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International Journal of Gynaecology... Jul 2024There is a high prevalence and incidence rate of asymptomatic sexually transmitted infections (STIs) during pregnancy in adolescent girls and young women in Africa. The...
OBJECTIVE
There is a high prevalence and incidence rate of asymptomatic sexually transmitted infections (STIs) during pregnancy in adolescent girls and young women in Africa. The association between STIs and pregnancy outcomes in a hyperepidemic HIV setting has not been well described.
METHODS
Pregnant women, HIV-1 negative and <28 weeks' gestation at three primary health clinics in KwaZulu-Natal, South Africa were enrolled from February 2017 to March 2018. Vaginal swabs collected at the first and later antenatal visits were stored and retrospectively tested for HSV-2, Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae at the end of the study. The association between STIs detected at first and later antenatal visits and pregnancy outcome was assessed using multivariable logistic regression models adjusted for maternal age and treatment received for symptomatic STIs.
RESULTS
Testing positive Mycoplasma genitalium at the first antenatal visit was significantly associated with low birth weight (odds ratio [OR] 5.22; 95% confidence interval [CI]: 1.10-15.98). Testing positive for T. vaginalis at the repeat visit was significantly associated with preterm births (OR 2.37; 95% CI: 1.11-5.03), low birth weight (OR 2.56; 1.16-5.63) and a composite adverse pregnancy outcome (OR 2.11; 95% CI: 1.09-4.08). Testing positive for HSV-2 at the repeat visit was also likely associated with experiencing a preterm birth or any adverse pregnancy outcome (OR 3.39; 95% CI: 0.86-13.3) (P = 0.096).
CONCLUSIONS
Among predominantly asymptomatic STIs, M. genitalium detected at baseline visit was significantly associated with low birth weight, while T. vaginalis detected at the repeat visit in later pregnancy was significantly associated with preterm birth. Further research is warranted to study the impact of etiological testing of STIs at more than one antenatal visit and empirical treatment on pregnancy outcomes.
Topics: Humans; Female; Pregnancy; Retrospective Studies; Pregnancy Complications, Infectious; South Africa; Adult; Pregnancy Outcome; Sexually Transmitted Diseases; Young Adult; Premature Birth; Adolescent; Infant, Low Birth Weight; Infant, Newborn; Chlamydia Infections; Mycoplasma genitalium; Herpes Genitalis; Prevalence; Logistic Models; Trichomonas vaginalis; Herpesvirus 2, Human; Prenatal Care; Trichomonas Vaginitis
PubMed: 38573181
DOI: 10.1002/ijgo.15529 -
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 -
Sexually Transmitted Diseases Apr 2024In South Africa, extragenital etiological sexually transmitted infection (STI) screening among men who have sex with men (MSM) is not routinely available. We aimed to...
BACKGROUND
In South Africa, extragenital etiological sexually transmitted infection (STI) screening among men who have sex with men (MSM) is not routinely available. We aimed to determine the prevalence of STI pathogens at rectal and pharyngeal sites, syphilis seroprevalence, and associated risk factors among a selection of high-risk MSM without symptomatic urethritis attending a men's health clinic in Johannesburg, South Africa.
METHODS
A cross-sectional study was conducted in 2022. Enrolled clients self-reported demographic, sexual behavioral risks, and clinical information. Client or clinician-collected rectal and pharyngeal swabs were tested for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis. C. trachomatis-positive rectal samples were reflex tested for lymphogranuloma venereum. Blood specimens were screened for syphilis. Univariate and multivariate regression models were used to determine factors independently associated with the presence of an extragenital STI or syphilis.
RESULTS
Among the 97 participants (median age, 29 years), 24.7% had an extragenital STI and 9.4% had high nontreponemal antibody titers (rapid plasma reagin ≥1:16). Rectal STIs were detected in 26.4% participants: N. gonorrhoeae (14.3%), C. trachomatis (9.9%), and M. genitalium (5.5%). Pharyngeal STIs were less prevalent (4.1%). Overall, the prevalence of any STI was 41%. Sex under the influence of drugs (adjusted odds ratio, 4.94; 95% confidence interval, 1.56-15.69) and engaging in condomless receptive anal intercourse with a casual partner (adjusted odds ratio, 8.36; 95% confidence interval, 1.73-40.28) were independent risk factors for having an extragenital STI.
CONCLUSIONS
The high burden of extragenital STIs and active syphilis in asymptomatic MSM underscores the importance of routine etiological screening in this key population, as the syndromic approach would not enable detection or treatment of these infections.
