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1.
BMC Infect Dis ; 21(1): 270, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33731049

RESUMEN

BACKGROUND: Neonatal ocular prophylaxis with silver nitrate does not prevent neonatal conjunctivitis due to Chlamydia trachomatis. The efficacy of antibiotic containing preparations for prevention of neonatal chlamydial conjunctivitis (NCC) has not been established. OBJECTIVE: To examine published literature to determine whether antibiotic containing preparation are efficacious for prevention of NCC and C. trachomatis in the nasopharynx. METHODS: A literature search of MEDLINE and EMBASE. Articles were selected for review if their content included 4 key criteria: (1) Prospective/comparative study. (2) Prenatal screening of mothers for C. trachomatis with results reported. (3) Follow-up of infants born to chlamydia-positive women. (4) Infants prospectively followed at regular intervals and tested for C. trachomatis in the eye/ nasopharynx (NP). RESULTS: The search yielded 159 studies; 11 were selected for full reviews, eight were excluded; three addressed the four criteria. Rates of C. trachomatis conjunctivitis in infants in included studies who received silver nitrate was 20-33%; positive NP, 1-28% and pneumonia, 3-8%. Rates of C. trachomatis conjunctivitis in neonates who received erythromycin or tetracycline prophylaxis did not differ from silver nitrate; 0-15 and 11%, respectively, who received erythromycin or tetracycline developed NCC. Similarly, 4-33 and 5% of infants who received erythromycin or tetracycline, respectively, had positive NP cultures; 0-4% developed chlamydial pneumonia. CONCLUSION: Neonatal ocular prophylaxis with erythromycin or tetracycline ophthalmic ointments does not reduce incidence of neonatal chlamydial conjunctivitis or respiratory infection in infants born to mothers with C. trachomatis infection compared to silver nitrate.


Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Conjuntivitis de Inclusión/prevención & control , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/prevención & control , Chlamydia trachomatis/efectos de los fármacos , Chlamydia trachomatis/aislamiento & purificación , Conjuntivitis de Inclusión/diagnóstico , Conjuntivitis de Inclusión/epidemiología , Femenino , Humanos , Incidencia , Recién Nacido , Embarazo
2.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33541962

RESUMEN

Lymphogranuloma venereum (LGV) has been increasingly reported, and many clinicians are familiar with it as a cause of proctocolitis or inguinal adenopathy. On the other hand, LGV is less commonly considered as a cause of isolated genital ulcerative disease in comparison to other etiologies such as syphilis or herpes simplex. We report a case of persistent perianal ulcerations due to LGV in an HIV-positive patient, confirmed by nucleic acid amplification testing.


Asunto(s)
Infecciones por VIH/complicaciones , Homosexualidad Masculina , Linfogranuloma Venéreo/complicaciones , Proctocolitis , Úlcera/etiología , Adulto , Chlamydia trachomatis/aislamiento & purificación , Seropositividad para VIH , Humanos , Masculino
3.
BMC Infect Dis ; 21(1): 95, 2021 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-33478403

RESUMEN

BACKGROUND: Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated. METHODS: This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg). RESULTS: Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic. CONCLUSIONS: Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Mycoplasma genitalium/aislamiento & purificación , Neisseria gonorrhoeae/aislamiento & purificación , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/microbiología , Adolescente , Adulto , Anciano , Canal Anal/microbiología , Estudios Transversales , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Faringe/microbiología , Prevalencia , Reunión/epidemiología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/transmisión , Sistema Urogenital/microbiología , Adulto Joven
5.
PLoS One ; 15(9): e0237424, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32870912

