中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (3): 201-208.doi: 10.35541/cjd.20230711
中国医学科学院皮肤病医院 中国疾病预防控制中心性病控制中心 中华医学会皮肤性病学分会性病学组 中国康复医学会皮肤病康复专业委员会
收稿日期:
2023-12-04
修回日期:
2024-01-08
发布日期:
2024-03-04
通讯作者:
苏晓红;王千秋;刘全忠
E-mail:suxh@ncstdlc.org; wangqq@ncstdlc.org; liuquanzhong@tmu.edu.cn
基金资助:
Hospital for Skin Diseases, Chinese Academy of Medical Sciences; National Center for STD Control, Chinese Center for Disease Control and Prevention; Venereology Group, Chinese Society of Dermatology; Chinese Association Rehabilitation of Dermatology
Received:
2023-12-04
Revised:
2024-01-08
Published:
2024-03-04
Contact:
Su Xiaohong; Wang Qianqiu; Liu Quanzhong
E-mail:suxh@ncstdlc.org; wangqq@ncstdlc.org; liuquanzhong@tmu.edu.cn
Supported by:
摘要: 【摘要】 生殖支原体可引起尿道炎、宫颈炎和盆腔炎等泌尿生殖道感染,并且与早产相关。因培养困难,诊断依赖于核酸检测,其耐药性增加导致临床治疗面临巨大挑战。中国医学科学院皮肤病医院、中国疾病与预防控制中心性病控制中心、中华医学会皮肤性病学分会和中国康复医学会皮肤病康复专业委员会组织国内有关专家依据国际最新生殖支原体诊疗指南及国内外研究进展,围绕生殖支原体感染病原学、流行病学、临床表现、实验室检测、诊断与治疗、随访和判愈、性伴管理、预防等内容进行充分讨论,形成此共识,旨在提高我国临床医师对生殖支原体感染的认识和诊疗水平。
中国医学科学院皮肤病医院 中国疾病预防控制中心性病控制中心 中华医学会皮肤性病学分会性病学组 中国康复医学会皮肤病康复专业委员会. [开放获取] 中国生殖支原体感染诊疗专家共识(2024)[J]. 中华皮肤科杂志, 2024,57(3):201-208. doi:10.35541/cjd.20230711
Hospital for Skin Diseases, Chinese Academy of Medical Sciences, National Center for STD Control, Chinese Center for Disease Control and Prevention, Venereology Group, Chinese Society of Dermatology, Chinese Association Rehabilitation of Dermatology . Chinese expert consensus on the diagnosis and treatment of Mycoplasma genitalium infection (2024)[J]. Chinese Journal of Dermatology, 2024, 57(3): 201-208.doi:10.35541/cjd.20230711
[1] | Taylor⁃Robinson D, Jensen JS. Mycoplasma genitalium: from chrysalis to multicolored butterfly[J]. Clin Microbiol Rev, 2011,24(3):498⁃514. doi: 10.1128/CMR.00006⁃11. |
[2] | Horner PJ, Martin DH. Mycoplasma genitalium infection in men[J]. J Infect Dis, 2017,216(suppl_2):S396⁃S405. doi: 10.1093/infdis/jix145. |
[3] | Lis R, Rowhani⁃Rahbar A, Manhart LE. Mycoplasma genitalium infection and female reproductive tract disease: a meta⁃analysis[J]. Clin Infect Dis, 2015,61(3):418⁃426. doi: 10.1093/cid/civ312. |
[4] | Barker EK, Malekinejad M, Merai R, et al. Risk of human immunodeficiency virus acquisition among high⁃risk hetero⁃sexuals with nonviral sexually transmitted infections: a systematic review and meta⁃analysis[J]. Sex Transm Dis, 2022,49(6):383⁃397. doi: 10.1097/OLQ.0000000000001601. |
[5] | Manhart LE, Mostad SB, Baeten JM, et al. High Mycoplasma genitalium organism burden is associated with shedding of HIV⁃1 DNA from the cervix[J]. J Infect Dis, 2008,197(5):733⁃736. doi: 10.1086/526501. |
[6] | US Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019[EB]. Atlanta: Department of Health and Human Services, 2019. |
[7] | Jensen JS, Cusini M, Gomberg M, et al. 2016 European guideline on Mycoplasma genitalium infections[J]. J Eur Acad Dermatol Venereol, 2016,30(10):1650⁃1656. doi: 10.1111/jdv.13849. |
