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1.
Wiad Lek ; 74(2): 184-189, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813469

RESUMEN

OBJECTIVE: The aim: To investigate the utility of testing for chlamydial heat shock protein 60 (CHSP60) antibodies in the diagnosis of tubal infertility. PATIENTS AND METHODS: Materials and methods: All the collected samples were assayed for IgM and IgG antibodies to chlamydia trachomatis and chlamydial heat shock protein 60 (CHSP60) by using immunofluorescence and enzyme-linked immunosorbent assay (ELISA) techniques, respectively. RESULTS: Results: There were no substantial differences between antibodies to C. trachomatis in females with tubal infertility (67%) and non-tubal infertility (48%). However, women with tubal infertility (45%) have more anti-CHSP60 antibodies than non-tubal infertility (9%). Antibody screening for C. trachomatis has only (63%) sensitivity and (54%) specificity for detecting tubal infertility. On the other hand, the CHSP60 antibody testing has (44%) sensitivity and 92% specificity for diagnosing tubal infertility. A positive microimmunofluorescence (MIF) titer was observed in 12 of 18 (67%) females with the tubal problem, 31 of 64 (48%) with non-tubal infertility (P=0.3, OR=2.2, 95% CI=0.71 to 8.01). The CHSP60 antibodies were found in 8 of 18 (45%) females with tubal problem & 6 of 64 (9%) women with non-tubal infertility, power factor alpha α P=0.004, OR=9.3, 95% CI=2.1 to 43.2, power= 1.002 for n= 0.05). Incorporating CHSP60 and C. trachomatis antibodies testing gives an excellent positive probability proportion of 10 to diagnose C. trachomatis associated tubal infertility. CONCLUSION: Conclusions: CHSP60 antibody testing is a more specific evaluation than antibody testing for C. trachomatis for predicting chlamydia-associated tubal infertility. Using these tests at the first infertility examination may help the immediate diagnosis for non-interceptive tubal infertility.


Asunto(s)
Infecciones por Chlamydia , Infertilidad Femenina , Anticuerpos Antibacterianos , Chaperonina 60 , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis , Femenino , Proteínas de Choque Térmico , Humanos , Infertilidad Femenina/diagnóstico , Estudios Prospectivos
2.
MMWR Morb Mortal Wkly Rep ; 69(50): 1911-1916, 2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332296

RESUMEN

Sexually transmitted infections (STIs) caused by the bacteria Neisseria gonorrhoeae (gonococcal infections) have increased 63% since 2014 and are a cause of sequelae including pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate transmission of human immunodeficiency virus (HIV) (1,2). Effective treatment can prevent complications and transmission, but N. gonorrhoeae's ability to acquire antimicrobial resistance influences treatment recommendations and complicates control (3). In 2010, CDC recommended a single 250 mg intramuscular (IM) dose of ceftriaxone and a single 1 g oral dose of azithromycin for treatment of uncomplicated gonococcal infections of the cervix, urethra, and rectum as a strategy for preventing ceftriaxone resistance and treating possible coinfection with Chlamydia trachomatis (4). Increasing concern for antimicrobial stewardship and the potential impact of dual therapy on commensal organisms and concurrent pathogens (3), in conjunction with the continued low incidence of ceftriaxone resistance and the increased incidence of azithromycin resistance, has led to reevaluation of this recommendation. This report, which updates previous guidelines (5), recommends a single 500 mg IM dose of ceftriaxone for treatment of uncomplicated urogenital, anorectal, and pharyngeal gonorrhea. If chlamydial infection has not been excluded, concurrent treatment with doxycycline (100 mg orally twice a day for 7 days) is recommended. Continuing to monitor for emergence of ceftriaxone resistance through surveillance and health care providers' reporting of treatment failures is essential to ensuring continued efficacy of recommended regimens.


