Abstract：
Approximately 1 in 5 adults in the US had a sexually transmitted infection (STI) in 2018. This review provides an update on the epidemiology, diagnosis, and treatment of gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, trichomoniasis, and genital herpes.
From 2015 to 2019, the rates of gonorrhea, chlamydia, and syphilis increased in the US; from 1999 to 2016, while the rates of herpes simplex virus type 1 (HSV-1) and HSV-2 declined. Populations with higher rates of STIs include people younger than 25 years, sexual and gender minorities such as men and transgender women who have sex with men, and racial and ethnic minorities such as Black and Latinx people. Approximately 70% of infections with HSV and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms. STIs are associated with HIV acquisition and transmission and are the leading cause of tubal factor infertility in women. Nucleic acid amplification tests have high sensitivities (86.1%-100%) and specificities (97.1%-100%) for the diagnosis of gonorrhea, chlamydia, M genitalium, trichomoniasis, and symptomatic HSV-1 and HSV-2. Serology remains the recommended method to diagnose syphilis, typically using sequential testing to detect treponemal and nontreponemal (antiphospholipid) antibodies. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles, such as metronidazole, are effective treatments for gonorrhea, chlamydia, syphilis, M genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral treatment options for gonorrhea and M genitalium. No cure is available for genital herpes. Effective STI prevention interventions include screening, contact tracing of sexual partners, and promoting effective barrier contraception.
Approximately 1 in 5 adults in the US had an STI in 2018. Rates of gonorrhea, chlamydia, and syphilis in the US have increased, while rates of HSV-1 and HSV-2 have declined. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles are effective treatments for gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral therapies for gonorrhea and Mycoplasma genitalium, and no cure is available for genital herpes.
From 2015 to 2019, the rates of gonorrhea, chlamydia, and syphilis increased in the US; from 1999 to 2016, while the rates of herpes simplex virus type 1 (HSV-1) and HSV-2 declined. Populations with higher rates of STIs include people younger than 25 years, sexual and gender minorities such as men and transgender women who have sex with men, and racial and ethnic minorities such as Black and Latinx people. Approximately 70% of infections with HSV and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms. STIs are associated with HIV acquisition and transmission and are the leading cause of tubal factor infertility in women. Nucleic acid amplification tests have high sensitivities (86.1%-100%) and specificities (97.1%-100%) for the diagnosis of gonorrhea, chlamydia, M genitalium, trichomoniasis, and symptomatic HSV-1 and HSV-2. Serology remains the recommended method to diagnose syphilis, typically using sequential testing to detect treponemal and nontreponemal (antiphospholipid) antibodies. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles, such as metronidazole, are effective treatments for gonorrhea, chlamydia, syphilis, M genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral treatment options for gonorrhea and M genitalium. No cure is available for genital herpes. Effective STI prevention interventions include screening, contact tracing of sexual partners, and promoting effective barrier contraception.
Approximately 1 in 5 adults in the US had an STI in 2018. Rates of gonorrhea, chlamydia, and syphilis in the US have increased, while rates of HSV-1 and HSV-2 have declined. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles are effective treatments for gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral therapies for gonorrhea and Mycoplasma genitalium, and no cure is available for genital herpes.
摘要：
2018年，美国约有五分之一的成年人患有性传播感染（STI）。这篇综述提供了流行病学的最新信息，诊断,和淋病的治疗，衣原体,梅毒,生殖支原体，滴虫病,和生殖器疱疹。
从2015年到2019年，淋病的发病率，衣原体,和梅毒在美国增加;从1999年到2016年，而单纯疱疹病毒1型（HSV-1）和HSV-2的发病率下降。性传播感染发生率较高的人群包括25岁以下的人群，性和性别少数群体，如男性和变性女性与男性发生性关系，以及黑人和拉丁裔等种族和少数民族。大约70％的HSV和滴虫感染以及53％至100％的生殖器外淋病和衣原体感染无症状或几乎没有症状。性传播感染与艾滋病毒的获取和传播有关，是女性输卵管因素不孕症的主要原因。核酸扩增试验对淋病的诊断具有较高的敏感性(86.1%-100%)和特异性(97.1%-100%),衣原体,生殖M，滴虫病,和有症状的HSV-1和HSV-2。血清学仍然是诊断梅毒的推荐方法，通常使用顺序测试来检测螺旋体和非螺旋体（抗磷脂）抗体。头孢曲松,多西环素,青霉素,莫西沙星,和硝基咪唑，如甲硝唑，是淋病的有效治疗方法，衣原体,梅毒,生殖M，和滴虫病,分别,但是抗菌素耐药性限制了淋病和生殖器的口服治疗选择。生殖器疱疹没有治愈方法。有效的性传播感染预防干预措施包括筛查，追踪性伴侣的接触者,促进有效的屏障避孕。
2018年，美国大约五分之一的成年人患有性传播感染。淋病率,衣原体,美国的梅毒增加了，而HSV-1和HSV-2的发病率有所下降。头孢曲松,多西环素,青霉素,莫西沙星,硝基咪唑是治疗淋病的有效方法，衣原体,梅毒,生殖支原体，和滴虫病,分别,但是抗菌素耐药性限制了淋病和生殖支原体的口服治疗，生殖器疱疹没有治愈方法.
从2015年到2019年，淋病的发病率，衣原体,和梅毒在美国增加;从1999年到2016年，而单纯疱疹病毒1型（HSV-1）和HSV-2的发病率下降。性传播感染发生率较高的人群包括25岁以下的人群，性和性别少数群体，如男性和变性女性与男性发生性关系，以及黑人和拉丁裔等种族和少数民族。大约70％的HSV和滴虫感染以及53％至100％的生殖器外淋病和衣原体感染无症状或几乎没有症状。性传播感染与艾滋病毒的获取和传播有关，是女性输卵管因素不孕症的主要原因。核酸扩增试验对淋病的诊断具有较高的敏感性(86.1%-100%)和特异性(97.1%-100%),衣原体,生殖M，滴虫病,和有症状的HSV-1和HSV-2。血清学仍然是诊断梅毒的推荐方法，通常使用顺序测试来检测螺旋体和非螺旋体（抗磷脂）抗体。头孢曲松,多西环素,青霉素,莫西沙星,和硝基咪唑，如甲硝唑，是淋病的有效治疗方法，衣原体,梅毒,生殖M，和滴虫病,分别,但是抗菌素耐药性限制了淋病和生殖器的口服治疗选择。生殖器疱疹没有治愈方法。有效的性传播感染预防干预措施包括筛查，追踪性伴侣的接触者,促进有效的屏障避孕。
2018年，美国大约五分之一的成年人患有性传播感染。淋病率,衣原体,美国的梅毒增加了，而HSV-1和HSV-2的发病率有所下降。头孢曲松,多西环素,青霉素,莫西沙星,硝基咪唑是治疗淋病的有效方法，衣原体,梅毒,生殖支原体，和滴虫病,分别,但是抗菌素耐药性限制了淋病和生殖支原体的口服治疗，生殖器疱疹没有治愈方法.
