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NCBI: db=pubmed; Term=(sexually transmitted infections OR sexually transmitted diseases) AND (point of care diagnostics OR pregnancy outcomes OR antibiotic resistance) NOT hiv
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Mycoplasma genitalium and Trichomonas vaginalis: addressing disparities and promoting public health control of two emerging sexually transmitted infections.

Thu, 06/11/2020 - 08:24
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Mycoplasma genitalium and Trichomonas vaginalis: addressing disparities and promoting public health control of two emerging sexually transmitted infections.

Curr Opin Pediatr. 2020 Jun 08;:

Authors: Korich F, Reddy NG, Trent M

Abstract
PURPOSE OF REVIEW: Mycoplasma genitalium (M. genitalium) and Trichomonas vaginalis (T. vaginalis), sexually transmitted infections that remain non-reportable in the United States, may lead to pelvic inflammatory disease (PID) and adverse pregnancy outcomes if left untreated. Prevalence estimates have highlighted socioeconomic and racial/ethnic disparities in rates of infection. This review summarizes the recent literature on M. genitalium and T. vaginalis with a focus on the epidemiology, screening, and treatment of M. genitalium and T. vaginalis.
RECENT FINDINGS: The burden of T. vaginalis testing remains on women. Antimicrobial resistance is of great concern for M. genitalium. Comprehensive screening and treatment guidelines present an opportunity to address these public health concerns.
SUMMARY: M. genitalium and T. vaginalis infections disproportionately affect sexual and racial/ethnic minorities and those facing socioeconomic disparities. The availability of nucleic acid amplification test testing has facilitated accurate diagnosis of both disorders. Safe and efficacious treatments are available for treatment of both disorders. Integrating macrolide resistance testing into treatment algorithms for M. genitalium and dual antibiotic therapy may prove a useful strategy for future US-based guidance. Public health reporting and increased public awareness campaigns are key next steps to addressing the observed reproductive health disparities.

PMID: 32520821 [PubMed - as supplied by publisher]

Point-by-point progress: gonorrhea point of care tests.

Sat, 06/06/2020 - 08:15
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Point-by-point progress: gonorrhea point of care tests.

Expert Rev Mol Diagn. 2020 Jun 05;:

Authors: Gaydos C, Melendez JH

Abstract
INTRODUCTION: Point-of-care (POC) tests for Neisseria gonorrhoeae (Ng) are urgently needed to control the gonorrhea epidemic, so patients can receive immediate diagnoses and treatment. While the advent of nucleic acid amplification tests (NAATs) have improved the accuracy of Ng identification, very few POC assays are able to provide results of such tests at the clinical visit. Additionally, antimicrobial resistance (AMR) presents a unique treatment challenge for NG.
AREAS COVERED: This review notes that older POC tests have lower sensitivity for Ng, compared to the currently-available NAATs, are not adequate for the current demand for high sensitivity. Promising newer assays, which can be used at the POC are covered. This review also includes data about clinicians' and patients' acceptability and expectations of POC tests for Ng, testing of extragenital specimens, pooling studies, as well as their impact clinically and use in low-resource settings.
EXPERT OPINION: The ability to use POC tests to identify and immediately treat Ng infections at the patient encounter offers many benefits and opportunities. POC tests for Ng are currently available, but not widely used especially in low-resource settings. Further development of POC test with AMR testing capacity is needed to help guide antimicrobial stewardship.

PMID: 32500764 [PubMed - as supplied by publisher]

Neisseria gonorrhoeae Septic Arthritis with Contiguous Infection Consistent with Acute Osteomyelitis.

Fri, 06/05/2020 - 08:13
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Neisseria gonorrhoeae Septic Arthritis with Contiguous Infection Consistent with Acute Osteomyelitis.

Sex Transm Dis. 2020 Jun 02;:

Authors: Russ-Friedman C, Coates K, Torabi M, Palavecino EL, McNeil CJ

Abstract
Neisseria gonorrhoeae osteomyelitis is a rare complication of disseminated gonococcal infection (DGI). As the rates of N. gonorrhea continue to increase in the U.S., clinicians may encounter patients with DGI complicated by gonococcal osteomyelitis. Screening and appropriate treatment of N. gonorrhoeae remains paramount, especially with growing antibiotic resistance.

PMID: 32496386 [PubMed - as supplied by publisher]

Use of Whole Genome Sequencing for the Molecular Comparison of Neisseria gonorrhoeae Isolates With Decreased Susceptibility to Extended Spectrum Cephalosporins From 2 Geographically Different Regions in America.

Fri, 06/05/2020 - 08:13
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Use of Whole Genome Sequencing for the Molecular Comparison of Neisseria gonorrhoeae Isolates With Decreased Susceptibility to Extended Spectrum Cephalosporins From 2 Geographically Different Regions in America.