Topics: Male; Humans; Adult; Homosexuality, Male; Syphilis; Gonorrhea; South Africa; Cross-Sectional Studies; Seroepidemiologic Studies; Chlamydia Infections; Sexual and Gender Minorities; Sexually Transmitted Diseases; Neisseria gonorrhoeae; Chlamydia trachomatis; Prevalence; HIV Infections
PubMed: 38534082
DOI: 10.1097/OLQ.0000000000001927 -
Nature Reviews. Microbiology Jul 2024Sexually transmitted infections (STIs) have been part of human life since ancient times, and their symptoms affect quality of life, and sequelae are common.... (Review)
Review
Sexually transmitted infections (STIs) have been part of human life since ancient times, and their symptoms affect quality of life, and sequelae are common. Socioeconomic and behavioural trends affect the prevalence of STIs, but the discovery of antimicrobials gave hope for treatment, control of the spread of infection and lower rates of sequelae. This has to some extent been achieved, but increasing antimicrobial resistance and increasing transmission in high-risk sexual networks threaten this progress. For Neisseria gonorrhoeae, the only remaining first-line treatment (with ceftriaxone) is at risk of becoming ineffective, and for Mycoplasma genitalium, for which fewer alternative antimicrobial classes are available, incurable infections have already been reported. For Chlamydia trachomatis, in vitro resistance to first-line tetracyclines and macrolides has never been confirmed despite decades of treatment of this highly prevalent STI. Similarly, Treponema pallidum, the cause of syphilis, has remained susceptible to first-line penicillin.
Topics: Humans; Anti-Bacterial Agents; Sexually Transmitted Diseases, Bacterial; Drug Resistance, Bacterial; Neisseria gonorrhoeae; Chlamydia trachomatis; Mycoplasma genitalium; Sexually Transmitted Diseases
PubMed: 38509173
DOI: 10.1038/s41579-024-01023-3 -
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 -
International Journal of Gynaecology... Jul 2024Mycoplasma genitalium is an emerging pathogen, which has been linked to cervicitis, urethritis and pelvic inflammatory disease (PID). With the advent of multiplex... (Review)
Review
BACKGROUND
Mycoplasma genitalium is an emerging pathogen, which has been linked to cervicitis, urethritis and pelvic inflammatory disease (PID). With the advent of multiplex polymerase chain reaction (PCR) panels for sexually transmitted infections, it is increasingly being identified in pregnant women.
OBJECTIVES
The aim was to review international guidelines, which had explicit recommendations for treatment of M. genitalium infection in pregnancy and breastfeeding.
SEARCH STRATEGY
PubMed, EMBASE and Cochrane databases were reviewed with no age, species, language or date restrictions.
SELECTION CRITERIA
Studies were included if they had an explicit recommendation for treatment of M. genitalium in pregnancy. Studies were excluded if there was no recommendation in pregnancy, if they referred to other international guideline recommendations or were historical versions of guidelines.
DATA COLLECTION AND ANALYSIS
References were manually reviewed and 50 papers were selected for review. Only four guidelines were included in the final analysis and they were from Europe, UK, Australia and Aotearoa New Zealand.
MAIN RESULTS
All studies recommended azithromycin as first-line treatment, and advised against moxifloxacin use. The dosing schedule of azithromycin, varied between guidelines, as did the utility/safety of pristinamycin for macrolide resistant infections. Safety data was generally reassuring for azithromycin but inconsistent for pristinamycin.
CONCLUSIONS
Azithromycin is the first-line treatment for macrolide susceptible or unknown resistance infections, but there is a lack of consistency regarding dosing of azithromycin or the utility/safety of pristinamycin for macrolide resistant infections in pregnancy/lactation.
Topics: Humans; Female; Pregnancy; Mycoplasma genitalium; Mycoplasma Infections; Anti-Bacterial Agents; Pregnancy Complications, Infectious; Practice Guidelines as Topic; Azithromycin
PubMed: 38491782
DOI: 10.1002/ijgo.15469 -
Sexually Transmitted Diseases Jul 2024Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are routinely tested and reported; however, Trichomonas vaginalis (TV) is the most common sexually transmitted...
BACKGROUND
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are routinely tested and reported; however, Trichomonas vaginalis (TV) is the most common sexually transmitted infection (STI) in the United States and the prevalence of Mycoplasma genitalium (MG) infections is likely higher than estimated. We examined the clinical performance of the Alinity m STI assay for detection and surveillance of CT/NG/TV/MG in urine specimens from patients at a large academic medical center.
