Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 397
Filtrar
2.
BMC Infect Dis ; 20(1): 201, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32143598

RESUMO

BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy. CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood. CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.


Assuntos
Melioidose/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Aborto Espontâneo , Adulto , Antibacterianos/uso terapêutico , Burkholderia pseudomallei/isolamento & purificação , Feminino , Humanos , Melioidose/tratamento farmacológico , Melioidose/microbiologia , Gravidez , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Vagina/microbiologia
3.
PLoS One ; 15(2): e0228467, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040516

RESUMO

Urethritis, or inflammation of the urethra, is one of the most common reasons men seek clinical care. Sexually transmitted pathogens including Neisseria gonorrhoeae are responsible for over half of the symptomatic urethritis cases in U.S. men. Recently, clinics in Indianapolis, Columbus, Atlanta, and other U.S. cities began to note increasing numbers of men presenting with urethritis and Gram-negative intracellular diplococci in their urethral smears who test negative for N. gonorrhoeae. Many of these discordant cases, which have periodically reached highs of more than 25% of presumed gonococcal cases in some sexually transmitted infection clinics in the U.S. Midwest, are infected with strains in a novel urethrotropic clade of Neisseria meningitidis ST-11 (US_NmUC). However, no cultivation-independent tests are available for the US_NmUC strains, and prior studies relied on microbial culture and genome sequencing to identify them. Here, we describe a PCR test that can identify the US_NmUC strains and distinguish them from commensal and invasive N. meningitidis strains as well as N. gonorrhoeae. Our SimpleProbe®-based real-time PCR assay targets a conserved nucleotide substitution in a horizontally acquired region of US_NmUC strain genomes. We applied the assay to 241 urine specimens whose microbial compositions had previously been determined by deep shotgun metagenomic sequencing. The assay detected the single US_NmUC positive case in this cohort, with no false positives. Overall, our simple and readily adaptable assay could facilitate investigation of the pathogenesis and epidemiology of the US_NmUC clade.


Assuntos
Neisseria meningitidis/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Uretrite/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Reações Falso-Positivas , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Gonorreia/microbiologia , Gonorreia/urina , Humanos , Masculino , Pessoa de Meia-Idade , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/isolamento & purificação , Neisseria meningitidis/classificação , Neisseria meningitidis/isolamento & purificação , Polimorfismo de Nucleotídeo Único , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/urina , Estados Unidos/epidemiologia , Uretra/microbiologia , Uretra/patologia , Uretrite/diagnóstico , Urinálise/métodos , Sequenciamento Completo do Genoma , Adulto Jovem
4.
Rev. argent. coloproctología ; 30(4): 80-87, dic. 2019. graf, tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1096677

RESUMO

Introducción: Las infecciones transmisibles sexualmente (ITS) con afectación anorrectal constituyen un desafío pues las manifestaciones producidas por Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) y Treponema pallidum (TP) son similares. Objetivo: Evaluar si las manifestaciones anorrectales debidas a CT, NG y TP asociadas al examen proctológico permiten diagnóstico certero, sin estudios complementarios. Pacientes y método: Estudio retrospectivo. Revisión de registros de pacientes atendidos en consultorio coloproctológico. Periodo: 01/08/2015-01/07/2016. Se incluyeron pacientes con diagnóstico de ITS anorrectal, excepto aquellos con HPV únicamente. A todos se les pesquisaron ITS mediante hisopado anal para CT por inmunofluorescencia y para estudio directo y cultivo de NG, VDRL para TP y además HIV. Variables: sexo, edad, HIV, sexo anal, uso de preservativo, motivo de consulta y resultado de estudios efectuados. Resultados: Treinta y cuatro pacientes (32 hombres). Edad mediana 31,5 años (rango: 19-65). Veinticinco pacientes HIV + (73,5%). Veintinueve pacientes (28 hombres) mantenían sexo anal. 91% no usaba preservativo adecuadamente. 65% tuvo una única infección (ITS pura). Se diagnosticaron 14 sífilis (8 puras), 14 clamidiasis (7 puras) y 11 gonococcias (7 puras). Co-infección entre ellas: 9% y con HPV: 26%. La úlcera fue la manifestación en 7/8 casos de sífilis puras (todas dolorosas, excepto una). El resto presentó síntomas variados (condilomas virales atípicos, secreción purulenta y proctorragia). Más del 50% de las gonococias puras (4/7) se manifestó con úlcera, sin embargo, el dolor estuvo presente siempre (8/8) y en tres se asoció secreción purulenta. En cambio, la mitad de los pacientes con clamidiasis puras, se manifestó con proctorragia causada por un tumor rectal/sigmoideo inflamatorio, clínicamente indistinguible de neoplasia maligna. Todos las sífilis y gonococias tuvieron correlato con las pruebas diagnósticas, no así las clamidiasis cuyo diagnóstico no pudo confirmarse en tres casos (37,5%), que respondieron al tratamiento empírico. Conclusión: NG y TP anorrectal provocaron mayormente síntomas similares a los de etiología no venérea y se requirió del laboratorio para el diagnóstico etiológico. La presencia de tumor con biopsia negativa para neoplasia maligna en pacientes de riesgo para ITS obliga a descartar clamidiasis. (AU)


