Assessing Sexually Transmitted Infections and HIV Risk Among Transgender Women in Lima, Peru: Beyond Behavior.

Purpose: The purpose of this study was to explore risk factors for HIV and sexually transmitted infections (STIs) among transgender women (TW) in Lima, Peru. Methods: HIV-negative or serostatus unknown TW reporting recent condomless receptive anal intercourse underwent testing for STIs and HIV and completed a sociobehavioral survey. Results: Among 120 TW, 29.6% had rectal Neisseria gonorrhoeae (GC) or Chlamydia trachomatis (CT) and 12.6% had HIV. Age and migrant status were associated with rectal GC/CT, and rectal GC/CT predicted HIV infection. Conclusions: Further study is needed to understand individual and social factors that contribute to HIV/STI vulnerability among TW.

Antimicrobial resistance in Neisseria gonorrhoeae: history, molecular mechanisms and epidemiological aspects of an emerging global threat

ABSTRACT Neisseria gonorrhoeae is the agent of gonorrhea, a sexually transmitted infection with an estimate from The World Health Organization of 78 million new cases in people aged 15-49 worldwide during 2012. If left untreated, complications may include pelvic inflammatory disease and infertility. Antimicrobial treatment is usually effective; however, resistance has emerged successively through various molecular mechanisms for all the regularly used therapeutic agents throughout decades. Detection of antimicrobial susceptibility is currently the most critical aspect for N. gonorrhoeae surveillance, however poorly structured health systems pose difficulties. In this review, we compiled data from worldwide reports regarding epidemiology and antimicrobial resistance in N. gonorrhoeae, and highlight the relevance of the implementation of surveillance networks to establish policies for gonorrhea treatment.(AU)

High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru.

OBJECTIVES: This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. SETTING: Cross-sectional study in Lima, Peru. PARTICIPANTS: We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. PRIMARY AND SECONDARY OUTCOME MEASURES: Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. RESULTS: Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. CONCLUSIONS: The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. TRIAL REGISTRATION NUMBER: NCT00670163; Results.

Neisseria gonorrhoeae pilus attenuates cytokine response of human fallopian tube explants.

BACKGROUND: A role for pilus during attachment of Neisseria gonorrhoeae to epithelia of the female reproductive tract is currently assumed. However, Pil⁻ gonococci have been observed during infection of the reproductive tract, which prompted us to examine the effect of pili on the dynamics of infection and the inflammatory responses of mucosal explants of the human fallopian tube. METHODS: Mucosal explants were infected in vitro with Opa negative Pil⁻ and Pil⁺N. gonorrhoeae strains. RESULTS: Piliation enhanced gonococcal adherence to the epithelium within 3 h of infection (P < 0.05) but thereafter did not offer advantage to gonococci to colonize the epithelial cell surface (P > 0.05). No differences were found between the strains in numbers of gonococci inside epithelial cells. Pil⁻ bacteria induced higher levels (P < 0.05) of IL-1ß, TNF-α, GM-CSF, MCP-1, and MIP-1ß than Pil⁺ bacteria. There were no differences between both strains in LOS pattern, and Pil expression did not change after coincubation with mucosal strips. CONCLUSIONS: Results show that gonococcal invasion of the human fallopian tube can occur independently of pilus or Opa expression, and suggest that pilus, by inhibition of several key elements of the initial inflammatory response, facilitates sustained infection of this organ.

Unusual phenotypic characteristic of Neisseria gonorrhoeae from male patients who have sex with men.

We describe four isolates of Ng from men who have sex with men (MSM) patients that were able to grow in the abscense of CO2, as previously was described for N. gonorrhoeae ssp. kochii. These isolates were able to grow aerobically (without any added CO2) at 37 degrees C giving small colonies after 48 hs; two of them isolated from pharynx and urethra of one patient, were also able to grow without the blood supplement in the same conditions. In these unusual isolates the major outer-membrane proteins are of the same molecular weight than Ng. These isolates could be taken for other members of the genus if not confirmed by means of these (or other) methods.

[Evaluation of different methods of utilization of sugars in Neisseria gonorrhoeae]. / Evaluación de diferentes métodos de utilización de azúcares en Neisseria gonorrhoeae.

