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Viruses Jun 2023The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital...
Diversity of Anal HPV and Non-HPV Sexually Transmitted Infections and Concordance with Genital Infections in HIV-Infected and HIV-Uninfected Women in the Tapajós Region, Amazon, Brazil.
The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital infections in HIV-infected and uninfected women living in the Tapajós region, Amazon, Brazil. A cross-sectional study was performed with 112 HIV-uninfected and 41 HIV-infected nonindigenous women. Anal and cervical scrapings were collected and analyzed for HPV, (CT) (NG), (TV), (MG), and 2 (HSV-2). The Kappa test evaluated the concordance between anal and genital infections. The overall prevalence of anal HPV infection was 31.3% in HIV-uninfected and 97.6% in HIV-infected women. The most frequent anal high-risk HPV (hrHPV) types were HPV18 and HPV16 in HIV-uninfected women and HPV51, HPV59, HPV31, and HPV58 in HIV-infected women. Anal HPV75 was also identified. Anal non-HPV STIs were identified in 13.0% of all participants. The concordance analysis was fair for CT, MG, and HSV-2, almost perfect agreement for NG, moderate for HPV, and variable for the most frequent anal hrHPV types. Thus, a high prevalence of anal HPV infection with moderate and fair concordance between anal and genital HPV and non-HPV STIs was observed in our study.
Topics: Humans; Female; Papillomavirus Infections; Brazil; Cross-Sectional Studies; Sexually Transmitted Diseases; Chlamydia trachomatis; Cervix Uteri; Neisseria gonorrhoeae; HIV Infections; Prevalence; Chlamydia Infections
PubMed: 37376627
DOI: 10.3390/v15061328 -
Journal of Clinical Microbiology Jul 2023With improvement in laboratory diagnosis of infection through molecular diagnostics, macrolide resistance determination within M. genitalium-positive patients is...
With improvement in laboratory diagnosis of infection through molecular diagnostics, macrolide resistance determination within M. genitalium-positive patients is necessary. In this study, we report baseline parameters for an analyte-specific reagent (ASR) macrolide resistance real-time reverse transcriptase PCR on an open access analyzer and evaluated detection of macrolide resistance-mediated mutation (MRM) within 23S rRNA in a clinical specimen set. Initial use of 1.2 μM M. genitalium primer and 0.8 μM M. genitalium detection probe concentrations yielded an 80% false-positive detection rate when challenged with 10,000 copies of wild-type RNA. Optimization experiments showed that lowering primer/detection probe and MgCl concentrations minimized these false-detections of wild-type 23S rRNA, while higher levels of KCl increased rates of MRM detection with concomitant lower cycle threshold values and higher fluorescence emission. Lower limit of A2058G mutation detection was 5000 copies/mL (180 copies/reaction; 20/20 detections). Utilization of a baseline correction slope limit of 250 units further mitigated false-detection from wild-type 23S rRNA at challenges up to 3.3 billion copies/mL. MRM was detected in 583/866 (67.3%) clinical specimens initially positive for M. genitalium by commercial transcription-mediated amplification. These data included 392/564 detections (69.5%) from M. genitalium-positive swab specimens and 191/302 (63.2%) from M. genitalium-positive-positive first-void urine specimens (0.06). Overall resistance detection rates did not vary by gender (0.76). Specificity of the M. genitalium macrolide resistance ASR was 100% (141 urogenital determinations). MRM detection by the ASR was confirmed at a concordance rate of 90.9% by Sanger sequencing of a clinical specimen subset.