Introduction: Sexually transmitted infections (STIs) are a challenge in medical consultation. The clinical manifestations of infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Treponema pallidum ( TP) share symptoms at anorectal level. This implies the need for a high index of suspicion for diagnosis, which is based on history, physical examination and laboratory tests that not always are accurate or available . Purpose: Assess whether clinical signs of anorectal infections by CT, NG and TP associated with proctologic exams, lead to an accurate etiologic diagnosis without the help of specific laboratory studies. Patients and methods: Observational, retrospective study, based on a review of records of patients treated at the outpatient clinic of the Hospital Fernandez (City of Buenos Aires) department of coloproctology, in the period between August 2015 and July 2016. Patients who underwent STI diagnosis were all considered, but to those whose only diagnosis was infection by human papilloma virus (HPV) were excluded from the analysis. All patients were tested after the three etiologies of STI (anal swab for CT study by immunofluorescence, swabbing for direct study, and cultivation of NG and TP VDRL) and HIV. Variables analyzed: sex, age, presence of HIV infection, practice of receptive anal sex, proper use of condoms, signs and symptoms that prompted the consultation, and results of diagnostic tests. Results: 34 patients (32 men) were included. Median age 31.5 years (range: 19-65, interquartile range: 26-37). Twenty-five patients (73.5%) were HIV+. Twenty-nine patients (28 men) remained receptive anal sex. 91% did not use condoms properly. 65% of infections were pure, without other STI asociada-. 14 cases of syphilis (8 pure), 14 Chlamydia (7 pure) and 11 gonococcias (7puras), including co-infection in 9% of cases, no evidence of a more frequent another co-infection diagnosed. Co-infection with HPV was detected in 9 (26%) cases. The ulcer was the sign in 7/8 cases of pure syphilis (all painful, except one). The rest is expressed by a variety of symptoms (atypical viral warts, purulent and bloody diarrhea). Similarly, just over 50% (4/7) of pure gonococcias demonstrated ulcer, but the pain was always present (8/8 of pure gonococcias) and three associated with purulent discharge. Instead of the ten patients with pure chlamydia, 50% manifested with bloody diarrhea caused by a rectal tumor / inflammatory sigmoid, clinically indistinguishable from malignancy. All cases of syphilis and gonococcal were correlated with diagnostic tests; not those whose diagnosis of chlamydial infection (confirmed in eight and was negative in three, 37.5%) who responded to empiric treatment indicated by the clinical suspicion. Conclusion: While this is a small series, it shows that the NG and TP in the anorectal location mostly caused symptoms similar to those of non-venereal ethology most of the times, and laboratory assistance for etiologic diagnosis was required. The presence of tumor with negative biopsy for malignancy in patients at risk for STIs, leads chlamydia to be ruled out. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Proctite/etiologia , Proctite/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/complicações , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Infecções por Chlamydia/diagnóstico , Gonorreia/diagnóstico , Sífilis/diagnóstico , Dor , Proctite/epidemiologia , Reto/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Comorbidade , Infecções por HIV , Estudos Retrospectivos , Distribuição por Sexo , Técnicas de Laboratório Clínico
5.
Microb Genom ; 5(11)2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31682221

