RESUMEN
PURPOSE: Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Mycoplasma hominis (MH), the three most common treatable bacterial sexually transmitted infections (STIs) worldwide can lead to many complications if remain untreated. Screening of high-risk population with highly sensitive methods will lead to significant improvement in patient outcomes and will prevent downward transmission. The advantages of Polymerase chain reaction (PCR) based assay are not only high sensitivity and specificity, but also detection of multiple organisms in a single reaction which reduce the result turn-around time. The aim of the present study was to evaluate the feasibility of a multiplex PCR assay method targeting 16S rRNA gene for simultaneous detection of NG, CT and MH infection along with their trend and occurrence among high-risk population in Assam, Northeast India. METHODS: A cross-sectional study was undertaken, where a total of 200 randomly selected patients from high-risk population were included. After validation of singleplex PCR, Multiplex PCR (M-PCR) was performed along with the traditional culture method for NG. RESULTS & CONCLUSION: The overall agreement of M-PCR with singleplex PCR was very high (100%). The occurrence of STI was found to be very high (101/200; 50.5%). Furthermore, co-infection was detected in 10/200; 5%) individuals. Infection was more common among young individuals (p < 0.05) and males out-numbered females (p < 0.05). The most common organism detected was CT (42/200; 21%) followed by NG (41/200; 20.5%) and MH (20/200; 10%). The M-PCR assay workflow is simple, cost effective and can be used in routine diagnostic laboratories with basic molecular facilities.
Asunto(s)
Chlamydia trachomatis , Neisseria gonorrhoeae , Sensibilidad y Especificidad , Humanos , India , Femenino , Masculino , Adulto , Estudios Transversales , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Reacción en Cadena de la Polimerasa Multiplex/métodos , Reacción en Cadena de la Polimerasa Multiplex/economía , Adulto Joven , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Diagnóstico Molecular/economía , ARN Ribosómico 16S/genética , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Reacción en Cadena de la Polimerasa/métodos , Reacción en Cadena de la Polimerasa/economía , Mycoplasma hominis/genética , Mycoplasma hominis/aislamiento & purificación , Adolescente , Persona de Mediana Edad , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/microbiologíaRESUMEN
Sexually transmitted infections (STIs) have been part of human life since ancient times, and their symptoms affect quality of life, and sequelae are common. Socioeconomic and behavioural trends affect the prevalence of STIs, but the discovery of antimicrobials gave hope for treatment, control of the spread of infection and lower rates of sequelae. This has to some extent been achieved, but increasing antimicrobial resistance and increasing transmission in high-risk sexual networks threaten this progress. For Neisseria gonorrhoeae, the only remaining first-line treatment (with ceftriaxone) is at risk of becoming ineffective, and for Mycoplasma genitalium, for which fewer alternative antimicrobial classes are available, incurable infections have already been reported. For Chlamydia trachomatis, in vitro resistance to first-line tetracyclines and macrolides has never been confirmed despite decades of treatment of this highly prevalent STI. Similarly, Treponema pallidum, the cause of syphilis, has remained susceptible to first-line penicillin.
Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana , Enfermedades Bacterianas de Transmisión Sexual , Humanos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Enfermedades Bacterianas de Transmisión Sexual/tratamiento farmacológico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Neisseria gonorrhoeae/efectos de los fármacos , Chlamydia trachomatis/efectos de los fármacos , Mycoplasma genitalium/efectos de los fármacos , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/microbiologíaRESUMEN
The public health value of whole genome sequencing (WGS) for Shigella spp. in England has been limited by a lack of information on sexual identity and behavior. We combined WGS data with other data sources to better understand Shigella flexneri transmission in men who have sex with men (MSM). WGS data for all S. flexneri isolates referred to the national reference laboratory were linked to i) clinical and behavioral data collected in seven of 21 health regions in England using a standardized exposure questionnaire and, ii) national HIV surveillance data. We included 926 S. flexneri isolates, of which 43.0% (n = 398) fell phylogenetically within two domestically circulating clades associated with genotypic markers of azithromycin resistance. Approximately one third of isolates in these clades were from people living with HIV, primarily acquired through sex between men. 182 (19.7%) isolates had linked questionnaire data; 88% (84/95) of MSM isolates fell phylogenetically within the domestically circulating clades, while 92% (72/78) of isolates from other cases fell within lineages linked with travel to high-risk regions. There was no evidence of sustained transmission between networks of MSM and the wider community. MSM were more likely to be admitted to hospital and receive antimicrobials. Our study emphasizes the importance of sex between men as a major route of transmission for S. flexneri. Combined WGS, epidemiological and clinical data provide unique insights that can inform contact tracing, clinical management and the delivery of targeted prevention activities. Future studies should investigate why MSM experience more severe clinical outcomes. IMPORTANCE Within the last 2 decades there have been an increasing number of Shigella spp. outbreaks among men who have sex with men (MSM) worldwide. In 2015, Public Health England (PHE) introduced routine whole genome sequencing (WGS) for the national surveillance of Shigella spp. However, the lack of information on sexual identity and behavior has hindered interpretation. Our study illustrates the power of linking WGS data with epidemiological, behavioral, and clinical data. We provide unique population-level insights into different transmission networks that can inform the delivery of appropriate public health interventions and patient management. Furthermore, we describe and compare clinical characteristics and outcomes of S. flexneri infection in MSM and other exposure groups. We found that MSM were more likely to be admitted to hospital and receive antimicrobials, indicating that their infections were potentially more severe. The exact reasons for this are unclear and require further exploration.
Asunto(s)
Disentería Bacilar/epidemiología , Disentería Bacilar/transmisión , Homosexualidad Masculina/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Shigella flexneri/aislamiento & purificación , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Trazado de Contacto , Brotes de Enfermedades/estadística & datos numéricos , Farmacorresistencia Bacteriana/genética , Disentería Bacilar/microbiología , Inglaterra/epidemiología , Femenino , Variación Genética/genética , Genoma Bacteriano/genética , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Bacterianas de Transmisión Sexual/transmisión , Shigella flexneri/genética , Encuestas y Cuestionarios , Secuenciación Completa del Genoma , Adulto JovenRESUMEN
National surveillance of shigellosis in England revealed an increase in sexually transmitted Shigella flexneri in adult males in 2019 that persisted throughout 2020. We observed a resurgence of azithromycin-resistant S. flexneri serotype 3a, and the emergence of two novel multidrug-resistant clades of S. flexneri 2a and S. flexneri 1b.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple , Disentería Bacilar , Enfermedades Bacterianas de Transmisión Sexual , Shigella flexneri/aislamiento & purificación , Adulto , Disentería Bacilar/epidemiología , Disentería Bacilar/microbiología , Inglaterra/epidemiología , Homosexualidad Masculina , Humanos , Masculino , Serogrupo , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiologíaRESUMEN
Gardnerella vaginalis in association with anaerobes has been linked to bacterial vaginosis in women, while urinary tract infections (UTIs) in men have rarely been reported. The aim of the review was to reveal the significance of G. vaginalis UTIs in men. Prevalence of G. vaginalis UTIs in men varied from 0.5 to >27% according to patients' groups. Most patients had comorbidity such as urolithiasis or stents, transplants, tumors and diabetes, however, infections can also affect immunocompetent patients. We observed G. vaginalis-associated bacteriuria and leukocyturia in a kidney transplant man. Complications of the UTIs such as bacteremia (in 9/11 cases), hydronephrosis (4/11) and abscesses or septic emboli have been reported. Bacterial vaginosis in female partners has been a risk factor for UTIs in males. In women, biofilm Gardnerella phenotype, stabilized by Atopobium vaginae and Prevotella bivia was linked to ≥6-fold higher antibiotic resistance rates compared with the planktonic phenotype. Non-susceptibility to metronidazole and levofloxacin was found also in males. Therefore, if aerobic urine cultures are negative, urine and blood samples from male patients with predisposing factors and clinical signs of UTIs and bacteremia, can be taken. Plates should be incubated for 2-4 days in capnophilic/microaerophilic conditions, however only anaerobic incubation can help with detecting G. vaginalis strains which grow only anaerobically. Susceptibility testing of the isolates is highly important. Briefly, adherent G. vaginalis phenotype can be sexually transmissible. Despite the infrequency of G. vaginalis UTIs in men, the infections should be considered since they are often linked to severe complications.
