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Prevalence of Chlamydia Trachomatis Infections among Selected Populations in a Community Hospital in Taiwan

台灣某一社區醫院對披衣菌感染的選擇性篩檢結果

摘要


研究目的:砂眼披衣菌感染是世界最普遍的傳染性性病,會引起廣泛的感染。過去披衣菌的偵測並不容易也不理想,因此我們並不知道我們的罹病率,因為這感染也沒有呈現明顯的症狀。如今去氧核糖核酸擴大科技,使此披衣菌的篩檢更加容易、正確。 材料與方法:我們在此利用羅氏大藥廠的聚合?連鎖反應法來選擇性的篩檢140位泌尿科門診患者,檢驗尿液中披衣菌及淋球菌的去氧核糖核酸血液中的抗披衣菌抗體。另外也選擇性篩檢針對69位不孕症門診女患者檢驗,利用其子宮棒檢體檢驗披衣菌的去氧核糖核酸。 結果:泌尿科門診患者中,36.4%的患者為披衣菌陽性,51.4%有抗披衣菌抗體,表示更多的舊感染。其中118位男性病人有30.5%為披衣菌陽性,大部分病人呈現尿道症狀。另外的32位為女性患者,因她們先生為披衣菌陽性,故被追蹤檢查;當中46.9%為披衣菌陽性,這些陽性女患者中卻只有34.4%呈現症狀。直接披衣菌檢驗結果與抗體檢驗的結果沒有直接的關連。研究結果也沒有發現某披衣菌和淋球菌一起的共同感染。選擇性篩檢針對69位不孕症門診女患者也發現高披衣菌陽性性率。 結論:此選擇性篩檢的披衣菌陽性率比過去在美國針對傳染性性病診所的青少年所發表的陽性率還高。結果也指出披衣菌抗體及病人的臨床症狀並不是可靠的活性感染指標。對此次選擇性篩檢的意義進一步做討論。

並列摘要


OBJECTIVES: Chlamydia trachomatis infection is the most prevalent sexually transmitted disease worldwide, responsible for a wide range of important infections. However, we do not have a good knowledge of its prevalence in our community, as infections are often asymptomatic. Amplified DNA technology haw improved the test accuracy and has improved the test accuracy and has rendered it easier to screen for Chlamydia trachomatis infections. MATERIALS AND METHODS: In a selective screening, we tested for chlamydia DNA and Neisseria gonorrhoeae DNA in voided urine specimens, and anti-chlamydia Ab in sera using the Roche Amplicor PCR test. One hundred forty patients from the urology clinic were studied. In addition, 69 patients from the infertility clinic were also studied for chlamydia DNA using cervical swabs. RESULTS: Among urology patients, 36.4% were positive for chlamydia DNA, and 51.4% were positive for the anti-chlamydia antibody, indicating more past infections than active ones. Of the 118 male patients, 30.5% were positive for chlamydia DNA, and most of them presented with urethral symptoms. Thirty-two female patients were also studied, primarily because their husbands were found to be positive for chlamydia DNA. Of these, 46.9% were positive for chlamydia DNA while only 34.4% showed urogenital symptoms. No direct relationship was observed between the results for chlamydia DNA and anti-chlamydia Ab. No evidence of co-infection with gonorrhea was observed. A similar high prevalence was also observed in patients from infertility clinics. CONCLUSIONS: In this selective screening, the positive rate for chlamydia DNA was significantly higher than the reported prevalence among adolescents visiting STD clinics in the US. Anti-chlamydia Ab per se and/or clinical symptoms are not reliable indicators for active chlamdia infection. The significance of selective screening for chlamydia infections is discussed.

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