Clin Infect Dis:我国无并发症淋病头孢曲松钠治疗现状及治疗效果的研究结果

2019-04-21 不详 中国医学科学院

中国医学科学院皮肤病医院尹跃平研究员团队近期在《Clinical Infectious Diseases》杂志上发表了题为《Widespread Use of High-dose Ceftriaxone Therapy for Uncomplicated Gonorrhea Without Reported Ceftriaxone Treatment Failure: Results From 5

中国医学科学院皮肤病医院尹跃平研究员团队近期在《Clinical Infectious Diseases》杂志上发表了题为《Widespread Use of High-dose Ceftriaxone Therapy for Uncomplicated Gonorrhea Without Reported Ceftriaxone Treatment Failure: Results From 5 Years of Multicenter Surveillance Data in China》的研究论文。

淋病是一种常见的性传播疾病,由淋病奈瑟菌(淋球菌)感染所致。该病可以使用抗生素治愈,但是由于抗菌药物的不正确使用甚至滥用,导致淋球菌耐药性不断出现变化。淋球菌相继对磺胺类药物、青霉素、四环素、喹诺酮类药物呈现高度耐药或普遍耐药。目前一线治疗药物为头孢曲松,但近年来的耐药研究数据显示,头孢菌素类药物对淋球菌的最低抑菌浓度呈现逐年上升的趋势,头孢曲松钠对于无并发症淋病的治疗效能受到了削弱。为此, 中国医学科学院皮肤病医院/全国性病控制中心启动了以随访临床治疗效果为基础的淋球菌对头孢曲松敏感性监测网络,以便早期发现我国使用头孢菌素类药物治疗无并发症淋病失败的病例。

该研究系统分析了2013-2017年淋球菌对头孢曲松敏感性监测数据。数据和标本取自广东、广西、海南、北京、天津5个省和直辖市的7个监测点1686例无并发症的淋病患者的流行病学、临床诊治、治疗后随访的资料。利用纸片法和琼脂稀释法(参考标准)对淋球菌标本进行了头孢曲松药物敏感性检测。结果表明,83.1%的淋病患者以头孢曲松钠作为一线治疗药物,其中72.7%的治疗剂量超过1000mg(目前全球无并发症淋病治疗指南中最高推荐剂量)。从无异常症状患者的分泌物中分离出菌株,利用纸片法检测,结果提示头孢曲松钠敏感性下降与利用琼脂稀释法测定的药物敏感性下降有着密切相关性。对于曾经感染过淋球菌或其他性病病原体或已经使用抗生素治疗的患者,应用高剂量头孢曲松治疗(>1000mg)的比例显着高于其他患者。监测系统内目前尚未得到治疗失败的病例。

该研究首次全面分析了我国无并发症淋病患者使用头孢曲松进行治疗的现状及治疗效果,为制定淋病治疗方案提供了基线数据,同时也为进一步开展淋球菌耐药监测研究提出了新的思路。

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[GetPortalCommentsPageByObjectIdResponse(id=1894108, encodeId=354d1894108d9, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Thu Jan 02 21:43:00 CST 2020, time=2020-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984684, encodeId=5d38198468419, content=<a href='/topic/show?id=000e44349df' target=_blank style='color:#2F92EE;'>#头孢曲松钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44349, encryptionId=000e44349df, topicName=头孢曲松钠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, 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objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64672, encryptionId=e19b646e254, topicName=治疗现状)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/4v5DMqK7WnzoBdibNsryQ8OEM5gFSdRH9j3HNCKPfKXlObInweOSHdQPATeTicYp7nvg3bsgicjLgRkdlhrpry21w/132, createdBy=6bf82500013, createdName=ms5822920152752585, createdTime=Sat Jun 29 03:43:00 CST 2019, time=2019-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379570, encodeId=8e9213e95702c, content=<a href='/topic/show?id=d9694434815' target=_blank style='color:#2F92EE;'>#头孢曲松#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44348, encryptionId=d9694434815, topicName=头孢曲松)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046804, encodeId=2d661046804a8, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=)]
    2019-10-09 丁鹏鹏
  5. 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12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046804, encodeId=2d661046804a8, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=)]
  6. 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12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, 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  7. 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12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046804, encodeId=2d661046804a8, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=)]
  8. 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12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046804, encodeId=2d661046804a8, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=)]
    2019-04-23 jj000003
  9. 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12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046804, encodeId=2d661046804a8, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=)]
    2019-04-22 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  10. 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12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459561, encodeId=b25614595611d, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Tue Apr 23 12:43:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032136, encodeId=6a6f103213692, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046804, encodeId=2d661046804a8, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Apr 22 00:43:00 CST 2019, time=2019-04-22, status=1, ipAttribution=)]
    2019-04-22 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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性传播疾病正在慢慢变得失控!最近,世界卫生组织在《PLoS Medicine》特刊中提出了很严重的警告,认为随着病菌耐药性的提升,绝大部分的抗生素药物将完全失效,这将导致以淋病为代表的性传染病将变得不可治愈。也正因如此,开发出新型的治疗药物在当下已经变的迫在眉睫。

Lancet:乙脑疫苗或能对抗超级淋病

一种针对乙型脑膜炎的疫苗或能阻止耐抗生素的超级淋病的扩散。

新型抗生素有助应对淋病

伦敦大学卫生和热带医学院发布的一项最新研究显示,一种新型抗生素在实验室环境下显示了对淋球菌的有效抑制作用,鉴于淋球菌耐药问题日益突出,未来有望基于这一发现开发新的治疗药物。

Lancet:B群脑膜炎球菌外膜囊胞疫苗预防淋病的效果。

淋病是一主要的全球性公共健康问题,因耐药性而更加棘手。开发有效的疫苗尚未成功,但监测数据提示B群脑膜炎球菌外膜囊胞疫苗会影响淋病的发病率。研究人员对在新西兰15-30岁人群中脑膜炎球菌外膜囊胞B疫苗(MeNZB)抗淋病的效果进行评估。

NEJM:单次口服Zoliflodacin可有效治疗淋病

研究认为口服Zoliflodacin可治愈大多数非复杂的泌尿生殖道和直肠淋球菌感染,但其对咽部感染的治疗效果不佳