[8] | Jensen JS, Cusini M, Gomberg M, et al. 2021 European guideline on the management of Mycoplasma genitalium infections[J]. J Eur Acad Dermatol Venereol, 2022,36(5):641⁃650. doi: 10. 1111/jdv.17972. |
[9] | 王千秋, 刘全忠, 徐金华, 等. 性传播疾病临床诊疗与防治指南[M]. 2版. 上海: 上海科学技术出版社, 2020. |
[10] | Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ, 2008,336(7650):924⁃926. doi: 10. 1136/bmj.39489.470347.AD. |
[11] | Dehon PM, McGowin CL. The immunopathogenesis of Mycoplasma genitalium infections in women: a narrative review[J]. Sex Transm Dis, 2017,44(7):428⁃432. doi: 10.1097/OLQ. 0000000000000621. |
[12] | Fraser CM, Gocayne JD, White O, et al. The minimal gene complement of Mycoplasma genitalium[J]. Science, 1995,270(5235):397⁃403. doi: 10.1126/science.270.5235.397. |
[13] | Burgos R, Pich OQ, Ferrer⁃Navarro M, et al. Mycoplasma genitalium P140 and P110 cytadhesins are reciprocally stabilized and required for cell adhesion and terminal⁃organelle development[J]. J Bacteriol, 2006,188(24):8627⁃8637. doi: 10. 1128/JB.00978⁃06. |
[14] | Li L, Krishnan M, Baseman JB, et al. Molecular cloning, expression, and characterization of a Ca2+⁃dependent, membrane⁃associated nuclease of Mycoplasma genitalium[J]. J Bacteriol, 2010,192(19):4876⁃4884. doi: 10.1128/JB.00401⁃10. |
[15] | Christodoulides A, Gupta N, Yacoubian V, et al. The role of lipoproteins in Mycoplasma⁃mediated immunomodulation[J]. Front Microbiol, 2018,9:1682. doi: 10.3389/fmicb.2018.01682. |
[16] | Burgos R, Wood GE, Iverson⁃Cabral SL, et al. Mycoplasma genitalium nonadherent phase variants arise by multiple mechanisms and escape antibody⁃dependent growth inhibition[J]. Infect Immun, 2018,86(4). doi: 10.1128/IAI.00866⁃17. |
[17] | Arfi Y, Minder L, Di Primo C, et al. MIB⁃MIP is a mycoplasma system that captures and cleaves immunoglobulin G[J]. Proc Natl Acad Sci U S A, 2016,113(19):5406⁃5411. doi: 10.1073/pnas.1600546113. |
[18] | McAuliffe L, Ellis RJ, Miles K, et al. Biofilm formation by mycoplasma species and its role in environmental persistence and survival[J]. Microbiology (Reading), 2006,152(Pt 4):913⁃922. doi: 10.1099/mic.0.28604⁃0. |
[19] | Li Y, Su X, Le W, et al. Mycoplasma genitalium in symptomatic male urethritis: macrolide use is associated with increased resistance[J]. Clin Infect Dis, 2020,70(5):805⁃810. doi: 10. 1093/cid/ciz294. |
[20] | Shipitsyna E, Kularatne R, Golparian D, et al. Mycoplasma genitalium prevalence, antimicrobial resistance⁃associated mutations, and coinfections with non⁃viral sexually transmitted infections in high⁃risk populations in Guatemala, Malta, Morocco, Peru and South Africa, 2019 -2021[J]. Front Microbiol, 2023,14:1130762. doi: 10.3389/fmicb.2023.1130762. |