Topics: Humans; Anti-Bacterial Agents; Macrolides; Indicators and Reagents; RNA, Ribosomal, 23S; Drug Resistance, Bacterial; Mycoplasma genitalium; Mutation; Mycoplasma Infections
PubMed: 37341596
DOI: 10.1128/jcm.00335-23 -
Revista Espanola de Quimioterapia :... Oct 2023Sexually Transmitted Infections (STI) are a major public health problem. The problems inherent to their diagnosis, treatment and prevention have to do not only with... (Review)
Review
Sexually Transmitted Infections (STI) are a major public health problem. The problems inherent to their diagnosis, treatment and prevention have to do not only with their nature, but also with organizational issues and overlapping competencies of the different health authorities in Spain. The real situation of STI in Spain, at present, is poorly known. For this reason, the Scientific Committee on COVID and Emerging Pathogens of the Illustrious Official College of Physicians of Madrid (ICOMEM) has formulated a series of questions on this subject which were distributed, not only among the members of the Committee, but also among experts outside it. The central health authorities provide very high and increasing figures for gonococcal infection, syphilis, Chlamydia trachomatis infection and lymphogranuloma venereum (LGV). Both HIV infection and Monkeypox are two important STI caused by viruses in our environment, to which it should be added, mainly, Herpes simplex virus (HSV) and Human papillomavirus (HPV) infections. Emerging microorganisms such as Mycoplasma genitalium pose not only pathogenic challenges but also therapeutic problems, as in the case of N. gonohrroeae. The pathways that patients with suspected STI follow until they are adequately diagnosed and treated are not well known in Spain. Experts understand that this problem is fundamentally managed in public health institutions, and that Primary Care and Hospital Emergency Services, together with some institutions that deal monographically with this problem, are the recipients of most of these patients. One of the most serious difficulties of STI lies in the availability of the microbiological tests necessary for their diagnosis, particularly in this era of outsourcing of microbiology services. Added to this is the increased cost of implementing the latest generation of molecular techniques and the difficulties of transporting samples. It is clear that STI are not diseases to which the entire population is equally exposed and it is necessary to have a better knowledge of the risk groups where to focus the necessary interventions adapted to their characteristics. It should not be forgotten that STI are also a problem in the pediatric age group and that their presence can be a marker of sexual abuse with all that this implies in terms of health care and medicolegal activity. Finally, STI are infections that are associated with a high cost of care for which we have very little information. The possibility of expanding the automatic performance of laboratory tests for STI surveillance through laboratory routines is encountering ethical and legal problems that are not always easy to solve. Spain has created a ministerial area of specific attention to STI and there are plans to improve the diagnosis, treatment and prevention of these problems, but we still lack the necessary evidence on their impact. We cannot forget that these are diseases that transcend the individual and constitute a Public Health problem.
Topics: Humans; Child; HIV Infections; Spain; COVID-19; Sexually Transmitted Diseases; Gonorrhea; Lymphogranuloma Venereum; Prevalence
PubMed: 37335757
DOI: 10.37201/req/038.2023 -
Journal of Natural Products Jun 2023Xanthoquinodins make up a distinctive class of xanthone-anthraquinone heterodimers reported as secondary metabolites from several fungal species. Through a collaborative...
Xanthoquinodins make up a distinctive class of xanthone-anthraquinone heterodimers reported as secondary metabolites from several fungal species. Through a collaborative multi-institutional screening program, a fungal extract prepared from a sp. was identified that exhibited strong inhibitory effects against several human pathogens (, , , and ). This report focuses on one of the unique samples that exhibited a desirable combination of biological effects: namely, it inhibited all four test pathogens and demonstrated low levels of toxicity toward HepG2 (human liver) cells. Fractionation and purification of the bioactive components and their congeners led to the identification of six new compounds [xanthoquinodins NPDG A1-A5 (-) and B1 ()] as well as several previously reported natural products (-). The chemical structures of - were determined based on interpretation of their 1D and 2D NMR, HRESIMS, and electronic circular dichroism (ECD) data. Biological testing of the purified metabolites revealed that they possessed widely varying levels of inhibitory activity against a panel of human pathogens. Xanthoquinodins A1 () and A2 () exhibited the most promising broad-spectrum inhibitory effects against (EC values: 0.13 and 0.12 μM, respectively), (EC values: 5.2 and 3.5 μM, respectively), (EC values: 3.9 and 6.8 μM, respectively), and (EC values: 0.29 and 0.50 μM, respectively) with no cytotoxicity detected at the highest concentration tested (HepG2 EC > 25 μM).
Topics: Humans; Cryptosporidiosis; Cryptosporidium; Anti-Infective Agents; Mitosporic Fungi; Anti-Bacterial Agents; Molecular Structure
PubMed: 37276438
DOI: 10.1021/acs.jnatprod.3c00283 -
Iranian Journal of Basic Medical... 2023and species threaten reproductive health and fertility worldwide. Due to the lack of sensitive, accurate, and affordable diagnostic tools, the simultaneous...
OBJECTIVES
and species threaten reproductive health and fertility worldwide. Due to the lack of sensitive, accurate, and affordable diagnostic tools, the simultaneous contributions of these agents in infertility have been overlooked. This study aims to detect and identify and species in the genital tracts of fertile and infertile females simultaneously.
MATERIALS AND METHODS
In a case-control study, cervicovaginal clinical samples were collected from patients referred to two teaching hospitals in Isfahan from July 2019 to February 2019. The initial screening was by using Real-time PCR and designed primer to evaluate the presence of and species including fertile and infertile women. The bacteria species were then detected and differentiated by using the melt curve and sequenced to confirm and identify. Finally, the standard curve was used to measure and compare the copy number of each species in each group. The isolates also were detected in clinical samples using the commercial PCR method.