Asunto(s)
Gonorrea/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Administración Oral , Ceftriaxona/administración & dosificación , Centers for Disease Control and Prevention, U.S. , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/tratamiento farmacológico , Chlamydia trachomatis , Coinfección/tratamiento farmacológico , Doxiciclina/administración & dosificación , Medicina Basada en la Evidencia , Gonorrea/complicaciones , Humanos , Inyecciones Intramusculares , Estados Unidos
4.
Pediatr Rev ; 41(10): 522-537, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33004664

RESUMEN

Sexually transmitted infections (STIs) disproportionately affect young people, with more than half of the infections occurring in youth aged 15 to 25 years. (1)(2) This review, the second in a 2-part series on STIs, focuses on infections that may cause abnormal vaginal or penile discharge, including trichomonas, chlamydia, gonorrhea, and pelvic inflammatory disease (PID). Most infected persons, however, are asymptomatic. Nucleic acid amplification tests are the most sensitive and specific for the detection of chlamydia, gonorrhea, and trichomoniasis, and they can be performed on provider- or patient-collected swabs. Providers should have a low threshold for diagnosing and treating PID because untreated PID can have serious long-term complications for young women. Indications for hospitalization for PID include the presence of a tubo-ovarian abscess, severe illness with systemic symptoms, pregnancy, human immunodeficiency virus infection, and failure to respond to outpatient oral treatment (within 48-72 hours) or inability to tolerate the oral treatment.


Asunto(s)
Enfermedad Inflamatoria Pélvica/diagnóstico , Enfermedades de Transmisión Sexual/diagnóstico , Excreción Vaginal/microbiología , Adolescente , Candidiasis/complicaciones , Candidiasis/diagnóstico , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/diagnóstico , Femenino , Gonorrea/complicaciones , Gonorrea/diagnóstico , Humanos , Masculino , Enfermedad Inflamatoria Pélvica/etiología , Parejas Sexuales , Enfermedades de Transmisión Sexual/complicaciones , Vaginitis por Trichomonas/diagnóstico , Cervicitis Uterina/complicaciones , Vaginosis Bacteriana/complicaciones , Vaginosis Bacteriana/diagnóstico
5.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 40(7): 930-935, 2020 May 25.
Artículo en Chino | MEDLINE | ID: mdl-32701231

RESUMEN

OBJECTIVE: To assess the effect of neutralizing CD96 on natural killer (NK) cell functions in mice with pulmonary Chlamydia muridarum infection and explore the possible mechanism. METHODS: Male BALB/c mice were randomly divided into infection group (Cm group), anti-CD96 treatment group (anti-CD96 group) and control group (n=5). In the former two groups, C. muridarum was inoculated via intranasal administration to establish mouse models of pulmonary C. muridarum infection, and the mice in the control group received intranasal administration of the inhalation buffer. In anti-CD96 group, the mice were injected with anti-CD96 antibody intraperitoneally at the dose of 250 µg every 3 days after the infection; the mice in Cm group received intraperitoneal injections of saline. The body weight of the mice was recorded daily. The mice were sacrificed 5 days after C. muridarum infection, and CD96 expression was detected by quantitative real-time PCR and Western blotting. HE staining and pathological scores were used to evaluate pneumonia of the mice. The inclusion body forming units (IFUs) were detected in the lung tissue homogenates to assess lung tissue chlamydia load. Flow cytometry and ELISA were used to assess the capacity of the lung NK cells to produce interferon-γ (IFN-γ) and regulate macrophages and Th1 cells. RESULTS: C. muridarum infection inhibited CD96 expression in NK cells of the mice. Compared with those in Cm group, the mice in antiCD96 mice showed significantly milder lung inflammation (P < 0.05) and reduced chlamydia load in the lung tissue (P < 0.05). Neutralizing CD96 with anti-CD96 significantly enhanced IFN-γ secretion by the NK cells (P < 0.05) and augmented the immunoregulatory effect of the NK cells shown by enhanced responses of the lung macrophages (P < 0.05) and Th1 cells (P < 0.05). CONCLUSIONS: Inhibition of CD96 alleviates pneumonia in C. muridarum-infected mice possibly by enhancing IFN-γ secretion by NK cells and augmenting the immunoregulatory effect of the NK cells on innate and adaptive immunity.