RESUMO

Since the 1970s, shigellosis has been reported as a sexually transmissible infection, and in recent years, genomic data have revealed the breadth of Shigella spp. transmission among global networks of men who have sex with men (MSM). In 2015, Public Health England (PHE) introduced routine whole-genome sequencing (WGS) of Shigella spp. to identify transmission clusters. However, limited behavioural information for the cases hampers interpretation. We investigated whether WGS can distinguish between clusters representing sexual transmission in MSM and clusters representing community (non-sexual) transmission to inform infection control. WGS data for Shigella flexneri from August 2015 to July 2017 were aggregated into single linkage clusters based on SNP typing using a range of SNP distances (the standard for Shigella surveillance at PHE is 10 SNPs). Clusters were classified as 'adult male', 'household', 'travel-associated' or 'community' using routine demographic data submitted alongside laboratory cultures. From August 2015 to March 2017, PHE contacted those with shigellosis as part of routine public-health follow-up and collected exposure data on a structured questionnaire, which for the first time included questions about sexual identity and behaviour. The questionnaire data were used to determine whether clusters classified as 'adult male' represented likely sexual transmission between men, thereby validating the use of the SNP clustering tool for informing appropriate public-health responses. Overall, 1006 S. flexneri cases were reported, of which 563 clustered with at least one other case (10-SNP threshold). Linked questionnaire data were available for 106 clustered cases, of which 84.0 % belonged to an 'adult male' cluster. At the 10-SNP threshold, 95.1 % [95 % confidence interval (CI) 88.0-98.1%] of MSM belonged to an 'adult male' cluster, while 73.2 % (95 % CI 49.1-87.5%) of non-MSM belonged to a 'community' or 'travel-associated' cluster. At the 25-SNP threshold, all MSM (95 % CI 96.0-100%) belonged to an 'adult male' cluster and 77.8 % (95 % CI 59.2-89.4%) of non-MSM belonged to a 'community' or 'travel-associated' cluster. Within one phylogenetic clade of S. flexneri, 9 clusters were identified (7 'adult male'; 2 'community') using a 10-SNP threshold, while a single 'adult male' cluster was identified using a 25-SNP threshold. Genotypic markers of azithromycin resistance were detected in 84.5 % (294/348) of 'adult male' cases and 20.9 % (9/43) of cases in other clusters (10-SNP threshold), the latter of which contained gay-identifying men who reported recent same-sex sexual contact. Our study suggests that SNP clustering can be used to identify Shigella clusters representing likely sexual transmission in MSM to inform infection control. Defining clusters requires a flexible approach in terms of genetic relatedness to ensure a clear understanding of underlying transmission networks.


Assuntos
Disenteria Bacilar/diagnóstico , Disenteria Bacilar/epidemiologia , Shigella flexneri/genética , Adulto , Análise por Conglomerados , Disenteria Bacilar/genética , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Minorias Sexuais e de Gênero , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/genética , Shigella/genética , Shigella flexneri/patogenicidade , Sequenciamento Completo do Genoma
7.
PLoS One ; 14(9): e0222962, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31550285

RESUMO

Urine is an acceptable, non-invasive sample for investigating the human urogenital microbiota and for the diagnosis of sexually transmitted infections. However, low quantities of bacterial DNA and PCR inhibitors in urine may prevent efficient PCR amplification for molecular detection of bacteria. Furthermore, cold temperatures used to preserve DNA and bacteria in urine can promote precipitation of crystals that interfere with DNA extraction. Saline, Dulbecco's Phosphate Buffered Saline, or Tris-EDTA buffer were added to urine from adult men to determine if crystal precipitation could be reversed without heating samples beyond ambient temperature. Total bacterial DNA concentrations and PCR inhibition were measured using quantitative PCR assays to compare DNA yields with and without buffer addition. Dissolution of crystals with Tris-EDTA prior to urine centrifugation was most effective in increasing bacterial DNA recovery and reducing PCR inhibition. DNA recovery using Tris-EDTA was further tested by spiking urine with DNA from bacterial isolates and median concentrations of Lactobacillus jensenii and Escherichia coli 16S rRNA gene copies were found to be higher in urine processed with Tris-EDTA. Maximizing bacterial DNA yield from urine may facilitate more accurate assessment of bacterial populations and increase detection of specific bacteria in the genital tract.


Assuntos
DNA Bacteriano/isolamento & purificação , Microbiota/genética , Reação em Cadeia da Polimerase , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Uretrite/diagnóstico , Adolescente , Cristalização , DNA Bacteriano/química , DNA Bacteriano/urina , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Genitália Masculina/microbiologia , Humanos , Lactobacillus/genética , Lactobacillus/isolamento & purificação , Masculino , RNA Ribossômico 16S/genética , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/urina , Uretrite/microbiologia , Uretrite/urina , Sistema Urinário/microbiologia , Urina/química , Urina/microbiologia
9.
Emerg Infect Dis ; 25(4): 719-727, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30882306

