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Sexually Transmitted Infections Apr 2024Little is known about the aetiology of urethral discharge syndrome (UDS) and genital ulcer disease (GUD) in Brazil due to limited access to laboratory tests and...
Aetiological molecular identification of sexually transmitted infections that cause urethral discharge syndrome and genital ulcer disease in Brazilian men: a nationwide study.
BACKGROUND
Little is known about the aetiology of urethral discharge syndrome (UDS) and genital ulcer disease (GUD) in Brazil due to limited access to laboratory tests and treatment based mainly on the syndromic approach.
OBJECTIVES
To update Brazilian treatment guidelines according to the current scenario, the first nationwide aetiological study for UDS and GUD was performed.
METHODS
Male participants with urethral discharge (UD) and/or genital ulcer (GU) reports were enrolled. Sample collection was performed by 12 sentinel sites located in the five Brazilian regions. Between 2018 and 2020, 1141 UD and 208 GU samples were collected in a Universal Transport Medium-RT (Copan). A multiplex quantitative PCR kit (Seegene) was used to detect UD: (CT), (MG), (MH), (NG), (TV), (UP), (UU) and another kit to detect GU: cytomegalovirus (CMV), (HD), herpes simplex virus type 1 (HSV1), herpes simplex virus type 2 (HSV2), lymphogranuloma venereum (LGV), (TP) and varicella-zoster virus (VZV).
RESULTS
In UD samples, the frequency of pathogen detection was NG: 78.38%, CT: 25.6%, MG: 8.3%, UU: 10.4%, UP: 3.5%, MH: 3.5% and TV: 0.9%. Coinfection was assessed in 30.9% of samples, with 14.3% of NG/CT coinfection. The most frequent pathogen identified in GU was HSV2, present in 40.8% of the samples, followed by TP at 24.8%, LGV and CMV at 1%, and HSV1 at 0.4%. Coinfection of TP/HSV2 was detected in 4.4% of samples. VZV and HD were not detected. In 27.7% of the GU samples, no pathogen was detected.
CONCLUSION
This study provided the acquisition of unprecedented data on the aetiology of UDS and GUD in Brazil, demonstrated the presence of a variety of pathogens in both sample types and reaffirmed the aetiologies known to be most prevalent globally.
Topics: Male; Humans; Ulcer; Brazil; Coinfection; Sexually Transmitted Diseases; Chlamydia trachomatis; Herpesvirus 2, Human; Treponema pallidum; Trichomonas vaginalis; Herpesvirus 1, Human; Neisseria gonorrhoeae; Genitalia; Cytomegalovirus Infections
PubMed: 38360847
DOI: 10.1136/sextrans-2023-055950 -
Diagnostic Microbiology and Infectious... Apr 2024This study aimed to investigate the genetic diversity of 108 geographically and temporally diverse strains of Mycoplasma hominis using a multi-locus sequence typing...
This study aimed to investigate the genetic diversity of 108 geographically and temporally diverse strains of Mycoplasma hominis using a multi-locus sequence typing scheme (MLST). We extracted MLST data of 87 strains from PubMLST database and retrieved MLST gene sequences from 21 complete genomes of M. hominis available in GenBank database. MLST scheme identified 65 Sequence types (STs), which were grouped into five clonal complexes (CC) and 47 singletons. Phylogenetic analysis revealed that the majority of M. hominis isolates were clustered according to their country of origin, showing some significant specificity trends for the nation. Although recombination was detected, it was not significant enough to alter the clonal population structure of M. hominis. In sum, MLST scheme provides insightful data on the phylogenetics of international strains of M. hominis, arguing for the existence of genetically differentiable STs according to their origin of isolation.
Topics: Humans; Multilocus Sequence Typing; Mycoplasma hominis; Phylogeny; Genotype; Genes, Bacterial; Genetic Variation
PubMed: 38310740
DOI: 10.1016/j.diagmicrobio.2024.116207 -
Journal of the European Academy of... Jun 2024Bacterial vaginosis (BV) is a common clinical manifestation of a perturbed vaginal ecology associated with adverse sexual and reproductive health outcomes if left...
BACKGROUND
Bacterial vaginosis (BV) is a common clinical manifestation of a perturbed vaginal ecology associated with adverse sexual and reproductive health outcomes if left untreated. The existing diagnostic modalities are either cumbersome or require skilled expertise, warranting alternate tests. Application of machine-learning tools to heterogeneous and high-dimensional multi-omics datasets finds promising potential in data integration and may aid biomarker discovery.