Asunto(s)
Infecciones por Chlamydia , Chlamydia muridarum , Interferón gamma , Lesión Pulmonar , Animales , Antígenos CD/metabolismo , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/inmunología , Infecciones por Chlamydia/fisiopatología , Interferón gamma/genética , Interferón gamma/metabolismo , Células Asesinas Naturales/metabolismo , Lesión Pulmonar/etiología , Lesión Pulmonar/genética , Lesión Pulmonar/prevención & control , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL
6.
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
7.
Artículo en Inglés | MEDLINE | ID: mdl-32110902

RESUMEN

We assessed whether patients repeatedly infected with Neisseria gonorrhoeae (NG) were different compared to patients repeatedly tested negative, to obtain insight into the characteristics of patients frequently tested and infected with NG. All patients tested for NG (n = 16,662) between January 2011 and July 2018 were included. Multivariable logistic regression analyses were performed for the outcomes "repeat NG infections" and "once NG positive and not retested" versus patients "repeatedly tested NG negative". Of the individuals tested for NG, 0.2% (40/16,662) had repeat (≥2) NG infections, and accounted for 23% of all diagnosed NG infections. STI clinic patients, men (mostly men who have sex with men (MSM)), patients aged ≥25 years, and patients co-infected with HIV or Chlamydia trachomatis (CT) more often had repeat NG infections. The number of patients not retested after their initial NG diagnosis was 29.9% (92/308). Men (mostly MSM), HIV positive patients, and patients notified for sexually transmitted infections (STIs) were more often NG positive and not retested. Concluding, only 40 patients tested for NG accounted for one in four diagnosed NG infections. However, re-infections are likely to be missed among MSM and HIV positive patients, as they were mainly not retested after NG infection. It remains important to test and re-test for NG, especially in MSM, in order to halt transmission.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Infecciones por VIH , Minorías Sexuales y de Género , Adulto , Infecciones por Chlamydia/complicaciones , Chlamydia trachomatis , Femenino , Gonorrea/complicaciones , Gonorrea/diagnóstico , Infecciones por VIH/complicaciones , Homosexualidad Masculina , Humanos , Masculino , Neisseria gonorrhoeae/aislamiento & purificación , Prevalencia , Recurrencia , Adulto Joven
8.
J Infect Public Health ; 13(4): 613-618, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31519382

RESUMEN

BACKGROUND: Endometrial and cervical carcinomas are the most common gynecologic malignancies in Western world and many countries. The human papillomavirus (HPV) high-risk genotypes are associated with cervical carcinoma (CC). Chlamydia trachomatis (C. trachomatis), the most common sexually transmitted bacterial infection worldwide, considered a cofactor for HPV infection and CC. Information on HPV infection rate and type distribution among Jordanian women having CC is currently limited and unavailable among those with endometrial carcinoma. Therefore, the present study aimed to provide an updated estimate on HPV infection rate and its high-risk genotypes' distribution among Jordanian women by comparing data from invasive cervical carcinoma (ICC) to normal cervical tissues. Similarly, assessment of HPV infection rate was extended to the endometrial tissues. C. trachomatis infection was investigated as well to explore its possibility as HPV cofactor for induction of such carcinomas. METHODS: Total DNA was extracted from 144 formaldehyde-fixed paraffin-embedded cervical and endometrial tissue, equally divided between age-matched control and carcinoma cases. Polymerase chain reaction (PCR) was used for general detection of HPV-DNA, high risk HPV-16 and 18 genotypes and C. trachomatis DNA using specific primers. RESULTS: HPV infection was detected in 91.7% and 61.1% of cervical cancer patients and controls, respectively. Likewise, it was higher among cases (47.2%) than controls (13.8%) in endometrial biopsies. Significantly higher HPV infection rates were found among ICC and endometrial control biopsies of women >50 years. Out of 33 HPV positive ICC cases, single HPV-16 infections were detected in 69.7% compared to HPV-18 (15.2%), while HPV-16/18 co-infections were only found in three (9%) samples. C. trachomatis was not detected in all studied groups. CONCLUSION: The present study has successfully provided an updated estimate on HPV infection rate among Jordanian women with and without ICC and endometrial carcinoma. In addition, a lack of co-infection was observed between HPV and C. trachomatis in both cancer types.