Asunto(s)
Gardnerella vaginalis , Infecciones por Bacterias Grampositivas/microbiología , Infecciones por Bacterias Grampositivas/transmisión , Infecciones Urinarias/microbiología , Manejo de la Enfermedad , Susceptibilidad a Enfermedades , Femenino , Gardnerella vaginalis/efectos de los fármacos , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/epidemiología , Humanos , Masculino , Prevalencia , Factores de Riesgo , Factores Sexuales , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Bacterianas de Transmisión Sexual/transmisión , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/epidemiología , Infecciones Urinarias/transmisión , Vaginosis Bacteriana/microbiologíaRESUMEN
Reactive arthritis is an extremely rare spondyloarthritis that affects the peripheral joints and spine, resulting in common symptoms such as arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. On rare occasions, oral lesions such as circinate erosions on the hard and soft palate, gums, tongue, and cheeks may occur. Reactive arthritis may develop during or after genitourinary or gastrointestinal bacterial infections such as Shigella, Salmonella, Yersinia, and Chlamydia. A 36-year-old man presented with circinate balanitis, urethral discharge, oligoarthralgia, conjunctivitis, lymphadenopathy, pharyngitis, and erythematous lesions on the palate. Culture examination showed presence of Neisseria gonorrhoeae and antibiotic treatment resulted in improvement of conjunctivitis and the lesions on the penis. However, severe oligoarthralgia, palatal erosions that increased in severity and size, and depilated areas on the tongue were observed. The definitive diagnosis was reactive arthritis. The prevalence of sexually transmitted infections is increasing, highlighting the need to increase awareness of associated risks such as reactive arthritis. Moreover, consideration of non-specific oral manifestations in a systemic context may aid in effective diagnosis and treatment, suggesting the need for multidisciplinary teams.
Asunto(s)
Artritis Reactiva/patología , Adulto , Artritis , Artritis Reactiva/tratamiento farmacológico , Artritis Reactiva/microbiología , Balanitis/microbiología , Balanitis/patología , Conjuntivitis Bacteriana/microbiología , Conjuntivitis Bacteriana/patología , Gonorrea/microbiología , Humanos , Masculino , Enfermedades de la Boca/microbiología , Enfermedades de la Boca/patología , Neisseria gonorrhoeae/aislamiento & purificación , Faringitis/microbiología , Faringitis/patología , Articulación Sacroiliaca/patología , Enfermedades Bacterianas de Transmisión Sexual/tratamiento farmacológico , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Bacterianas de Transmisión Sexual/patología , Dolor de Hombro , Sexo Inseguro , Enfermedades Uretrales/microbiologíaRESUMEN
The obligate intracellular pathogen Chlamydia trachomatis (Ct) is the leading cause of bacterial sexually transmitted infections and blindness globally. To date, Ct urogenital strains are considered tryptophan prototrophs, utilizing indole for tryptophan synthesis within a closed-conformation tetramer comprised of two α (TrpA)- and two ß (TrpB)-subunits. In contrast, ocular strains are auxotrophs due to mutations in TrpA, relying on host tryptophan pools for survival. It has been speculated that there is strong selective pressure for urogenital strains to maintain a functional operon. Here, we performed genetic, phylogenetic, and novel functional modeling analyses of 595 geographically diverse Ct ocular, urethral, vaginal, and rectal strains with complete operon sequences. We found that ocular and urogenital, but not lymphogranuloma venereum, TrpA-coding sequences were under positive selection. However, vaginal and urethral strains exhibited greater nucleotide diversity and a higher ratio of nonsynonymous to synonymous substitutions [Pi(a)/Pi(s)] than ocular strains, suggesting a more rapid evolution of beneficial mutations. We also identified nonsynonymous amino acid changes for an ocular isolate with a urogenital backbone in the intergenic region between TrpR and TrpB at the exact binding site for YtgR-the only known iron-dependent transcription factor in Chlamydia-indicating that selective pressure has disabled the response to fluctuating iron levels. In silico effects on protein stability, ligand-binding affinity, and tryptophan repressor (TrpR) affinity for single-stranded DNA (ssDNA) measured by calculating free energy changes (ΔΔG) between Ct reference and mutant tryptophan operon proteins were also analyzed. We found that tryptophan synthase function was likely suboptimal compared to other bacterial tryptophan prototrophs and that a diversity of urogenital strain mutations rendered the synthase nonfunctional or inefficient. The novel mutations identified here affected active sites in an orthosteric manner but also hindered α- and ß-subunit allosteric interactions from distant sites, reducing efficiency of the tryptophan synthase. Importantly, strains with mutant proteins were inclined toward energy conservation by exhibiting an altered affinity for their respective ligands compared to reference strains, indicating greater fitness. This is not surprising