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Emerging Infectious Diseases Jun 2023We compared cycle thresholds from mpox skin lesions with other specimen sites and over time from onset of clinical signs among 104 patients in Sweden. Cycle thresholds...
We compared cycle thresholds from mpox skin lesions with other specimen sites and over time from onset of clinical signs among 104 patients in Sweden. Cycle thresholds differed by anatomic site. We identified 2 early mpox cases from anorectal swab specimens after skin samples were negative, indicating necessity of sampling multiple sites.
Topics: Humans; Sweden; Mpox (monkeypox); Polymerase Chain Reaction; Monkeypox virus
PubMed: 37069700
DOI: 10.3201/eid2906.230253 -
Frontiers in Cellular and Infection... 2023(MG) is one of the most warning emerging sexually transmitted pathogens also due to its ability in developing resistance to antibiotics. MG causes different conditions...
BACKGROUND
(MG) is one of the most warning emerging sexually transmitted pathogens also due to its ability in developing resistance to antibiotics. MG causes different conditions ranging from asymptomatic infections to acute mucous inflammation. Resistance-guided therapy has demonstrated the best cure rates and macrolide resistance testing is recommended in many international guidelines. However, diagnostic and resistance testing can only be based on molecular methods, and the gap between genotypic resistance and microbiological clearance has not been fully evaluated yet. This study aims at finding mutations associated with MG antibiotic resistance and investigating the relationship with microbiological clearance amongst MSM.
METHODS
From 2017 to 2021, genital (urine) and extragenital (pharyngeal and anorectal swabs) biological specimens were provided by men-who-have-sex-with-men (MSM) attending the STI clinic of the Infectious Disease Unit at the Verona University Hospital, Verona, Italy. A total of 1040 MSM were evaluated and 107 samples from 96 subjects resulted positive for MG. Among the MG-positive samples, all those available for further analysis (n=47) were considered for detection of mutations known to be associated with macrolide and quinolone resistance. 23S rRNA, and genes were analyzed by Sanger sequencing and Allplex™ MG and AziR Assay (Seegene).
RESULTS
A total of 96/1040 (9.2%) subjects tested positive for MG in at least one anatomical site. MG was detected in 107 specimens: 33 urine samples, 72 rectal swabs and 2 pharyngeal swabs. Among them, 47 samples from 42 MSM were available for investigating the presence of mutations associated with macrolide and quinolone resistance: 30/47 (63.8%) showed mutations in 23S rRNA while 10/47 (21.3%) in or genes. All patients with positive Test of Cure (ToC) after first-line treatment with azithromycin (n=15) were infected with 23S rRNA-mutated MG strains. All patients undergoing second-line moxifloxacin treatment (n=13) resulted negative at ToC, even those carrying MG strains with mutations in gene (n=6).
CONCLUSION
Our observations confirm that mutations in 23S rRNA gene are associated with azithromycin treatment failure and that mutations in gene alone are not always associated with phenotypic resistance to moxifloxacin. This reinforces the importance of macrolide resistance testing to guide the treatment and reduce antibiotic pressure on MG strains.
Topics: Male; Humans; Anti-Bacterial Agents; Moxifloxacin; Azithromycin; Mycoplasma genitalium; Homosexuality, Male; Fluoroquinolones; RNA, Ribosomal, 23S; Macrolides; Drug Resistance, Bacterial; Sexual and Gender Minorities; Mutation; Sexually Transmitted Diseases; Genitalia; Prevalence
PubMed: 37065200
DOI: 10.3389/fcimb.2023.1155451 -
Frontiers in Immunology 2023Squamous cell carcinoma of the anus (SCCA) is a rare gastrointestinal cancer. Factors associated with progression of HPV infection to anal dysplasia and cancer are...
BACKGROUND
Squamous cell carcinoma of the anus (SCCA) is a rare gastrointestinal cancer. Factors associated with progression of HPV infection to anal dysplasia and cancer are unclear and screening guidelines and approaches for anal dysplasia are less clear than for cervical dysplasia. One potential contributing factor is the anorectal microbiome. In this study, we aimed to identify differences in anal microbiome composition in the settings of HPV infection, anal dysplasia, and anal cancer in this rare disease.
METHODS
Patients were enrolled in two prospective studies. Patients with anal dysplasia were part of a cross-sectional cohort that enrolled women with high-grade lower genital tract dysplasia. Anorectal tumor swabs were prospectively collected from patients with biopsy-confirmed locally advanced SCCA prior to receiving standard-of-care chemoradiotherapy (CRT). Patients with high-grade lower genital tract dysplasia without anal dysplasia were considered high-risk (HR Normal). 16S V4 rRNA Microbiome sequencing was performed for anal swabs. Alpha and Beta Diversity and composition were compared for HR Normal, anal dysplasia, and anal cancer.