Sex Transm Dis. 2019 08;46(8):548-555

Authors: Gianecini RA, Zittermann S, Oviedo C, Galas M, Pardo PR, Allen VG, Galarza P, Melano RG

Abstract
BACKGROUND: Neisseria gonorrhoeae isolates with reduced susceptibility or resistance to the recommended first-line antimicrobial therapy have been described in several countries. The purpose of this study was to use genome analyses to compare the molecular characteristics of N. gonorrhoeae isolates with decreased susceptibility to extended-spectrum cephalosporin from Ontario, Canada, and Argentina.
METHODS: A total of 128 N. gonorrhoeae isolates, collected in 2015, were included. The susceptibility to penicillin G, tetracycline, ciprofloxacin, cefixime, ceftriaxone, and azithromycin was determined using the agar dilution method. Isolates were subjected to whole genome sequencing, and an in silico analysis was performed to identify antimicrobial resistance determinants and for genotyping.
RESULTS: Decreased susceptibility to extended-spectrum cephalosporin was mainly associated with penA mosaic allele 34.001, together with an mtrR promoter A deletion and porB1b alterations G120K/A121N. N. gonorrhoeae multiantigen sequence typing ST1407 or closely related genotypes were identified circulating in both regions.
CONCLUSIONS: An international multi-drug resistant clone of N. gonorrhoeae was associated with decreased susceptibility to extended-spectrum cephalosporin (ESC) in 2 different regions in America. Evidence of clonal dissemination of the organism in some regions suggests that the strength of surveillance programs and establishment of collaborative projects are essential.

PMID: 31295224 [PubMed - indexed for MEDLINE]

Men Who Have Sex With Men With Mycoplasma genitalium-Positive Nongonococcal Urethritis Are More Likely to Have Macrolide-Resistant Strains Than Men With Only Female Partners: A Prospective Study.

Fri, 06/05/2020 - 08:13
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Men Who Have Sex With Men With Mycoplasma genitalium-Positive Nongonococcal Urethritis Are More Likely to Have Macrolide-Resistant Strains Than Men With Only Female Partners: A Prospective Study.

Sex Transm Dis. 2019 08;46(8):513-517

Authors: McIver R, Jalocon D, McNulty A, Jeoffreys NJ, Chen SC, Power M, Couldwell DL

Abstract
BACKGROUND: Mycoplasma genitalium was previously less common among men who have sex with men (MSM) compared with men with only female partners (MSW) in men with nongonococcal urethritis (NGU) in Sydney, Australia. We aimed to determine the prevalence of M. genitalium and of macrolide-resistant M. genitalium in men with NGU and to compare differences between prevalence and resistance rates between MSM and MSW.
METHODS: We enrolled 588 men with NGU in a prospective study at two urban sexual health services. The ResistancePlus MG assay (SpeeDx, Australia) was used to detect both M. genitalium, and macrolide resistance-associated mutations in first-void urine samples. Demographic, behavioral and clinical data were analyzed to investigate associations with M. genitalium infection or the presence of macrolide resistance.
RESULTS: Mycoplasma genitalium prevalence was 12.8% (75 of 588) overall and among MSM (12.8% [39 of 306]) and MSW (12.8% [36 of 282]; risk ratio [RR], 1.00; 95% confidence interval [CI], 0.65-1.52). Overall, 70.7% (53 of 75) of M. genitalium strains were macrolide-resistant, with significantly more resistance among MSM (89.7%, 35 of 39) than MSW (50%, 18 of 36) (RR, 1.80; 95% CI, 1.27-2.54; P = 0.001). On multivariate analysis, the presence of M. genitalium macrolide resistance mutations was independently associated with having male sexual partners compared with having only female partners (RR, 1.55; 95% CI, 1.02-2.38; P = 0.042).
CONCLUSIONS: Prevalence of M. genitalium among men with NGU is now similar for MSW and MSM and has increased locally from 5.2% to 12.8% within the last 10 years. Men who have sex with men are significantly more likely than MSW to harbor macrolide-resistant M. genitalium infections. This has treatment implications.

PMID: 31295218 [PubMed - indexed for MEDLINE]

Herpes Simplex Infection During Pregnancy, Results of a Tertiary Referral Center in Turkey.

Fri, 06/05/2020 - 08:13
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Herpes Simplex Infection During Pregnancy, Results of a Tertiary Referral Center in Turkey.

Z Geburtshilfe Neonatol. 2020 Feb;224(1):22-25

Authors: Sert UY, Ozgu-Erdinc AS, Saygan S, Engin-Ustun Y

Abstract
OBJECTIVE: The present study aimed to determine herpes simplex virus (HSV) infection during pregnancy, serologic status of symptomatic patients, and the frequency of PCR and culture positivity and neonatal disease in an obstetric population.
MATERIALS AND METHODS: Sera of 1,690 women with genital lesions were tested for HSV IgM and/or HSV IgG between 2008 and 2017. All the patients were evaluated by PCR and viral culture to demonstrate genital herpes infection.
RESULTS: The frequency of HSV IgG and IgM seropositivity was 73.8% (1245/1685) and 28.6% (484/1690). The number with a positive viral culture was 288, whereas positive PCR was 305. Five infants had localized skin lesions of HSV infection at the time of birth.
CONCLUSION: This study shows the serologic status, viral culture and PCR testing results of pregnant women who had a symptomatic genital HSV infection and efficacy of management strategies to prevent neonatal herpes infection.