RESUMEN

BACKGROUND: There is a need for a rapid diagnostic point of care test to detect Neisseria gonorrhoeae (NG) infection to prevent incorrect, lack or excess of treatment resulting from current syndromic management in low-resource settings. An assay to identify NG antimicrobial resistance (AMR) is also highly desirable to facilitate antibiotic stewardship. Here we describe the development of two target product profiles (TPPs): one for a test for etiological diagnosis of NG and Chlamydia trachomatis (CT) (TPP1) and one for the detection of NG AMR/susceptibility (TPP2). METHODS: Draft TPPs were initially developed based on a landscape analysis of existing diagnostics and expert input. TPPs were refined via an online Delphi survey with two rounds of input from 68 respondents. TPP characteristics on which <75% of non-industry respondents agreed were further discussed and revised by an expert working group. RESULTS: The need for a test to identify NG in patients with urethral or vaginal discharge was identified as a minimal requirement of TPP1, with a test that can diagnose NG in asymptomatic patients as the optimal requirement. A sensitivity of 80% was considered acceptable, either in context of syndromic management or screening high-risk populations. For TPP2, the agreed minimal requirement was for a test to be used at level 2 healthcare facilities and above, with an optimal requirement of level 1 or above. A lateral flow format was preferred for TPP1, while it was considered likely that TPP2 would require a molecular format. A total of 31 test characteristics were included in TPP1 and 27 in TPP2. CONCLUSIONS: Following the working group revisions, TPPs were posted online for public feedback for two months, and are now finalized. The final TPPs are currently guiding the development of new diagnostics that meet the defined characteristics to reach the market within two years.


Asunto(s)
Infecciones por Chlamydia/diagnóstico , Farmacorresistencia Bacteriana , Gonorrea/diagnóstico , Pruebas en el Punto de Atención , Chlamydia trachomatis/aislamiento & purificación , Pruebas Diagnósticas de Rutina , Humanos , Neisseria gonorrhoeae/aislamiento & purificación
6.
BMC Public Health ; 20(1): 1239, 2020 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-32795362

RESUMEN

BACKGROUND: Repeat Chlamydia trachomatis (CT) infections are common. To better understand the characteristics of patients frequently infected with CT at our sexually transmitted infection (STI) care services, we assessed the differences between patients repeatedly infected with CT and those who repeatedly tested negative. METHODS: In this cross-sectional analysis of cohort data, we assessed individuals tested for CT at different STI care providers between 2011 and mid-2018 in Southwest Limburg, the Netherlands (n = 17,616). Patients with ≥2 repeat CT infections in the study period were categorized as "patients with repeat CT infections." Multivariable logistic regression analyses were performed for the binary outcome measure: patients with repeat CT infections versus patients who repeatedly tested negative (reference group). Additional analyses were performed for only the STI clinic population. RESULTS: Patients aged < 25 years (OR: 1.83; 95%CI:1.38-2.43), co-infected with HIV (OR: 2.07; 95%CI: 1.02-4.22) or co-infected with Neisseria gonorrhoeae (NG) (OR: 5.04; 95%CI: 3.33-7.63) had more repeat CT infections. In additional analyses among exclusively STI clinic visitors, patients with urogenital symptoms (OR: 2.17; 95%CI: 1.41-3.35), and patients notified for STIs (OR: 4.55; 95%CI: 3.17-6.54) had more frequent repeat CT infections. CONCLUSIONS: Patients aged < 25 years and patients coinfected with HIV or NG had more frequent repeat CT infections, accounting for ~ 20% of the diagnosed CT infections. These patients are likely at the highest risk for transmitting and acquiring CT. Therefore, testing and retesting this group remains important to enhance CT control.


Asunto(s)
Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Tamizaje Masivo/estadística & datos numéricos , Adolescente , Adulto , Estudios de Cohortes , Coinfección , Estudios Transversales , Femenino , Gonorrea/epidemiología , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Neisseria gonorrhoeae , Países Bajos/epidemiología , Factores de Riesgo , Adulto Joven
7.
BMC Infect Dis ; 20(1): 589, 2020 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-32770958