RESULTS
60 patients with high-grade lower genital tract dysplasia were initially enrolled. Seven patients had concurrent anal dysplasia and 44 patients were considered HR Normal. Anorectal swabs from 21 patients with localized SCCA were included, sequenced, and analyzed in the study. Analysis of weighted and unweighted UniFrac distances demonstrated significant differences in microbial community composition between anal cancer and HR normal (p0.018). LEfSe identified that all three groups exhibited differential enrichment of specific taxa. (p=0.028), (p=0.0295) (p=0.034) (p=0.029) were enriched in anal cancer specimens when compared to HR normal.
CONCLUSION
Although alpha diversity was similar between HR Normal, dysplasia and cancer patients, composition differed significantly between the three groups. Increased anorectal , , and abundance were associated with anal cancer. These organisms have been reported in various gastrointestinal cancers with roles in facilitating the proinflammatory microenvironment and neoplasia progression. Future work should investigate a potential role of microbiome analysis in screening for anal dysplasia and investigation into potential mechanisms of how these microbial imbalances influence the immune system and anal carcinogenesis.
Topics: Humans; Female; Papillomavirus Infections; Prospective Studies; Cross-Sectional Studies; Anus Neoplasms; Carcinoma, Squamous Cell; Microbiota; Tumor Microenvironment
PubMed: 37063829
DOI: 10.3389/fimmu.2023.1051431 -
Asian Journal of Surgery Sep 2023
Topics: Humans; Fasciitis, Necrotizing; Abscess; Anus Diseases; Magnetic Resonance Imaging
PubMed: 37059679
DOI: 10.1016/j.asjsur.2023.03.139 -
Frontiers in Microbiology 2023, a gram-negative obligate intracellular bacterium, commonly causes sexually transmitted infections (STIs). Little is known about transmission within the host, which is...
INTRODUCTION
, a gram-negative obligate intracellular bacterium, commonly causes sexually transmitted infections (STIs). Little is known about transmission within the host, which is important for understanding disease epidemiology and progression.
METHODS
We used RNA-bait enrichment and whole-genome sequencing to compare rectal, vaginal and endocervical samples collected at the same time from 26 study participants who attended Fijian Ministry of Health and Medical Services clinics and tested positive for at each anatomic site.
RESULTS
The 78 genomes from participants resolved into two major clades of the phylogeny (the "prevalent urogenital and anorectal" clade and "non-prevalent urogenital and anorectal" clade). For 21 participants, genome sequences were almost identical in each anatomic site. For the other five participants, two distinct strains were present in different sites; in two cases, the vaginal sample was a mixture of strains.
DISCUSSION
The absence of large numbers of fixed SNPs between genomes within many of the participants could indicate recent acquisition of infection prior to the clinic visit without sufficient time to accumulate significant genetic variation in different body sites. This model suggests that many infections may be resolved relatively quickly in the Fijian population, possibly reflecting common prescription or over-the-counter antibiotics usage.
PubMed: 37056744
DOI: 10.3389/fmicb.2023.1154664 -
Frontiers in Pediatrics 2023To assess the effect of megarectum on postoperative defecation of female patients with congenital rectovestibular fistula or rectoperineal fistula.
BACKGROUND
To assess the effect of megarectum on postoperative defecation of female patients with congenital rectovestibular fistula or rectoperineal fistula.
METHODS
From March 2013 to February 2021, 74 female patients with congenital rectovestibular fistula or rectoperineal fistula were treated. The age of patients ranged from 3 months to 1 year. Barium enema and spinal cord MRI were performed in all children. 4 patients were removed from the study because of spinal cord and sacral agenesis. Finally, 70 patients underwent one-stage anterior sagittal anorectoplasty (ASARP). Anal endoscopy and anorectal pressure measurement were performed 1 year after surgery. All patients were divided into two groups depending on the presence of megarectum (+) and (-) and observed for constipation and anal sphincter function.
RESULTS
16 patients (4 months to 1 year) were complicated with megarectum, and 5 patients (3 months to 9 months) were without megarectum. The incision infection was seen in 3 patients. All patients were followed up for 1 year to 5 years. Fecal soiling was seen in 2 patients and constipation in 14 patients. Among 16 patients with megarectum, soiling was seen in 1 patient and the constipation in 12 patients. Among 54 patients without megarectum, soiling was seen in 1 patient and constipation in 2 patients. There was a significant difference in the incidence of postoperative constipation between the two groups (megarectum (+) 75% vs. megarectum (-) 3.7% ( < 0.05)). However, there was no significant difference in the score of anal sphincters between the two groups ( < 0.05). And there was no significant difference in anal resting pressure ( = 0.49) and length of anal high pressure area ( = 0.76). 7 patients with constipation and megarectum acquired normal anal function after the dilated rectum was resected.
CONCLUSION
Megarectum increases the possibility of difficult postoperative defecation in the patients with congenital rectovestibular fistula or rectoperineal fistula. However, constipation was not associated with ASARP postoperative effects on sphincter function. Resection of megarectum is helpful to the improvement of constipation.