Asunto(s)
Neoplasias Endometriales/virología , Infecciones por Papillomavirus/complicaciones , Neoplasias del Cuello Uterino/virología , Factores de Edad , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Neoplasias Endometriales/etiología , Femenino , Humanos , Jordania/epidemiología , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Reacción en Cadena de la Polimerasa , Factores de Riesgo , Neoplasias del Cuello Uterino/etiología
9.
J Pediatric Infect Dis Soc ; 9(1): 75-81, 2020 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-30624683

RESUMEN

BACKGROUND: Trichomonas vaginalis infection causes significant morbidity in the United States. Despite its high national disease burden, the epidemiologic characteristics of child and adolescent cases are not well understood. In this study, we aimed to describe the socioeconomic, transmission risk factors, clinical manifestations, and geospatial variables associated with cases of T vaginalis infection in the Houston, Texas, metropolitan area. METHODS: We performed a retrospective chart abstraction of all T vaginalis cases at 2 large pediatric hospitals in Houston between 2008 and 2016. RESULTS: We identified 87 patients (mean age, 16 years; range, 4-18 years); 30% of them were asymptomatic, and 39% were coinfected with another sexually transmitted infection(s). Almost all T vaginalis infections in sexually assaulted patients were diagnosed incidentally. Geospatial analysis identified clustering of cases in areas of high poverty and in minority populations. CONCLUSIONS: Our findings indicate that children and adolescents are at risk for T vaginalis infection; however, their risk factors might differ from those in adults. In addition, our geospatial analysis revealed the need for dedicated resources in neighborhoods associated with health disparities to prevent future incident cases.


Asunto(s)
Tricomoniasis/epidemiología , Trichomonas vaginalis , Adolescente , Niño , Preescolar , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Femenino , Disparidades en el Estado de Salud , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Violación , Estudios Retrospectivos , Delitos Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/parasitología , Texas/epidemiología , Tricomoniasis/complicaciones
10.
Asian Pac J Cancer Prev ; 20(12): 3843-3847, 2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-31870131

RESUMEN

OBJECTIVE: High-risk human papillomavirus (HR HPV) was associated with the development of cervical cancer. Asymptomatic Chlamydia trachomatis (C. trachomatis) infection is the most common bacterial, sexually-transmitted infection. This study aimed to investigate the association of C. trachomatis in positive HR HPV and the cytological results from liquid-based cytology (LBC). METHODS: 150 residual LBC specimens were collected; all of which had undergone cytology and HPV testing by Cobas. The samples were established as C. trachomatis using real-time PCR (RT-PCR) with Cryptic F/Cryptic R primers. RESULTS: Of 150 positive HPV findings, the most common (72.7%, 109/150) were the 12 other HR HPVs (viz., 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68). The cervical cytology of those positive HR HPVs were mostly negative (70.0%, 105/150).  The C. trachomatis infections in positive HR HPV were 16% (24/150) HPV. The analysis of the abnormal cytology revealed that 41.6% had C. trachomatis co-infection (C. trachomatis and HPV infection) viz., LSIL (20.8%), HSIL (12.5%), and ASC-US (8.3%). A comparison with positive HPV without C. trachomatis co-infection revealed that the highest prevalence was for LSIL, ASC-US, and HSIL (11.1%, 10.3%, and 6.4%, respectively). There was no difference between the abnormalities and negative cervical cytology with negative and positive C. trachomatis co-infection in HR HPV positive (p = 0.174). CONCLUSION: C. trachomatis infection was not significantly associated HR-HPV and abnormal cytology. This study confirms the increasing rate of C. trachomatis infection in asymptomatic women so routine screening for these infections has been suggested to (a) prevent complications such as the chronic pelvic pain associated with prolong infection and (b) reduce sexual transmission of the infection.


