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1.
Virulence ; 15(1): 2351234, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38773735

RESUMEN

Chlamydia infection is an important cause of public health diseases, and no effective vaccine is currently available. Owing to its unique intracellular lifestyle, Chlamydia requires a variety of nutrients and substrates from host cells, particularly sphingomyelin, cholesterol, iron, amino acids, and the mannose-6-phosphate receptor, which are essential for inclusion development. Here, we summarize the recent advances in Chlamydia nutrient acquisition mechanism by hijacking host cell vesicular transport, which plays an important role in chlamydial growth and development. Chlamydia obtains the components necessary to complete its intracellular developmental cycle by recruiting Rab proteins (major vesicular trafficking regulators) and Rab effector proteins to the inclusion, interfering with Rab-mediated multivesicular trafficking, reorienting the nutrition of host cells, and reconstructing the intracellular niche environment. Consequently, exploring the role of vesicular transport in nutrient acquisition offers a novel perspective on new approaches for preventing and treating Chlamydia infection.


Asunto(s)
Infecciones por Chlamydia , Chlamydia , Interacciones Huésped-Patógeno , Nutrientes , Humanos , Infecciones por Chlamydia/microbiología , Infecciones por Chlamydia/metabolismo , Chlamydia/metabolismo , Chlamydia/fisiología , Chlamydia/patogenicidad , Nutrientes/metabolismo , Animales , Transporte Biológico
2.
Front Cell Infect Microbiol ; 14: 1366136, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38698906

RESUMEN

Introduction: Vitamin D deficiency is the most common nutritional deficiency worldwide. Chronic vitamin D deficiency causes immune system dysfunction, which increases susceptibility to pathogens such as bacteria, especially intracellular parasites, and viruses. Chlamydia trachomatis (C. t) is an obligate intracellular parasitic bacterium that causes a variety of sequelae. We speculated that vitamin D might be associated with C. t infection. This study aimed to address this gap in knowledge by investigating the relationship between vitamin D and C. t infection using both in vitro and in vivo models. Methods and results: The addition of calcitriol to McCoy cell culture in vitro delayed and reduced the quantity and volume of inclusions compared to the control group. Macrophages of peritoneally lavaged mice co-cultured with McCoy decreased the infection rate and delayed the appearance of inclusions. In mice models of vitamin D deficiency, mice in the VD-group exhibited more severe genital tract inflammation and a longer duration of infection after inoculation with C. t in the genital tract. Supplementing these mice with vitamin D3 during treatment enhanced the therapeutic effect of antibiotics. We also conducted a case-control study involving 174 C. t-positive patients (95 males and 79 females) and 380 healthy volunteers (211 males and 169 females) aged 20-49 from January 2016 to March 15, 2017. Serum 25-(OH)D concentration was measured by assessing morning fasting blood samples of healthy volunteers and C. t-positive patients 1 day before antibiotic treatment and the next day after one course of treatment. The patients were followed up for 1 month and evaluated for recovery. The results showed that vitamin D deficiency was a risk factor for C. t infection and treatment failure. Conclusion: In summary, findings from experimental and clinical studies indicate a close association between vitamin D levels and C. t infection and treatment outcomes. Given the affordability and safety of vitamin D, both healthy individuals and patients should focus on vitamin D intake. Vitamin D supplementation could enhance treatment success and should be used as an adjunctive therapy alongside antibiotic therapy for C. t infections, pending confirmation in larger, prospective, randomized controlled trials.


Asunto(s)
Infecciones por Chlamydia , Chlamydia trachomatis , Modelos Animales de Enfermedad , Deficiencia de Vitamina D , Vitamina D , Chlamydia trachomatis/efectos de los fármacos , Animales , Humanos , Estudios de Casos y Controles , Femenino , Infecciones por Chlamydia/tratamiento farmacológico , Ratones , Masculino , Adulto , Deficiencia de Vitamina D/complicaciones , Persona de Mediana Edad , Vitamina D/sangre , Vitamina D/farmacología , Adulto Joven , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Macrófagos , Calcitriol
3.
PLoS One ; 19(5): e0302785, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38768150

RESUMEN

INTRODUCTION: The rates of gonorrhea and chlamydia have been increasing in the years preceding the COVID19 pandemic. Because most gonorrhea and chlamydia infections are located in the oropharynx and rectum for men who have sex with men (MSM), and because at-home self-collected swabs for these infections are not licensed by Health Canada or the United States Food and Drug Administration, decreased accessed to in-person care during and since the COVID19 pandemic potentially means missed case findings. OBJECTIVES: To evaluate the performance of at-home self-collected pharyngeal and rectal swabs for gonorrhea and chlamydia nucleic acid amplification testing. METHODOLOGY: All persons who contacted our Sexual Health Clinic and who had a clinical indication to complete oral and/or rectal swabs for gonorrhea and chlamydia were invited to complete at-home swabs in advance of their scheduled appointments. We mailed swabs and instructions to those who consented. Participants brought these swabs to their scheduled in clinic appointments, where we repeated the same swabs. All matching swabs were sent to the laboratory for analysis to determine concordance. RESULTS: From September 8, 2022 to July 18, 2023, we enrolled 296 eligible participants who provided 1184 swabs. For analysis, cancelled specimens and specimens with invalid results were excluded, leaving 1032 swabs for comparison. We identified 66 STI diagnoses in 47 unique participants. Overall accuracy was high (exceeding 99%), except for rectal chlamydia, which was 96.0%. While the performance of self-swabs for chlamydia was lower compared to gonorrhea, at-home swabs identified six chlamydia infections that were missed by in-clinic collected swabs (two pharyngeal, four rectal). Removing these six cases as "false positives" increased overall accuracy for chlamydia detection to 99.7% (pharyngeal) and 97.8% (rectal). CONCLUSION: Self-collected at-home swabs had good performance acceptable for gonorrhea and chlamydia nucleic acid amplification testing.


