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Actas Dermo-sifiliograficas Jun 2024
Topics: Humans; Portugal; Tertiary Care Centers; Female; Multiplex Polymerase Chain Reaction; Mycoplasma genitalium; Mycoplasma Infections; Real-Time Polymerase Chain Reaction; Male; Adult; Time Factors; Middle Aged
PubMed: 38570090
DOI: 10.1016/j.ad.2024.03.028 -
Frontiers in Cellular and Infection... 2024Human papillomavirus (HPV) is a sexually transmitted virus, which infects approximately 80% of all men and women at some time in their lives. Usually, the infection is...
Human papillomavirus (HPV) is a sexually transmitted virus, which infects approximately 80% of all men and women at some time in their lives. Usually, the infection is resolved successfully by the body's immune system. Persistent infection with high-risk HPV (hrHPV) is necessary but not sufficient for cervical cancer development, and additional factors, such as the vaginal microbiome (vaginome), are thought to be involved. The aim of this study is to investigate whether either vaginal dysbiosis (imbalance in vaginal bacterial composition) or sexually transmitted pathogens, e.g., (CT), are possible cofactors for hrHPV infection and HPV-induced cervical dysplasia in asymptomatic women attending the Dutch Cervical Cancer Screening Program. In this study, 492 hrHPV-positive and 500 hrHPV-negative cervical smears from women attending the Screening Program were included. Age and cytology were known for the hrHPV-positive samples. All cervical smears were diluted in Aptima specimen transfer medium and tested with Aptima transcription-mediated amplification assays targeting CT (NG) (MG) spp. (CS), (CG) (TV), and bacterial vaginosis (BV). The prevalences of CT, NG, MG, CS, CG, TV, and BV in this cohort were found to be 1.9%, 0.0%, 1.7%, 5.4%, 1.4%, 0.1%, and 27.2%, respectively. When comparing HPV groups, it was found that CT, MG, and BV had a significantly higher prevalence in hrHPV-positive smears as compared with hrHPV-negative samples (for all < 0.001). No significant differences were found when comparing different age groups and cytology outcomes. In conclusion, vaginal dysbiosis seems associated with hrHPV infection in women attending the Dutch Cervical Cancer Screening Program.
Topics: Female; Humans; Uterine Cervical Neoplasms; Papillomavirus Infections; Early Detection of Cancer; Dysbiosis; Vaginal Smears; Trichomonas vaginalis; Neisseria gonorrhoeae; Chlamydia trachomatis; Mass Screening
PubMed: 38544527
DOI: 10.3389/fcimb.2024.1330844 -
Canada Communicable Disease Report =... Nov 2023The bacteria has been identified as a causative agent of urethritis in men, especially in gay, bisexual and other men who have sex with men (gbMSM). Canadian...
BACKGROUND
The bacteria has been identified as a causative agent of urethritis in men, especially in gay, bisexual and other men who have sex with men (gbMSM). Canadian clinic-based data have identified a high prevalence of and resistance to antibiotic treatments. This article estimates the prevalence of infections among Montréal gbMSM, explores correlates for infection and estimates the prevalence of mutations associated with antimicrobial resistance (AMR).
METHODS
Engage Cohort Study is a multi-site longitudinal study on sexually active gbMSM, aged 16 years and older, recruited via respondent-driven sampling in Montréal, Toronto and Vancouver. Participants completed a questionnaire on behaviour and were tested for sexually transmitted and blood-borne infections at each visit. For this sub-study, Montréal participants with a follow-up visit that occurred between November 2018 and November 2019 were included.
RESULTS
A total of 2,064 samples were provided by 716 participants. Prevalence of infection was 5.7% at rectal and/or urethral sites, 4.0% at rectal site and 2.2% at urethral site. Correlates for infection were younger age and reporting six or more sexual partners in the past six months. Prevalence of macrolide resistance associated mutations (MRAM), quinolone resistance associated mutations (QRAM) and either MRAM or QRAM, was 82%, 29% and 85%, respectively.