Asunto(s)
Cuello del Útero/microbiología , Cuello del Útero/virología , Infecciones por Chlamydia/microbiología , Coinfección/complicaciones , Tamizaje Masivo/métodos , Infecciones por Papillomavirus/virología , Neoplasias del Cuello Uterino/diagnóstico , Células Escamosas Atípicas del Cuello del Útero/microbiología , Células Escamosas Atípicas del Cuello del Útero/virología , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/epidemiología , Neoplasia Intraepitelial Cervical/microbiología , Neoplasia Intraepitelial Cervical/virología , Infecciones por Chlamydia/complicaciones , Chlamydia trachomatis/aislamiento & purificación , Coinfección/microbiología , Coinfección/virología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Pronóstico , Factores de Riesgo , Lesiones Intraepiteliales Escamosas/diagnóstico , Lesiones Intraepiteliales Escamosas/epidemiología , Lesiones Intraepiteliales Escamosas/microbiología , Lesiones Intraepiteliales Escamosas/virología , Tailandia/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/microbiología , Neoplasias del Cuello Uterino/virología , Frotis Vaginal/métodos
11.
PLoS One ; 14(11): e0224658, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31738795

RESUMEN

The cervical microbiota constitutes an important protective barrier against the invasion of pathogenic microorganisms. A disruption of microbiota within the cervical milieu has been suggested to be a driving factor of sexually transmitted infections. These include Chlamydia trachomatis which frequently causes serious reproductive sequelae such as infertility in women. In this study, we profiled the cervical microbial composition of a population of 70 reproductive-age Malaysian women; among which 40 (57.1%) were diagnosed with genital C. trachomatis infection, and 30 (42.8%) without C. trachomatis infection. Our findings showed a distinct compositional difference between the cervical microbiota of C. trachomatis-infected subjects and subjects without C. trachomatis infection. Specifically, significant elevations of mostly strict and facultative anaerobes such as Streptococcus, Megasphaera, Prevotella, and Veillonella in the cervical microbiota of C. trachomatis-positive women were detected. The results from the current study highlights an interaction of C. trachomatis with the environmental microbiome in the endocervical region.


Asunto(s)
Cuello del Útero/microbiología , Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/aislamiento & purificación , Infertilidad/microbiología , Microbiota/inmunología , Centros Médicos Académicos , Adulto , Bacterias Anaerobias/inmunología , Bacterias Anaerobias/aislamiento & purificación , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/inmunología , Chlamydia trachomatis/patogenicidad , Estudios de Cohortes , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Femenino , Interacciones Huésped-Patógeno/inmunología , Humanos , Infertilidad/inmunología , Malasia , Metagenómica , Microbiota/genética , Servicio Ambulatorio en Hospital , ARN Ribosómico 16S/genética , Adulto Joven
12.
Sci Rep ; 9(1): 15979, 2019 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-31685849

RESUMEN

Chlamydia trachomatis (CT) infection is an important factor for tubal pregnancy. However, whether Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) infections are also involved in tubal pregnancy remains unknown. This study is aimed to detect CT, UU, and MH in cervical secretions from patients with tubal pregnancy and control women in early pregnancy, to explore their prevalence rates and drug susceptibilities. Analysis was performed on patients with tubal pregnancy and those requiring termination of early pregnancy at <12 weeks from July 2013 to March 2014. Cervical secretions were tested for UU/MH with a UU/MH isolation and culture kit and for CT antigen by an immunochromatographic assay. Mycoplasma samples were tested for resistance to 12 antibiotics. There were no cases of CT infection detected. Mycoplasma infection rates (single or mixed) were similar in the tubal pregnancy and control groups, but the total rate of infection was higher for tubal pregnancy. All MH samples were sensitive to tetracyclines as well as josamycin and azithromycin. Josamycin and clarithromycin were effective against all UU cultures. Over 50% of the samples tested were resistant to ciprofloxacin.


Asunto(s)
Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/microbiología , Chlamydia trachomatis , Infecciones por Mycoplasma/complicaciones , Infecciones por Mycoplasma/microbiología , Embarazo Tubario/etiología , Adulto , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/efectos de los fármacos , Susceptibilidad a Enfermedades , Farmacorresistencia Bacteriana , Femenino , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/epidemiología , Embarazo , Embarazo Tubario/diagnóstico , Embarazo Tubario/epidemiología , Medición de Riesgo , Factores de Riesgo , Adulto Joven
14.
Medicine (Baltimore) ; 98(40): e17233, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577714