5 methods of utilization of sugars were evaluated in 25 strains previously identified as N. gonorrhoeae: CTA agar, modified CTA agar, gelatin starch agar, Mueller Hinton agar plus bromotimol blue and rapid method. 100% of the strains of N. gonorrhoeae were identified by the CTA and rapid methods, whereas 96% were identified by the modified CTA and gelatin starch agar methods. No strain of gonoccocus was identified by the Mueller Hinton agar method plus bromotimol blue. The cystine tripticase agar medium (CTA) is the elective method to confirm the isolates of Neisseria gonorrhoeae. As it is mainly made by U.S. companies, it is difficult for Cuba to acquire it. The gelatin-starch agar method and the rapid method are useful alternative of the CTA medium, so their use is proposed in this paper.

Filtrados de cultivos de Neisseria gonorrhoeae GC-9(T4) que la protegen del efecto bactericida del suero humano normal / Culture filtrates of Neisseria gonorrhoeae GC-9(T4) that protect it againts the bactericidal effect of normal human serum

Se determinó el efecto bactericida del suero humano normal contra una suspensión de Neisseria gonorrhoeae (GC-9)T4. Se prepararon cultivos del gonococo en caldo GC, en medio de Catlin y en medio de LaScolea y Young (GGM). Los cultivos se filtraron a través de membranas Millipore. A cada filtrado se le probó su efecto protector contra la actividad bactericida del suero humano normal. Los filtrados preparados en medio GGM mostraron un franco efecto protector. La diferencia entre la población bacteriana sobreviviente al efecto bactericida del suero y la población en presencia del suero y del filtrado protector, fue de alrededor de 1.5 logaritmos. Los filtrados preparados en los otros medios no tuvieron ninguna actividad inhibidora del efecto bactericida del suero. Se hicieron algunos experimentos tendientes a determinar la influencia de diversas condiciones de incubación sobre el desarrollo gonocócico y sobre la actividad protectora de los filtros protectores. Todos los filtrados preparados en medio GGM y en diferentes condiciones de incubación mostraron un efecto protector semejante

Agar dilution method for susceptibility testing of Neisseria gonorrhoeae.

The antibiotic susceptibilities of Neisseria gonorrhoeae isolates obtained from patients attending a clinic for sexually transmitted diseases in Tucumán, Argentina, were determined by the agar dilution method (MIC). 3.5% of the isolates produced beta-lactamase. A total of 96.5% of beta-lactamase negative isolates tested were susceptible to penicillin (MIC < or = 2 micrograms/ml-1); 14.03% of the tested isolates were resistant to tetracycline (MIC < or = 2 micrograms/ml-1), and 98% of the tested isolates were susceptible to spectinomycin (MIC < or = 64 micrograms/ml-1). The MICs for 95% of the isolates, tested for other drugs were: < or = 2 micrograms/ml-1 for cefoxitin, < or = 0.06 microgram/ml-1 for cefotaxime, < or = 0.25 microgram/ml-1 for norfloxacin, < or = 10 micrograms/ml-1 for cephaloridine, < or = 10 micrograms/ml-1 for cephalexin, and < or = 50 micrograms/ml-1 for kanamycin. Antibiotic resistance among N. gonorrhoeae isolates from Tucumán, Argentina, appeared to be primarily limited to penicillin and tetracycline, which has been a general use against gonorrhoeae in Tucumán since 1960. Periodic monitoring of the underlying susceptibility profiles of the N. gonorrhoeae strains prevalent in areas of frequent transmission may provide clues regarding treatment options and emerging of drug resistance.

Neisseria gonorrhoeae productora de betalactamasa

De un total de 674 pacientes, 308 hombres y 366 mujeres, se aisló Neisseria gonorrhoeae por cultivo en 27.3 po ciento y 14.2 po ciento para cada sexo respectivamente. A 126 de los aislamientos se les determinó la capacidad de producir betalactamasa, utilizando los métodos iodométrico, acidométrico y de la cefalosporina cromagénica. En 1987, 26 por ciento de los pacientes tenía N. gonorrhoeae productora de betalactamasa, en 1988 fueron 26.3 y en 1989 llegaron a 63.2. Este resultado no es aplicable a la infección gonocóccica en la población general, por ser un grupo altamente seleccionado con problemas de resistencia al tratamiento.