Asunto(s)
Infecciones por Chlamydia , Chlamydia trachomatis , Gonorrea , Neisseria gonorrhoeae , Faringe , Recto , Manejo de Especímenes , Humanos , Chlamydia trachomatis/aislamiento & purificación , Chlamydia trachomatis/genética , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/microbiología , Gonorrea/diagnóstico , Gonorrea/microbiología , Masculino , Neisseria gonorrhoeae/aislamiento & purificación , Neisseria gonorrhoeae/genética , Recto/microbiología , Faringe/microbiología , Manejo de Especímenes/métodos , Adulto , Femenino , Técnicas de Amplificación de Ácido Nucleico/métodos , Homosexualidad Masculina , Persona de Mediana Edad , Autocuidado , Adulto Joven
4.
Front Public Health ; 12: 1348686, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38770362

RESUMEN

Background: Men who have sex with men (MSM) face significant risks of Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) infection. Nevertheless, only limited studies have looked into the site-specific infection and clearance of CT/NG. In order to prevent transmission, it is essential to understand the underlying factors that drive infection and spontaneous clearance. Methods: A 12-week cohort study examined the association between CT/NG infection, self-clearance, and sexual behaviors among MSM. The Willingness Service recruited participants who completed weekly questionnaires and provided urine, throat, and rectal swab samples. Results: The study involved 151 men, in which 51 (33.8%) were diagnosed with CT/NG infection during the study period. HIV (OR = 11.31), kissing (OR = 1.59), receptive oral sex (OR = 36.64), and insertive anal sex (OR = 19.73) constituted significant risk factors. 100% condom use (OR = 5.78) and antibiotic (OR = 7.53) were more likely to cause spontaneous clearance. Discussion: MSM may engage in riskier sexual behaviors due to insufficient knowledge and awareness of STI prevention, leading to increased susceptibility to NG/CT. It is crucial to concentrate on enhancing health education for MSM. Conclusion: This study found that the rectum was the most prevalent site of CT/NG and sexual behavior can influence the infection. Additionally, the appropriate use of antibiotics and consistent condom use may contribute to clear spontaneously.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Homosexualidad Masculina , Conducta Sexual , Humanos , Masculino , Gonorrea/epidemiología , Infecciones por Chlamydia/epidemiología , China/epidemiología , Homosexualidad Masculina/estadística & datos numéricos , Adulto , Estudios Prospectivos , Incidencia , Factores de Riesgo , Conducta Sexual/estadística & datos numéricos , Chlamydia trachomatis/aislamiento & purificación , Encuestas y Cuestionarios , Neisseria gonorrhoeae/aislamiento & purificación , Adulto Joven , Persona de Mediana Edad
5.
PLoS Med ; 21(5): e1004385, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38768094

RESUMEN

BACKGROUND: Syndromic management is widely used to treat symptomatic sexually transmitted infections in settings without aetiologic diagnostics. However, underlying aetiologies and consequent treatment suitability are uncertain without regular assessment. This systematic review estimated the distribution, trends, and determinants of aetiologies for vaginal discharge, urethral discharge, and genital ulcer in sub-Saharan Africa (SSA). METHODS AND FINDINGS: We searched Embase, MEDLINE, Global Health, Web of Science, and grey literature from inception until December 20, 2023, for observational studies reporting aetiologic diagnoses among symptomatic populations in SSA. We adjusted observations for diagnostic test performance, used generalised linear mixed-effects meta-regressions to generate estimates, and critically appraised studies using an adapted Joanna Briggs Institute checklist. Of 4,418 identified records, 206 reports were included from 190 studies in 32 countries conducted between 1969 and 2022. In 2015, estimated primary aetiologies for vaginal discharge were candidiasis (69.4% [95% confidence interval (CI): 44.3% to 86.6%], n = 50), bacterial vaginosis (50.0% [95% CI: 32.3% to 67.8%], n = 39), chlamydia (16.2% [95% CI: 8.6% to 28.5%], n = 50), and trichomoniasis (12.9% [95% CI: 7.7% to 20.7%], n = 80); for urethral discharge were gonorrhoea (77.1% [95% CI: 68.1% to 84.1%], n = 68) and chlamydia (21.9% [95% CI: 15.4% to 30.3%], n = 48); and for genital ulcer were herpes simplex virus type 2 (HSV-2) (48.3% [95% CI: 32.9% to 64.1%], n = 47) and syphilis (9.3% [95% CI: 6.4% to 13.4%], n = 117). Temporal variation was substantial, particularly for genital ulcer where HSV-2 replaced chancroid as the primary cause. Aetiologic distributions for each symptom were largely the same across regions and population strata, despite HIV status and age being significantly associated with several infection diagnoses. Limitations of the review include the absence of studies in 16 of 48 SSA countries, substantial heterogeneity in study observations, and impeded assessment of this variability due to incomplete or inconsistent reporting across studies. CONCLUSIONS: In our study, syndrome aetiologies in SSA aligned with World Health Organization guidelines without strong evidence of geographic or demographic variation, supporting broad guideline applicability. Temporal changes underscore the importance of regular aetiologic re-assessment for effective syndromic management. PROSPERO NUMBER: CRD42022348045.