as l-tryptophan is one of the most energetically costly amino acids to synthesize. Mutations in the tryptophan repressor gene (trpR) among urogenital strains were similarly detrimental to function. Our findings indicate that urogenital strains are evolving more rapidly than previously recognized with mutations that impact tryptophan operon function in a manner that is energetically beneficial, providing a novel host-pathogen evolutionary mechanism for intracellular survival.IMPORTANCEChlamydia trachomatis (Ct) is a major global public health concern causing sexually transmitted and ocular infections affecting over 130 million and 260 million people, respectively. Sequelae include infertility, preterm birth, ectopic pregnancy, and blindness. Ct relies on available host tryptophan pools and/or substrates to synthesize tryptophan to survive. Urogenital strains synthesize tryptophan from indole using their intact tryptophan synthase (TS). Ocular strains contain a trpA frameshift mutation that encodes a truncated TrpA with loss of TS function. We found that TS function is likely suboptimal compared to other tryptophan prototrophs and that urogenital stains contain diverse mutations that render TS nonfunctional/inefficient, evolve more rapidly than previously recognized, and impact operon function in a manner that is energetically beneficial, providing an alternative host-pathogen evolutionary mechanism for intracellular survival. Our research has broad scientific appeal since our approach can be applied to other bacteria that may explain evolution/survival in host-pathogen interactions.
Asunto(s)
Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/genética , Variación Genética , Mutación , Operón/genética , Filogenia , Triptófano Sintasa/metabolismo , Triptófano/metabolismo , Chlamydia trachomatis/clasificación , Chlamydia trachomatis/patogenicidad , Infecciones Bacterianas del Ojo/microbiología , Femenino , Enfermedades Urogenitales Femeninas/microbiología , Regulación Bacteriana de la Expresión Génica , Geografía , Interacciones Huésped-Patógeno , Humanos , Embarazo , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Transcripción Genética , Triptófano/clasificación , Triptófano/genética , Triptófano Sintasa/genéticaRESUMEN
OBJECTIVE: This study aimed to investigate the prevalence of sexually transmitted infections (STIs) and colonizing bacteria in relation to urogenital symptoms. MATERIALS AND METHODS: In this cross-sectional study, patients visiting the STI clinic at Umeå University Hospital were asked for symptoms and condom use. Samples from 759 patients (465 male and 294 female) were analyzed for 4 STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium) and 3 colonizing bacteria (Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum). RESULTS: Chlamydia trachomatis prevalence was 11% among women and 9.5% among men. Neisseria gonorrhoeae prevalence was 0.7% among women and 0.9% among men. Mycoplasma genitalium was found in 11% and 5.6% of women and men, respectively. Asymptomatic men and women had similar distribution patterns of microorganisms as those with urogenital symptoms, with the exceptions of Neisseria gonorrhoeae- and Mycoplasma genitalium-infected men who declared symptoms more frequently. Of 158 men with urogenital symptoms, 55% were test-negative. Of 129 women with urogenital symptoms, 12% were test-negative. CONCLUSIONS: This study reveals a complex picture, where a large number of multi-positive tests made it complicated to correlate urogenital symptoms with microorganisms. A high number of test-negative but symptomatic patients indicate a need of searching for additional pathogens.
Asunto(s)
Enfermedades Urogenitales Femeninas/microbiología , Enfermedades Urogenitales Masculinas/microbiología , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Adulto , Anciano , Bacterias/aislamiento & purificación , Chlamydia trachomatis/aislamiento & purificación , Estudios Transversales , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Mycoplasma genitalium/aislamiento & purificación , Neisseria gonorrhoeae/aislamiento & purificación , Suecia , Trichomonas vaginalis/aislamiento & purificación , Adulto JovenRESUMEN
The cultural diagnosis of the causal agent of contagious equine metritis (Taylorella equigenitalis) using transport swabs is challenging. Swabs must be placed in Amies charcoal medium, refrigerated during transport, and plated out at the laboratory no later than 48 h after sampling. In this study, the viability of T. equigenitalis strain CIP 79.7T in 11 commercial swab transport systems was initially compared at 1 day and 2 days of storage at ambient (20 ± 3 °C) or refrigerated (5 ± 3 °C) temperature. The four best swab transport systems, systems B, E, F (used as the reference) and K, were then compared at 0, 2, 3, 4, 7 and 10 days at refrigerated temperatures. Statistically significant differences were observed after 10 days only for system K compared to the reference, with approximately 95% viable T. equigenitalis recovered in system K compared to approximately 77% in system F. System K is thus promising for preservation and transport of viable T. equigenitalis for culture.
