1 2 3
1 2 3
1
: Reiter
9-1-1 Annal of internal medicine 5PMN/1000 (+) (+) NGU DFA 10PMN/1000 DFA(+) + GS=Gram Stain PMN=polymorphonuclear leukocytes DFA=direct fulorescent antibody
(Annal internal medicine) ----------------------- 30PMN/1000 DFA, DFA 7 GS DFA IgM,IgG GS=Gram Stain MPC=mucopurulent cervicitis DFA=direct fulorescent antibody
2 1 2 3 : 1 2 3 4 DNA PCR LCR TMA
5 70% 80% 1 2 HeLa229 3
6 LPS MOMP DFA EIA DFA 80% 85% EIA 60% 80% DFA EIA >99% DFA Clearview Magic Lite
7 NAATs---- FDA 3 : PCR Roche Molecular Systems, Branchburg, NJ, USA LCR Abbott Laboratories, Abbott Park, IL, USA TMA Gen-Probe, Inc., LA Jolla, CA, USA NAATs 90-95% 60-70%
1. 2. 3. 1. 2. 1. 2. 1. 2. 3. 1. 2. 3.
- CDC 2006 2001 WHO2003 CDC 2006 1g 100mg 2 7 d 500mg 4 7 d 800mg 4 7 d 300mg 2 7 d 500mg 1 7 d 1g 100mg 2 7 d 500mg 4 7d 300mg 2 7d 150mg 2 7d 500mg 2 7 d 100mg 2 7 d 1g 0.5g 3 7d 500mg 4 7 d 300mg 2 7 d 500mg 4 7d 1g 100mg 2 7 d 100mg 2 10 d 500mg 4 7 d 500mg 4 10d 150mg 2 10 d 250mg 2 10 d 300mg 2 7 d 500mg 1 7 d 200mg 1 10 d
(1) 0.1g,1 2 14 500mg 1 3 30 1.0g 12 250mg 30
(2) 0.1 g 1 2 10 - sulfamethoxazoletrimethoprim, SMZ-TMP
3 (cefuroxime)2g (ceftriaxone)250mg 0.1g 1 2 0.5g 1 4 14 400mg 1 2 14 450mg 1 4 14 metronidazole 500mg 1 2 14
5 Reitter 0.5g 1 4 7 14 0.1g 1 2 7 14 25 50mg 1 3 100mg 3 4 1 2mg/kg/d 3 15 25mg/W 3.0/d
Ct 95 [1] rrna [13]
1... ( ) ( ) Chinese Journal of Sexually transmitted Infections2005 01
2 1 223 CT ----------------------------------------------------------------------------------------- N 1 3 6 12 --------------------------------------------------------------------------------------- 138 29 23 9 4 85 22 21 16 6 ---------------------------------------------------------------------------------------- X=10.41; P<0.05 2 2 ---------------------------------------------------------------------------------------- N 1 3 6 12 --------------------------------------------------------------------------------------- 11 4 3 2 1 11 6 3 3 3 --------------------------------------------------------------------------------------- X=1.62; P>0.05. 1998;7(2):40.
3 1950 1980 3 NGU 15% Workowski KA et al. Long term eradication of chlamydia trachomatis genital infection after antimicrobial therapy: evidence against persistent infection. JAMA 270:2071-2075,1993. 221 Munday 45 (20%) 3 38% Hillis SD et al. Recurrent chlamydial infections increase the risk of hospitalization for ecopic pregnancy and pelvic inflammatory disease. Am J Obstet Gynecol 176:103-107,1997 5 New insights into a persistent problem chlamydial infections Richard P. Morrison 2003, American Society for Clinical Investigation Clin Invest. 2003 June 1; 111 (11): 1647 1649
attachment & entry N lysis 0 hr 2-5 hrs redistribution N N 40+ hrs Developmental Cycle 5-8 hrs differentiatio N N 20-40 hrs growth & differentiation N 8-20 hrs growth
2
1986 35.2 /10 2005 332.5/10 14.86/10 [19]
CDC 2 CDC CDC CDC
CDC CDC CDC 2005 4 19-23 2006 [17] 1 CDC 2 CDC [17] CDC: Workowski KA,Berman SM. Sexually transmitted diseases treatment guidelines, 2006.MMWR Recomm Rep. 2006 Aug 4;55(RR-11):1-94.
CDC 1 2006 CDC 3-4 =19 20-24
1 C.t 2 3 4 C.t
2 2006 CDC : 2 3 4 3 4
MIC 0.005~0.25 0.025~0.25 0.03~1.0 0.1~1.0 0.5~1.0 0.5~10.0 1.0~10.0 0.5~4.0 2~16 32~100 500 1000
1 1 urethritis 1 2 1 3 3 1000 >5 3 4 15mL 400 >15 24 21
2 2. prostatitis 1 2 3 IgA 22
3 3. (epididymitis) 1 2 3 45
4 4. (proctitis) 1 2 3 LGV
5 5.Reiter Reiter s syndrome 1 2 3 4 5 6 Reiter
2 1 2 50% 3
1 mucopurulent cervicitis, MPC 1 2 1 3 3 1000 >30 4 1 2 3 230
3 (endometritis) 1 2 3
4 1 2, 3
5 (pelvic inflammatory disease PID) 1 PMN 1000 30 2 3
6 (perihepatitis Fitz-Hugh-Curtis ) 1 2 3 4 IgM IgG