Asunto(s)
Úlcera , Excreción Vaginal , Humanos , África del Sur del Sahara/epidemiología , Femenino , Excreción Vaginal/epidemiología , Excreción Vaginal/etiología , Úlcera/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/diagnóstico , Vaginosis Bacteriana/epidemiología , Vaginosis Bacteriana/diagnóstico , Vaginosis Bacteriana/complicaciones , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/diagnóstico , Enfermedades Uretrales/epidemiología , Enfermedades Uretrales/etiología , Enfermedades de los Genitales Femeninos/epidemiología
6.
Sex Transm Dis ; 51(6): 388-392, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38733972

RESUMEN

BACKGROUND: Standard-of-care nucleic acid amplification tests (routine NAATs) for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) can take several days to result and therefore delay treatment. Rapid point-of-care GC/CT NAAT (rapid NAAT) could reduce the time to treatment and therefore onward transmission. This study evaluated the incremental cost per infectious day averted and overall cost of implementation associated with rapid compared with routine NAAT. METHODS: Prospective sexually transmitted infection (STI) treatment data from men who have sex with men and transgender women in San Diego who received rapid NAAT between November 2018 and February 2021 were evaluated. Historical time from testing to treatment for routine NAAT was abstracted from the literature. Costs per test for rapid and routine NAAT were calculated using a micro-costing approach. The incremental cost per infectious day averted comparing rapid to routine NAAT and the costs of rapid GC/CT NAAT implementation in San Diego Public Health STI clinics were calculated. RESULTS: Overall, 2333 individuals underwent rapid NAAT with a median time from sample collection to treatment of 2 days compared with 7 to 14 days for routine NAAT equating to a reduction of 5 to 12 days. The cost of rapid and routine GC/CT NAAT was $57.86 and $18.38 per test, respectively, with a cost-effectiveness of between $2.43 and $5.82 per infectious day averted. The incremental cost of rapid NAAT improved when at least 2000 tests were performed annually. CONCLUSIONS: Although rapid GC/CT NAAT is more expensive than routine testing, the reduction of infectious days between testing and treatment may reduce transmission and provide improved STI treatment services to patients.


Asunto(s)
Infecciones por Chlamydia , Chlamydia trachomatis , Gonorrea , Homosexualidad Masculina , Neisseria gonorrhoeae , Técnicas de Amplificación de Ácido Nucleico , Humanos , Masculino , Gonorrea/diagnóstico , Gonorrea/economía , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/economía , Técnicas de Amplificación de Ácido Nucleico/economía , Neisseria gonorrhoeae/aislamiento & purificación , Chlamydia trachomatis/aislamiento & purificación , Adulto , California/epidemiología , Análisis Costo-Beneficio , Estudios Prospectivos , Femenino , Pruebas en el Punto de Atención/economía , Personas Transgénero
7.
BMC Infect Dis ; 24(1): 480, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38730346

RESUMEN

BACKGROUND: Tubal factor infertility (TFI) is common in sub-Saharan Africa and often secondary to pelvic inflammatory disease (PID). Anaerobes associated with bacterial vaginosis (BV) are also found in PIDs widely dominated by Chlamydia trachomatis (C. trachomatis), whose role in TFI is better demonstrated than that of BV. OBJECTIVES: To determine the prevalence of BV and C. trachomatis and to investigate the association between BV, C. trachomatis and TFI. METHODS: We included 137 patients treated for infertility between January 2020 and November 2021. Cases were defined as women with infertility aged 18-45 years presenting with TFI (n = 52), and controls as infertile women in the same age groups without TFI (n = 85). Data on social habits, life style and infertility parameters were collected, and we performed screening for BV and C. trachomatis. Multiple regression was used to measure associations. RESULTS: The prevalence of BV and C. trachomatis was 42.3% (58/137) and 23.4% (32/137), respectively. BV (61.5% vs 30.6%, p<0.001) and C. trachomatis (48.1 vs 8.2%, p<0.001) were more frequent in cases of TFI. BV and C. trachomatis increased the risk of TFI approximately 4-fold [aOR: 3.77 (1.61-8.83), p=0.002] and 14-fold [aOR: 13.77 (4.59-41.27), p<0.001], respectively. CONCLUSION: BV and C. trachomatis infection are strongly associated with TFI in Bukavu. Prevention and screening should be implemented to reduce the risk of TFI.