RESUMO

During 2016-2017, we tested asymptomatic men who have sex with men (MSM) in Melbourne, Australia, for Mycoplasma genitalium and macrolide resistance mutations in urine and anorectal swab specimens by using PCR. We compared M. genitalium detection rates for those asymptomatic men to those for MSM with proctitis and nongonococcal urethritis (NGU) over the same period. Of 1,001 asymptomatic MSM, 95 had M. genitalium; 84.2% were macrolide resistant, and 17% were co-infected with Neisseria gonorrhoeae or Chlamydia trachomatis. Rectal positivity for M. genitalium was 7.0% and urine positivity was 2.7%. M. genitalium was not more commonly detected in the rectums of MSM (n = 355, 5.6%) with symptoms of proctitis over the same period but was more commonly detected in MSM (n = 1,019, 8.1%) with NGU. M. genitalium is common and predominantly macrolide-resistant in asymptomatic MSM. M. genitalium is not associated with proctitis in this population.


Assuntos
Homossexualidade Masculina , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/microbiologia , Mycoplasma genitalium , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Antibacterianos/farmacologia , Austrália/epidemiologia , Coinfecção , Estudos Transversais , Farmacorresistência Bacteriana , Humanos , Masculino , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/transmissão , Mycoplasma genitalium/efeitos dos fármacos , Razão de Chances , Prevalência , Vigilância em Saúde Pública , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Avaliação de Sintomas
11.
Sex Transm Dis ; 46(1): 25-30, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30044334

RESUMO

BACKGROUND: Prevention of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) requires timely disease detection, but this is complicated by asymptomatic infection. We estimated screening/testing rates by symptomatic status to evaluate adherence to Centers for Disease Control and Prevention STI screening guidelines. METHODS: In a cross-sectional study of 2572 US MSM aged 15 to 65 years in 2017 to 2018, we measured the reported number of asymptomatic STI screens in the past 2 years versus tests prompted by disease symptoms. Using negative binominal regression within a hierarchical Bayesian framework, we estimated yearly rates of asymptomatic screening and symptomatic testing by geographic, demographic, and behavioral factors. RESULTS: Human immunodeficiency virus (HIV) status was most strongly associated with all testing/screening frequency (incidence rate ratio [IRR], 1.72; 95% credible interval [Crl], 1.49, 1.97). The HIV-uninfected MSM had 0.14 (95% credible interval [CrI], 0.12-0.17) symptomatic tests and 0.88 (95% CrI, 0.77-1.01) asymptomatic screens per year. The HIV-infected MSM had 0.25 (95% CrI, 0.18-0.35) symptomatic tests and 1.53 (95% CrI, 1.24-1.88) asymptomatic screens per year. Rates of asymptomatic screening were higher among black compared with white MSM (IRR, 1.41; 95% CrI, 1.15-1.73), but weakly associated with number of past-year sexual partners (IRR, 1.01; 95% CrI, 1.00-1.01). Overall, 85% to 90% of diagnostic events were asymptomatic screens. CONCLUSIONS: Self-reported rates of STI screening were close to Centers for Disease Control and Prevention's recommended overall annual screening frequency, but with gaps defined by demographics and behavioral risk. Targeted screening efforts may be indicated specifically for younger MSM and those with multiple partners.


Assuntos
Infecções Assintomáticas/epidemiologia , Homossexualidade Masculina , Programas de Rastreamento , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Idoso , Teorema de Bayes , Estudos Transversais , Infecções por HIV/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Minorias Sexuais e de Gênero , Estados Unidos/epidemiologia , Adulto Jovem
13.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 36(9): 576-585, nov. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-176836

RESUMO

Sexually transmitted diseases (STDs) are one of the most common and universal problems of public health. Human immunodeficiency virus (HIV) and STD infections are clearly interrelated, and share risks, incidence and transmission mechanisms. The aim of this document is to inform health professionals about the current situation and management of STDs, which, because of their relevance, need greater care, both in the general population and in the population with HIV. These guidelines for STD treatment, although clinically oriented and focused especially on treatment, contain other aspects related to assessing and evaluating patients, as well as recommendations for diagnosis