Asunto(s)
Endometritis/veterinaria , Infecciones por Bacterias Gramnegativas/veterinaria , Enfermedades de los Caballos/microbiología , Preservación Biológica/veterinaria , Enfermedades Bacterianas de Transmisión Sexual/veterinaria , Taylorella equigenitalis/fisiología , Animales , Endometritis/microbiología , Femenino , Infecciones por Bacterias Gramnegativas/microbiología , Caballos , Preservación Biológica/instrumentación , Preservación Biológica/métodos , Refrigeración , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Manejo de Especímenes/instrumentación , Manejo de Especímenes/métodos , Manejo de Especímenes/veterinariaRESUMEN
Mycoplasma genitalium is a widespread sexually transmitted infection (STI) with growing rate of antimicrobials resistance. In our study, 137 vaginal and 131 urethral M. genitalium-positive swabs were sequentially collected through the work of Reference Center for STI during 2019. For prevalence evaluation of macrolide-resistance mutations three commercially available kits were used: AmpliSens® M. genitalium-ML/FQ-Resist-FL (Central Research Institute of Epidemiology, Russia), ResistancePlus® MG (SpeeDx, Australia), and S-DiaMGRes™ (Diagenode, Belgium). Macrolide resistance mutations were detected in 16% (43 of 268) of samples. Diagnostic characteristics were evaluated against Sanger sequencing. For AmpliSens® M. genitalium-ML/FQ-Resist-FL specificity was shown to be 100% (CI 95%, 98.4-100), and sensitivity was 90.7% (CI 95%, 77.9-97.4). ResistancePlus® MG specificity was 100% (CI 95%, 98.3-100), and sensitivity was 92.1% (CI 95%, 78.6-98.3). S-DiaMGRes™ specificity was shown to be 88.6% (CI 95%, 83.9-92.4), and sensitivity was 100% (CI 95%, 84.4-100). Mutations of parC gene region were detected in 14.5% (38 of 268) using AmpliSens® M. genitalium-ML/FQ-Resist-FL with further validation by Sanger sequencing. Of studied samples, 6.3% (17 of 268) contained both antimicrobials of class resistance mutations. Prevalence of macrolide-resistant M. genitalium in Moscow was 21.7% (23 of 106) and of fluoroquinolone-resistant M. genitaliuim was 20.8% (22 of 106). In Moscow region, macrolide-resistant M. genitalium were 12.3% (20 of 162) and 9.9% (16 of 162) of fluoroquinolone-resistant M. genitalium. All three kits can be used both for epidemiological monitoring of M. genitalium presence and mutation prevalence estimation. In Moscow, macrolide- and fluoroquinolone-resistant mutant prevalence increased in 3.9 and 2.7 times in 3 years.
Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Infecciones por Mycoplasma/inmunología , Mycoplasma genitalium/efectos de los fármacos , Reacción en Cadena de la Polimerasa/métodos , Adulto , Femenino , Humanos , Masculino , Moscú/epidemiología , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/microbiología , Mycoplasma genitalium/genética , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiologíaRESUMEN
The use of azithromycin for the treatment of Mycoplasma genitalium infections has led to resistance to macrolides. From July 2014 to July 2020, 7150 samples were analysed for the detection of sexually transmitted infections at the Policlinico of Bari. A total of 67/7150 samples (0.93%) were positive for MG DNA and 47 samples were analysed for the evaluation of six azithromycin resistance-associated mutations. In 5/47 samples, the A2058G mutation was detected (10.63%). Although the cases of positive MG samples and mutations are low in our reality, diagnostic tests to detect azithromycin resistant-associated genes may provide a convenient way to monitor resistance rate.