Asunto(s)
Infecciones por Chlamydia , Chlamydia trachomatis , Infertilidad Femenina , Vaginosis Bacteriana , Humanos , Femenino , Adulto , Vaginosis Bacteriana/epidemiología , Vaginosis Bacteriana/microbiología , Vaginosis Bacteriana/complicaciones , Chlamydia trachomatis/aislamiento & purificación , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Infecciones por Chlamydia/complicaciones , Prevalencia , Adulto Joven , Adolescente , República Democrática del Congo/epidemiología , Persona de Mediana Edad , Infertilidad Femenina/microbiología , Infertilidad Femenina/epidemiología
8.
Euro Surveill ; 29(19)2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38726697

RESUMEN

BackgroundIn France, lymphogranuloma venereum (LGV) testing switched from universal to selective testing in 2016.AimTo investigate changes in LGV-affected populations, we performed a nationwide survey based on temporarily reinstated universal LGV testing from 2020 to 2022.MethodsEach year, during three consecutive months, laboratories voluntarily sent anorectal Chlamydia trachomatis-positive samples from men and women to the National Reference Centre for bacterial sexually transmitted infections. We collected patients' demographic, clinical and biological data. Genovars L of C. trachomatis were detected using real-time PCR. In LGV-positive samples, the ompA gene was sequenced.ResultsIn 2020, LGV positivity was 12.7% (146/1,147), 15.2% (138/907) in 2021 and 13.3% (151/1,137) in 2022 (p > 0.05). It occurred predominantly in men who have sex with men (MSM), with rare cases among transgender women. The proportion of HIV-negative individuals was higher than that of those living with HIV. Asymptomatic rectal LGV increased from 36.1% (44/122) in 2020 to 52.4% (66/126) in 2022 (p = 0.03). Among users of pre-exposure prophylaxis (PrEP), LGV positivity was 13.8% (49/354) in 2020, 15.6% (38/244) in 2021 and 10.9% (36/331) in 2022, and up to 50% reported no anorectal symptoms. Diversity of the LGV ompA genotypes in the Paris region increased during the survey period. An unexpectedly high number of ompA genotype L1 variant was reported in 2022.ConclusionIn rectal samples from MSM in France, LGV positivity was stable, but the proportion of asymptomatic cases increased in 2022. This underscores the need of universal LGV testing and the importance of continuous surveillance.


Asunto(s)
Chlamydia trachomatis , Homosexualidad Masculina , Linfogranuloma Venéreo , Humanos , Linfogranuloma Venéreo/epidemiología , Linfogranuloma Venéreo/diagnóstico , Masculino , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Homosexualidad Masculina/estadística & datos numéricos , Francia/epidemiología , Adulto , Femenino , Persona de Mediana Edad , Encuestas y Cuestionarios , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/diagnóstico , Adulto Joven , Recto/microbiología , Prevalencia , Minorías Sexuales y de Género/estadística & datos numéricos
9.
Sci Rep ; 14(1): 11825, 2024 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-38783017

RESUMEN

In the United States (US), chlamydia is the most frequently reported sexually transmitted infection that is nationally notifiable. We examined trends in chlamydia prevalence in the US in 2011-2016 compared with 2005-2010. Cross-sectional, nationally representative surveys, National Health and Nutrition Examination Surveys (NHANES), were used to compare national chlamydia prevalence estimates from 2011 to 2016 with those from 2005 to 2010, and changes in prevalence since 1999-2004 were also reviewed. Persons aged 18-39 years were included in these analyses. Prevalence of chlamydia was based on results from urine specimens. Results were weighted to represent the U.S. civilian, noninstitutionalized population. The baseline characteristics of the study population were similar in gender, age and race/ethnicity between the two groups (P > 0.05). The overall chlamydia prevalence was 1.88% (95% confidence interval [CI] 1.55-2.22%) in 2011-2016 and 1.57% (95% CI 1.27-1.87%) in 2005-2010, a relative increase of 19.7% (95% CI 0.2-39.2%; P < 0.05) between the two surveys. Increases in chlamydia prevalence was especially concentrated in persons who were male, aged 18 to 29 years, had > high school educational level, never married, age at first sex < 18 years, had 2-5 sexual partners in lifetime and had no past sexually transmitted diagnosis between 2005 and 2016 (P < 0.05). Multivariable logistic regression analysis demonstrated that chlamydia was more prevalent in those aged 18-29 years, being non-Hispanic Blacks, had high school educational level, being widowed/divorced/separated and had > 5 sexual partners. The chlamydia prevalence had an increasing trend from 2005-2010 to 2011-2016. Those with high chlamydia prevalence such as sexually active young adults and Non-Hispanic Black should be screened annually so that infected persons can be diagnosed and they and their sex partners can be treated promptly.