PubMed: 37051433
DOI: 10.3389/fped.2023.1095054 -
International Journal of Environmental... Apr 2023This study's purpose was to investigate risk factors for mortality from anorectal abscesses through a more comprehensive examination. This was a retrospective study that...
This study's purpose was to investigate risk factors for mortality from anorectal abscesses through a more comprehensive examination. This was a retrospective study that evaluated National Inpatient Sample patient data of adult and elderly patients emergently admitted with a primary diagnosis of anorectal abscess. Data was stratified by variables of interest and examined through statistical analysis, including backward logistic regression modelling. Roughly 40,000 adult patients and nearly 7000 elderly patients were admitted emergently with a primary diagnosis of abscess in anorectal regions. The mean age of adult male patients was 43 years while elderly male patients were, on average, 73 years old. Both adult males (69.0%) and elderly males (63.9%) were more frequently seen in the hospital for anorectal abscess compared to females. Mortality rates were lower in adult patients as only 0.2% (n = 62) of adult patients and 1.0% (n = 73) of elderly patients died in the hospital. Age increased the odds of mortality (OR = 1.03; 95% CI: 1.02-1.04, < 0.001) as did hospital length of stay (OR = 1.02; 95% CI: 1.01-1.03, < 0.001). Surgical procedure decreased the odds of mortality by more than 50% (OR = 0.49; 95% CI: 0.33-0.71, < 0.001). Risk factors for mortality from anorectal abscess included age and non-operative management, which leads to prolonged hospital length of stay. Surgical management of anorectal abscesses offered protective benefits.
Topics: Adult; Female; Humans; Male; Middle Aged; Aged; Abscess; Retrospective Studies; Anus Diseases; Hospitalization; Patients
PubMed: 37048002
DOI: 10.3390/ijerph20075387 -
Asian Journal of Surgery Aug 2023
Topics: Humans; Crohn Disease; Abscess; Anus Diseases; Rectal Fistula; Patients
PubMed: 36990810
DOI: 10.1016/j.asjsur.2023.03.032 -
Cureus Feb 2023is a rare manifestation of infection and may manifest with anorectal symptoms, rectitis, proctitis, and inguinal masses. The new outbreaks of Chlamydia infection...
is a rare manifestation of infection and may manifest with anorectal symptoms, rectitis, proctitis, and inguinal masses. The new outbreaks of Chlamydia infection have allowed the description of new cases with rectal symptoms (rectitis/proctitis), mainly in people living with HIV and men who have sex with men. The authors present the clinical findings in people living with HIV men who have sex with men with lymphogranuloma venereum with ulcerative rectitis identified by colonoscopy. Differentiation of proctitis was made from other causes of sexually transmitted infections, such as gonorrhea and herpes virus, inflammatory diseases (Crohn's disease), and neoplastic and opportunistic infections such as cytomegalovirus, tuberculosis, and histoplasmosis. The symptoms of the patient and the endoscopic lesions were suspected of lymphogranuloma venereum with ulcerative proctitis, which was confirmed by biopsy and performing the polymerase chain reaction. After appropriate treatment with doxycycline, the patient evolved favorably.
PubMed: 36987466
DOI: 10.7759/cureus.35420 -
Current Issues in Molecular Biology Feb 2023Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection caused by serovars L1 to L3. The current LGV cases in Europe are mainly characterized by an...
Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection caused by serovars L1 to L3. The current LGV cases in Europe are mainly characterized by an anorectal syndrome, spreading within men who have sex with men (MSM). Whole-genome sequencing of LGV strains is crucial to the study of bacterial genomic variants and to improve strategies for contact tracing and prevention. In this study, we described the whole genome of a strain (LGV/17) responsible for a case of rectal LGV. LGV/17 strain was isolated in 2017 in Bologna (North of Italy) from a HIV-positive MSM, presenting a symptomatic proctitis. After the propagation in LLC-MK2 cells, the strain underwent whole-genome sequencing by means of two platforms. Sequence type was determined using the tool MLST 2.0, whereas the genovariant was characterized by an sequence evaluation. A phylogenetic tree was generated by comparing the LGV/17 sequence with a series of L2 genomes, downloaded from the NCBI website. LGV/17 belonged to sequence type ST44 and to the genovariant L2f. Nine ORFs encoding for polymorphic membrane proteins A-I and eight encoding for glycoproteins Pgp1-8 were detected in the chromosome and in the plasmid, respectively. LGV/17 was closely related to other L2f strains, even in the light of a not-negligible variability. The LGV/17 strain showed a genomic structure similar to reference sequences and was phylogenetically related to isolates from disparate parts of the world, indicative of the long-distance dynamics of transmission.
PubMed: 36975489
DOI: 10.3390/cimb45030119