CAJ | 학술논문

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x2=3.97,P＜0.05,x2=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,x2=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.
목적 탐토엄서오주화하주암창인군(FSW)사안의원체적류행정황급기인형별적분포.방법 2009년7월지2010년9월간,재엄서오주화하주적오악장소공초모810례부합조건적FSW.근거기불동장소분위저당장소、중당장소화고당장소.용라씨Amplicor사안의원체핵산검측시제대소유수집적궁경식자표본진행검측;용Qiagen DNA제취시제대사안의원체양성표본적진행DNA제취,경소식PCR방법확증ompA기인적VS2구,확증후적산물이용측서의진행쌍향측서후분석기인형별.잡방검험분석사안의원체감염솔급기기인형별재래원우불동장소화불동지구적FSW간적차이.결과 경핵산검측161례사안의원체양성,사안의원체감염솔20.0％(161/805).경잡방분석현시:고당장소화중당장소적FSW사안의원체감염솔저우저당장소,분별위x2=3.97,P＜0.05,x2=5.95,P＜0.05.기인형E재저당장소FSW인군중분포교중당장소FSW인군중다,x2=5.02,P＜0.05,이기인형K재저당장소FSW인군중분포교중당장소FSW인군중소,Fisher정학법,t=0.048,P=0.048.결론 저당장소적FSW사안의원체적감염솔교고,주요류행적기인형위E,이이증상위기출적사사책략회루검허다감염사안의원체기인형E적환자,인차수요가대재저당FSW인군중사안의원체적사사적력도.
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 (x2 =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 (x2 =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.