RESUMO
Fifty-seven cases of gonococcal and chlamydial infections complicated by acute epididymitis seen at 2 Alberta STI clinics from 2004 to 2014 were reviewed. The majority responded to treatment recommended by national guidelines. Three of 6 treatment failures were not treated according to guidelines.
Assuntos
Infecções por Chlamydia/epidemiologia , Epididimite/epidemiologia , Epididimite/microbiologia , Gonorreia/epidemiologia , Adulto , Alberta/epidemiologia , Antibacterianos/uso terapêutico , Infecções por Chlamydia/microbiologia , Infecções por Chlamydia/fisiopatologia , Epididimite/tratamento farmacológico , Epididimite/fisiopatologia , Gonorreia/microbiologia , Gonorreia/fisiopatologia , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
Trichomonas vaginalis prevalence (2.8%) in female sexually transmitted infection clinic attendees was within the prevalence of chlamydia (5.8%) and gonorrhea (1.8%), while being very low for male attendees (0.2%). Correlates among women were indigenous ethnicity, other ethnicity, and being symptomatic.
Assuntos
Infecções Sexualmente Transmissíveis/epidemiologia , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Adulto , Alberta/epidemiologia , Demografia , Feminino , Humanos , Masculino , Prevalência , Estudos Prospectivos , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/parasitologia , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/parasitologia , Adulto JovemRESUMO
We examined the prevalence of rectal chlamydia treatment failures in men who have sex with men and women attending Alberta sexually transmitted infection clinics. Among those completing a test of cure, there was no significant difference among patients treated initially with azithromycin (treatment failure, 39/460 [8.5%]; 95% confidence interval, 5.9%-11.0%) compared with patients treated with doxycycline (0/16; 95% confidence interval, 0%-0.2%; P = 0.63).
Assuntos
Antibacterianos/farmacologia , Azitromicina/farmacologia , Infecções por Chlamydia/tratamento farmacológico , Chlamydia trachomatis/efeitos dos fármacos , Doxiciclina/farmacologia , Doenças Retais/tratamento farmacológico , Adulto , Alberta , Feminino , Homossexualidade Masculina , Humanos , Masculino , Estudos Retrospectivos , Falha de Tratamento , Adulto JovemRESUMO
The implementation of express testing in an sexually transmitted infection (STI) clinic reduced the length of visit time compared with other visit types and increased the proportion of STIs diagnosed at clinic visits. Express testing did not impact the time to treatment for asymptomatic patients diagnosed as having an STI.
Assuntos
Infecções por Chlamydia/diagnóstico , Gonorreia/diagnóstico , Técnicas de Amplificação de Ácido Nucleico/estatística & dados numéricos , Visita a Consultório Médico , Sífilis/diagnóstico , Triagem/estatística & dados numéricos , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Canadá/epidemiologia , Feminino , Humanos , Masculino , Visita a Consultório Médico/estatística & dados numéricos , Prevalência , Comportamento Sexual , Fatores de TempoRESUMO
OBJECTIVES: To determine the prevalence and correlates of Mycoplasma genitalium (MG) infection among men and women, determine the prevalence of gene mutations conferring resistance and compare test performance of female specimen types. METHODS: A cross-sectional study was conducted on specimens collected for gonorrhoea (NG, Neisseria gonorrhoeae) and chlamydia (CT, Chlamydia trachomatis) among male and female Alberta STI clinic attendees using the M. genitalium transcription-mediated amplification-research use only test. Positive specimens were sequenced for 23SrRNA, parC and gyrA genes. Gender-stratified analysis compared test results using χ2 or Fisher's exact test, Mann-Whitney U test and logistic regression. Female endocervical and urine specimens were compared. RESULTS: A total of 2254 individuals were tested; 53.8% (n=1212) were male. Male prevalence of MG was 5.3%; CT was 5.9% and NG was 1.8%. Correlates of male infection were a non-gonococcal urethritis diagnosis and NG coinfection. MG prevalence for women was 7.2%; CT was 5.8% and NG was 1.8%. Correlates of female infection were younger age, Indigenous/Other ethnicity and CT/NG coinfection. Nearly two-thirds of eligible specimens had mutations associated with macrolide resistance and 12.2% of specimens had a parC mutation signifying possible moxifloxacin resistance. There was high concordance (98.1%) of results between urine and endocervical swabs. CONCLUSIONS: The high prevalence of MG relative to CT and NG supports the incorporation of MG testing into routine sexually transmissible infection screening. The high rate of resistance to macrolides and moxifloxacin raises concerns about treatment options. The good concordance of results between urine and endocervical swabs supports the use of female urine specimens for testing.