Persistence of Mycoplasma genitalium Following Azithromycin Therapy 英文参考文献.docVIP

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Persistence of Mycoplasma genitalium Following Azithromycin Therapy 英文参考文献.doc

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Persistence of Mycoplasma genitalium Following Azithromycin Therapy 英文参考文献

PersistenceofMycoplasmagenitaliumFollowing AzithromycinTherapy CatrionaS.Bradshaw1,2,3*,MarcusY.Chen2,3,ChristopherK.Fairley2,3 1Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, 2Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne,Victoria,Australia,3SchoolofPopulationHealth,UniversityofMelbourne,Melbourne,Victoria,Australia Abstract Background:TodetermineclinicaloutcomesandcureratesforM.genitaliumgenitalinfectioninmenandwomenfollowing azithromycin1g. Methodology: Patients attending Melbourne Sexual Health Centre between March 2005 and November 2007 with urethritis/epididymitis, cervicitis/pelvic inflammatory disease and sexual contacts of M.genitalium were tested for M.genitaliumbypolymerasechainreaction(PCR).M.genitalium-infectionwastreatedwith1gofazithromycinandatest- of-cure (toc) was performed one month post-azithromycin. Response to azithromycin, and response to moxifloxacin (400mgdailyfor10days)inindividualswithpersistentinfectionpost-azithromycin,wasdetermined. Principal Findings: Of 1538 males and 313 females tested, 161 males (11%) and 30 females (10%) were infected with M.genitalium.Atocwasavailableon131(69%)infectedindividuals(median=36days[range12-373]).Of120individuals prescribedazithromycinonlypre-toc,M.genitaliumwaseradicatedin101(84%,95%confidenceintervals[CI]:77–90%)and persisted in 19 (16%, 95% CI: 10–23%). Eleven individuals with persistent infection (9%, 95% CI: 5–15%) had no risk of reinfectionfromuntreated-partners,whileeight(7%,95%CI:3–12%)mayhavebeenatriskofreinfectionfromdoxycycline- treatedoruntreated-partners.Moxifloxacinwaseffectiveineradicatingpersistentinfectioninallcasesnotrespondingto azithromycin.Patientswithpersistent-M.genitaliumweremorelikelytoexperiencepersistentsymptoms(91%),comparedto patientsinwhomM.genitaliumwaseradicated(17%),p,0.0001. Conclusion:Useofazithromycin1ginM.genitalium-infectedpatientswasassociatedwithunacceptableratesofpersistent infection,which