[Primary care management of sexually transmitted infections (I). Epidemiology. Secreting syndrome].

Autor:	Besa Castellà M; Centro de Atención Primaria Florida Sud, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, España; Grupo de trabajo sobre infecciones, subgrupo de infecciones de transmisión sexual, de la CAMFiC. Electronic address: mbesa.bcn.ics@gencat.cat., Agustí Benito C; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España; Institut Germans Trias i Pujol (IGTP), Campus Can Ruti, Badalona, Barcelona, España., Roca Saumell C; Centro de Atención Primaria el Clot, Institut Català de la Salut, Barcelona, España; Facultad de Medicina, Universitat de Barcelona, Barcelona, España., Mascort Roca JJ; Centro de Atención Primaria Florida Sud, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, España; Departament de Ciències Clíniques, Facultat de Medicina, Universitat de Barcelona, Barcelona, España; Grupo de trabajo sobre VIH de la semFYC.
Jazyk:	Spanish; Castilian
Zdroj:	Atencion primaria [Aten Primaria] 2023 May; Vol. 55 (5), pp. 102597. Date of Electronic Publication: 2023 Mar 17.
DOI:	10.1016/j.aprim.2023.102597
Abstrakt:	These days sexually transmitted infections (STIs) are important public health problems not only due to their high prevalence, but also because they require early diagnosis and treatment to avoid complications. In recent years, there has been an exponential increase in cases of infections caused by Chlamydia trachomatis and gonococcus in the population under 25years of age. In addition, an increase in the incidence of syphilis and hepatitisC (HCV) has also been detected, especially in men who have sex with other men (MSM). Genital herpes continues to be the second most frequent STI in the world, behind condyloma acuminata, and the first cause of genital ulcer among Spain in the sexually active population. A decrease in reported HIV cases was observed during 2020, but almost half of these new cases had a late diagnosis (<350CD4cell/μL). Current guidelines recommend offering STI annual screening to populations at risk or more often depending on the risk. STIs can appear in the form of syndromes, such as secretory syndrome (urethritis, proctitis, and cervicitis) or ulcerated syndrome (ulcers). The STIs that can cause secretory syndrome are mainly caused by Neisseria gonorrhoeae and C.trachomatis, which co-infect up to 40% of cases, and also cause urethritis, cervicitis or proctitis depending on where they are located. Gonococcus has an incubation period of 2-7days and Chlamydia 2-6weeks, and they are diagnosed using PCR and/or culture (the last one only valid for gonococcus) of samples collected according to sexual activities. Empirical treatment to cover both germs will be accomplished with ceftriaxone, 1g single intramuscular dose plus doxycycline 100mg every 12h orally for 7days, or azithromycin 1g single dose orally (we will use azithromycin only if we suspect a poor compliance with treatment, difficulty in going to the control or in pregnancy). Likewise, whenever we diagnose an STI firstly, we must offer advice and health education in order to promote the adoption of safe sexual behaviours and the correct use of barrier methods. Secondly, we must also screen for other STIs (HIV, syphilis, hepatitisB, and hepatitisA andC depending on the risk), offer HBV and HAV vaccination if it is appropriate, and finally study and treat all sexual partners from the previous 3months. (Copyright © 2023 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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