流行病学的动态情况。
研究人群包括857例经培养证实患有淋病且淋病菌株已进行血清分型的患者。在690例患者中确定了感染的可能地理来源。
共鉴定出108种Ph/GS血清型。大多数（73%）血清型仅在研究期的一两个季度被识别出，占分离株的16%。在所有八个季度中都发现了七种血清型。其中三种血清型，即Arost/Aedgkih（IA - 1，IA - 2）、Bropt/Bajk（IB - 3，IB - 6）、Brpyust/Bacejk（IB - 1，IB - 2）在整个研究中最为普遍，在研究的第一季度占分离株的60%，在最后一个季度占分离株的36%。57%的患者在斯德哥尔摩感染（本地感染）。在整个研究期间，三种最常见血清型中本地分离株的比例下降（第一季度为77%；最后一个季度为47%）。在80株耐青霉素淋病菌株中识别出总共32种Ph/GS血清型。这32种血清型中只有四种在两个以上季度被发现。在57例耐青霉素淋病菌株且感染地理来源已知的患者中，只有七例（12%），均在瑞典感染，可能将感染进一步传播到社会中。
研究期间斯德哥尔摩淋病病例总数的下降主要是由于三种最普遍血清型的本地分离株减少。接触者追踪和血清分型结果表明，在国外获得的耐青霉素淋病感染很少在社区中传播开来。血清型测定似乎主要作为一种监测工具很有价值，借此可以追踪淋病菌株在社区中的引入和传播情况。