CONCLUSION
This first population-based study among gbMSM in Canada documents a high prevalence of urethral and rectal infection and high levels of AMR. Our results highlight the importance of access to testing and AMR detection when indicated.
PubMed: 38504874
DOI: 10.14745/ccdr.v49i1112a03 -
[Tropical sexually transmitted infections Summary of the SFMTSI Scientific Day of November 9, 2023].Medecine Tropicale Et Sante... Dec 2023Sexually transmitted infections (STIs) deserve more attention today than ever in the tropics. Indeed, the emergence of monkeypox in 2022 in Western countries reminds the...
Sexually transmitted infections (STIs) deserve more attention today than ever in the tropics. Indeed, the emergence of monkeypox in 2022 in Western countries reminds the risk of exporting STIs from the tropics as it was already known for decades with the worldwide spread of HIV/AIDS infection from tropical Africa. Some hazards are already well identified. According to WHO 2023 report STIs are increasing in the world. Antibiotic resistance is increasing for and already well established for whereas has become resistant to macrolides within the last twenty years. Some neglected tropical diseases (Zika, Ebola, monkeypox) can also be sexually transmitted, sometimes months after cure (Ebola). In this setting, the use of PrEP in migrants, and in Africa, is worth to be discussed beyond traditional circles.
Topics: Humans; Hemorrhagic Fever, Ebola; Mpox (monkeypox); Sexually Transmitted Diseases; HIV Infections; Sexual Behavior; Acquired Immunodeficiency Syndrome; Zika Virus; Zika Virus Infection
PubMed: 38390016
DOI: 10.48327/mtsi.v3i4.2023.447 -
Euro Surveillance : Bulletin Europeen... Feb 2024BackgroundAntimicrobial resistance (AMR) of (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference...
BackgroundAntimicrobial resistance (AMR) of (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking.AimWe aimed to estimate the occurrence of resistant MG in Belgium.MethodsBetween July and November 2022, frozen remnants of MG-positive samples from 21 Belgian laboratories were analysed at the NRC-STI. Macrolide and fluoroquinolone resistance-associated mutations (RAMs) were assessed using Sanger sequencing of the 23SrRNA and gene. Differences in resistance patterns were correlated with surveillance methodology, socio-demographic and behavioural variables via Fisher's exact test and logistic regression analysis.ResultsOf the 244 MG-positive samples received, 232 could be sequenced for macrolide and fluoroquinolone RAMs. Over half of the sequenced samples (55.2%) were resistant to macrolides. All sequenced samples from men who have sex with men (MSM) (24/24) were macrolide-resistant. Fluoroquinolone RAMs were found in 25.9% of the samples and occurrence did not differ between socio-demographic and sexual behaviour characteristics.ConclusionAlthough limited in sample size, our data suggest no additional benefit of testing MG retrieved from MSM for macrolide resistance in Belgium, when making treatment decisions. The lower occurrence of macrolide resistance in other population groups, combined with emergence of fluoroquinolone RAMs support macrolide-resistance testing in these groups. Continued surveillance of resistance in MG in different population groups will be crucial to confirm our findings and to guide national testing and treatment strategies.
Topics: Male; Humans; Anti-Bacterial Agents; Homosexuality, Male; Mycoplasma genitalium; Belgium; Macrolides; Drug Resistance, Bacterial; Mycoplasma Infections; Mutation; RNA, Ribosomal, 23S; Sexual and Gender Minorities; Fluoroquinolones; Sexually Transmitted Diseases
PubMed: 38362626
DOI: 10.2807/1560-7917.ES.2024.29.7.2300318 -
Microbiology Spectrum Feb 2024is fastidious to culture, and its detection in human clinical specimens relies mainly on molecular methods. Phenotypic determination of antibiotic susceptibility for...