[21] | Aboud S, Buhalata SN, Onduru OG, et al. High prevalence of Sexually Transmitted and Reproductive Tract Infections (STI/RTIs) among patients attending STI/Outpatient department clinics in Tanzania[J]. Trop Med Infect Dis, 2023,8(1). doi: 10.3390/tropicalmed8010062. |
[22] | Baumann L, Cina M, Egli⁃Gany D, et al. Prevalence of Mycoplasma genitalium in different population groups: systematic review and meta⁃analysis[J]. Sex Transm Infect, 2018,94(4):255⁃262. doi: 10.1136/sextrans⁃2017⁃053384. |
[23] | 宣岩, 魏兰馨, 洪翔, 等. 我国不同人群生殖支原体感染率的Meta分析[J]. 中华流行病学杂志, 2021,42(2):335⁃342. doi: 10.3760/cma.j.cn112338⁃20200530⁃00791. |
[24] | Cina M, Baumann L, Egli⁃Gany D, et al. Mycoplasma genitalium incidence, persistence, concordance between partners and progression: systematic review and meta⁃analysis[J]. Sex Transm Infect, 2019,95(5):328⁃335. doi: 10.1136/sextrans⁃2018⁃053823. |
[25] | Balkus JE, Manhart LE, Jensen JS, et al. Mycoplasma genitalium infection in Kenyan and US Women[J]. Sex Transm Dis, 2018,45(8):514⁃521. doi: 10.1097/OLQ.0000000000000799. |
[26] | Latimer RL, Vodstrcil L, De Petra V, et al. Extragenital Mycoplasma genitalium infections among men who have sex with men[J]. Sex Transm Infect, 2020,96(1):10⁃18. doi: 10.1136/sextrans⁃2019⁃054058. |
[27] | Sonnenberg P, Ison CA, Clifton S, et al. Epidemiology of Mycoplasma genitalium in British men and women aged 16 - 44 years: evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal⁃3)[J]. Int J Epidemiol, 2015,44(6):1982⁃1994. doi: 10.1093/ije/dyv194. |
[28] | Bissessor M, Tabrizi SN, Bradshaw CS, et al. The contribution of Mycoplasma genitalium to the aetiology of sexually acquired infectious proctitis in men who have sex with men[J]. Clin Microbiol Infect, 2016,22(3):260⁃265. doi: 10.1016/j.cmi.2015. 11.016. |
[29] | Francis SC, Kent CK, Klausner JD, et al. Prevalence of rectal Trichomonas vaginalis and Mycoplasma genitalium in male patients at the San Francisco STD clinic, 2005 -2006[J]. Sex Transm Dis, 2008,35(9):797⁃800. doi: 10.1097/OLQ.0b013e 318177ec39. |
[30] | Ong JJ, Aung E, Read T, et al. Clinical characteristics of anorectal Mycoplasma genitalium infection and microbial cure in men who have sex with men[J]. Sex Transm Dis, 2018,45(8):522⁃526. doi: 10.1097/OLQ.0000000000000793. |
[31] | Ito S, Tsuchiya T, Yasuda M, et al. Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years⁃of⁃age with acute epididymitis[J]. Int J Urol, 2012,19(3):234⁃238. doi: 10.1111/j.1442⁃2042.2011.02917.x. |
[32] | Krieger JN, Riley DE, Roberts MC, et al. Prokaryotic DNA sequences in patients with chronic idiopathic prostatitis[J]. J Clin Microbiol, 1996,34(12):3120⁃3128. doi: 10.1128/jcm.34.12. 3120⁃3128.1996. |
[33] | Mo X, Zhu C, Gan J, et al. Prevalence and correlates of Mycoplasma genitalium infection among prostatitis patients in Shanghai, China[J]. Sex Health, 2016,doi: 10.1071/SH15155. |