OBJECTIVES
The present study aimed to evaluate the potential of the microbiome and metabolome-derived biomarkers in BV diagnosis. Interpretable machine-learning algorithms were used to evaluate the utility of an integrated-omics-derived classification model.
METHODS
Vaginal samples obtained from reproductive-age group women with (n = 40) and without BV (n = 40) were subjected to 16S rRNA amplicon sequencing and LC-MS-based metabolomics. The vaginal microbiome and metabolome were characterized, and machine-learning analysis was performed to build a classification model using biomarkers with the highest diagnostic accuracy.
RESULTS
Microbiome-based diagnostic model exhibited a ROC-AUC (10-fold CV) of 0.84 ± 0.21 and accuracy of 0.79 ± 0.18, and important features were Aerococcus spp., Mycoplasma hominis, Sneathia spp., Lactobacillus spp., Prevotella spp., Gardnerella spp. and Fannyhessea vaginae. The metabolome-derived model displayed superior performance with a ROC-AUC of 0.97 ± 0.07 and an accuracy of 0.92 ± 0.08. Beta-leucine, methylimidazole acetaldehyde, dimethylethanolamine, L-arginine and beta cortol were among key predictive metabolites for BV. A predictive model combining both microbial and metabolite features exhibited a high ROC-AUC of 0.97 ± 0.07 and accuracy of 0.94 ± 0.08 with diagnostic performance only slightly superior to the metabolite-based model.
CONCLUSION
Application of machine-learning tools to multi-omics datasets aid biomarker discovery with high predictive performance. Metabolome-derived classification models were observed to have superior diagnostic performance in predicting BV than microbiome-based biomarkers.
Topics: Humans; Female; Vaginosis, Bacterial; Biomarkers; Adult; Machine Learning; Microbiota; Metabolomics; Young Adult; Vagina; Metabolome; RNA, Ribosomal, 16S; Multiomics
PubMed: 38284174
DOI: 10.1111/jdv.19805 -
Heliyon Jan 2024() commonly colonizes the genitourinary tract of adult women and may result in neonatal meningitis through vertical transmission. Although there are few case reports,...
BACKGROUND
() commonly colonizes the genitourinary tract of adult women and may result in neonatal meningitis through vertical transmission. Although there are few case reports, if the treatment is not conducted timely, the disease progresses rapidly, which may lead to serious complications and a poor prognosis.
CASE PRESENTATION
In the present study, a 10-day-old full-term neonate who presented with fever as the initial symptom and was eventually diagnosed with meningitis caused by was reported. In the present case, the pathogen was not detected during the initial routine investigations, and the therapeutic effects of empiric antibiotic therapy were poor. Metagenomic next-generation sequencing (mNGS) in the cerebrospinal fluid (CSF) was conducted with the detection of , and the antibiotics were adjusted to moxifloxacin combined with doxycycline. The clinical symptoms of the pediatric patient disappeared with an improvement in related laboratory results.
CONCLUSION
It was difficult to detect by routine bacterial culture. Therefore, infection should be checked for in children with meningitis who had a negative result in CSF culture and poor therapeutic effects of empirical medication. mNGS in CSF should be conducted as soon as possible, and sensitive antibiotics should be administered in time to reduce the incidence of complications and improve the prognosis.
PubMed: 38192762
DOI: 10.1016/j.heliyon.2023.e23489 -
Diagnostic Microbiology and Infectious... Mar 2024Mediastinitis and sternal osteitis are critical complications in cardiac surgery. Cases of these complications caused by Mycoplasma hominis are extremely rare.
BACKGROUND
Mediastinitis and sternal osteitis are critical complications in cardiac surgery. Cases of these complications caused by Mycoplasma hominis are extremely rare.
CASE PRESENTATION
We present a case of mediastinitis and sternal osteitis caused by M. hominis infection following ascending aortic replacement surgery. Whole gene sequencing analysis suggested the genitourinary tract as the most likely source of this M. hominis infection. Successful infection control was achieved through a regimen of moxifloxacin treatment. Additionally, a notable correlation was observed between serum levels of interleukin-6 and M. hominis infection.
CONCLUSIONS
The significance of M. hominis as a potential cause of postoperative infection in cardiac surgery is still not fully recognized. Special attention should be paid to patients with bacteriologically negative infections, as M. hominis should not be disregarded, despite its rarity.
Topics: Humans; Mycoplasma hominis; Mediastinitis; Osteitis; Cardiac Surgical Procedures; Postoperative Complications; Mycoplasma Infections
PubMed: 38176301
DOI: 10.1016/j.diagmicrobio.2023.116170 -
International Journal of STD & AIDS Apr 2024Men who have sex with men (MSM) are at risk for sexually transmitted infections (STIs), but more data on extragenital carriage are needed.