RESUMEN

RATIONALE: The pathology of gouty arthritis and reactive arthritis (ReA) partially overlaps, and both diseases are characterized by the production of inflammatory cytokines associated with the activation of monocytes and macrophages. However, the precise cytokine profile of cases with a coexistence of both diseases is unknown, and there are few reports on the course of treatment in patients with both gouty arthritis and ReA. PATIENT CONCERNS: A 39-year-old man with a recurrent episode of gouty arthritis presented prednisolone-resistant polyarthritis with high level of C-reactive protein (CRP). He had the features of gouty arthritis such as active synovitis of the first manifestation of metatarsophalangeal (MTP) joints and the presence of monosodium urate (MSU) crystals from synovial fluid. But he also had the features of ReA such as the presence of tenosynovitis in the upper limb, the positivity of human leukocyte antigen (HLA)-B27, a history of sexual contact and positive findings of anti-Chlamydia trachomatis-specific IgA and IgG serum antibodies. DIAGNOSES: He was diagnosed with HLA-B27 associated Chlamydia-induced ReA accompanied by gout flares. INTERVENTIONS: He was treated with 180 mg/day of loxoprofen, 1 mg/day of colchicine, and 10 mg/day of prednisolone for gout flares. However, his polyarthritis worsened with an increased level of CRP (23.16 mg/dL). Accordingly, we added 500 mg/day of salazosulfapyridine followed by adalimumab (ADA) 40 mg once every 2 weeks. OUTCOMES: After starting ADA, the patient's symptoms and laboratory findings showed rapid improvement and he achieved clinical remission 1 month after initiation of ADA treatment. As of this writing, the patient's clinical remission has been maintained for >1 year. LESSONS: This case suggests that with exacerbation of arthritis during gouty arthritis, coexistence with other pathologies such as peripheral spondyloarthritis should be considered, and early intensive treatment including tumor necrosis factor inhibitors may be necessary.


Asunto(s)
Artritis Reactiva/etiología , Infecciones por Chlamydia/complicaciones , Gota/complicaciones , Adulto , Artritis Reactiva/tratamiento farmacológico , Proteína C-Reactiva/análisis , Infecciones por Chlamydia/tratamiento farmacológico , Chlamydia trachomatis , Citocinas/metabolismo , Gota/tratamiento farmacológico , Humanos , Mediadores de Inflamación/metabolismo , Masculino , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
15.
Atherosclerosis ; 290: 103-110, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31604170

RESUMEN

BACKGROUND AND AIMS: Atherosclerosis is a chronic inflammatory disease, and recent studies have shown that infection at remote sites can contribute to the progression of atherosclerosis in hyperlipidemic mouse models. In this report, we tested the hypothesis that genital Chlamydia infection could accelerate the onset and progression of atherosclerosis. METHODS: Apolipoprotein E (Apoe-/-) and LDL receptor knockout (Ldlr-/-) mice on a high-fat diet were infected intra-vaginally with Chlamydia muridarum. Atherosclerotic lesions on the aortic sinuses and in the descending aorta were assessed at 8-weeks post-infection. Systemic, macrophage, and vascular site inflammatory responses were assessed and quantified. RESULTS: Compared to the uninfected groups, infected Apoe-/- and Ldlr-/- mice developed significantly more atherosclerotic lesions in the aortic sinus and in the descending aorta. Increased lesions were associated with higher circulating levels of serum amyloid A-1, IL-1ß, TNF-α, and increased VCAM-1 expression in the aortic sinus, suggesting an association with inflammatory responses observed during C. muridarum infection. Genital infection courses were similar in Apoe-/-, Ldlr-/-, and wild type mice. Further, Apoe-/- mice developed severe uterine pathology with increased dilatations. Apoe-deficiency also augmented cytokine/chemokine response in C. muridarum infected macrophages, suggesting that the difference in macrophage response could have contributed to the genital pathology in Apoe-/- mice. CONCLUSIONS: Overall, these studies demonstrate that genital Chlamydia infection exacerbates atherosclerotic lesions in hyperlipidemic mouse and suggest a novel role for Apoe in full recovery of uterine anatomy after chlamydial infection.


