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1.
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
2.
Emerg Infect Dis ; 24(7): 1195-1203, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29912682

RESUMO

Contemporary strategies to curtail the emergence of antimicrobial resistance in Neisseria gonorrhoeae include screening for and treating asymptomatic infections in high-prevalence populations in whom antimicrobial drug-resistant infections have typically emerged. We argue that antimicrobial resistance in these groups is driven by a combination of dense sexual network connectivity and antimicrobial drug exposure (for example, through screen-and-treat strategies for asymptomatic N. gonorrhoeae infection). Sexual network connectivity sustains a high-equilibrium prevalence of N. gonorrhoeae and increases likelihood of reinfection, whereas antimicrobial drug exposure results in selection pressure for reinfecting N. gonorrhoeae strains to acquire antimicrobial resistance genes from commensal pharyngeal or rectal flora. We propose study designs to test this hypothesis.


Assuntos
Anti-Infecciosos/farmacologia , Farmacorresistência Bacteriana , Gonorreia/epidemiologia , Gonorreia/microbiologia , Neisseria gonorrhoeae/efeitos dos fármacos , Comportamento Sexual , Feminino , Gonorreia/tratamento farmacológico , Gonorreia/transmissão , Humanos , Masculino , Prevalência , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão
3.
Clin Infect Dis ; 65(10): 1751-1753, 2017 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-29020280
4.
Acta Derm Venereol ; 97(10): 1235-1238, 2017 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-28681067

RESUMO

Mycoplasma genitalium is a sexually transmitted infection ordinarily treated with azithromycin. Emerging resistance to macrolide is linked to mutations in the 23S rRNA gene. We analysed the frequency of such mutations of M. genitalium isolates from patients that were symptomatic, and from sexual partners of symptomatic individuals, from October to December of 2015, in the Skåne Region of Sweden. Mutations were analysed by the use of DNA sequencing. Overall, 11.9% (145/1,311) and 17.0% (116/704) of females and males were positive for M. genitalium, respectively. Macrolide resistant mutations were detected in 13% (31/239) of M. genitalium isolates from first-test patient samples. Twenty-one (8.8%) and 10 (4.2%) of the isolates had point mutations of the 23S-gene at position 2072 and 2071, respectively. Two different M. genitalium isolates were detected simultaneously in two cases. In summary, we found a relatively low rate of macrolide-resistant M. genitalium in the region of Southern Sweden.


Assuntos
Antibacterianos/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/genética , Macrolídeos/uso terapêutico , Mutação , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma genitalium/efeitos dos fármacos , Mycoplasma genitalium/genética , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Genótipo , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/transmissão , Estudos Retrospectivos , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Suécia/epidemiologia , Adulto Jovem
5.
Sex Transm Dis ; 44(6): 338-343, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28499282

RESUMO

BACKGROUND: Saskatchewan has one of the highest rates of gonorrhea among the Canadian provinces-more than double the national rate. In light of these high rates, and the growing threat of untreatable infections, improved understanding of gonorrhea transmission dynamics in the province and evaluation of the current system and tools for disease control are important. METHODS: We extracted data from a cross-sectional sample of laboratory-confirmed gonorrhea cases between 2003 and 2012 from the notifiable disease files of the Regina Qu'Appelle Health Region. The database was stratified by calendar year, and social network analysis combined with statistical modeling was used to identify associations between measures of connection within the network and the odds of repeat gonorrhea and risk of coinfection with chlamydia at the time of diagnosis. RESULTS: Networks were highly fragmented. Younger age and component size were positively associated with being coinfected with chlamydia. Being coinfected, reporting sex trade involvement, and component size were all positively associated with repeat infection. CONCLUSIONS: This is the first study to apply social network analysis to gonorrhea transmission in Saskatchewan and contributes important information about the relationship of network connections to gonorrhea/chlamydia coinfection and repeat gonorrhea. This study also suggests several areas for change of systems-related factors that could greatly increase understanding of social networks and enhance the potential for bacterial sexually transmitted infection control in Saskatchewan.


