Lancet Infect Dis:男男同性行为是志贺氏菌病致病的诱发因素

2015-05-14 范伟译 MedSci原创

背景:志贺氏菌病是一种急性、严重细菌结肠炎,在高收入国家,通常与到高风险地区旅游(非洲、亚洲和拉丁美洲)有相关性。自1970年代以来,志贺氏菌病在男男同性传播感染(男男同性恋者)中也有报道,在高收入国家男男同性传播是志贺氏菌病流行病学的一个重要组成部分。我们旨在使用复杂的分型和国际抽样确定在男男同性恋者中志贺氏菌病在英国爆发的驱动因素。方法:我们做了一个大规模、横断面,基因流行病学的研究,志贺氏菌

背景:志贺氏菌病是一种急性、严重细菌结肠炎,在高收入国家,通常与到高风险地区旅游(非洲、亚洲和拉丁美洲)有相关性。自1970年代以来,志贺氏菌病在男男同性传播感染(男男同性恋者)中也有报道,在高收入国家男男同性传播是志贺氏菌病流行病学的一个重要组成部分。我们旨在使用复杂的分型和国际抽样确定在男男同性恋者中志贺氏菌病在英国爆发的驱动因素。

方法:我们做了一个大规模、横断面,基因流行病学的研究,志贺氏菌病病例的收集是从1995年12月到2014年6月8日间来自29个国家的流行病学研究中得到。关注英国持续的流行病情,从高风险到低风险地区,我们收集和全基因组测序志贺菌的临床分离株 flexneri血清型3a,包括与旅行相关联的和男男同性之间的病例。我们考察了地域之间、人口统计学和隔离的抗生素敏感性,基因数据等临床患者数据之间的关系,推断发展的关系。

结果:我们获得331株临床分离株S flexneri血清型3a,包括275株来自低风险地区(44株来自个人前往高风险地区),52株来自高风险地区,和四个外群样本(即密切相关,但遗传学上截然不同的分离株用于确定系统发育进化树的根支)。我们确定最近出现的S flexneri 3a系,在不到20年的时间里在整个地区志贺氏菌病在男男同性恋者中通过性进行洲际传播。S flexneri 3a系具有获得性多个抗菌素耐药性的因素,流行的子系列与大环内酯物阿奇霉素抵抗密切相关。206株中8株(4%)来自男男同性行为-相关联系列的分离株;这些连续的分离株表明了非典型的感染模式(例如,再感染)。

结论:我们发现在志贺氏菌病-感染的男男同性行为中传播-促进的行为和非典型的感染是致病的诱发因素。已有传播途径的阿奇霉素-抵抗志贺氏菌病的洲际传播突出表明需要建立新的方法应对男男同性恋者性传播感染的公共卫生挑战。

原始出处:

Baker KS, Dallman TJ, Ashton PM, Day M,et,al.Intercontinental dissemination of azithromycin resistant shigellosis through sexual transmission: a cross-sectional study. Lancet  Infect Dis. 2015 Apr 27. 

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    2015-05-15 lovejing

    男男,啊呸

    1

    展开1条回复
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    2015-07-15 howi
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    2015-05-17 huaxipanxing

    看看

    0

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    2015-05-16 xugc
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    2015-05-15 等你一年又一年

    怎么得出

    0