Las infecciones de transmisión sexual (ITS) son uno de los problemas más frecuentes y universales de Salud Pública. La infección por el virus de la inmunodeficiencia humana y las ITS están claramente interrelacionadas, compartiendo riesgos, incidencia y mecanismos de transmisión. El objetivo de este documento es dar a conocer a los profesionales sanitarios la situación actual y el manejo de aquellas ITS, que por su relevancia necesitan una mayor atención, tanto en población general como en población infectada por el virus de la inmunodeficiencia humana. Estas directrices para el tratamiento de las ITS, aunque orientadas desde el punto de vista clínico y centrado especialmente en el tratamiento, también recogen otros aspectos relacionados con la evaluación y valoración del paciente así como recomendaciones de diagnóstico


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/terapia
14.
Int J Infect Dis ; 73: 60-62, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29879525

RESUMO

Tuberculosis screening was performed for a healthy asymptomatic woman to determine whether she had been infected with active genital tuberculosis via sexual intercourse with her husband who had epididymal tuberculosis. Vaginal swab culture yielded Mycobacterium tuberculosis. Furthermore, whole genome sequencing revealed that the two causative isolates were genetically identical. This appears to be the first report on the sexual transmission of genital tuberculosis from a man to an asymptomatic woman, detected by active screening for genital tuberculosis and molecular analysis, including whole genome sequencing. Active screening for genital tuberculosis in the female partner should be considered soon after diagnosis of male genital tuberculosis, even when the female partner is asymptomatic.


Assuntos
Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Tuberculose dos Genitais Femininos/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Cônjuges , Tuberculose dos Genitais Femininos/transmissão
15.
Ugeskr Laeger ; 180(20)2018 May 14.
Artigo em Dinamarquês | MEDLINE | ID: mdl-29798753

RESUMO

Mycoplasma genitalium infection is sexually transmitted, and it is almost as common as chlamydia in most European settings. Symptoms are indistinguishable from those of chlamydia, and late sequelae are believed to be similar. Treatment of M. genitalium infection is complicated due to widespread antimicrobial resistance not only to first-line azithromycin but now also increasingly to second-line moxifloxacin, leaving no other antibiotics registered in Denmark available for effective treatment. In the absence of available antimicrobials, screening of asymptomatic individuals should be avoided.


Assuntos
Antibacterianos/farmacologia , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma genitalium/isolamento & purificação , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Feminino , Humanos , Masculino , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Mycoplasma genitalium/ultraestrutura , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia
16.
Sci Rep ; 8(1): 7542, 2018 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-29765114

RESUMO

Even though syphilis can be easily diagnosed by simple and low-cost laboratory methods, it continues to be an important health problem. Rapid tests (RT) for the detection of treponemal antibodies can facilitate earlier diagnosis, access to treatment and linkage to care. The aim of this study was to analyse the usefulness of the incorporation of a RT in the detection of patients infected with T. pallidum in a sexually-transmitted disease (STD) clinic. Between March and December 2015, a syphilis RT was offered to patients who spontaneously attended the clinic. Conventional serology testing was additionally indicated to every participant. The RT for syphilis was offered to 1887 patients, of whom 31.1% agreed to get tested. VDRL test was performed in 84.0% of patients that were also tested with syphilis RT, with a significantly higher frequency observed among participants with reactive RT (94.3% vs. 79.8%, p < 0.001). These results showed that 33.7% of the participants were reactive for the RT and 27.0% were reactive for the VDRL test. Both tests were reactive in 24.9% and non-reactive in 64.3%. A high prevalence of active syphilis was detected in patients attending the clinic. The use of a syphilis RT had a positive impact, which in combination with the VDRL test increased the number of patients that were effectively diagnosed.


Assuntos
Cardiolipinas/análise , Colesterol/análise , Fosfatidilcolinas/análise , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adulto , Argentina/epidemiologia , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/imunologia , Sífilis/epidemiologia , Sífilis/imunologia
17.
Int J STD AIDS ; 29(10): 974-979, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29690825

RESUMO

Home-based testing is an alternative, convenient and cost-effective method of testing for sexually transmitted infections compared to traditional clinic-based testing, in patients who are asymptomatic and, or, would otherwise feel stigmatised about attending sexual health clinics. The sexual health service in Birmingham and Solihull, called Umbrella, provides an online home-based testing service, which has been in operation since August 2015. The aim of this study was to evaluate the uptake and return rate of home-based testing kits and compare home-based testing to clinic-based testing in terms of diagnosis and treatment rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Our study showed that home-based testing is a popular method of testing and relatively more popular amongst asymptomatic, young, heterosexual female and White patients than clinic-based testing, with a return rate of 48%. The diagnosis rates for CT/GC are comparable to patients who attend clinic for testing (8% vs. 10% in home-based and clinic-based groups, respectively, p < 0.001). The overall treatment rate was lower in the home-based compared to the clinic-based group (82% vs. 88%, p < 0.001). Umbrella will continue to provide this service within Birmingham and Solihull and aim to provide patients with alternative pathways for more convenient access to treatment.