Assuntos
Saúde Pública , Trabalho Sexual/estatística & dados numéricos , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Apoio Social , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/prevenção & controle , Infecções por Chlamydia/transmissão , Análise por Conglomerados , Coinfecção/epidemiologia , Coinfecção/prevenção & controle , Busca de Comunicante , Estudos Transversais , Feminino , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Gonorreia/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Masculino , Distribuição de Poisson , Recidiva , Fatores de Risco , Saskatchewan/epidemiologia , Parceiros Sexuais , Doenças Bacterianas Sexualmente Transmissíveis/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
7.
Sex Transm Dis ; 42(11): 629-33, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26462187

RESUMO

BACKGROUND: Although HIV incidence has declined in India, men and transgender women who have sex with men (MSM) continue to have high rates of HIV and sexually transmitted disease (STD). Indian MSM face substantial pressures to marry and have families, but the HIV/STD burden among married Indian MSM is not well characterized. METHODS: A diverse sample of Indian MSM were recruited through respondent-driven sampling. Independent variables that produced a P value of 0.10 or less were then added to a multivariable logistic regression model. RESULTS: Most of the 307 MSM (95 married and 212 unmarried) recruited into the study were younger than 30 years, and less than one-third had more than a high school education. Almost two-thirds of the married men had children, compared with 1.4% of the unmarried men (P < 0.001). The numbers of condomless anal sex acts did not differ by marriage status. Although unmarried MSM more often identified themselves as "kothi" (receptive role), their rates of HIV or bacterial STD were similar to married MSM, with 14.3% being HIV infected. The respondent-driven sampling-adjusted prevalence of any bacterial STD was 18.3% for married MSM and 20% for unmarried MSM (not significant). Participants reported high levels of psychological distress, with 27.4% of married and 20.1% of unmarried MSM reporting depressive symptoms (not significant). CONCLUSIONS: Men who have sex with men in Mumbai had high rates of HIV, STD, and behavioral health concerns. Clinicians need to become more comfortable in eliciting sexual histories so that they can identify MSM who need HIV/STD treatment and/or prevention services.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Casamento/estatística & dados numéricos , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/psicologia , Pessoa Solteira/estatística & dados numéricos , Sexo sem Proteção/psicologia , Adulto , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Modelos Logísticos , Masculino , Prevalência , Serviços Preventivos de Saúde/organização & administração , Amostragem , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Estigma Social , Sexo sem Proteção/estatística & dados numéricos
8.
Clin Infect Dis ; 61(10): 1549-52, 2015 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-26187024
9.
J Clin Microbiol ; 53(6): 1947-50, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25832302

RESUMO

Of 23 unique Escherichia coli strains from 10 men with febrile urinary tract infections (UTIs) and their female sex partners, 6 strains (all UTI causing) were shared between partners. Molecularly, the 6 shared strains appeared more virulent than the 17 nonshared strains, being associated with phylogenetic group B2, sequence types ST73 and ST127, and multiple specific virulence genes. This indicates that UTIs are sometimes sexually transmitted.


Assuntos
Portador Sadio/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/genética , Infecções Urinárias/microbiologia , Adulto , Idoso , Portador Sadio/transmissão , Escherichia coli/classificação , Escherichia coli/patogenicidade , Infecções por Escherichia coli/transmissão , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Parceiros Sexuais , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Infecções Urinárias/transmissão
10.
Rev. argent. microbiol ; 47(1): 9-16, Mar. 2015. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: lil-757138