RESUMEN

BACKGROUND: Estimating prevalence of Chlamydia trachomatis (CT) worldwide is necessary in designing control programs and allocating health resources. We performed a meta-analysis to calculate the prevalence of CT in the general population. METHODS: The Pubmed and Embase databases were searched for eligible population-based studies from its inception through June 5, 2019. Q test and I2 statistic were used to calculate the heterogeneity between studies. Random effects models were used to pool the prevalence of CT. Meta regression was performed to explore the possible sources of heterogeneity. Publication bias was evaluated using a funnel plot and "trim and fill" method. RESULTS: Twenty nine studies that reported prevalence of CT infection from 24 countries were identified, including a total population of 89,886 persons. The pooled prevalence of CT among the general population was 2.9% (95% CI, 2.4-3.5%), and females had a higher CT prevalence (3.1, 95% CI, 2.5-3.8%) than males (2.6, 95% CI, 2.0-3.2%) (χ2 = 10.38, P <  0.01). Prevalence of CT was highest in region of America (4.5, 95% CI, 3.1-5.9%), especially in Latin America (6.7, 95% CI, 5.0-8.4%), followed by females in region of Africa (3.8, 95% CI, 0.7-6.9%), while South-East Asia had a lowest CT prevalence 0.8% (95% CI, 0.3-1.3%). CONCLUSIONS: This study provided the updated prevalence of CT among general population worldwide. General population from Latin America, especially females, and women in Africa should be given priority by WHO when design and delivery CT control programs.


Asunto(s)
Infecciones por Chlamydia/epidemiología , África/epidemiología , Infecciones por Chlamydia/microbiología , Infecciones por Chlamydia/prevención & control , Chlamydia trachomatis/aislamiento & purificación , Bases de Datos Factuales , Femenino , Humanos , América Latina/epidemiología , Masculino , Prevalencia , Organización Mundial de la Salud
9.
PLoS One ; 15(7): e0236036, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32722712

RESUMEN

The human vagina harbor a rich microbiota. The optimal state is dominated by lactobacilli that help to maintain health and prevent various diseases. However, the microbiota may rapidly change to a polymicrobial state that has been linked to a number of diseases. In the present study, the temporal changes of the vaginal microbiota in patients treated for sexually transmitted diseases or bacterial vaginosis (BV) and in untreated controls were studied for 26 days. The patients included 52 women treated with azithromycin, tetracyclines or moxifloxacin for present or suspected infection with Chlamydia trachomatis or Mycoplasma genitalium. Women with concurrent BV were also treated with metronidazole. The controls were 10 healthy women of matching age. The microbiota was analyzed by 16S rRNA gene deep sequencing, specific qPCRs and microscopy. There was generally good correlation between Nugent score and community state type (CST) and qPCR confirmed the sequencing results. By sequencing, more than 600 different taxa were found, but only 33 constituted more than 1 ‰ of the sequences. In both patients and controls the microbiota could be divided into three different community state types, CST-I, CST-III and CST-IV. Without metronidazole, the microbiota remained relatively stable regarding CST although changes were seen during menstrual periods. Administration of metronidazole changed the microbiota from CST-IV to CST-III in approximately 50% of the treated patients. In contrast, the CST was generally unaffected by azithromycin or tetracyclines. In 30% of the BV patients, Gardnerella vaginalis was not eradicated by metronidazole. The majority of women colonized with Ureaplasma parvum remained positive after azithromycin while U. urealyticum was eradicated.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Chlamydia/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Microbiota/efectos de los fármacos , Infecciones por Mycoplasma/microbiología , Vagina/microbiología , Vaginosis Bacteriana/microbiología , Adolescente , Adulto , Infecciones por Chlamydia/tratamiento farmacológico , Chlamydia trachomatis/efectos de los fármacos , Chlamydia trachomatis/aislamiento & purificación , Femenino , Gardnerella vaginalis/efectos de los fármacos , Gardnerella vaginalis/aislamiento & purificación , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Humanos , Persona de Mediana Edad , Infecciones por Mycoplasma/tratamiento farmacológico , Mycoplasma genitalium/efectos de los fármacos , Mycoplasma genitalium/aislamiento & purificación , Vagina/efectos de los fármacos , Vaginosis Bacteriana/tratamiento farmacológico , Adulto Joven
10.
Pediatrics ; 146(2)2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32636237