Assuntos
Infecções por Chlamydia/diagnóstico , Gonorreia/diagnóstico , Programas de Rastreamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Autocuidado , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Chlamydia trachomatis/isolamento & purificação , Feminino , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Neisseria gonorrhoeae/isolamento & purificação , Kit de Reagentes para Diagnóstico , Fatores Socioeconômicos , Manejo de Espécimes , Reino Unido , Adulto Jovem
18.
Isr Med Assoc J ; 20(1): 9-13, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29658200

RESUMO

BACKGROUND: Ureaplasma species (Usp) are the most prevalent genital Mycoplasma isolated from the urogenital tract of both men and women. Usp may be commensals in the genital tract but may also be contributors to a number of pathological conditions of the genital tract. Because they can also just colonize the genital tract of healthy people, their pathogenic role can be difficult to prove. OBJECTIVES: The aim of the study was to evaluate the efficacy of a quantitative polymerase chain reaction (qPCR) method for the discrimination between infection and colonization by measuring prevalence of Usp in asymptomatic versus symptomatic patients. METHODS: Urine samples were tested for U. parvum and U. urealyticum using a semi-quantitative multiplex PCR technique for sexually transmitted diseases (Anyplex™ STI-7 Detection Kit, Seegene, South Korea). A total of 250 symptomatic and 250 asymptomatic controls were included. RESULTS: A strong positive result for U. parvum was significantly more prevalent in symptomatic compared to asymptomatic patients. This finding was observed especially in women and in the young group (15-35 years of age). No significant differences were observed between the prevalence in symptomatic and asymptomatic patients of U. parvum with low strength of positivity and for U. urealyticum in all groups by age, gender, and strength of positivity. CONCLUSIONS: The significant difference between the symptomatic and asymptomatic group in the highest positivity group for U. parvum using the Anyplex™ STI-7 detection kit in urine may indicate a high probability of infection rather than colonization, especially in women and young patients.


Assuntos
Reação em Cadeia da Polimerase/métodos , Doenças Bacterianas Sexualmente Transmissíveis , Infecções por Ureaplasma , Ureaplasma , Adolescente , Adulto , Doenças Assintomáticas/epidemiologia , Carga Bacteriana/métodos , DNA Bacteriano/análise , Feminino , Genitália/microbiologia , Humanos , Masculino , Valor Preditivo dos Testes , Prevalência , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Avaliação de Sintomas/métodos , Ureaplasma/classificação , Ureaplasma/genética , Ureaplasma/isolamento & purificação , Ureaplasma/patogenicidade , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/fisiopatologia
19.
Int J Clin Pharmacol Ther ; 56(5): 212-216, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29393849

RESUMO

BACKGROUND: The aim of this study was to analyze the prevalence and treatment of sexually transmitted diseases (STDs) in gynecological practices in Germany. MATERIALS AND METHODS: This study included women who were followed in gynecological practices in Germany between 2013 and 2015. The first outcome was the prevalence of women diagnosed with STDs during this time period. Eight different types of STD infections were included in the analysis: chlamydial infection, gonococcal infection, anogenital warts, anogenital herpes infection, trichomoniasis, ulcus molle, phthiriasis, and syphilis. The second outcome was the prevalence of women with STDs who received appropriate medication within 90 days of STD diagnosis. RESULTS: There were 1,030,968 patients available for analysis. The most frequent infection was chlamydia (0.59%), and the least frequent one was syphilis (0.01%). The prevalence of STDs was found to be the highest in women aged 21 - 25 years (3.42%). Mean age at diagnosis ranged from 27.3 years (chlamydia infection) to 40.6 years (syphilis). Finally, the share of women receiving medication therapy was the highest for syphilis (83.3%) and the lowest for anogenital warts (52.7%). CONCLUSIONS: The prevalence of STDs ranged from 0.01 to 0.59% in women followed in gynecological practices in Germany between 2013 and 2015.
.


Assuntos
Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Ginecologia , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Virais Sexualmente Transmissíveis/tratamento farmacológico , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Padrões de Prática Médica , Prevalência , Estudos Retrospectivos , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Virais Sexualmente Transmissíveis/diagnóstico , Doenças Virais Sexualmente Transmissíveis/virologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA