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Objective:To investigate outcomes and safety of doxycycline-moxifloxacin sequential regimen in the treatment of Mycoplasma genitalium urethritis/cervicitis. Methods:From June 2019 to December 2020, patients with Mycoplasma genitalium urethritis/cervicitis confirmed by nucleic acid amplification testing were successively recruited at Department of Sexually Transmitted Diseases, Hospital of Dermatology, Chinese Academy of Medical Sciences, and received sequential therapy with oral doxycycline for 7 days followed by oral moxifloxacin for 7 days. Clinical and/or etiological assessment was conducted 2 to 3 weeks after the end of treatment. Fisher′s exact test was used to analyze factors influencing the treatment outcome. Results:Totally, 36 eligible subjects were enrolled, including 30 males and 6 females. Among them, 18 (50%) patients completed post-treatment etiological assessment, which showed that 12 achieved microbiological cure, and treatment failures occurred in 6; another 18 patients achieved clinical cure. The overall response rate to doxycycline-moxifloacin sequential therapy was 83.3% (30/36, 95% confidence interval[ CI]: 70.5%, 96.1%) . The treatment outcome showed no significant association with the patients′ age, gender, marital status, number of sexual partners in the past 1 month, history of sexually transmitted diseases, history of antibiotic use in the past 1 month, or co-infections (all P > 0.05) . Conclusion:The efficacy of doxycycline-moxifloacin sequential regimen is limited in the treatment of Mycoplasma genitalium infections in Nanjing area, and clinicians should be alerted to the possibility of treatment failure in clinical practice.
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Objectives To investigate the infection and colonization of Mycoplasma genitalium and Ureaplasma urealyticum in different male populations, to explore the association of M. genitalium and U. urealyticum with nongonococcal urethritis (NGU) respectively. Methods A case-controlled, cross sectional study of four different male populations was performed, namely: NGU patients (G1), non-NGU subjects attending STD clinic (G2), men who had sex with men participating in a health education program (G3), and healthy volunteers (G4). Nested PCR and culture were used to detect U. urealyticum. Nested PCR and PCR product sequencing were applied to detect M. genitalium. Results The prevalence rates of M. genitalium in the four study populations were 25.0%(25/100), 6.4%(6/94), 5.5%(6/110) and 0% respectively. Significant difference was found between each two groups except G2～G3 with a p value of 0.80. By multivariate regression analysis, controlling for the age of first sex, new sexual partners, urethritis and condom use in the previous 3 months, M. genitalium was only associated with urethritis (P= 0.004, OR = 6.754, 95% CI 1.833～24.893). The direct sequencing of PCR products showed gene mutations, in comparison with the reference sequence in GenBank, in 3 samples. The prevalence rates of U. urealyticum by PCR in 4 groups were 40.0%, 44.7%, 22.7% and 46.9% respectively, and there was no significant difference between G1～G2, G1～G4 or G2～G4 with a p value of 0.419, 0.325, 0.868 respectively, but the prevalence rate of U. urealyticum in G3 was significantly lower than that in other groups. Conclusions M. genitalium is strongly associated with NGU and the prevalence rate is significantly higher in groups with high risk sexual behaviors than that in general population. There is no association between the colonization of U. urealyticum and NGU.
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ObjectiveTostudytheincidenceandclinicalcharacteristicsoftheco-infectedsexuallytransmittedinfections(STI)inpatientswithgenitalherpes.MethodsTheclinicaldataof287caseswithherpeticlesionsorpatientswithsuspectedherpeslesionswerecollected,andthepathogensofsexuallytransmittedinfectionsweredetected.ResultsGenitalherpeswasconfirmedin64.8%(186/287)oftherecruitedcases.HIVantibodiesweredetectedin68cases,andnoHIVantibodywasdetected.Theco-infectionssuchascondylomaacuminatum,activeorlatentsyphilis,genitalcandidiasisandotherSTIswerediscoveredin23.1%(43/186)ofpatientswithgenitalherpes.Allgenitalherpescasesco-infectedwithotherSTIswerecausedbyHSV-2.ConclusionTheco-infectionsarecommoninpatientswithgenitalherpes,andthefeaturesofthelesionsmaybechangedbytheseco-infections.
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Objective To detect and type herpes simplex virus (HSV) in genital lesions of the patients attending STD clinic. Methods Clinical data were collected and analyzed from patients with anogenital non-herpetic lesions including induration or furuncle, fissure, folliculitis, single ulcer and so on. HSV was detected and typed by culture and PCR with specimens taken from these lesions. Results One hundred and five cases were recruited in this study. Among them, 18 cases presented induration (furuncle), 15 fissure, 16 folliculitis, 7 abrasion, 12 single ulcer, 25 nonspecific erythema and 12 balanoposthitis with edema and exudation. HSV was found in 33.3%(6/18), 20%(3/15), 37.5%(6/16), 28.6%(2/7), 33.3%(4/12), 20%(5/25) and 50%(6/12) of these lesions, repectively, by PCR, while in 22.2%(4/18), 13.3%(2/15), 25%(4/16), 14.3%(1/7), 33.3%(4/12), 8%(2/25) and 41.7%(5/12), repectively, by viral culture. The positive rates of HSV from all these non-herpetic lesions were 30.5% (32/105) and 21% (22/105), respectively (? = 0.095, P = 0.114), by PCR and viral culture. The results of HSV typing were consistent between PCR and immunofluorescence with type-specific monoclonal antibodies. Among those with HSV infections, HSV-1 infection acounted for 9.4% (3/32), and HSV-2 90.6% (29/32). Conclusions The clinical manifestations of genital HSV infections vary, and HSV could be isolated from lesions of induration (furuncle), fissure, folliculitis, abrasion, single ulcer, nonspecific erythema and balanoposthitis with edema and exudation. HSV-2 is the predominant type.