Asunto(s)
Antibacterianos/farmacología , Azitromicina/farmacología , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/microbiología , Mycoplasma genitalium/efectos de los fármacos , Farmacorresistencia Bacteriana Múltiple , Hospitales , Humanos , Italia/epidemiología , Prevalencia , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiologíaRESUMEN
Rab proteins belong to the Ras superfamily of small monomeric GTPases. These G proteins are the main controllers of vesicular transport in every tissue, among them, the endometrium. They are in charge of to the functional subcellular compartmentalization and cargo transport between organelles and the plasma membrane. In turn, intracellular trafficking contributes to endometrial changes during the menstrual cycle, secretion to the uterine fluid, and trophoblast implantation; however, few reports analyze the role of Rab proteins in the uterus. In general, Rab proteins control the release of cytokines, growth factors, enzymes, hormones, cell adhesion molecules, and mucus. Further, the secretion of multiple compounds into the uterine cavity is required for successful implantation. Therefore, alterations in Rab-controlled intracellular transport likely impair secretory processes to the uterine fluid that may correlate with abnormal endometrial development and failed reproductive outcomes. Overall, they could explain recurrent miscarriages, female infertility, and/or assisted reproductive failure. Interestingly, estrogen (E2) and progesterone (P) regulate gene expression of Rab proteins involved in secretory pathways. This review aims to gather information regarding the role of Rab proteins and intracellular trafficking in the endometrium during the different menstrual phases, and in the generation of a receptive stage for embryo implantation, modulated by E2 and P. This knowledge might be useful for the development of novel reproductive therapies that overcome low implantation rates of assisted reproductive procedures.
Asunto(s)
Endometrio/metabolismo , Ciclo Menstrual/metabolismo , Proteínas de Unión al GTP rab/metabolismo , Animales , Endometrio/microbiología , Endometrio/virología , Estradiol/metabolismo , Femenino , Interacciones Huésped-Patógeno , Humanos , Progesterona/metabolismo , Transporte de Proteínas , Enfermedades Bacterianas de Transmisión Sexual/metabolismo , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Virales de Transmisión Sexual/metabolismo , Enfermedades Virales de Transmisión Sexual/virologíaRESUMEN
BACKGROUND: Antimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China. METHODS: A total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA). RESULTS: 98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I). CONCLUSIONS: The high antimicrobial resistance rate of M. genitalium in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.
Asunto(s)
Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana Múltiple/genética , Fluoroquinolonas/uso terapéutico , Macrólidos/uso terapéutico , Mutación , Infecciones por Mycoplasma/tratamiento farmacológico , Mycoplasma genitalium/genética , Enfermedades Bacterianas de Transmisión Sexual/tratamiento farmacológico , China/epidemiología , Girasa de ADN/genética , Topoisomerasa de ADN IV/genética , ADN Bacteriano/genética , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Femenino , Humanos , Masculino , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/microbiología , Mycoplasma genitalium/aislamiento & purificación , Prevalencia , ARN Ribosómico 23S/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiologíaRESUMEN
Mycoplasma species can colonize the urogenital tract of dairy cattle. However, interrelationships between Mycoplasma spp. and reproductive performance in dairy herds are unclear. In this study, we measured apparent prevalences of Mycoplasma spp. in the vaginas of dairy cows (n = 629) pre- and post-bull exposure in dairy herds with and without Mycoplasma bovis clinical disease (n = 5 herds), and assessed associations between variables describing reproductive performance and consequent Mycoplasma spp. isolation. Mycoplasma spp. were infrequently isolated from the vagina pre- (1.9%; 12/629) and post-bull (3.2%; 20/629) exposure. Of the mycoplasmas isolated, Mycoplasma bovigenitalium was isolated most frequently (87.5%; 28/32), followed by Mycoplasma californicum (9.3%; 3/32). Mycoplasma bovis was only isolated from one cow. We were unable to provide any evidence of venereal transmission of M. bovis in cows in M. bovis-infected herds that use natural service bulls. There was an insufficient number of cows with Mycoplasma spp. in the vagina pre-bull exposure to assess effects on subsequent reproductive performance. Cows that had not conceived before post-bull exposure sampling had much greater odds (odds ratio 14.8; 95% confidence interval 4.2 to 52.3) of having a Mycoplasma sp. isolated from the vagina at this time compared with those that had conceived. Also, within those that had conceived, delayed conception increased the odds of having a Mycoplasma spp. isolated from the vagina at the post-bull exposure sampling by a factor of 1.62 for every additional week not pregnant. The likely cause of these findings is that cows that remain not pregnant for longer are more likely to be served by a bull (likely repeatedly) and subsequently become colonized with a Mycoplasma sp. (mostly M. bovigenitalium) through venereal transmission. In dairy herds that use bulls, there is a greater chance of isolating a Mycoplasma sp. (mostly M. bovigenitalium) after a period of bull breedings from the vaginas of cows that have remained nonpregnant for longer during the bull breeding period.