BACKGROUND
Men who have sex with men (MSM) are at risk for sexually transmitted infections (STIs), but more data on extragenital carriage are needed.
AIM
We assessed the genital and extragenital prevalence of bacterial and other STIs in MSM in a Lisbon sexual health clinic.
METHODS
We screened oral, anal, and urine samples of MSM visiting the GAT-CheckpointLX clinic June 2017-December 2021 for (including lymphogranuloma venereum, LGV), , , , , , and . Ano-oro-genital lesions were tested for LGV, , and Herpes Simplex Virus. Blood was tested for HIV and antibodies.
RESULTS
was found in 16.6% of the MSM followed by (13.2%), (10.3%) and (0.2%). The most frequent occurrence was anorectal (, ) and oral (). We found high carriage of (36.1%) and (22.1%). LGV was detected in 21.8% of chlamydia-positive anorectal swabs. Syphilis was detected in 22.6% of tested MSM, while 13.8% had HIV. Gonorrhoea and chlamydia were significantly more prevalent in MSM with concomitant HIV or syphilis.
CONCLUSION
The substantial extragenital prevalence of bacterial STIs in MSM, and HIV and syphilis coinfections, suggest screening has value in identifying hidden carriage and in contributing for providing better care.
Topics: Male; Humans; Chlamydia trachomatis; Neisseria gonorrhoeae; Homosexuality, Male; Mycoplasma genitalium; Syphilis; Sexual and Gender Minorities; Mycoplasma Infections; Sexually Transmitted Diseases; Gonorrhea; Anus Diseases; Lymphogranuloma Venereum; HIV Infections; Chlamydia Infections; Prevalence
PubMed: 38166231
DOI: 10.1177/09564624231221591 -
BMJ Open Dec 2023Preterm birth complications are the most common cause of death in children under 5 years. The presence of multiple microorganisms and genital tract inflammation could be...
INTRODUCTION
Preterm birth complications are the most common cause of death in children under 5 years. The presence of multiple microorganisms and genital tract inflammation could be the common mechanism driving early onset of labour. South Africa has high levels of preterm birth, genital tract infections and HIV infection among pregnant women. We plan to investigate associations between the presence of multiple lower genital tract microorganisms in pregnancy and gestational age at birth.
METHODS AND ANALYSIS
This cohort study enrols around 600 pregnant women at one public healthcare facility in East London, South Africa. Eligible women are ≥18 years and at <27 weeks of gestation, confirmed by ultrasound. At enrolment and 30-34 weeks of pregnancy, participants receive on-site tests for and , with treatment if test results are positive. At these visits, additional vaginal specimens are taken for: PCR detection and quantification of , spp., , and ; microscopy and Nugent scoring; and for 16S ribosomal RNA gene sequencing and quantification. Pregnancy outcomes are collected from a postnatal visit and birth registers. The primary outcome is gestational age at birth. Statistical analyses will explore associations between specific microorganisms and gestational age at birth. To explore the association with the quantity of microorganisms, we will construct an index of microorganism load and use mixed-effects regression models and classification and regression tree analysis to examine which combinations of microorganisms contribute to earlier gestational age at birth.
ETHICS AND DISSEMINATION
This protocol has approvals from the University of Cape Town Research Ethics Committee and the Canton of Bern Ethics Committee. Results from this study will be uploaded to preprint servers, submitted to open access peer-reviewed journals and presented at regional and international conferences.
TRIAL REGISTRATION NUMBER
NCT06131749; Pre-results.
Topics: Child; Female; Pregnancy; Infant, Newborn; Humans; Child, Preschool; Premature Birth; Pregnant Women; Cohort Studies; HIV Infections; Gestational Age; Pregnancy Complications, Infectious; Reproductive Tract Infections; South Africa; Pregnancy Outcome; Chlamydia trachomatis; Mycoplasma Infections
PubMed: 38154893
DOI: 10.1136/bmjopen-2023-081562 -
Drug Resistance Updates : Reviews and... Jan 2024Mycoplasma hominis, a commensal bacterium that commonly inhabits the genital tract, leading to infections in both the genitourinary and extragenital regions. However,...