Asunto(s)
Enfermedades de la Aorta/etiología , Aterosclerosis/etiología , Infecciones por Chlamydia/complicaciones , Chlamydia muridarum/patogenicidad , Hiperlipidemias/complicaciones , Infecciones del Sistema Genital/complicaciones , Útero/microbiología , Animales , Enfermedades de la Aorta/metabolismo , Enfermedades de la Aorta/microbiología , Enfermedades de la Aorta/patología , Aterosclerosis/metabolismo , Aterosclerosis/microbiología , Aterosclerosis/patología , Células Cultivadas , Infecciones por Chlamydia/microbiología , Infecciones por Chlamydia/patología , Citocinas/sangre , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Femenino , Hiperlipidemias/metabolismo , Mediadores de Inflamación/sangre , Macrófagos/metabolismo , Macrófagos/microbiología , Ratones Noqueados para ApoE , Placa Aterosclerótica , Receptores de LDL/deficiencia , Receptores de LDL/genética , Infecciones del Sistema Genital/microbiología , Infecciones del Sistema Genital/patología , Factores de Tiempo , Útero/patología
16.
Hum Reprod ; 34(10): 1891-1898, 2019 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-31586185

RESUMEN

STUDY QUESTION: Can Chlamydia be found in the testes of infertile men? SUMMARY ANSWER: Chlamydia can be found in 16.7% of fresh testicular biopsies and 45.3% of fixed testicular biopsies taken from a selection of infertile men. WHAT IS KNOWN ALREADY: Male chlamydial infection has been understudied despite male and female infections occurring at similar rates. This is particularly true of asymptomatic infections, which occur in 50% of cases. Chlamydial infection has also been associated with increased sperm DNA damage and reduced male fertility. STUDY DESIGN, SIZE, DURATION: We collected diagnostic (fixed, n = 100) and therapeutic (fresh, n = 18) human testicular biopsies during sperm recovery procedures from moderately to severely infertile men in a cross-sectional approach to sampling. PARTICIPANTS/MATERIALS, SETTING, METHODS: The diagnostic and therapeutic biopsies were tested for Chlamydia-specific DNA and protein, using real-time PCR and immunohistochemical approaches, respectively. Serum samples matched to the fresh biopsies were also assayed for the presence of Chlamydia-specific antibodies using immunoblotting techniques. MAIN RESULTS AND THE ROLE OF CHANCE: Chlamydial major outer membrane protein was detected in fixed biopsies at a rate of 45.3%. This was confirmed by detection of chlamydial DNA and TC0500 protein (replication marker). C. trachomatis DNA was detected in fresh biopsies at a rate of 16.7%, and the sera from each of these three positive patients contained C. trachomatis-specific antibodies. Overall, C. trachomatis-specific antibodies were detected in 72.2% of the serum samples from the patients providing fresh biopsies, although none of the patients were symptomatic nor had they reported a previous sexually transmitted infection diagnosis including Chlamydia. LIMITATIONS, REASONS FOR CAUTION: No reproductively healthy male testicular biopsies were tested for the presence of Chlamydia DNA or proteins or Chlamydia-specific antibodies due to the unavailability of these samples. WIDER IMPLICATIONS FOR THE FINDINGS: Application of Chlamydia-specific PCR and immunohistochemistry in this human male infertility context of testicular biopsies reveals evidence of a high prevalence of previously unrecognised infection, which may potentially have a pathogenic role in spermatogenic failure. STUDY FUNDING/COMPETING INTEREST(S): Funding for this project was provided by the Australian NHMRC under project grant number APP1062198. We also acknowledge assistance from the Monash IVF Group and Queensland Fertility Group in the collection of fresh biopsies, and the Monash Health and co-author McLachlan (declared equity interest) in retrieval and sectioning of fixed biopsies. E.M. declares an equity interest in the study due to financing of fixed biopsy sectioning. All other authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.


Asunto(s)
Azoospermia/microbiología , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/aislamiento & purificación , Testículo/microbiología , Infecciones Asintomáticas , Azoospermia/diagnóstico , Azoospermia/patología , Azoospermia/terapia , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/microbiología , Infecciones por Chlamydia/patología , Chlamydia trachomatis/genética , Estudios Transversales , ADN Bacteriano/aislamiento & purificación , Humanos , Masculino , Recuperación de la Esperma , Testículo/patología
18.
Rev Esp Enferm Dig ; 111(10): 813-814, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31545062

RESUMEN

Infectious proctitis by sexually transmitted diseases are increasing in incidence and should be considered in men who have sex with men with rectal symptoms. In this case, we show an exuberant form of syphilitic and chlamydial proctitis that could be diagnosed as another anorectal disease such as inflammatory proctitis or even as a neoplasm if the clinical history is not taken into account.