[34] | Ahmadi MH, Mirsalehian A, Gilani M, et al. Improvement of semen parameters after antibiotic therapy in asymptomatic infertile men infected with Mycoplasma genitalium[J]. Infection, 2018,46(1):31⁃38. doi: 10.1007/s15010⁃017⁃1075⁃3. |
[35] | Huang C, Zhu HL, Xu KR, et al. Mycoplasma and ureaplasma infection and male infertility: a systematic review and meta⁃analysis[J]. Andrology, 2015,3(5):809⁃816. doi: 10.1111/andr. 12078. |
[36] | Olson E, Gupta K, Van Der Pol B, et al. Mycoplasma genitalium infection in women reporting dysuria: a pilot study and review of the literature[J]. Int J STD AIDS, 2021,32(13):1196⁃1203. doi: 10.1177/09564624211030040. |
[37] | Lewis J, Horner PJ, White PJ. Incidence of pelvic inflammatory disease associated with Mycoplasma genitalium infection: evidence synthesis of cohort study data[J]. Clin Infect Dis, 2020,71(10):2719⁃2722. doi: 10.1093/cid/ciaa419. |
[38] | Latimer RL, Read T, Vodstrcil LA, et al. Clinical features and therapeutic response in women meeting criteria for presumptive treatment for pelvic inflammatory disease associated with Mycoplasma genitalium[J]. Sex Transm Dis, 2019,46(2):73⁃79. doi: 10.1097/OLQ.0000000000000924. |
[39] | Frenzer C, Egli⁃Gany D, Vallely LM, et al. Adverse pregnancy and perinatal outcomes associated with Mycoplasma genitalium: systematic review and meta⁃analysis[J]. Sex Transm Infect, 2022,98(3):222⁃227. doi: 10.1136/sextrans⁃2021⁃055352. |
[40] | Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021[J]. MMWR Recomm Rep, 2021,70(4):1⁃187. doi: 10.15585/mmwr.rr7004a1. |
[41] | The Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). Australian STI management guidelines for use in primary care[EB/OL]. [2023⁃07⁃20]. https://sti.guidelines.org.au/sexually⁃transmissible⁃infections/mycoplasma⁃genitalium/. |
[42] | Soni S, Horner P, Rayment M, et al. British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018)[J]. Int J STD AIDS, 2019,30(10):938⁃950. doi: 10.1177/0956462419825948. |
[43] | Jensen JS, Björnelius E, Dohn B, et al. Comparison of first void urine and urogenital swab specimens for detection of Mycoplasma genitalium and Chlamydia trachomatis by polymerase chain reaction in patients attending a sexually transmitted disease clinic[J]. Sex Transm Dis, 2004,31(8):499⁃507. doi: 10.1097/01.olq.0000135992.98883.e4. |
[44] | Gaydos CA, Manhart LE, Taylor SN, et al. Molecular testing for Mycoplasma genitalium in the United States: results from the AMES prospective multicenter clinical study[J]. J Clin Microbiol, 2019,57(11):e01125⁃01119. doi: 10.1128/JCM.01125⁃19. |
[45] | Peris MP, Dehesa B, Alonso H, et al. Retrospective and comparative study of three molecular assays for the macrolide resistance detection in Mycoplasma genitalium positive urogenital specimens[J]. Int J Mol Sci, 2023,24(8):7218. doi: 10.3390/ijms24087218. |