RESULTS
The frequencies of and were (0.0, 10.0%) in the fertile group and (4.3%, 34.3%) in the infertile group, respectively. and species in the fertile group (7.1%, 5.7%) and in the infertile group (32.9%, 24.3) were determined, respectively. The comparison of the results obtained from PCR and Real-time PCR showed that the recent technique has the ability to track 101-103 copy numbers.
CONCLUSION
The present method allows differential diagnosis and quantification of and species in a short time and simultaneously.
PubMed: 37275751
DOI: 10.22038/IJBMS.2023.66170.14545 -
Sexually Transmitted Infections Nov 2023Sexually transmitted infection (STI) prevalence and incidence estimates for pregnant adolescents are under-reported. We estimated prevalence and incidence of STIs in...
INTRODUCTION
Sexually transmitted infection (STI) prevalence and incidence estimates for pregnant adolescents are under-reported. We estimated prevalence and incidence of STIs in pregnant adolescents (15-19 years) in comparison with pregnant women 20-24 and >25 years.
METHODS
Pregnant women registering at primary care clinics in Umlazi, a periurban subdistrict in KwaZulu-Natal, South Africa, were enrolled in an HIV incidence cohort study during February 2017-March 2018. Women were examined for abnormal vaginal discharge, received empirical treatment, tested for HIV-1 and had vaginal swabs taken at their first and a subsequent visit in the third trimester. Vaginal swabs were stored for STI testing at completion of study and tested for and using PCR.
RESULTS
A total of 752 HIV-negative pregnant women were enrolled at a median gestational age of 17 weeks: 180 (23.9%), 291 (38.7%) and 281 (37.4%) in the 15-19, 20-24 and >25 years age groups. Pregnant adolescents had an STI prevalence of 26.7% at baseline, not significantly lower than the 20-24 (34.7%, OR 1.4; 95% CI 1.0 to 2.1, p=0.09) and >25 years (33.8%, OR 1.4; 95% CI 0.9 to 2.1, p=0.12) age groups. (11.1%), (7.8%) and (4.4%) were most prevalent in adolescents, a trend similar to the other age groups. Overall, 43.4% were symptomatic and treated at baseline. Overall, 40.7% (118 of 290) of women who tested negative for an STI at baseline tested positive at the repeat visit (incidence 19.5/100 person years). STI incidence in pregnant adolescents was 23.9/100 person years and comparable with older age groups (20.5/100 person years and 16.2/100 person years). At the repeat visit, 19.0% of all women with an STI were symptomatic and treated. Performance of syndromic management was poor at baseline (negative predictive value (NPV) 68.6%, positive predictive value (PPV) 34.0%) and at repeat visit (NPV 58.4%, PPV 34.3%).
CONCLUSIONS
Prevalence of asymptomatic curable STIs in pregnant adolescents is high and comparable with women >20 years old. Adolescents remain at substantial risk of asymptomatic incident STIs during pregnancy.
Topics: Female; Adolescent; Pregnancy; Humans; Aged; Infant; Young Adult; Adult; Gonorrhea; Reproductive Tract Infections; Cohort Studies; Incidence; Chlamydia Infections; South Africa; Sexually Transmitted Diseases; Trichomonas vaginalis; Chlamydia trachomatis; Neisseria gonorrhoeae; HIV Seropositivity; Prevalence; HIV Infections
PubMed: 37208192
DOI: 10.1136/sextrans-2022-055658 -
The Journal of Infectious Diseases Nov 2023Sexually transmitted infections, specifically Chlamydia trachomatis (CT), may be associated with epithelial ovarian cancer (EOC) risk. The association between CT and EOC...
BACKGROUND
Sexually transmitted infections, specifically Chlamydia trachomatis (CT), may be associated with epithelial ovarian cancer (EOC) risk. The association between CT and EOC subtypes is unclear. Our aim was to investigate whether history of CT and other infections (Mycoplasma genitalium [MG], herpes simplex virus type 2 [HSV-2], and human papillomavirus [HPV]) are associated with EOC risk by histotype.
METHODS
We measured antibodies (Abs) to CT, MG, HSV-2, and HPV-16/18 in serum samples in a nested case-control study in the Finnish Maternity Cohort (N = 484 cases 1:1 matched to controls). Logistic regression was used to calculate relative risks (RRs) and 95% confidence intervals (CIs) in seropositive versus seronegative individuals in all cases, as well as serous (n = 249), clear cell and endometrioid (n = 91), and mucinous (n = 144) EOC.