Asunto(s)
Enfermedades de los Bovinos/microbiología , Infecciones por Mycoplasma/veterinaria , Mycoplasma/aislamiento & purificación , Enfermedades Bacterianas de Transmisión Sexual/veterinaria , Animales , Bovinos , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/transmisión , Femenino , Fertilización , Masculino , Mycoplasma/clasificación , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/microbiología , Infecciones por Mycoplasma/transmisión , Mycoplasma bovis/aislamiento & purificación , Embarazo , Prevalencia , Reproducción , Enfermedades Bacterianas de Transmisión Sexual/microbiologíaRESUMEN
Pubic hair grooming is common in many countries, but little is known about this practice in Africa. Grooming has been positively associated with self-reported sexually transmitted infections (STIs). This study aimed to investigate the prevalence and safety of pubic hair grooming in two South African settings. In KwaZulu-Natal province, 1218 women participating in the Evidence for Contraceptive Options and HIV Outcomes Trial completed an interviewer-administered questionnaire on pubic hair grooming practices, and were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and herpes simplex virus type 2 (HSV-2). Pubic hair removal was reported by 705 (58.2%) of women. Common areas for grooming were the pubis (n = 616, 99.4%), vagina/perineum (n = 529, 85.3%) and inner thigh (n = 255, 41.1%). Half (n= 361, 51.4%) removed some or all of their pubic hair at least monthly and 59 (8.4%) once a week or more often. Common side effects reported included itching (n = 439, 77.1%) and pimples and blisters (n = 249, 43.9%). A quarter (n = 173, 24.5%) of groomers had a positive result for either or both of CT and NG compared to a fifth (n = 98, 19.4%) of non-groomers (p-value < 0.033). There was no difference between the groups for HSV-2. After adjusting for age and having more than one sex partner, groomers were significantly more likely to have CT or NG than non-groomers (OR: 1.31; 95% CI: 1.19-1.45). Similarly, those who experienced hair removal-related complications had 1.26 times the odds of testing positive for CT or NG (95% CI: 1.03-1.54). The practice of pubic hair removal is common and reporting of side effects is high in this population. These injuries could put women at a higher risk of STIs.
Asunto(s)
Infecciones por Chlamydia/complicaciones , Genitales Femeninos/lesiones , Genitales Masculinos/lesiones , Gonorrea/complicaciones , Remoción del Cabello/efectos adversos , Herpes Genital/complicaciones , Conducta Sexual/estadística & datos numéricos , Adulto , Animales , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Chlamydia trachomatis , Estudios Transversales , Femenino , Gonorrea/epidemiología , Gonorrea/microbiología , Herpes Genital/epidemiología , Herpesvirus Humano 2 , Humanos , Laceraciones/microbiología , Masculino , Neisseria gonorrhoeae , Prevalencia , Parejas Sexuales , Enfermedades Bacterianas de Transmisión Sexual/complicaciones , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Sudáfrica/epidemiologíaRESUMEN
BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy. CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood. CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.
