Evaluation of Chlamydia trachomatis Genotypes in Endocervical Specimens by Sequence Analysis of ompA Gene among Women in Tehran.

Tehran's actual prevalence of Chlamydia trachomatis (CT) and its genotypes are still unclear. Molecular typing of CT strains can provide essential epidemiological knowledge and contribute to improved control measures. In this study, we aimed to determine the prevalence of CT and its genotypes in the endocervical infections of females who attended the gynecology and infertility clinics in Tehran. A total of 291 women were tested for chlamydial infection by in-house PCR using specific primers for the CT cryptic plasmid. Nested PCR for amplification of the ompA gene in positive samples was carried out, genotyping was performed by sequencing this gene, and further phylogenetic analysis was conducted. Sexual infection by CT was observed in 10.3% (30/291) of the subjects, and the mean age of patients was 30.4. The ompA gene was sequenced in 27 samples, revealing E genotypes 40.7%, (n = 11), F 25.9%, (n = 7), G 18.5%, (n = 5), D 11.1%, (n = 3), and K 3.7%, (n = 1). This study emphasizes the importance of the diversity among CT genotypes in our studied population and the need for wide-screening the neglected bacterial infection among women in Tehran.

Antimicrobial susceptibility testing and molecular characterization of Neisseria gonorrhoeae in Tehran, Iran.

Gonorrhea is a sexually transmitted infection occurring worldwide. Antimicrobial resistance (AMR) surveillance in Neisseria gonorrhoeae and associated molecular epidemiological studies are crucial to ascertain the spread of antibiotic-resistant and developing the local treatment guidelines. This study was performed to determine the antimicrobial susceptibility testing (AST) and molecular epidemiology of N. gonorrhoeae isolates in Tehran, Iran. During 1 July 2018-30 July 2020, a total of 500 urogenital (468 endocervical, 32 urethral) swabs were collected from patients with signs and symptoms of genitourinary infections presenting to two women's hospitals and one health center located center and south of Tehran. Specimens were cultured and examined for the presence of N. gonorrhoeae isolates by biochemical tests. MIC Test Strip determined the MICs of ceftriaxone, azithromycin, and ciprofloxacin. Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) was also performed. A total of 38 N. gonorrhoeae isolates were identified. The proportions of resistant N. gonorrhoeae isolates were as follows: ceftriaxone (MIC ≥0.125 µg/mL) 10.5% (4/38), azithromycin (MIC >1 µg/mL) 34% (13/38), and ciprofloxacin (MIC ≥1 µg/mL) 31.5% (12/38). In total, 25 different NG-MAST STs were identified. The STs comprised 1-4 isolates each, and the predominant ST was ST266 (n = 4). Our study demonstrates a diverse gonococcal population with high rates of resistance to azithromycin and evidence of resistance to ceftriaxone. The results have potential implications for antibiotic choice for the gonococcal treatment and highlight the need to broaden gonococcal AMR monitoring in Iran.

Impact of Laboratory Methods and Gene Targets on Detection of Streptococcus pneumoniae in Isolates and Clinical Specimens.

BACKGROUND: Timely identification of Streptococcus pneumoniae infections can lead to a decrease in mortality rates. Differentiation of S. pneumoniae from other similar species using traditional culture-based and molecular methods is problematic. In this study, we assessed the efficacy of identifying the blpA and lytA for the detection of S. pneumoniae from isolates and various clinical samples using molecular methods. METHODS: A total of 440 clinical samples were collected from patients with suspected invasive pneumococcal infections during February 2016 to October 2018. Biochemical tests were used to confirm the dubious colonies on 5% sheep blood agar. Fifty-seven confirmed isolates, 57 culture-positive samples, and 57 culture-negative samples were analyzed for the presence of blpA and lytA using both conventional and real-time PCR. RESULTS: All the isolates and culture-positive samples were positive for blpA and lytA by both PCR methods. Of the 57 culture-negative samples, conventional and real-time PCR amplified blpA from six and two samples, and lytA from seven and two samples, respectively. CONCLUSION: The specificity of real-time PCR assay was significantly higher than that of conventional PCR for the identification of S. pneumoniae. In addition, it is suggested that respiratory secretions are not suitable specimen for direct diagnosis of pneumococcal infections.

Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among women with genitourinary infection and pregnancy-related complications in Tehran: A cross-sectional study.

The present study investigates the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among women with genitourinary infection and pregnancy-related complications in Tehran. It also evaluates the demographic information, symptoms, and sequelae. Endocervical samples were obtained over a period of eight months from 360 women including 180 symptomatic patients and 180 patients with pregnancy-related complications and infertility. CT, NG, and TV were detected in 10.8%, 6.9%, and 8.3% of all patients, respectively. The prevalence of CT, NG, and TV among women in the symptomatic group was 11.1%, 7.2%, and 13.3%, respectively, and among women with pregnancy-related complications and infertility was 10.6%, 6.7%, and 3.3%, respectively. Associations between chlamydia and ectopic pregnancy (p = 0.001), and infertility (p < 0.001) were observed. Abortion (p = 0.008), infertility (p = 0.005), and ectopic pregnancy (p < 0.001) were associated with gonorrhea. Abnormal vaginal discharge (p = 0.02) and vulvar itching (p = 0.02) were associated with trichomoniasis. Overall, the prevalence rates of CT, NG, and TV were high in these patient groups. These high prevalences suggest that screening programs are required to reduce the burden of these sexually transmitted infections and their effects on genitourinary symptoms, pregnancy-related complications, and infertility.