Abstract
The aim of the study was to evaluate clinical, epidemiological and demographic data of patients treated with syphilis at the Department of Dermatovenereology of the 1st faculty of medicine and General University Hospital in Prague (STD centre) in 2017-2019 and compare them with the previous survey carried out in 2007-2009 and with the nationwide data from the Czech Registry of veneral diseases and the european data from the European Surveillance System of the ECDC. A total of 325 patients (83,4 % men and 16,6 % women) were hospitalized during the period 2017-2019.
The total number of hospitalised patients decreased by 148 cases (31.3 %), the decrease was more pronounced in the female group (61.2%) as compared to the male group (18.9%). The increase of the male-to-female ratio is statistically significant (p < 0.001).
The patients' age has not changed in the long term, most of them were aged between 30 and 40. The percentage of foreigners was 26.5% and did not change significantly.
In the male group, the proportion of primary syphilis decreased (24.4% vs 32.0 %; p = 0.046) and there was a significant increase in the number of HIV-positive patients (7.7% vs 3.0 %; p = 0.017), while the proportion of homo/bisexual men remained approximately the same (p = 0.934). The proportion of homo/bisexual men was 48.4% of all patients and 58.3% of men.
In the female group, the number of primary and secondary syphilis cases was low and this proportion did not change significantly. Similarly, the proportion of pregnant women did not change significantly either (p = 0.371).
The testing of samples for macrolide resistance showed a significant decrease in the number of sensitive strains (9.5% vs 57.6%). Accurate and continuous collection of epidemiological and clinical data is necessary for trend analysis and targeted syphilis prevention.
Our as well as European data show that men having sex with men are the most vulnerable group. Regular screening for syphilis and other sexually transmitted infections must be a priority in this group, regardless of the HIV status.