Asunto(s)
Melioidosis/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Aborto Espontáneo , Adulto , Antibacterianos/uso terapéutico , Burkholderia pseudomallei/aislamiento & purificación , Femenino , Humanos , Melioidosis/tratamiento farmacológico , Melioidosis/microbiología , Embarazo , Enfermedades Bacterianas de Transmisión Sexual/tratamiento farmacológico , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Vagina/microbiologíaAsunto(s)
Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Gonorrea/epidemiología , Infecciones por Mycoplasma/epidemiología , Mycoplasma genitalium/aislamiento & purificación , Neisseria gonorrhoeae/aislamiento & purificación , Vagina/microbiología , Adolescente , Adulto , Brasil/epidemiología , Infecciones por Chlamydia/diagnóstico , Estudios Transversales , Femenino , Gonorrea/diagnóstico , Humanos , Tamizaje Masivo , Persona de Mediana Edad , Infecciones por Mycoplasma/diagnóstico , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiologíaRESUMEN
Urethritis, or inflammation of the urethra, is one of the most common reasons men seek clinical care. Sexually transmitted pathogens including Neisseria gonorrhoeae are responsible for over half of the symptomatic urethritis cases in U.S. men. Recently, clinics in Indianapolis, Columbus, Atlanta, and other U.S. cities began to note increasing numbers of men presenting with urethritis and Gram-negative intracellular diplococci in their urethral smears who test negative for N. gonorrhoeae. Many of these discordant cases, which have periodically reached highs of more than 25% of presumed gonococcal cases in some sexually transmitted infection clinics in the U.S. Midwest, are infected with strains in a novel urethrotropic clade of Neisseria meningitidis ST-11 (US_NmUC). However, no cultivation-independent tests are available for the US_NmUC strains, and prior studies relied on microbial culture and genome sequencing to identify them. Here, we describe a PCR test that can identify the US_NmUC strains and distinguish them from commensal and invasive N. meningitidis strains as well as N. gonorrhoeae. Our SimpleProbe®-based real-time PCR assay targets a conserved nucleotide substitution in a horizontally acquired region of US_NmUC strain genomes. We applied the assay to 241 urine specimens whose microbial compositions had previously been determined by deep shotgun metagenomic sequencing. The assay detected the single US_NmUC positive case in this cohort, with no false positives. Overall, our simple and readily adaptable assay could facilitate investigation of the pathogenesis and epidemiology of the US_NmUC clade.
Asunto(s)
Neisseria meningitidis/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Uretritis/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Reacciones Falso Positivas , Gonorrea/diagnóstico , Gonorrea/epidemiología , Gonorrea/microbiología , Gonorrea/orina , Humanos , Masculino , Persona de Mediana Edad , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Neisseria meningitidis/clasificación , Neisseria meningitidis/aislamiento & purificación , Polimorfismo de Nucleótido Simple , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Bacterianas de Transmisión Sexual/orina , Estados Unidos/epidemiología , Uretra/microbiología , Uretra/patología , Uretritis/diagnóstico , Urinálisis/métodos , Secuenciación Completa del Genoma , Adulto JovenAsunto(s)
Condones/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Profilaxis Pre-Exposición , Conducta Sexual/psicología , Parejas Sexuales , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Adulto , Anciano , Alabama/epidemiología , Infecciones por Chlamydia/epidemiología , Gonorrea/epidemiología , Infecciones por VIH/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Prevalencia , Estudios Retrospectivos , Conducta Sexual/estadística & datos numéricos , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Sífilis/epidemiologíaRESUMEN
Mycoplasma genitalium is a fastidious organism of the class Mollicutes, the smallest prokaryote capable of independent replication. First isolated in 1981, much is still unknown regarding its natural history in untreated infection. It is recognized as a sexually transmitted pathogen causing acute and chronic non-gonococcal urethritis (NGU) in men, with a growing body of evidence to suggest it also causes cervicitis and pelvic inflammatory disease in women. Its role in several other clinical syndromes is uncertain. The majority of people infected remain asymptomatic and clear infection without developing disease; asymptomatic screening is therefore not recommended. Prevalence rates are higher in patients attending sexual health clinics and in men with NGU. Limited availability of diagnostics has encouraged syndromic management, resulting in widespread antimicrobial resistance and given that few antimicrobial classes have activity against M. genitalium, there is significant concern regarding the emergence of untreatable strains. There is a need for wider availability of testing, which should include detection of macrolide resistance mediating mutations. Expertise in interpretation of microbiological results with clinical correlation ensures targeted treatment avoiding unnecessary antibiotic exposure. Public health surveillance nationally and internationally is vital in monitoring and responding to changing epidemiology trends. In this review, we summarize current knowledge of M. genitalium, including epidemiology, clinical and microbiological data, and discuss treatment challenges in the era of rising multidrug resistance.