METHODS
Urine specimen from 198 patients was tested in this evaluation. Alinity m STI and Aptima Combo 2 CT/NG and TV assay (Panther System) results were compared, with discrepant results run on the cobas 6800 CT/NG, TV/MG assays. Analyzer turnaround times, time from loading the specimen on the analyzer to results reporting, were determined for Alinity m and Panther systems.
RESULTS
Overall percent agreements of the Alinity m in comparison with the Aptima and cobas assays for CT, NG, TV, and MG were 99.5% (97.2%, 99.9%), 99.5% (97.2%, 99.9%), 98.4% (95.5%, 99.5%), and 86.4% (66.7%, 95.3), respectively. There were 5 discrepant samples (CT, 1; NG, 1; TV, 3) between the Alinity m and the Aptima assays, and 3 MG discrepant samples between the Alinity m STI and cobas 6800. Two of the 5 Aptima and Alinity m discrepant samples were resolved as they yielded similar results on both Alinity m and cobas 6800. TV and MG infections comprised 54% of the positive samples and were more often asymptomatic than CT and NG infections. Analyzer turnaround time was 3 hours 25 minutes for the Aptima CT/NG, 3 hours 25 minutes for Aptima TV, and 1 hour 55 minutes for Alinity m STI assay.
CONCLUSIONS
The Alinity m STI assay allows for fast and simultaneous detection of the 4 major STI pathogens, which can facilitate surveillance and provide accurate results to help clinicians diagnose for initiation of appropriate treatment.
Topics: Humans; Female; Chlamydia trachomatis; Multiplex Polymerase Chain Reaction; Neisseria gonorrhoeae; Trichomonas vaginalis; Male; Mycoplasma genitalium; Gonorrhea; Sexually Transmitted Diseases; Chlamydia Infections; Mycoplasma Infections; Sensitivity and Specificity; Adult; United States; Trichomonas Vaginitis; Reagent Kits, Diagnostic
PubMed: 38465972
DOI: 10.1097/OLQ.0000000000001964 -
International Journal of Gynaecology... Jul 2024Sexually transmitted infections (STIs) are a public health problem. The aim of the present study was to assess the prevalence and risk factors associated with at least...
Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium and risk factors among pregnant women in Brazil: Results from the national molecular diagnosis implementation project.
BACKGROUND
Sexually transmitted infections (STIs) are a public health problem. The aim of the present study was to assess the prevalence and risk factors associated with at least one STI (Chlamydia trachomatis [CT], Neisseria gonorrhoeae [NG], Trichomonas vaginalis [TV], and Mycoplasma genitalium [MG]) in Brazil.
METHODS
A cross-sectional study was conducted using secondary data from the pilot implementation of the National Service for molecular diagnosis of CT, NG, TV, and MG in pregnancy. We obtained Ministry of Health surveillance data from the implementation project. Data encompassing pregnant women aged 15-49 years from public antenatal clinics in Brazil in 2022 were included.
RESULTS
A total of 2728 data of pregnant women were analyzed. The prevalence of at least one infection was 21.0% (573), with the highest prevalence in the Southeast region (23.3%) and the lowest in the Center-West region (15.4%). The prevalence of CT was 9.9% (270), NG 0.6% (16), TV 6.7% (184), and MG 7.8% (212). Factors associated with any infection were from 15 to 24 years (AOR = 1.93; 95% CI: 1.58-2.35); reported family income up to US$400 (AOR = 1.79; 95% CI: 1.03-3.34); declared not living maritally with their partners (AOR = 1.90, 95% CI: 1.52-2.37) and had more than one sexual partner in their lifetime (AOR = 2.09, 95% CI: 1.55-2.86).
CONCLUSION
This study showed a high prevalence of at least one STI among pregnant women in Brazil, particularly among younger women. It also provides up-to-date national data on CT, NG, TV, and MG infections in this population. These findings underscore the importance of enhancing access to STI screening for young pregnant women within the Brazilian public health system.
Topics: Humans; Female; Brazil; Pregnancy; Adult; Cross-Sectional Studies; Adolescent; Prevalence; Young Adult; Mycoplasma genitalium; Risk Factors; Mycoplasma Infections; Gonorrhea; Neisseria gonorrhoeae; Trichomonas vaginalis; Pregnancy Complications, Infectious; Chlamydia trachomatis; Chlamydia Infections; Trichomonas Vaginitis; Middle Aged; Sexually Transmitted Diseases
PubMed: 38425195
DOI: 10.1002/ijgo.15447 -
[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