RESUMO

La infección genital por Chlamydia trachomatis es considerada en la actualidad una de las causas más frecuentes de infecciones transmisibles sexualmente (ITS) a nivel mundial y afecta principalmente al grupo de jóvenes menores de 25 años. El objetivo de este estudio fue determinar la prevalencia de la infección por C. trachomatis en alumnos ingresantes a la Universidad Nacional del Sur (Bahía Blanca, Argentina) y evaluar los factores de riesgo para la adquisición de ITS. Participaron en el estudio 204 jóvenes de edad media de 19 años, que remitieron una muestra de orina de primera micción y respondieron a una encuesta anónima. La investigación de C. trachomatis se realizó sobre 114 muestras válidas mediante una técnica de amplificación génica, cuyo blanco molecular es el gen ompA. Se detectaron 4 casos de infección por C. trachomatis, lo que implicó una prevalencia del 3,5 %. Los factores de riesgo que demostraron estar asociados con la adquisición de esta ITS fueron un historial de 7 o más parejas desde el comienzo de las relaciones sexuales y el contacto con una nueva pareja sexual en los últimos 4 meses. La prevalencia de infección por C. trachomatis reflejó una moderada circulación de este microorganismo en la población estudiada. Si bien algunos aspectos revelados en las encuestas sugieren una población de bajo riesgo para la adquisición de ITS en general, otros datos evidencian lo contrario y alertan sobre la necesidad de incrementar la vigilancia y desarrollar acciones de concienciación y prevención en esta población.


Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5 %. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Chlamydia trachomatis , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/transmissão , Estudos Transversais , Prevalência , Fatores de Risco , Estudantes , Inquéritos e Questionários , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Universidades
11.
Rev Argent Microbiol ; 47(1): 9-16, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-25683522

RESUMO

Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5%. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population.


Assuntos
Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/transmissão , Chlamydia trachomatis , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Estudantes , Inquéritos e Questionários , Universidades , Adulto Jovem
12.
Curr Opin Obstet Gynecol ; 26(6): 448-54, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25304606

RESUMO

PURPOSE OF REVIEW: Bacterial vaginosis epidemiology has been transformed by new theoretical insights and methodologies, such as molecular sequencing. We summarize the progress made in these domains. RECENT FINDINGS: The vaginal microbiome can be classified in five to eight clusters. Bacterial vaginosis-type clusters typically constitute one of these clusters, but in higher risk women, it can constitute up to three clusters. The vaginal microbiomes may be fairly stable or be subject to rapid changes in their constitutive makeup. Bacterial vaginosis does not appear to be a single entity. Certain bacterial communities are associated with particular symptoms of bacterial vaginosis that are paired with unique adverse outcomes. Biofilm-producing Gardnerella vaginalis are likely to play an important role in initiating the structured polymicrobial biofilm that is a hallmark of bacterial vaginosis. SUMMARY: Longitudinal studies currently underway should help elucidate how to best define bacterial vaginosis and its subtypes. Risk factors and outcomes associated with particular bacterial vaginosis subtypes should also be further clarified through these studies.


Assuntos
Medicina Baseada em Evidências , Gardnerella vaginalis/patogenicidade , Saúde Global , Infecções por Bactérias Gram-Positivas/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Vaginose Bacteriana/epidemiologia , Biofilmes , Feminino , Gardnerella vaginalis/classificação , Gardnerella vaginalis/crescimento & desenvolvimento , Gardnerella vaginalis/fisiologia , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/transmissão , Humanos , Masculino , Microbiota , Risco , Parceiros Sexuais , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Vaginose Bacteriana/diagnóstico , Vaginose Bacteriana/microbiologia
13.
Int J Emerg Ment Health ; 16(1): 237-40, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25345236

RESUMO

INTRODUCTION: Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated properly and promptly. In addition, it can cause ophthalmia neonatorum, which manifests as neonatal conjunctivitis in the newborns. METHODOLOGY: The data was collected from fourteen tertiary care hospitals in two provinces of Pakistan during the time period of four months (September-December 2013). Inclusion criteria included all medical practitioners working at those hospitals and there were no limitations of age and gender to participate. The participants were approached through email which included a self administered questionnaire. Written consent was obtained from the participants and the study was approved by the ethical committee of all selected hospital. RESULTS: Overall 130 participants participated with a response rate of 65%. Females were 52.3% and males were 47.7%. In the study 17.7% of male and 29.4% of female participants proclaimed that they referred a patient to an infectious disease specialist in case the diagnosis of Chlamydia was dubious. 72.5% of the male and 55.8% of the female medical practitioners indicated that they yield detailed sexual history from the patients with Chlamydia. Regarding inquiring about the drugs history from the patient at risk of STDs, 22.6% male and 35.3% of female participants informed that they took a detailed drug history. Only 1.5% of the female medical practitioners notified Chlamydia to the partner of diseased patient themselves (provider referral). 24% male and 17.6% female participants had an understanding regarding the definite test of diagnosis for sexually transmitted Chlamydia. CONCLUSION: More sexual health skills development is required in medical practitioners working in Pakistan. The major deficient areas are sexual and drug history taking, management of sexually transmitted diseases and partner notification.