RESUMEN

OBJECTIVE: The Centers for Disease Control and Prevention recommend testing for Chlamydia trachomatis in sexually active female patients <25 years old using nucleic-acid amplification tests (NAAT) from a vaginal swab. Our providers were typically testing using the less sensitive urine NAATs. We aimed to increase the percentage of urogenital C trachomatis NAATs performed by using vaginal swabs in adolescent female patients ages 10 through 20 years from 1.4% to 25%. METHODS: We implemented 3 interventions at 3 pediatric practices over 12 months including education, process standardization, and cross-training. We used statistical process control to analyze the effect of interventions on our primary outcome: the percentage of urogenital C trachomatis tests performed with a vaginal swab. Our balance measure was the total number of urogenital C trachomatis tests. RESULTS: There were 818 urogenital C trachomatis tests performed: 289 before and 529 after the first intervention. Of urogenital C trachomatis tests in the preintervention time period, 1.4% were performed by using vaginal swabs. We surpassed our aim of 25% 6 weeks after the first intervention. We noted sustained improvement after the second intervention, with an average of 68.3% of tests performed by using vaginal swabs for the remaining postintervention period. There was no difference in the overall number of urogenital C trachomatis tests pre- and postintervention. CONCLUSIONS: Using quality improvement methodology and implementing easily replicable interventions, we significantly and sustainably increased use of vaginal swabs. The interventions standardizing processes were associated with a higher impact than the educational intervention.


Asunto(s)
Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/aislamiento & purificación , Técnicas de Amplificación de Ácido Nucleico/métodos , Pediatras/educación , Pautas de la Práctica en Medicina/tendencias , Vagina/microbiología , Frotis Vaginal/tendencias , Adolescente , Niño , Infecciones por Chlamydia/epidemiología , Femenino , Humanos , Massachusetts/epidemiología , Técnicas de Amplificación de Ácido Nucleico/estadística & datos numéricos , Folletos , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/estadística & datos numéricos , Utilización de Procedimientos y Técnicas/tendencias , Evaluación de Programas y Proyectos de Salud , Mejoramiento de la Calidad , Conducta Sexual , Adulto Joven
11.
New Microbiol ; 43(3): 115-120, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32656570

RESUMEN

Chlamydia trachomatis and Neisseria gonorrhoeae are the most common agents of bacterial sexually transmitted infections (STIs) worldwide. Here, we evaluated genital and extra-genital C. trachomatis and N. gonorrhoeae infection prevalence in a cohort of young women attending an STI Outpatients Clinic in Italy. From May 2019 to December 2019, 134 women aged 18-26 years were enrolled. A vaginal, a pharyngeal and a rectal swab for the molecular detection of C. trachomatis and N. gonorrhoeae were collected from each patient. Chlamydia-positive samples underwent a molecular genotyping based on pmpH gene. Total prevalence of C. trachomatis and N. gonorrhoeae infections was 17.9% and 11.2%, respectively. Chlamydial infections were prevalent in the urogenital (16.4%) and rectal (13.4%) sites, whereas N. gonorrhoeae predominated in the genital (7.4%) and pharyngeal (6%) mucosa. Overall, 5.2% of cases would have been missed if extra-genital sites had not been tested. Notably, 60% of women with a rectal infection did not report anal sex. A history of sexual contacts with a positive partner (P=0.03) and a history of ≥3 partners in the last 6 months (P=0.0075) were highly predictive of a bacterial STI. No cases of lymphogranuloma venereum were found. These data could help set up effective strategies to prevent the spread of STIs.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Enfermedades de Transmisión Sexual , Adolescente , Adulto , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Femenino , Genitales , Gonorrea/epidemiología , Humanos , Italia/epidemiología , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Prevalencia , Adulto Joven
12.
Arch Gynecol Obstet ; 302(3): 553-567, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32643040

