2013—2018年北京协和医院4种常见性传播疾病病原体检出情况

杜娟; 张栋; 张睿; 陈雨; 伊洁; 吴洁; 窦亚玲; 杨卓; 叶阿里; 孔令君; 甘勇; 杨启文

doi:10.12290/xhyxzz.2021-0304

2013—2018年北京协和医院4种常见性传播疾病病原体检出情况

Analysis of Four Common Pathogens of Sexually Transmitted Diseases in Peking Union Medical College Hospital from 2013 to 2018

摘要

摘要:
目的探究北京协和医院诊治的疑似性传播疾病(sexually transmitted diseases, STD)患者沙眼衣原体(Chlamydia trachomatis, CT)、解脲支原体(Ureaplasma urealyticum, UU)、生殖支原体(Mycoplasma genitalun, MG)及淋病奈瑟球菌(Neisseria gonorrhoeae，NG)感染情况，旨在为临床诊治提供依据。
方法回顾性收集2013年1月—2018年12月北京协和医院疑似STD患者的送检标本(包括尿液标本及生殖道拭子标本)。采用实时荧光核酸恒温扩增检测技术检测样本中CT、UU、MG、NG，并计算其阳性率。
结果 2013—2018年，共接收CT、UU、MG、NG检测标本12 804份。4种病原体阳性率由高至低依次为UU(42.88%，4833/11 271)、CT(8.43%，905/10 739)、MG(5.44%，231/4246)、NG(3.78%，338/8932)；合并感染以UU+CT(4.13%，402/9725)、UU+MG(1.98%，74/3745)较常见。女性患者UU阳性率均高于同年龄段男性患者，CT、NG、MG阳性率低于同年龄段男性患者。除女性患者NG、UU单一感染外，4种病原体单一感染率及合并感染率(UU+CT、UU+MG)均以≤20岁患者最高。NG、MG阳性率整体呈下降趋势，CT、UU阳性率呈小范围波动。男性患者中，尿道拭子标本NG阳性率明显高于尿液标本(12.37% 比5.27%，P＜0.001)；女性患者中，宫颈拭子标本UU阳性率明显高于尿液标本(61.78% 比54.74%，P＜0.001)，CT阳性率低于尿液标本(6.16% 比7.73%，P=0.022)。
结论 2013—2018年北京协和医院诊治疑似STD患者中，4种常见病原体阳性率由高至低依次为UU、CT、MG、NG；UU+CT、UU+MG是常见的合并感染类型；≤20岁患者病原体阳性率较高；不同类型标本中病原体检出率存在差异。

Abstract:
Objective To explore the prevalence of Chlamydia trachomatis(CT), Neisseria gonorrhoeae(NG), Ureaplasma urealyticum(UU), and Mycoplasma genitalium(MG) in patients with suspected sexually transmitted diseases(STD) in Peking Union Medical College Hospital(PUMCH), and to provide evidence for clinical treatment.
Methods The samples (including urine and genital swabs) of suspected STD patients in PUMCH between January 2013 and December 2018 were collected retrospectively. CT, UU, MG, and NG were detected using the simultaneous amplification and testing technique.
Results A total of 12 804 samples were analyzed. The positive rates of the four pathogens were 42.88% (4833/11 271)for UU, 8.43% (905/10 739) for CT, 5.44% (231/4246) for MG and 3.78% (338/8932) for NG. UU+CT(4.13%, 402/9725) and UU + MG (1.98%, 74/3745) were common co-infections. The positive rates of UU in female patients were higher than those in male patients of the same age, while the positive rates of CT, NG, and MG in female patients were lower than those in male patients. Except for NG and UU in female, the positive rate of single infection and co-infection(UU+CT, UU+MG) in patients ≤20 years old was the highest. The positive rates of NG and MG decreased, while the positive rates of CT and UU fluctuated in a small range. Among male patients, the positive rate of NG in urethral swabs was significantly higher than that in urine samples (12.37% vs. 5.27%, P < 0.001). Among female patients, the positive rate of UU in cervical swabs was significantly higher than that in urine (61.78% vs. 54.74%, P < 0.001) and the positive rate of CT in cervical swabs was significantly lower than that in urine (6.16% vs. 7.73%, P=0.022).
Conclusions From 2013 to 2018, the prevalence rates of four common STD pathogens from high to low were UU, CT, MG, and NG. UU+CT and UU+MG were common co-infections. The young people at the age of ≤20 had the highest positive rates. The positive detection rate of different items varies with different specimen types.

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