is fastidious to culture, and its detection in human clinical specimens relies mainly on molecular methods. Phenotypic determination of antibiotic susceptibility for this bacterium is not a timely or feasible option for most clinical laboratories. This study sought to determine whether next-generation sequencing technologies can effectively be employed in determining genetic mutations associated with drug resistance in samples collected in Aptima Hologic tubes and possibly integrating them into viable workflows in public health laboratories. Following analysis by a custom-designed bioinformatics pipeline, at least one mutation/sample has been identified in 94/98 specimens in at least one of seven loci (macrolides: , , ; fluoroquinolones: , , , ) described previously to be connected to antibiotic resistance. This method identified a total of 469 single nucleotide polymorphisms (SNPs) (452 mutations): 134 of 23S rRNA SNPs and 318 amino acid mutations: 114 substitutions and 204 synonymous; the turnaround time (sample to analyzed sequence) was typically 3 days. The assays and workflows described in this work demonstrated that the determination of a drug resistance profile for macrolides and fluoroquinolones of samples by using next-generation sequencing in clinical samples is a feasible approach that can be implemented in clinical laboratories, following thorough and extensive validation studies.IMPORTANCEThe mechanisms of drug resistance in are complex and involve several genetic loci. The molecular methods for accurately characterizing resistance to fluoroquinolones and macrolides in this organism are often not available or approved for patient use and do not cover all genetic determinants. To this end, we propose a next-generation sequencing-based method with a turnaround time of 3 days that includes the investigation of all drug resistance loci of . Following adaptation, validation, and verification for routine clinical use, assays based on this method may yield molecular results that can be used to guide proper treatment regimens and for surveillance of drug resistance in the general population.
PubMed: 38349187
DOI: 10.1128/spectrum.03845-23 -
Actas Dermo-sifiliograficas Jun 2024
Topics: Humans; Portugal; Tertiary Care Centers; Female; Multiplex Polymerase Chain Reaction; Mycoplasma genitalium; Mycoplasma Infections; Real-Time Polymerase Chain Reaction; Male; Adult; Time Factors; Middle Aged
PubMed: 38307165
DOI: 10.1016/j.ad.2023.03.018 -
The Lancet Regional Health. Western... Mar 2024Empiric treatment of sexually transmitted infections can cause unnecessary antibiotic use. We determined if near-to-patient-testing (NPT) for , and (MG) improved...
BACKGROUND
Empiric treatment of sexually transmitted infections can cause unnecessary antibiotic use. We determined if near-to-patient-testing (NPT) for , and (MG) improved antibiotic-use for a range of clinical presentations.
METHODS
Clients attending with non-gonococcal urethritis (NGU), proctitis, as STI-contacts, or for an MG-test-of-cure (MG-TOC) between March and December 2021 were recruited. Participants received near-to-patient-testing (NPT-group) for the three STIs using the GeneXpert® System (Cepheid), and concurrent routine-testing by transcription-mediated-amplification (TMA; Aptima, Hologic). Antibiotic-use among NGU or proctitis cases in the NPT-group was compared to clinic-controls undergoing routine-testing only. The proportion in the NPT-group who notified partners <24 hrs of their STI-specific result was calculated.
FINDINGS
Among 904 consults by 808 NPT-participants, ≥1 STI was detected in 63/252 (25.0%) with NGU, 22/51 (43.1%) with proctitis, and 167/527 (31.7%) STI-contacts. MG was detected among 35/157 (22.3%) MG-TOC consults. Among NGU and proctitis cases, fewer in the NPT-group received empiric treatment compared to clinic-controls (29.4% [95% CI: 24.3-34.9%] 83.8% [95% CI: 79.2-87.8%], p < 0.001), resulting in more NPT-group cases appropriately treated (STI-specific drug/no drug appropriately; 80.9% [95% CI: 76.0-85.1%] 33.0% [95% CI: 27.7-38.6%], p < 0.001) and fewer mistreated (incorrect drug/treated but pathogen-negative; 17.8% [13.7-22.6%] 61.4% [55.6-66.9%], p < 0.001). Of 167/264 in the NPT-group with an STI who responded regarding partner-notification, 95.2% notified all/some partners; 85.9% notified them <24 hrs of the STI-specific result.