Asunto(s)
Infecciones por Chlamydia , Humanos , Estados Unidos/epidemiología , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Masculino , Femenino , Adulto , Adolescente , Prevalencia , Adulto Joven , Estudios Transversales , Encuestas Nutricionales
10.
Comp Med ; 74(2): 121-129, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38561234

RESUMEN

Chlamydia muridarum (Cm), an intracellular bacterium of historical importance, was recently rediscovered as moderately prevalent in research mouse colonies. Cm was first reported as a causative agent of severe pneumonia in mice about 80 y ago, and while it has been used experimentally to model Chlamydia trachomatis infection of humans, there have been no further reports of clinical disease associated with natural infection. We observed clinical disease and pathology in 2 genetically engi- neered mouse (GEM) strains, Il12rb2 KO and STAT1 KO, with impaired interferon-γ signaling and Th1 CD4+ T cell responses in a colony of various GEM strains known to be colonized with and shedding Cm. Clinical signs included poor condition, hunched posture, and poor fecundity. Histopathology revealed disseminated Cm with lesions in pulmonary, gastrointestinal, and urogenital tissues. The presence of Cm was confirmed using both immunohistochemistry for Cm major outer membrane protein-1 antigen and in situ hybridization using a target probe directed against select regions of Cm strain Nigg. Cm was also found in association with a urothelial papilloma in one mouse. These cases provide additional support for excluding Cm from research mouse colonies.


Asunto(s)
Infecciones por Chlamydia , Chlamydia muridarum , Ratones Noqueados , Factor de Transcripción STAT1 , Animales , Infecciones por Chlamydia/patología , Infecciones por Chlamydia/veterinaria , Infecciones por Chlamydia/microbiología , Ratones , Factor de Transcripción STAT1/genética , Factor de Transcripción STAT1/metabolismo , Femenino , Receptores de Interleucina-12/deficiencia , Receptores de Interleucina-12/genética , Masculino , Enfermedades Pulmonares/microbiología , Enfermedades Pulmonares/patología , Enfermedades Pulmonares/veterinaria
11.
Emerg Infect Dis ; 30(13): S62-S67, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38561843

RESUMEN

We reviewed data obtained in October 2021-May 2023 from youth who reported a history of sexual activity upon admission to 1 of 12 juvenile justice facilities in Utah, USA, that offered screening for Chlamydia trachomatis and Neisseria gonorrhoeae. Urinalysis revealed C. trachomatis positivity of 10.77%, N. gonorrhoeae positivity of 1.08%, and coinfection C. trachomatis N. gonorrhoeae) of 0.90%. Prevalence of infection was similar for youths in rural and urban facilities. A total of 12.01% of those identifying as male and 14.01% of those identifying as female tested positive for C. trachomatis, N. gonorrhoeae, or coinfection. Of young adults who tested positive, 74.65% received their results while incarcerated, all of whom accepted treatment. Our research underscores the feasibility of providing prompt C. trachomatis/N. gonorrhoeae screening and treatment in juvenile correctional facilities. The pervasiveness of infection emphasizes the urgent need for early identification and treatment for C. trachomatis and N. gonorrhoeae in incarcerated youth nationwide.


Asunto(s)
Infecciones por Chlamydia , Coinfección , Gonorrea , Adulto Joven , Adolescente , Masculino , Femenino , Humanos , Gonorrea/diagnóstico , Gonorrea/epidemiología , Gonorrea/prevención & control , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Utah/epidemiología , Coinfección/epidemiología , Neisseria gonorrhoeae , Chlamydia trachomatis , Instalaciones Correccionales , Prevalencia , Tamizaje Masivo/métodos
12.
PLoS One ; 19(4): e0301873, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38578759

RESUMEN

Men having sex with men (MSM) represent a key population, in which sexually transmitted rectal infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and high-risk HPV (HR-HPV) are very common and linked to significant morbidity. Investigating the anorectal microbiome associated with rectal STIs holds potential for deeper insights into the pathogenesis of these infections and the development of innovative control strategies. In this study, we explored the interplay at the rectal site between C. trachomatis, N. gonorrhoeae, HR-HPV infection, and the anorectal microbiome in a cohort of 92 MSM (47 infected by CT and/or NG vs 45 controls). Moreover, we assessed the presence of Torquetenovirus (TTV), a non-pathogenic endogenous virus, considered as a possible predictor of immune system activation. We found a high prevalence of HR-HPV rectal infections (61%), especially in subjects with a concurrent CT/NG rectal infection (70.2%) and in people living with HIV (84%). In addition, we observed that TTV was more prevalent in subjects with CT/NG rectal infections than in non-infected ones (70.2% vs 46.7%, respectively). The anorectal microbiome of patients infected by CT and/or NG exhibited a reduction in Escherichia, while the presence of TTV was significantly associated with higher levels of Bacteroides. We observed a positive correlation of HR-HPV types with Escherichia and Corynebacterium, and a negative correlation with the Firmicutes phylum, and with Prevotella, Oscillospira, Sutterella. Our findings shed light on some of the dynamics occurring within the rectal environment involving chlamydial/gonococcal infections, HPV, TTV, and the anorectal microbiome. These data could open new perspectives for the control and prevention of STIs in MSM.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Infecciones por VIH , Microbiota , Infecciones por Papillomavirus , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Masculino , Humanos , Neisseria gonorrhoeae , Chlamydia trachomatis , Homosexualidad Masculina , Gonorrea/epidemiología , Gonorrea/microbiología , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Prevalencia , Infecciones por VIH/epidemiología
13.
J Med Microbiol ; 73(4)2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38591530