RESUMEN

PURPOSE: To analyze the effect of Chlamydia trachomatis (C. trachomatis) on adverse pregnancy outcomes based on the currently available evidence. METHODS: Multiple databases were comprehensively searched from the available date of inception through December 9, 2019. The effect of C. trachomatis on adverse pregnancy outcomes was assessed using pooled odds rations (ORs) and 95% confidence intervals (CIs). Egger's test was used for publication bias. RESULTS: Fifty studies involving 502,141 participants were identified. C. trachomatis infection was found to be associated with preterm birth in antibody detection [OR (95% CI): 1.571 (1.112-2.220), P = 0.010] and high-quality assessment [OR (95% CI): 1.734 (1.295-2.321), P < 0.001], preterm premature rupture of membranes (PPROM) in culture detection [OR (95% CI): 4.339 (1.806-10.424), P = 0.001] and high-quality assessment [OR (95% CI): 2.822 (1.333-5.973), P = 0.007], stillbirth [OR (95% CI): 1.585 (1.219-2.062), P = 0.001], low-birthweight babies [OR (95% CI): 2.205 (1.137-4.274), P = 0.019], and babies small for gestational age [OR (95% CI): 1.193 (1.091-1.305), P < 0.001]. No publication bias was exhibited in miscarriage (P = 0.170), preterm birth (P = 0.303), PPROM (P = 0.341), stillbirth (P = 0.533), and low-birthweight babies (P = 0.535). CONCLUSIONS: C. trachomatis infection during pregnancy is associated with a higher risk of preterm birth, PPROM, stillbirth, low-birthweight babies, and babies small for gestational age.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Rotura Prematura de Membranas Fetales/epidemiología , Trabajo de Parto Prematuro/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Aborto Espontáneo , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/microbiología , Femenino , Rotura Prematura de Membranas Fetales/microbiología , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/microbiología , Resultado del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Mortinato
13.
J Vis Exp ; (160)2020 06 10.
Artículo en Inglés | MEDLINE | ID: mdl-32597859

RESUMEN

The intracellular bacterial pathogen Chlamydia trachomatis undergoes a developmental cycle consisting of two morphologically discrete developmental forms. The non-replicative elementary body (EB) initiates infection of the host. Once inside, the EB differentiates into the reticulate body (RB). The RB then undergoes multiple rounds of replication, before differentiating back to the infectious EB form. This cycle is essential for chlamydial survival as failure to switch between cell types prevents either host invasion or replication. Limitations in genetic techniques due to the obligate intracellular nature of Chlamydia have hampered identification of the molecular mechanisms involved in the cell-type development. We designed a novel dual promoter-reporter plasmid system that, in conjunction with live-cell microscopy, allows for the visualization of cell type switching in real time. To identify genes involved in the regulation of cell-type development, the live-cell promoter-reporter system was leveraged for the development of a forward genetic approach by combining chemical mutagenesis of the dual reporter strain, imaging and tracking of Chlamydia with altered developmental kinetics, followed by clonal isolation of mutants. This forward genetic workflow is a flexible tool that can be modified for directed interrogation into a wide range of genetic pathways.


Asunto(s)
Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Genómica/métodos , Mutación/genética , Chlamydia trachomatis/crecimiento & desarrollo , Análisis de Datos , Regulación Bacteriana de la Expresión Génica , Genes Reporteros , Humanos , Cinética , Mutagénesis/genética , Fenotipo , Regiones Promotoras Genéticas/genética , Reproducibilidad de los Resultados
14.
Adv Clin Exp Med ; 29(6): 707-713, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32589825

RESUMEN

BACKGROUND: Chlamydia trachomatis (C. trachomatis) and Streptococcus agalactiae (GBS) may be present in the female cervical canal without any symptoms of infection. Chronic chlamydial infections lead to many serious complications and perinatal infections, while the presence of GBS is a reservoir for infections of newborns or invasive streptococcal infection in adults. OBJECTIVES: To examine healthy women for C. trachomatis without symptoms from the reproductive system, assess the frequency of asymptomatic infections, detect GBS in the cervical canal, demonstrate differences in drug susceptibility, and determine the serotype of S. agalactiae strains and correlations among the ones present in the cervical canal. MATERIAL AND METHODS: A total of 315 cervical swabs were collected for genetic and microbiological analysis for the presence of C. trachomatis and S. agalactiae. Latex and diffusion-disk methods were used to determine the serotype and susceptibility of streptococci. RESULTS: Ten out of 315 women (3.2%) were C. trachomatis-positive. Using traditional methods of microscopy, culture and serology, 42 strains (13.3% of the subjects) obtained from patients were identified as S. agalactiae and further analyzed. The most common serotypes identified were II (18/42, 42.9%), V (11/42, 26.2%) and III (10/42, 23.8%). The less common serotypes found were VII (2/10, 4.8%), and Ib (1/10, 2.4%); no Ia, IV or VII serotypes were found. All the strains were susceptible to penicillin, while 71.4% of them were susceptible to erythromycin and 81.0% were susceptible to clindamycin. Seven isolates (16.7%) were concomitantly resistant to erythromycin and clindamycin. CONCLUSIONS: Chlamydia trachomatis was confirmed in 3.2% of the respondents, and GBS was found in 13.3%, despite a lack of symptoms of infection. The incidence of C. trachomatis infections and GBS colonization in Poland is similar to those in other European countries.