Asunto(s)
Infecciones por Chlamydia/complicaciones , Proctitis/etiología , Sífilis/complicaciones , Anciano , Infecciones por Chlamydia/diagnóstico , Homosexualidad Masculina , Humanos , Masculino , Sigmoidoscopía , Sífilis/diagnóstico
19.
Artículo en Inglés | MEDLINE | ID: mdl-31514378

RESUMEN

Chlamydia trachomatis (Ct) and human papillomavirus (HPV) are the most prevalent sexually transmitted infections throughout the world. Despite the serious complications associated with chronic Ct infections in sexually active women, a screening program is not yet available in Italy. Moreover, HPV/Ct co-infections are also known to occur frequently, increasing the risk of HPV-induced carcinogenesis. The aim of this study was to evaluate the prevalence of Ct infections, the distribution of Ct serovars, and the incidences of Ct/HPV co-infections among women with a recent history of abnormal cervical cytology. Cervical samples were collected from 199 women referred for a gynecological visit following an abnormal Pap test results. All samples were tested for the presence of Ct and HPV DNA using real-time PCR assays; Ct typing of positive samples was performed by PCR-RFLP (restriction fragment length polymorphism) targeting the ompA gene. A high percentage of these women (12.8% and 21.7% with or without abnormal cytology on "retesting", respectively) were found to be Ct positive. Serovar F was the most prevalent type in Ct positive women, followed by E and K. Ct/HPV co-infections were detected in 7% (14/199) of enrolled women, with HPV-16, HPV-51, and HPV-52 being most frequently identified in co-infections. This study provides new epidemiological data on the prevalence of Ct and associated HPV infection in women with a recent history of abnormal cervical cytology in Italy, where notification of cases is not mandatory.


Asunto(s)
Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Displasia del Cuello del Útero/microbiología , Adulto , Chlamydia trachomatis/genética , Coinfección , Femenino , Papillomavirus Humano 16/genética , Humanos , Incidencia , Italia/epidemiología , Tamizaje Masivo , Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Reacción en Cadena de la Polimerasa , Prevalencia , Serogrupo , Enfermedades de Transmisión Sexual/epidemiología
20.
Sci Rep ; 9(1): 11405, 2019 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-31388084

RESUMEN

Genital chlamydia infection in women causes complications such as pelvic inflammatory disease and tubal factor infertility, but it is unclear why some women are more susceptible than others. Possible factors, such as time of day of chlamydia infection on chlamydial pathogenesis has not been determined. We hypothesised that infections during the day, will cause increased complications compared to infections at night. Mice placed under normal 12:12 light: dark (LD) cycle were infected intravaginally with Chlamydia muridarum either at zeitgeber time 3, ZT3 and ZT15. Infectivity was monitored by periodic vaginal swabs and chlamydiae isolation. Blood and vaginal washes were collected for host immunologic response assessments. The reproductive tracts of the mice were examined histopathologically, and fertility was determined by embryo enumeration after mating. Mice infected at ZT3 shed significantly more C. muridarum than mice infected at ZT15. This correlated with the increased genital tract pathology observed in mice infected at ZT3. Mice infected at ZT3 were less fertile than mice infected at ZT15. The results suggest that the time of day of infection influences chlamydial pathogenesis, it indicates a possible association between complications from chlamydia infection and host circadian clock, which may lead to a better understanding of chlamydial pathogenesis.


Asunto(s)
Infecciones por Chlamydia/inmunología , Chlamydia muridarum/patogenicidad , Relojes Circadianos/inmunología , Enfermedad Inflamatoria Pélvica/inmunología , Vagina/microbiología , Animales , Infecciones por Chlamydia/sangre , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/microbiología , Modelos Animales de Enfermedad , Femenino , Interacciones Microbiota-Huesped/inmunología , Humanos , Ratones , Enfermedad Inflamatoria Pélvica/microbiología , Fotoperiodo , Vagina/inmunología , Vagina/patología
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