RESUMEN

Sexually transmitted infections (STI) are a public health problem. Real-time PCR assays are the most sensitive test for screening and diagnosis of these infections. The aim of this study was to evaluate a new CT/NG/TV/MG Real-Time PCR (RT-PCR) kit (Vircell) for the detection of Chamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis for the diagnosis of sexual transmitted infections using the Allplex STI Essential Assay (Seegene) as the reference's method. A total of 497 samples from different anatomical sites (endocervical, urethral, rectal, pharyngeal and urine) were analysed from October 2022 to February 2023. A total of 108 (21.73 %) and 106 (21.33 %) positive samples were found for any of the assays used. The most commonly detected pathogen was N. gonorrhoeae (52 samples; 10.46 %), and the least commonly detected was T. vaginalis (three samples; 0.60 %). The anatomical site with the highest prevalence of micro-organisms was a non-urogenital site, the pharynx (26 positive samples; 5.23 %). Using the Allplex STI Essential Assay (Seegene) as the reference method, the diagnosis performance showed that the average specificity of CT/NG/TV/MG RT-PCR Kit (Vircell) was 99.84 % and the sensitivity was 99.53 %. The overall concordance was k=0.98 (CI95 %; 0.96-1). In conclusion, the CT/NG/TV/MG RT-PCR Kit (Vircell) assay shows a good sensitivity and specificity and constitutes a promising and additional alternative to routine procedures for distinct types of clinical specimen in diagnosis STI.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Infecciones por Mycoplasma , Mycoplasma genitalium , Enfermedades de Transmisión Sexual , Trichomonas vaginalis , Humanos , Reacción en Cadena en Tiempo Real de la Polimerasa , Chlamydia trachomatis/genética , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Trichomonas vaginalis/genética , Neisseria gonorrhoeae/genética , Mycoplasma genitalium/genética , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/epidemiología , Tomografía Computarizada por Rayos X , Infecciones por Chlamydia/diagnóstico , Gonorrea/diagnóstico , Gonorrea/epidemiología
14.
Scand J Immunol ; 99(5): e13359, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38605527

RESUMEN

Chlamydia trachomatis infection is the leading cause of bacterial urogenital infection and has been demonstrated to drive inflammation and scarring of the reproductive tract. Recent studies have identified key triggers of proinflammatory adaptive immune responses driven by innate leukocytes and epithelia driving immunopathology. Utilizing chimeric mouse models, we investigated the definitive source and role of IL17 and IL17 signalling receptors during early Chlamydia muridarum infection of the female urogenital tract. Bone marrow transplants from wild-type (WT) and IL17A-/- mice to recipients demonstrated equivocal infection kinetics in the reproductive tract, but interestingly, adoptive transfer of IL17A-/- immune cells to WT recipients resulted in no infertility, suggesting a haematopoietic (as opposed to tissue) source of IL17 driving immunopathology. To further delineate the role of IL17 in immunopathology, we infected WT and IL17 receptor A (IL17RA)-/- female mice and observed a significant reduction in immunopathology in IL17RA-/- mice. WT bone marrow transplants to IL17RA-/- recipient mice prevented hydrosalpinx, suggesting signalling through IL17RA drives immunopathology. Furthermore, early chemical inhibition of IL17 signalling significantly reduced hydrosalpinx, suggesting IL17 acts as an innate driver of disease. Early during the infection, IL17 was produced by γδ T cells in the cervico-vagina, but more importantly, by neutrophils at the site of infertility in the oviducts. Taken together, these data suggest innate production of IL17 by haematopoietic leukocytes drives immunopathology in the epithelia during early C. muridarum infection of the female reproductive tract.


Asunto(s)
Infecciones por Chlamydia , Chlamydia muridarum , Interleucina-17 , Infecciones del Sistema Genital , Animales , Femenino , Ratones , Ratones Endogámicos C57BL , Infecciones del Sistema Genital/patología
15.
Vet Microbiol ; 293: 110085, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38581768

RESUMEN

To overcome shortcomings in discriminating Chlamydia pecorum strains infecting the koala (Phascolarctos cinereus) at the local level, we developed a novel genotyping scheme for this pathogen to inform koala management at a fine-scale subpopulation level. We applied this scheme to two geographically distinct koala populations in New South Wales, Australia: the Liverpool Plains and the Southern Highlands to South-west Sydney (SHSWS). Our method provides greater resolution than traditional multi-locus sequence typing, and can be used to monitor strain emergence, movement, and divergence across a range of fragmented habitats. Within the Liverpool Plains population, suspected recent introduction of a novel strain was confirmed by an absence of genetic diversity at the earliest sampling events and limited diversity at recent sampling events. Across the partially fragmented agricultural landscape of the Liverpool Plains, diversity within a widespread sequence type suggests that this degree of fragmentation may hinder but not prevent spread. In the SHSWS population, our results suggest movement of a strain from the south, where diverse strains exist, into a previously Chlamydia-free area in the north, indicating the risk of expansion towards an adjacent Chlamydia-negative koala population in South-west Sydney. In the south of the SHSWS where koala subpopulations appear segregated, we found evidence of divergent strain evolution. Our tool can be used to infer the risks of strain introduction across fragmented habitats in population management, particularly through practices such as wildlife corridor constructions and translocations.