Asunto(s)
Infecciones por Chlamydia , Chlamydia trachomatis , Infecciones Estreptocócicas , Streptococcus agalactiae , Adulto , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Farmacorresistencia Bacteriana , Femenino , Humanos , Recién Nacido , Pruebas de Sensibilidad Microbiana , Polonia/epidemiología , Embarazo , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/aislamiento & purificación
15.
BMC Infect Dis ; 20(1): 375, 2020 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-32460721

RESUMEN

BACKGROUND: Sexually transmitted infections (STIs) cause a major public health problem that affect both men and women in developing and developed countries. The aim of the study was to estimate the prevalence of 11 STIs among women who voluntarily participated in the study, while seeking gynecological checkup. The existence of an association between the presence of pathogens and symptoms and various sociodemographic risk factors was assessed. METHODS: A total of 505 vaginal and cervical specimens were collected from women above 18 years of age, with or without symptoms related to gynecological infections. Nucleic acid was extracted and samples were tested by real-time PCR for the following pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Ureaplasma urealyticum, Urealplasma parvum, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma girerdii, Gardnerella vaginalis, Candida albicans and Human Papillomavirus (HPV). Positive HPV samples underwent genotyping using a microarray system. RESULTS: Of the 505 samples, 312 (62%) were screened positive for at least one pathogen. Of these, 36% were positive for Gardnerella vaginalis, 35% for Ureaplasma parvum, 8% for Candida albicans, 6.7% for HPV, 4.6% for Ureaplasma urealyticum, 3.6% for Mycoplasma hominis, 2% for Trichomonas vaginalis, 0.8% for Chlamydia trachomatis, 0.4% for Mycoplasma girerdii, 0.2% for Mycoplasma genitalium and 0.2% for Neisseria gonorrhoeae. Lack of symptoms was reported in 187 women (37%), among whom 61% were infected. Thirty-four samples were HPV positive, with 17 high risk HPV genotypes (HR-HPV); the highest rates being recorded for types 16 (38%), 18 (21%) and 51 (18%). Out of the 34 HPV positives, 29 participants had HR-HPV. Association with various risk factors were reported. CONCLUSIONS: This is the first study that presents data about the presence of STIs among women in Lebanon and the MENA region by simultaneous detection of 11 pathogens. In the absence of systematic STI surveillance in Lebanon, concurrent screening for HPV and PAP smear is warranted.


Asunto(s)
Enfermedades de Transmisión Sexual/epidemiología , Adulto , Cuello del Útero/microbiología , Cuello del Útero/parasitología , Cuello del Útero/virología , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Estudios Transversales , Femenino , Gardnerella vaginalis/genética , Gardnerella vaginalis/aislamiento & purificación , Humanos , Líbano/epidemiología , Masculino , Epidemiología Molecular , Infecciones por Mycoplasma/epidemiología , Mycoplasma genitalium/genética , Mycoplasma genitalium/aislamiento & purificación , Mycoplasma hominis/genética , Mycoplasma hominis/aislamiento & purificación , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Factores de Riesgo , Enfermedades de Transmisión Sexual/microbiología , Enfermedades de Transmisión Sexual/parasitología , Enfermedades de Transmisión Sexual/virología , Trichomonas vaginalis/genética , Trichomonas vaginalis/aislamiento & purificación , Ureaplasma/genética , Ureaplasma/aislamiento & purificación , Vagina/microbiología , Vagina/parasitología , Vagina/virología , Frotis Vaginal , Adulto Joven
16.
Int J STD AIDS ; 31(7): 627-636, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32403988

RESUMEN

Partner notification and treatment are essential components of sexually transmitted infection (STI) management, but little is known about such practices among adolescents and young adults. Using data from a prospective cohort study (AYAZAZI) of youth aged 16-24 years in Durban, South Africa, we assessed the STI care cascade across participant diagnosis, STI treatment, partner notification, and partner treatment; index recurrent STI and associated factors; and reasons for not notifying partner of STI. Participants completed laboratory-based STI screening (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis) at enrollment and at 12 months. Of the 37/216 participants with STI (17%), 27/37 (73%) were women and 10/37 (27%) were men. Median age was 19 years (IQR: 18-20). Of the participants with STI, 23/37 (62%) completed a Treatment and Partner Tracing Survey within 6 months of diagnosis. All survey participants reported completing STI treatment (100%), 17/23 (74%) notified a partner, and 6/23 (35%) reported partner treatment. Overall, 4/23 (11%) participants had 12-month recurrent C. trachomatis infection, with no association with partner notification or treatment. Stigma and lack of STI knowledge were reasons for not notifying partner of STI. STI partner notification and treatment is a challenge among youth. Novel strategies are needed to overcome barriers along the STI care cascade.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Chlamydia/tratamiento farmacológico , Trazado de Contacto/estadística & datos numéricos , Gonorrea/tratamiento farmacológico , Parejas Sexuales , Adolescente , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Femenino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Neisseria gonorrhoeae , Estudios Prospectivos , Enfermedades de Transmisión Sexual , Estigma Social , Sudáfrica/epidemiología , Resultado del Tratamiento , Adulto Joven
19.
BMC Infect Dis ; 20(1): 314, 2020 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-32345231

RESUMEN

BACKGROUND: Mycoplasma genitalium is an emerging sexually transmitted infection, with increasing rates of resistance to fluroquinolones and macrolides, the recommended treatments. Despite this, M. genitalium is not part of routine screening for Sexually Transmitted Infections (STIs) in many countries and the prevalence of infection and patterns of disease remain to be determined in many populations. Such data is of particular importance in light of the reported rise in antibiotic resistance in M. genitalium isolates. METHODS: Urine and urethral swab samples were collected from the primary public sexual health clinic in Singapore and tested for C. trachomatis (CT) or N. gonorrhoeae (NG) infection and for the presence of M. genitalium. Antibiotic resistance in M. genitalium strains detected was determined by screening for genomic mutations associated with macrolide and fluroquinolone resistance. RESULTS: We report the results of a study into M. genitalium prevalence at the national sexual health clinic in Singapore. M. genitalium was heavily associated with CT infection (8.1% of cases), but present in only of 2.4% in CT negative cases and not independently linked to NG infection. Furthermore, we found high rates of resistance mutations to both macrolides (25%) and fluoroquinolones (37.5%) with a majority of resistant strains being dual-resistant. Resistance mutations were only found in strains from patients with CT co-infection. CONCLUSIONS: Our results support targeted screening of CT positive patients for M. genitalium as a cost-effective strategy to reduce the incidence of M. genitalium in the absence of comprehensive routine screening. The high rate of dual resistance also highlights the need to ensure the availability of alternative antibiotics for the treatment of multi-drug resistant M. genitalium isolates.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/efectos de los fármacos , Farmacorresistencia Bacteriana Múltiple , Infecciones por Mycoplasma/diagnóstico , Mycoplasma genitalium/efectos de los fármacos , Instituciones de Atención Ambulatoria , Antibacterianos/uso terapéutico , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/tratamiento farmacológico , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , ADN Bacteriano/genética , ADN Bacteriano/metabolismo , Farmacorresistencia Bacteriana Múltiple/genética , Fluoroquinolonas/farmacología , Fluoroquinolonas/uso terapéutico , Humanos , Macrólidos/farmacología , Macrólidos/uso terapéutico , Infecciones por Mycoplasma/complicaciones , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/epidemiología , Mycoplasma genitalium/genética , Mycoplasma genitalium/aislamiento & purificación , Prevalencia , ARN Ribosómico 23S/química , ARN Ribosómico 23S/genética , ARN Ribosómico 23S/metabolismo , Análisis de Secuencia de ADN , Singapur/epidemiología , Uretra/microbiología
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