[46] | Fernández⁃Huerta M, Bodiyabadu K, Esperalba J, et al. Multicenter clinical evaluation of a novel multiplex real⁃time PCR (qPCR) assay for detection of fluoroquinolone resistance in Mycoplasma genitalium[J]. J Clin Microbiol, 2019,57(11):e00886⁃19. doi: 10.1128/JCM.00886⁃19. |
[47] | Bradshaw CS, Jensen JS, Waites KB. New horizons in Mycoplasma genitalium treatment[J]. J Infect Dis, 2017,216(suppl_2):S412⁃S419. doi: 10.1093/infdis/jix132. |
[48] | Abavisani M, Keikha M. Global analysis on the mutations associated with multidrug⁃resistant urogenital mycoplasmas and ureaplasmas infection: a systematic review and meta⁃analysis[J]. Ann Clin Microbiol Antimicrob, 2023,22(1):70. doi: 10. 1186/s12941⁃023⁃00627⁃6. |
[49] | Ke W, Li D, Tso LS, et al. Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at a STI Clinic in Guangzhou, China, 2016 -2018[J]. BMC Infect Dis, 2020,20(1):950. doi: 10.1186/s12879⁃020⁃05659⁃3. |
[50] | Wang L, Li Z, Wan C, et al. Prevalence of Mycoplasma genitalium infection with antimicrobial resistance mutations among gay sex workers in China[J]. Int J STD AIDS, 2023,34(8):518⁃524. doi: 10.1177/09564624231160676. |
[51] | Bissessor M, Tabrizi SN, Twin J, et al. Macrolide resistance and azithromycin failure in a Mycoplasma genitalium⁃infected cohort and response of azithromycin failures to alternative antibiotic regimens[J]. Clin Infect Dis, 2015,60(8):1228⁃1236. doi: 10.1093/cid/ciu1162. |
[52] | Murray GL, Bodiyabadu K, Vodstrcil LA, et al. parC Variants in Mycoplasma genitalium: trends over time and association with moxifloxacin failure[J]. Antimicrob Agents Chemother, 2022,66(5):e0027822. doi: 10.1128/aac.00278⁃22. |
[53] | Murray GL, Bodiyabadu K, Danielewski J, et al. Moxifloxacin and sitafloxacin treatment failure in Mycoplasma genitalium infection: association with parC mutation G248T (S83I) and concurrent gyrA mutations[J]. J Infect Dis, 2020,221(6):1017⁃1024. doi: 10.1093/infdis/jiz550. |
[54] | 袁梦瑾. MG感染耐药性和治疗的研究[D]. 北京: 北京协和医学院, 2023. |
[55] | Read T, Fairley CK, Murray GL, et al. Outcomes of resistance⁃guided sequential treatment of Mycoplasma genitalium infections: a prospective evaluation[J]. Clin Infect Dis, 2019,68(4):554⁃560. doi: 10.1093/cid/ciy477. |
[56] | Durukan D, Read T, Murray G, et al. Resistance⁃guided antimicrobial therapy using doxycycline⁃moxifloxacin and doxycycline⁃2.5 g azithromycin for the treatment of Mycoplasma genitalium infection: efficacy and tolerability[J]. Clin Infect Dis, 2020,71(6):1461⁃1468. doi: 10.1093/cid/ciz1031. |
[57] | Durukan D, Doyle M, Murray G, et al. Doxycycline and sitafloxacin combination therapy for treating highly resistant Mycoplasma genitalium[J]. Emerg Infect Dis, 2020,26(8):1870⁃1874. doi: 10.3201/eid2608.191806. |
[58] | 李赛, 薛华忠, 张树文, 等. 多西环素⁃莫西沙星序贯疗法治疗生殖支原体尿道炎/宫颈炎的临床观察[J]. 中华皮肤科杂志, 2022,55(12):1092⁃1095. doi: 10.35541/cjd.20210631. |
[59] | Li L, Yuan Y, He W, et al. Emerging multidrug resistance contributes to treatment failure in Mycoplasma genitalium infected patients in China[J]. Diagn Microbiol Infect Dis, 2023,105(2):115854. doi: 10.1016/j.diagmicrobio.2022.115854. |