Asunto(s)
Infecciones por Chlamydia , Chlamydia , Variación Genética , Tipificación de Secuencias Multilocus , Phascolarctidae , Phascolarctidae/microbiología , Animales , Chlamydia/genética , Chlamydia/clasificación , Chlamydia/aislamiento & purificación , Infecciones por Chlamydia/veterinaria , Infecciones por Chlamydia/microbiología , Genotipo , Nueva Gales del Sur , Filogenia
16.
AIDS ; 38(7): 1033-1045, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38669203

RESUMEN

OBJECTIVE: To evaluate the effect of preexposure prophylaxis (PrEP) initiation on bacterial sexually transmitted infection (STI) occurrence (overall; chlamydia; gonorrhea; syphilis), in MSM. DESIGN: Systematic review and meta-analysis. METHODS: Systematic searches were performed in PubMed, Embase, and Scopus without language restrictions until 1 February 2023. We sought studies reporting data for the estimation of incidence rate ratios (IRR), prevalence ratios or cumulative incidence ratios (the latter in equal time periods before and after PrEP initiation) regarding bacterial STI occurrence. Separate analyses were performed overall for any STI, syphilis, chlamydia and gonorrhea (overall; rectal; urethral; pharyngeal for the two latter conditions); ratios greater than unity denoted increase in STI occurrence after PrEP initiation. RESULTS: Twenty-three eligible studies with 11 776 participants (age range: 18-71 years) with a median follow-up of 12 months were included. Overall, PrEP initiation was associated with a significant increase in the occurrence of any STI (pooled effect size: 1.15, 95% confidence interval (CI): 1.04-1.26), any gonorrhea (pooled effect size: 1.17, 95% CI: 1.02-1.34), any chlamydia (pooled effect size: 1.31, 95% CI: 1.09-1.58) and rectal chlamydia (pooled effect size: 1.31, 95% CI: 1.05-1.64), whereas a borderline increase was found in urethral chlamydia (pooled effect size: 1.25, 95% CI: 0.99-1.60, P  = 0.064). Changes in pharyngeal chlamydia and site-specific gonorrhea occurrence did not reach statistical significance. Syphilis showed virtually no change after PrEP initiation (pooled effect size: 0.99, 95% CI: 0.72-1.37). CONCLUSION: These results highlight the need for more comprehensive, accessible STI testing to tackle bacterial STI infections in PrEP users.


Asunto(s)
Gonorrea , Infecciones por VIH , Homosexualidad Masculina , Profilaxis Pre-Exposición , Enfermedades Bacterianas de Transmisión Sexual , Humanos , Masculino , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/prevención & control , Gonorrea/epidemiología , Gonorrea/prevención & control , Incidencia , Adulto , Persona de Mediana Edad , Adulto Joven , Prevalencia , Sífilis/epidemiología , Sífilis/prevención & control , Adolescente , Infecciones por Chlamydia/prevención & control , Infecciones por Chlamydia/epidemiología , Anciano
17.
BMC Infect Dis ; 24(1): 405, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38622501

RESUMEN

BACKGROUND: Genital infection with Chlamydia trachomatis (C. trachomatis) is a major public health issue worldwide. It can lead to cervicitis, urethritis, and infertility. This study was conducted to determine the characteristics of genital C. trachomatis infection among women attending to the infertility and gynecology clinics. METHODS: Endocervical swabs were collected from 8,221 women for C. trachomatis nucleotide screening and genotyping, while serum samples were collected for C. trachomatis pgp3 antibody determination using luciferase immunosorbent assays. RESULTS: High C. trachomatis DNA prevalence (3.76%) and seroprevalence (47.46%) rates were found, with genotype E (27.5%) being the most prevalent. C. trachomatis omp1 sense mutation was associated with cervical intraepithelial neoplasia (CIN) (odds ratio [OR] = 6.033, 95% confidence interval [CI] = 1.219-39.185, p = 0.045). No significant differences in C. trachomatis seroprevalence rates were observed between women with detectable C. trachomatis DNA in the infertility and routine physical examination groups (86.67% vs. 95%, p > 0.05); however, among women with negative C. trachomatis DNA, the former group had a markedly higher seroprevalence than the latter group (56.74% vs. 20.17%, p < 0.001). C. trachomatis DNA, but not pgp3 antibody, was significantly associated with CIN (OR = 4.087, 95% CI = 2.284-7.315, p < 0.001). CONCLUSION: Our results revealed a high prevalence, particularly seroprevalence, of C. trachomatis among women with infertility. Furthermore, we found an association between C. trachomatis omp1 sense mutations and CIN. Therefore, C. trachomatis serves as a risk factor for CIN.