Assuntos
Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/terapia , Chlamydia trachomatis , Competência Clínica , Países em Desenvolvimento , Padrões de Prática Médica , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Chlamydia/transmissão , Busca de Comunicante , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Encaminhamento e Consulta , Sexo Seguro , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Centros de Atenção Terciária
14.
Adv Anat Pathol ; 21(2): 83-93, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24508691

RESUMO

There are many insults that result in gastrointestinal tract inflammation. Infections can be particularly challenging because (1) only a limited number of organisms provoke a specific endoscopic and/or histologic appearance; and (2) although some organisms may be present on biopsies, the findings may be so subtle or organisms so few that they are easily missed if the reviewer is not performing a specific search for the offender. Sexually transmitted infections (STI) are rarely a consideration at the time of GI biopsy examination and clinicians rarely inquire about sexual behavior at the time of initial patient interview. Although establishing a definitive STI diagnosis is not possible on histology alone, these infections are associated with inflammatory patterns that may help raise this diagnostic possibility. Becoming familiar with these patterns is necessary as worldwide outbreaks of these infections are being reported. This review aims to provide the pathologist with histologic clues associated with the most frequently encountered bacterial pathogens in the setting of STI proctitis, namely, Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum.


Assuntos
Decepção , Proctocolite/patologia , Reto/patologia , Doenças Bacterianas Sexualmente Transmissíveis/patologia , Sexo sem Proteção , Biópsia , Infecções por Chlamydia/microbiologia , Infecções por Chlamydia/patologia , Comunicação , Feminino , Gonorreia/microbiologia , Gonorreia/patologia , Humanos , Masculino , Relações Médico-Paciente , Valor Preditivo dos Testes , Proctocolite/microbiologia , Proctoscopia , Reto/microbiologia , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Sífilis/microbiologia , Sífilis/patologia
17.
Ann Ig ; 25(5): 443-56, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24048183

RESUMO

Healthy vaginal microbiota is an important biological barrier to pathogenic microorganisms. When this predominantly Lactobacillus community is disrupted, decreased in abundance and replaced by different anaerobes, bacterial vaginosis (BV) may occur. BV is associated with prevalence and incidence of several sexually transmitted infections. This review provides background on BV, discusses the epidemiologic data to support a role of altered vaginal microbiota for acquisition of sexually transmitted diseases and analyzes mechanisms by which lactobacilli could counteract sexually transmitted viral infections.


Assuntos
Microbiota , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Vagina/microbiologia , Adolescente , Adulto , Coinfecção , Feminino , Infecções por HIV/microbiologia , Infecções por Herpesviridae/epidemiologia , Infecções por Herpesviridae/virologia , Humanos , Lactobacillus/isolamento & purificação , Lactobacillus/fisiologia , Metanálise como Assunto , Pessoa de Meia-Idade , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Fatores de Risco , Comportamento Sexual , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/prevenção & controle , Doenças Virais Sexualmente Transmissíveis/microbiologia , Doenças Virais Sexualmente Transmissíveis/prevenção & controle , Doenças Virais Sexualmente Transmissíveis/transmissão , Superinfecção , Vagina/virologia , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/transmissão , Adulto Jovem
19.
Presse Med ; 42(4 Pt 1): 432-9, 2013 Apr.
Artigo em Francês | MEDLINE | ID: mdl-23419462

