中华皮肤科杂志 ›› 2013, Vol. 46 ›› Issue (5): 313-316.

• 论著 • 上一篇    下一篇

广西梧州和贺州不同场所暗娼泌尿生殖道沙眼衣原体感染及其基因型别分布

韩燕1,尹跃平2,施美琴3,陈绍椿4,向志1,李红敏1   

  1. 1. 中国医学科学院皮肤病研究所
    2. 南京 中国医学科学院北京协和医学院皮肤病研究所
    3. 南京医科院皮研所
    4. 中国医学科学院皮肤病研究所，中国疾病预防控制中心性病控制中心
  • 收稿日期:2012-06-27 修回日期:2012-08-24 出版日期:2013-05-15 发布日期:2013-05-01
  • 通讯作者: 尹跃平 E-mail:yinyp@ncstdlc.org
  • 基金资助:
    “艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“防治性病对预防艾滋病的作用研究”

Prevalence of urogenital infection with and genotype distribution of Chlamydia trachomatis among female sex workers from different entertainment venues in Wuzhou and Hezhou cities of Guangxi Zhuang Autonomous Region

  • Received:2012-06-27 Revised:2012-08-24 Online:2013-05-15 Published:2013-05-01
  • Contact: Yue-ping YIN E-mail:yinyp@ncstdlc.org
  • Supported by:
    Mega Project of China National Science Research for the 11th Five-Year Plan

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摘要： 【摘要】 目的 探讨广西梧州和贺州暗娼人群（FSW）沙眼衣原体的流行情况及基因型别的分布。方法2009年7月至2010年9月间，在广西梧州和贺州的娱乐场所共招募810例符合条件的FSW。根据其不同场所分为低档场所、中档场所和高档场所。用罗氏Amplicor 沙眼衣原体核酸检测试剂对所有收集的宫颈拭子标本进行检测；用Qiagen DNA提取试剂对沙眼衣原体阳性标本的进行DNA提取，经巢式PCR方法扩增ompA基因的VS2区，扩增后的产物利用测序仪进行双向测序后分析基因型别。卡方检验分析沙眼衣原体感染率及其基因型别在来源于不同场所和不同地区的FSW间的差异。结果 经核酸检测161例沙眼衣原体阳性，沙眼衣原体感染率20.0%（161/805）。经卡方分析显示：高档场所和中档场所的FSW沙眼衣原体感染率低于低档场所，分别为χ2 = 3.97，P < 0.05，χ2 = 5.95，P < 0.05。基因型E在低档场所FSW人群中分布较中档场所FSW人群中多，χ2 = 5.02，P < 0.05，而基因型K在低档场所FSW人群中分布较中档场所FSW人群中少，Fisher 精确法，t = 0.048，P = 0.048。结论 低档场所的FSW沙眼衣原体的感染率较高，主要流行的基因型为E，而以症状为基础的筛查策略会漏检许多感染沙眼衣原体基因型E的患者，因此需要加大在低档FSW人群中沙眼衣原体的筛查的力度。 【关键词】 衣原体，沙眼； 基因； 卖淫

关键词: 衣原体，沙眼, 卖淫, 基因

Abstract: HAN Yan, YIN Yue-ping, SHI Mei-qin, CHEN Shao-chun, XIANG Zhi, LI Hong-min. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical Collage; National Center for Sexually Transmitted Disease Control, China Center for Disease Control and Prevention, Nanjing 210042, China Corresponding author: YIN Yue-ping, Email: yinyp@ncstdlc.org 【Abstract】 Objective To assess the prevalence of urogenital infection with and genotype distribution of C. trachomatis among female sex workers （FSWs） from different entertainment venues in Wuzhou and Hezhou cities of Guangxi Zhuang Autonomous Region. Methods A total of 810 FSWs were recruited to this study by convenience sampling from entertainment venues in Wuzhou and Hezhou cities of Guangxi Zhuang Autonomous Region from July 2009 to September 2010. Based on the venues where they solicited clients，the FSWs were classified into three tiers, i.e., high-tier, middle-tier and low-tier. Cervical swabs were collected from all of these subjects followed by detection of C. trachomatis with the Amplicor PCR test kit. Then, DNA was extracted from C. trachomatis-positive specimens and subjected to nested PCR assay targeting the ompA gene followed by bidirectional sequencing. The genotype of C. trachomatis was determined according to the sequence of ompA gene. Chi-square test was conducted to compare the urogenital infection rate and genotype distribution of C. trachomatis between different tiers of FSWs. Results Among the 805 FSWs, the prevalence rate of urogenital C. trachomatis infection was 20.0% （161/805）. Chi-square test showed that the prevalence rate of urogenital C. trachomatis infection was significantly lower in high- and middle-tier FSWs than in low-tier FSWs（χ2 = 3.97, 5.95, respectively, both P < 0.05）. Nine genotypes of C. trachomatis were identified in these FSWs, with serotype F as the most prevalent genotype （39/154, 25.3%）. Low-tier FSWs showed a higher frequency of genotype E （χ2 = 5.02，P < 0.05） but a lower frequency of genotype K （Fisher′s Exact test, P = 0.048） compared with middle-tier FSWs. Conclusions Low-tier FSWs show a high rate of urogenital infection with C. trachomatis, with serotype E as the prevalent type. Since C. trachomatis serovar E-infected patients are likely to be missed by symptom-based screening and preventive strategies, standardized screening for and efficient treatment of urogenital C. trachomatis infection should be enhanced among low-tier FSWs for the prevention of C. trachomatis transmission. 【Key words】 Chlamydia trachomatis ; Genes; Prostitution