INTERPRETATION
Near-to-patient-testing significantly improved antibiotic use and a high proportion of individuals rapidly notified partners of STI-specific results, highlighting the broad benefits of timely diagnostic strategies for STIs in clinical decision making and partner notification.
FUNDING
ARC ITRP Hub-grant; NHMRC.
PubMed: 38292654
DOI: 10.1016/j.lanwpc.2023.101005 -
European Journal of Microbiology &... Feb 2024Doxycycline-based prevention of bacterial sexually transmitted infections (STIs) has been assessed in various studies and has been recommended by the European AIDS...
BACKGROUND
Doxycycline-based prevention of bacterial sexually transmitted infections (STIs) has been assessed in various studies and has been recommended by the European AIDS Clinical Society to be proposed to persons with repeated STIs on a case-by-case basis. However, while good preventive effects could be shown for Chlamydia trachomatis and Treponema pallidum in Europe, no reliable prevention against doxycycline resistance-affected bacterial causes of STIs like Neisseria gonorrhoeae and Mycoplasma genitalium was confirmed.
METHODS
In a modelling-approach, we assessed potential beneficial effects even against the latter microorganisms in case of optimized adherence with doxycycline prevention. These effects were modelled for Germany in comparison to traditional prevention schemes like condom-based STI-prevention and testing-as-prevention.
RESULTS
With estimated risk reduction in the ranges of 86% for N. gonorrhoeae and of 82% for Mycoplasma genitalium, expectable preventive efficacy similar to alternative preventive approaches could be calculated in case of optimized adherence with doxycycline prevention. In case of repeated risk exposure, the preventive potential of condom-based prevention was decreased compared to both optimized doxycycline prevention and testing-as-prevention.
CONCLUSIONS
As suggested by the applied modelling, the preventive effect of optimized doxycycline prevention against bacterial STIs is in a similar range, like other common prevention strategies.
PubMed: 38289395
DOI: 10.1556/1886.2023.00059 -
Indian Journal of Sexually Transmitted... 2023During pregnancy, sexually transmitted infections can be transmitted vertically to the fetus, leading to an increase in morbidity and mortality for both mother and child.
CONTEXT
During pregnancy, sexually transmitted infections can be transmitted vertically to the fetus, leading to an increase in morbidity and mortality for both mother and child.
AIMS
This study aimed to determine the profile of cervical and vaginal infections in pregnant women receiving prenatal care in a single institute.
SETTINGS AND DESIGN
The study was conducted in a tertiary hospital. Molecular testing was used to detect , , , and .
MATERIALS AND METHODS
Samples of vaginal secretions were collected from pregnant women using the Aptima Multitest Swab Specimen Collection kit to test for the pathogens. The inclusion criteria consisted of pregnant women of 15-45 years of age receiving prenatal care at the institute, irrespective of gestational age, who agreed to provide vaginal swab. The exclusion criterion was the use of antibiotics in the preceding 3 months.
STATISTICAL ANALYSIS
Frequencies and percentages were calculated for the pathogens detected in the samples evaluated.
RESULTS
Overall, 200 samples were tested. Of the pathogens detected, there was a predominance of (15.5% of the samples) and (14.5%), followed by (10.0%) and (0.5%).
CONCLUSION
Identifying the microorganisms present in the microbiota of pregnant women is of the utmost importance in assuring the appropriate treatment for each pathogen, thus avoiding complications both for the woman and for her fetus. These results should serve to stimulate the debate on implementing these tests as routine during prenatal care.
PubMed: 38223143
DOI: 10.4103/ijstd.ijstd_119_22