Asunto(s)
Infecciones por Chlamydia , Infertilidad , Humanos , Femenino , Chlamydia trachomatis/genética , Estudios Seroepidemiológicos , Infertilidad/epidemiología , Infertilidad/complicaciones , Infecciones por Chlamydia/diagnóstico , ADN , Genitales
18.
Infect Immun ; 92(4): e0050323, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38451079

RESUMEN

Non-neutralizing functions of antibodies, including phagocytosis, may play a role in Chlamydia trachomatis (CT) infection, but these functions have not been studied and assays are lacking. We utilized a flow-cytometry-based assay to determine whether serum samples from a well-characterized cohort of CT-infected and naïve control individuals enhanced phagocytosis via Fc-receptor-expressing THP-1 cells, and whether this activity correlated with antibody titers. Fc-receptor-mediated phagocytosis was detected only in CT+ donors. Phagocytosis generally did not correlate well with antibody titer. In addition, we found that complement from both CT+ and negative individuals enhanced phagocytosis of CT into primary neutrophils. These results suggest that anti-CT antibodies can have functions that are not reflected by titer. This method could be used to quantitively measure Fc-receptor-mediated function of anti-CT antibodies or complement activity and could reveal new immune correlates of protection.


Asunto(s)
Infecciones por Chlamydia , Receptores Fc , Humanos , Fagocitosis , Neutrófilos , Anticuerpos Antibacterianos , Chlamydia trachomatis
19.
Sex Transm Dis ; 51(4): 276-282, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38534084

RESUMEN

BACKGROUND: The effective testing of sexually transmitted infections (STIs) requires sampling from potential infection sites. This study aimed to assess the choice, satisfaction, and performance of self-collected samples (SCS) from potential infection sites for STI testing among transgender women in Brazil. METHODS: TransOdara was a multicentric, cross-sectional STI prevalence study conducted in 5 Brazilian cities. Using respondent-driven sampling, 1317 transgender women 18 years or older were recruited. Participants completed interviewer-led questionnaires and provided swab samples from multiple sites (anorectal, oropharyngeal, genital) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and human papillomavirus (HPV) testing. Participants were given a choice of SCS or provider-collected samples (PCS) at each site. RESULTS: Most participants selected SCS for anorectal (74.9%; 95% confidence interval [CI], 72.4-77.3) and genital (72.7%; 95% CI, 70.2-75.1) sites, whereas fewer chose for oropharyngeal samples (49.8%; 95% CI, 47.0-52.6). For future testing, most participants expressed a preference for SCS for genital (72.2%; 95% CI, 69.5-74.7) and anorectal (70.2%; 95% CI, 67.6-72.7) sites. There was no significant difference in the positive test results for CT and NG between SCS and PCS at anorectal and oropharyngeal sites, or for HPV at anorectal and genital (penile or neovaginal) sites. CONCLUSIONS: This study demonstrated a high level of acceptability and usability of self-sampling for STI testing among transgender women. A preference for SCS was evident at the anorectal and genital sites, and the results of SCS were comparable to those of PCS. The findings suggest that multisite STI testing utilizing self-collection methods as a provided option can be effectively integrated into sexual health services for transgender women.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Infecciones por Papillomavirus , Enfermedades de Transmisión Sexual , Personas Transgénero , Femenino , Humanos , Brasil , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Estudios Transversales , Gonorrea/epidemiología , Neisseria gonorrhoeae , Prevalencia , Enfermedades de Transmisión Sexual/epidemiología , Masculino , Adulto
20.
Euro Surveill ; 29(13)2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38551099

RESUMEN

BackgroundPre-exposure prophylaxis (PrEP) effectively prevents HIV, but its association with sexually transmitted infections (STIs) has raised concerns about risk compensation, potentially impacting the expansion of PrEP programmes.AimWe examined the relationship between PrEP and the incidence of chlamydia, gonorrhoea and syphilis.MethodsIn this prospective cohort study, we compared STI rates before and after PrEP initiation among users in the capital region of Denmark (2019-2022), calculating incidence rate ratios adjusted for age and testing frequency (aIRR). To pinpoint when increases began, we plotted weekly STI rates, adjusting the timeline to correspond with PrEP initiation.ResultsThe study included 1,326 PrEP users with a median age of 35 years. The STI incidence rate per 100,000 person-years rose from 35.3 before to 81.2 after PrEP start, with an aIRR of 1.35 (95% CI: 1.18-1.56). Notably, this increase preceded PrEP initiation by 10-20 weeks. Specific aIRR for chlamydia, gonorrhoea and syphilis were 1.23 (95% CI: 1.03-1.48), 1.24 (95% CI: 1.04-1.47) and 1.15 (95% CI: 0.76-1.72), respectively. In subanalyses for anatomical sites aIRR was 1.26 (95% CI: 1.01-1.56) for rectal chlamydia and 0.66 (95% CI: 0.45-0.96) for genital gonorrhoea.ConclusionWe found a 35% increase in STI incidence associated with PrEP use. It started before PrEP initiation, challenging the assumption that PrEP leads to risk compensation. Instead, the data suggest that individuals seek PrEP during periods of heightened sexual risk-taking. Consequently, PrEP programmes should include sexual health consultations, STI testing, treatment and prevention strategies to prevent HIV and improve sexual health.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Infecciones por VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Sífilis , Masculino , Humanos , Adulto , Gonorrea/epidemiología , Gonorrea/prevención & control , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Sífilis/epidemiología , Homosexualidad Masculina , Estudios Prospectivos , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Dinamarca/epidemiología , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/prevención & control
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