RESUMO

Sexually transmitted infections (STIs) remains a major problem of public health in France. Voluntary networks of physicians (RésIST) and laboratories (Rénago, Rénachla, lymphogranuloma venereum: LGV network) produce indicators showing the evolution of the main bacterial STIs. In 2010, the main findings were the following. The number of gonococcal infections has increased throughout the decade 2000 to 2010. The decrease in susceptibility of gonococcal strains to first-line antibiotics (extended-spectrum cephalosporins) needs to keep great attention. The number of screening and diagnosis of chlamydial urogenital infections also continues to rise in both sexes, particularly due to increased screening among young people. The relatively stable number of cases of early syphilis and of rectal LGV needs to be confirmed over the coming years. Both of these STIs affect overwhelmingly homo/bisexual men. There is still a high level of HIV co-infection with LGV and syphilis, and to a lesser extent with gonorrhea. We observe that condom use is still inadequate, especially during oral sex.


Assuntos
Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle , Infecções Oportunistas Relacionadas com a AIDS/transmissão , Antibacterianos/uso terapêutico , Bissexualidade , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/prevenção & controle , Infecções por Chlamydia/transmissão , Comorbidade , Estudos Transversais , Farmacorresistência Bacteriana Múltipla , Feminino , França , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Gonorreia/transmissão , Homossexualidade Masculina , Humanos , Recém-Nascido , Linfogranuloma Venéreo/tratamento farmacológico , Linfogranuloma Venéreo/epidemiologia , Linfogranuloma Venéreo/prevenção & controle , Linfogranuloma Venéreo/transmissão , Masculino , Vigilância da População , Gravidez , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/prevenção & controle , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Sífilis/tratamento farmacológico , Sífilis/epidemiologia , Sífilis/prevenção & controle , Sífilis/transmissão , Sífilis Congênita/tratamento farmacológico , Sífilis Congênita/epidemiologia , Sífilis Congênita/prevenção & controle , Sífilis Congênita/transmissão
20.
Med Mal Infect ; 42(9): 381-92, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22975074

RESUMO

Mycoplasma genitalium is a sexually transmitted organism associated with non-gonococcal urethritis in men and several inflammatory reproductive tract syndromes in women such as cervicitis, pelvic inflammatory disease, and infertility. There was evidence for an association of M. genitalium with endometritis and pelvic inflammatory disease (PID), but additional studies are necessary to confirm this. The evidence as to whether M. genitalium can cause adverse pregnancy outcomes such as preterm labor is conflicting. But the authors of some studies on M. genitalium as a cause of infertility have reported this association. This species is very difficult to culture; thus, nucleic acid amplification testing is the only method available for M. genitalium detection. The lack of a cell wall makes M. genitalium intrinsically resistant to antibiotics acting at this level, such as beta-lactams. The treatment of M. genitalium infections is not standardized. Macrolides are recommended, especially single-dose azithromycin; tetracyclines are responsible for a great number of therapeutic failures even no resistance mechanism has yet been demonstrated. Acquired resistance to macrolides and fluoroquinolones leading to therapeutic failure has also been reported. All this raises the issue of the most appropriate therapeutic management and requires drafting diagnostic and therapeutic guidelines for the treatment of M. genitalium infections.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium/patogenicidade , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Antibacterianos/uso terapêutico , Portador Sadio/epidemiologia , Ensaios Clínicos como Assunto , Doenças Transmissíveis Emergentes/tratamento farmacológico , Doenças Transmissíveis Emergentes/microbiologia , Doenças Transmissíveis Emergentes/transmissão , Comorbidade , Gerenciamento Clínico , Farmacorresistência Bacteriana Múltipla , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/transmissão , Mycoplasma genitalium/efeitos dos fármacos , Mycoplasma genitalium/genética , Mycoplasma genitalium/isolamento & purificação , Mycoplasma genitalium/ultraestrutura , Trabalho de Parto Prematuro/etiologia , Doença Inflamatória Pélvica/epidemiologia , Doença Inflamatória Pélvica/microbiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Prevalência , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Uretrite/epidemiologia , Uretrite/microbiologia , Cervicite Uterina/epidemiologia , Cervicite Uterina/microbiologia
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