RESULTS
CT seropositivity was not associated with EOC risk (eg, CT pGP3-Ab: RR, 0.92 [95% CI, .72-1.19]), regardless of disease subtype. We observed a positive association between MG seropositivity and mucinous EOC (RR, 1.66 [95% CI, 1.09-2.54]; P for heterogeneity by histotype ≤ .001), but not other subtypes. No associations were observed with seropositivity to multiple STIs.
CONCLUSIONS
CT infection was not associated with EOC risk, with associations observed only for MG and mucinous EOC. Mechanisms linking MG to mucinous EOC remain to be elucidated.
Topics: Humans; Female; Pregnancy; Carcinoma, Ovarian Epithelial; Finland; Case-Control Studies; Human papillomavirus 16; Human papillomavirus 18; Sexually Transmitted Diseases; Herpesvirus 2, Human; Chlamydia trachomatis; Antibodies, Bacterial; Ovarian Neoplasms
PubMed: 37196097
DOI: 10.1093/infdis/jiad171 -
Revista Espanola de Quimioterapia :... Aug 2023Mycoplasma genitalium (MG) is a recognized sexually transmitted pathogen. Increasing resistance to main lines of treatment (macrolides and quinolones) justifies a...
OBJECTIVE
Mycoplasma genitalium (MG) is a recognized sexually transmitted pathogen. Increasing resistance to main lines of treatment (macrolides and quinolones) justifies a genetic study of mutations to improve cure rates.
METHODS
A total of 8,508 samples from April 2018 to July 2022 were processed using AllplexTM STI Essential Assay. In MG positive cases 23S rRNA V domain, gyrA and parC genes were studied. Mutations detected were checked to assess their clinical significance and medical records were reviewed to obtain demographic and treatment information.
RESULTS
Resistance study was performed on 92 samples (65 men and 27 women). In relation to the genotypic study, 28 patients presented mutations to macrolides (30.43%). Most common was A2059G (18.48%). For quinolones, 5 patients (5.43%) had clinically relevant mutations in parC gene. Of note was a patient with G295 mutation in gyrA associated with G248T in parC. Thirty subjects underwent a test of cure (TOC). Azithromycin was the most common empirical regimen and moxifloxacin the main alternative.
CONCLUSIONS
High rate of resistance in our environment evidences the need for targeted therapy by genotypic study of macrolide resistance, supported by the detection of mutations in parC and gyrA to predict quinolones susceptibility and the use of TOC to evaluate treatment response.
Topics: Male; Humans; Female; Anti-Bacterial Agents; Fluoroquinolones; Macrolides; Mycoplasma genitalium; Drug Resistance, Bacterial; Mycoplasma Infections; RNA, Ribosomal, 23S; Mutation; Prevalence
PubMed: 37149902
DOI: 10.37201/req/014.2023 -
Epidemiology and Infection May 2023The aim of this paper is to describe the prevalence of and in patients who visited general practitioners in the Netherlands. Additionally, we describe the prevalence...
The aim of this paper is to describe the prevalence of and in patients who visited general practitioners in the Netherlands. Additionally, we describe the prevalence of resistance to azithromycin and moxifloxacin. We used data from 7,411 consecutive female patients who were screened for , , , and and data from 5,732 consecutive male patients screened for , , and . The prevalence of and in female patients was 6.7% (95% CI: 6.2 to 7.4) and 1.9% (95%CI: 1.6 to 2.2%), respectively. prevalence in male patients was 3.7% (3.3 to 4.3). co-occurred with in 1.4% (0.3 to 0.6%) of female and in 0.7% (0.5 to 0.9) of male patients. Macrolide resistance gene mutations and fluoroquinolone resistance gene mutations were detected in 73.8% and 9.9%, respectively. We concluded that is relatively infrequently found in a large general practitioner population in the Netherlands. It can co-occur with , and is often resistant to azithromycin. Therefore, when treating sexually transmitted infections, these prevalence and resistance data should be taken into account.
Topics: Female; Humans; Male; Anti-Bacterial Agents; Azithromycin; Chlamydia trachomatis; Drug Resistance, Bacterial; Macrolides; Mycoplasma genitalium; Mycoplasma Infections; Neisseria gonorrhoeae; Netherlands; Prevalence; Primary Health Care; Sexually Transmitted Diseases; Trichomonas vaginalis; Trichomonas Vaginitis; Coinfection
PubMed: 37144297
DOI: 10.1017/S095026882300064X -
Open Forum Infectious Diseases Apr 2023
PubMed: 37113590
DOI: 10.1093/ofid/ofad126