Mycoplasma hominis, a commensal bacterium that commonly inhabits the genital tract, leading to infections in both the genitourinary and extragenital regions. However, the antimicrobial resistance and pathogenic mechanisms of M. hominis isolated from extra-urogenital cystic abscess is largely unknown. This study reports the genomic epidemiological characteristics of a M. hominis isolate recovered from a pelvic abscess sample in China. Genomic DNA was extracted and sequenced using Illumina HiSeq X Ten platform. De novo assembly was performed and in silico analysis was accomplished by multiple bioinformatics tools. For phylogenomic analysis, publicly available M. hominis genomes were retrieved from NCBI GenBank database. Whole genome sequencing data showed that the genome size of M. hominis MH4246 was calculated as 679,746 bp, with 558 protein-coding sequences and a G + C content of 26.9%. M. hominis MH4246 is resistant to fluoroquinolones and macrolides, harboring mutations in the quinolone resistance-determining regions (QRDRs) (GyrA S153L, ParC S91I and ParE V417I) and 23S rRNA gene (G280A, C1500T, T1548C and T2218C). Multiple virulence determinants, such as tuf, hlyA, vaa, oppA, MHO_0730 and alr genes, were identified. Phylogenetic analysis showed that the closest relative of M. hominis MH4246 was the strain MH-1 recovered from China, which differed by 3490 SNPs. Overall, this study contributes to the comprehension of genomic characteristics, antimicrobial resistance patterns, and the mechanisms underlying the pathogenicity of this pathogen.
Topics: Humans; Mycoplasma hominis; Abscess; Phylogeny; Anti-Bacterial Agents; Fluoroquinolones
PubMed: 38071861
DOI: 10.1016/j.drup.2023.101029 -
Microbial Drug Resistance (Larchmont,... Jan 2024Updated data on genital Mollicutes prevalence and antimicrobial susceptibility can help provide guidance for antibiotic stewardship and set up effective strategies for...
Updated data on genital Mollicutes prevalence and antimicrobial susceptibility can help provide guidance for antibiotic stewardship and set up effective strategies for infection control policies. In this multicentre study, we assessed the prevalence and the resistance profile of (MH) and species (), analyzing data from 21,210 subjects who provided urogenital samples for Mollicutes detection by culture over a 5-year period (2017-2021) in two high-density urban areas in the North of Italy (, Bologna and Lecco). Overall prevalence of Mollicutes infection was 22.3%, with women showing a significantly higher detection rate than men ( < 0.00001). The prevalence decreased with age (highest prevalence <30 years) and over the years considered. strains were much more frequently detected (62.3%) compared to MH (8.3%) and to mixed infections (29.4%). species showed high levels of ciprofloxacin resistance (39.5%), whereas MH strains were nonsusceptible to azithromycin and roxithromycin in about 60% of cases. Over time, a significant decrease of resistance to azithromycin and doxycycline was detected ( < 0.0001 and 0.0004, respectively), in parallel with an important increase of ciprofloxacin-resistance levels ( < 0.0001). Overall, our results revealed that minocycline and josamycin can be first-line drugs for Mollicutes empirical treatment.
Topics: Male; Humans; Female; Adult; Anti-Bacterial Agents; Ureaplasma; Azithromycin; Mycoplasma Infections; Ureaplasma urealyticum; Drug Resistance, Bacterial; Microbial Sensitivity Tests; Mycoplasma hominis; Ciprofloxacin; Genitalia; Prevalence
PubMed: 38060805
DOI: 10.1089/mdr.2023.0202 -
Peritonsillar abscess caused by Mycoplasma hominis and Fusobacterium necrophorum following oral sex.Auris, Nasus, Larynx Apr 2024Mycoplasma hominis is a bacterium that colonizes the genital tract of some females and males, as well as their respiratory tracts. Although only two cases of deep neck...
Mycoplasma hominis is a bacterium that colonizes the genital tract of some females and males, as well as their respiratory tracts. Although only two cases of deep neck infection have been reported, the associations between the onset and sexual intercourse have not been reported. A healthy 19-year-old female was diagnosed with a left peritonsillar abscess. The patient had sexual intercourse with a new partner, including oral sex, two days prior to symptom onset. It was not known whether the male partner had urethritis symptoms. M. hominis and Fusobacterium necrophorum were isolated from the abscess culture. The patient's condition improved after drainage, and sulbactam ampicillin was switched to oral clindamycin.
Topics: Female; Humans; Male; Young Adult; Adult; Peritonsillar Abscess; Fusobacterium necrophorum; Mycoplasma hominis; Fusobacterium Infections; Sexual Behavior; Anti-Bacterial Agents
PubMed: 38042699
DOI: 10.1016/j.anl.2023.10.004