京都府下男性尿道炎の推移

Abstract

京都府下における男性尿道炎の特徴と問題点を考察するために, 男性性感染症(STD)発生状況を調査した.2004年1～12月に, 24施設で1275名が男性尿道炎と診断された.原因微生物検査では, 淋菌性368例(30%), クラミジア性336例(27%), 淋菌・クラミジア混合感染85例(7%), 非淋菌・非クラミジア性453例(36%)を示した.年齢別では20歳代579例(45%)が最多で, 30歳代393例(31%)が続いた.感染源は10歳代の65%が「素人」(非性産業従事者)であった.クラミジア感染は, 10歳代感染者の47%, 素人からの感染者の42%を占めた.淋菌性尿道炎103例(38%), クラミジア性尿道炎159例(53%)の初回治療薬はキノロン系であった.京都府下の10歳代は, 男女ともSTD感染の蔓延が示唆され, 若年層における性生活の問題点を反映していると思われた.又, キノロン剤への耐性は急激に進行しており, 日本感染症学会や日本医師会のガイドラインで推奨されているセフィキシムなどの投与が望まれた

The data of sexually transmitted urethritis in males have been collected at 24 institutes in Kyoto Prefecture since October, 2002. The data collected from January to December in 2004 are summarized herein. A total of 1, 275 patients were diagnosed with urethritis during this period. Microbiological examinations isolated Neisseria gonorrhoeae alone in 368 (29%), Chlamydia tracomatis alone in 336 (26%), both in 85 (7%), and others in 453 (36%). Male patients under 20 years old tended to have Chlamydial urethritis, alone or combined with gonococcal infection, and had a predominant infectious source, a non-commercial-sexual-worker female partner, suggesting a profound problem in sexual life of adolescents. The urologist preferred to use quinolones as the first therapeutic modality against male urethritis. However, drug resistance of N. gonorrhoeae, especially against quinolones, has rapidly progressed, which was also observed by a sensitivity examination test. Antibiotics should be used adequately against male urethrits according to the recent guidelines.