[60] | Ando N, Mizushima D, Takano M, et al. Effectiveness of sitafloxacin monotherapy for quinolone⁃resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study[J]. J Antimicrob Chemother, 2023,78(8):2070⁃2079. doi: 10.1093/jac/dkad208. |
[61] | Doyle M, Vodstrcil LA, Plummer EL, et al. Nonquinolone options for the treatment of Mycoplasma genitalium in the era of increased resistance[J]. Open Forum Infect Dis, 2020,7(8):ofaa291. doi: 10.1093/ofid/ofaa291. |
[62] | Clarke EJ, Vodstrcil LA, Plummer EL, et al. Efficacy of minocycline for the treatment of Mycoplasma genitalium[J]. Open Forum Infect Dis, 2023,10(8):ofad427. doi: 10.1093/ofid/ofad427. |
[63] | Glaser AM, Geisler WM, Ratliff AE, et al. Two cases of multidrug⁃resistant genitourinary Mycoplasma genitalium infection successfully eradicated with minocycline[J]. Int J STD AIDS, 2019,30(5):512⁃514. doi: 10.1177/0956462418816757. |
[64] | Read T, Jensen JS, Fairley CK, et al. Use of pristinamycin for macrolide⁃resistant Mycoplasma genitalium infection[J]. Emerg Infect Dis, 2018,24(2):328⁃335. doi: 10.3201/eid2402.170902. |
[65] | Falk L, Enger M, Jensen JS. Time to eradication of Mycoplasma genitalium after antibiotic treatment in men and women[J]. J Antimicrob Chemother, 2015,70(11):3134⁃3140. doi: 10.1093/jac/dkv246. |
[1] | 中华医学会皮肤性病学分会 中国医师协会皮肤科医师分会 中国中西医结合学会皮肤性病专业委员会 . [开放获取] 中国化学剥脱术临床应用专家共识(公众版2024版)[J]. 中华皮肤科杂志, 2024, 0(5): 20230620-e20230620. |
[2] | 宋雨晴 杨楠 刘琳琳 冯子仪 韩世新 周梅娟. [开放获取] 皮肤磨削术治疗家族性良性慢性天疱疮6例临床观察[J]. 中华皮肤科杂志, 2024, 0(4): 20220278-e20220278. |
[3] | 刘祎 曲莹 雷文知 刘晓刚 潘炜华 张超. 食盐封包法治疗化脓性肉芽肿25例临床观察[J]. 中华皮肤科杂志, 2024, 0(4): 20230553-e20230553. |
[4] | 严可心 张韡 宋昊 徐秀莲. 纳米医学在恶性黑色素瘤中的诊断和治疗新策略[J]. 中华皮肤科杂志, 2024, 0(3): 20230109-e20230109. |
[5] | 宗杨永怡 马楚君 苏忠兰. 银屑病生物制剂治疗后湿疹化发生机制及应对策略[J]. 中华皮肤科杂志, 2024, 0(3): 20220578-e20220578. |
[6] | 王煜坤 刘洁. 深度学习在非肿瘤性皮肤病中的应用进展[J]. 中华皮肤科杂志, 2024, 0(3): 20220660-e20220660. |
[7] | 杨玉婷 顾国林 吴敏娟 盛志杰 李晋 莫星帆 吴敏智 胥萍. 血清纤维连接蛋白联合梅毒非特异性抗体检测在梅毒血清固定患者中排除无症状神经梅毒的初步探讨[J]. 中华皮肤科杂志, 2024, 57(3): 246-249. |
[8] | 谢琳 陈锐 牛建军 杨天赐. 新型神经梅毒诊断标志物UCH-L1、GFAP和NF-L与传统神经梅毒检测指标的诊断效能比较[J]. 中华皮肤科杂志, 2024, 57(3): 224-232. |
[9] | 王柳苑 张晓辉 罗丹阳 柯吴坚 薛耀华 黄进梅 李畅畅 赵培祯 杨立刚. 广东省医疗机构性传播疾病规范化诊疗服务现况调查[J]. 中华皮肤科杂志, 2024, 57(3): 218-223. |
[10] | 陈娜娜 李峥 张杰 李世慎 李伟. 南宁市147例隐性梅毒患者中早期感染情况的横断面调查[J]. 中华皮肤科杂志, 2024, 57(3): 213-217. |
[11] | 王千秋 郑晓丽 杜方智 张栩. 遏制梅毒传播:新形势与新策略[J]. 中华皮肤科杂志, 2024, 57(3): 209-212. |
[12] | 中华医学会皮肤性病学分会 中国疾病预防控制中心性病控制中心 中国医师协会皮肤科医师分会 中国康复医学会皮肤病康复专业委员会. 中国沙眼衣原体泌尿生殖道感染临床诊疗指南(2024)[J]. 中华皮肤科杂志, 2024, 57(3): 193-200. |
[13] | 刘佳 谷映桦 贺小宁. 遗传性血管性水肿治疗方式与疾病负担研究进展[J]. 中华皮肤科杂志, 2024, 0(3): 20220205-e20220205. |
[14] | 张瑾 陈绍椿 尹跃平. 耐药淋球菌的备选治疗方案[J]. 中华皮肤科杂志, 2024, 57(3): 272-275. |
[15] | 戴叶芹 宋秀祖. 毛囊及毛囊细胞移植在白癜风治疗中的应用进展[J]. 中华皮肤科杂志, 2024, 0(3): 20230274-e0230274. |
|