PMID: 30831604 [PubMed - indexed for MEDLINE]

Diagnosis and treatment of gonorrhoea: 2019 Belgian National guideline for primary care.

Wed, 06/03/2020 - 08:09
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Diagnosis and treatment of gonorrhoea: 2019 Belgian National guideline for primary care.

Acta Clin Belg. 2020 Jun 02;:1-9

Authors: Jespers V, Stordeur S, Berghe WV, Mokrane S, Libois A, Kenyon C, Jones C, Dekker N, De Cannière AS, De Baetselier I, Crucitti T

Abstract
OBJECTIVES: Gonorrhoea continues to be a public health concern in Belgium with pharyngeal and rectal infections increasing in persons with high-risk sexual behaviour. Belgian health care practitioners rely on international guidance when managing gonorrhoea resulting in non-adapted suboptimal care for the Belgian patient. This guideline will rectify this situation.
METHODS: This guideline was developed following an evidence-based approach and involving a guideline development group (GDG). Research questions were prioritised by the GDG and researchers conducted a systematic review of the evidence that was assessed using GRADE approach.
RESULTS: The guideline offers recommendations for gonorrhoea diagnosis, treatment and management for primary care professionals in Belgium and applies a risk group approach. This approach aims for improved identification of at-risk persons and targeted testing of at-risk groups; it includes behavioural questioning when deciding on diagnostic sampling and provides clear advice on treatment. The guideline defines when to add surveillance testing for antibiotic resistance, and what consists of good follow-up.
RESULTS: A concerted application of this guideline by all stakeholders in Belgium may result in improving the diagnosis of infections and eventually addressing the emerging multi-drug resistance.

PMID: 32484428 [PubMed - as supplied by publisher]

Mycoplasma genitalium and antimicrobial resistance in Europe: a comprehensive review.

Tue, 06/02/2020 - 08:07
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Mycoplasma genitalium and antimicrobial resistance in Europe: a comprehensive review.

Int J STD AIDS. 2020 03;31(3):190-197

Authors: Fernández-Huerta M, Barberá MJ, Serra-Pladevall J, Esperalba J, Martínez-Gómez X, Centeno C, Pich OQ, Pumarola T, Espasa M

PMID: 32000587 [PubMed - indexed for MEDLINE]

Mosaic structure of the penA gene in the oropharynx of men who have sex with men negative for gonorrhoea.

Tue, 06/02/2020 - 08:07
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Mosaic structure of the penA gene in the oropharynx of men who have sex with men negative for gonorrhoea.

Int J STD AIDS. 2020 03;31(3):230-235

Authors: Marangoni A, Marziali G, Salvo M, D'Antuono A, Gaspari V, Foschi C, Re MC

PMID: 32000586 [PubMed - indexed for MEDLINE]

Prenatal chlamydial, gonococcal, and trichomonal screening in the Democratic Republic of Congo for case detection and management.

Tue, 06/02/2020 - 08:07
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Prenatal chlamydial, gonococcal, and trichomonal screening in the Democratic Republic of Congo for case detection and management.

Int J STD AIDS. 2020 03;31(3):221-229

Authors: Gadoth A, Shannon CL, Hoff NA, Mvumbi G, Musene K, Okitolonda-Wemakoy E, Hoffman RM, Rimoin AW, Klausner JD

PMID: 31996095 [PubMed - indexed for MEDLINE]

Characterization of antimicrobial resistance genes from Neisseria gonorrhoeae positive remnant Aptima urine specimens.

Fri, 05/29/2020 - 07:56
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Characterization of antimicrobial resistance genes from Neisseria gonorrhoeae positive remnant Aptima urine specimens.

Future Microbiol. 2019 12;14:1559-1571

Authors: Parmar NR, Perera SR, Wang J, Levett PN, Minion J, Dillon JR

Abstract
Aim: To ascertain the antimicrobial resistance and strain types (STs) of Neisseria gonorrhoeae from 50 remnant Aptima urine specimens using molecular methods. Methods: Mutations predictive of resistance to six antibiotics were identified in eight genes. STs were determined using NG-MAST and NG-STAR. Results: All eight antimicrobial resistance genes could be characterized in 36 specimens. A total of 17 specimens were predicted to be susceptible to all antibiotics, including ceftriaxone. Decreased susceptibility to cefixime and ciprofloxacin resistance was predicted in 11 specimens (PBP2 type 34.001). Overall, 38/50 specimens were predicted to be ciprofloxacin susceptible; three were azithromycin resistant. Nineteen NG-MAST and 21 NG-STAR STs were noted. Conclusion: Molecular analysis of remnant Aptima specimens enabled the prediction of emerging gonococcal cefixime and azithromycin resistance which would otherwise have been undetected.

PMID: 31992068 [PubMed - indexed for MEDLINE]

The power and limitations of genomic surveillance of bacteria.

Fri, 05/29/2020 - 07:56
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The power and limitations of genomic surveillance of bacteria.

Future Microbiol. 2019 11;14:1345-1348

Authors: González-Candelas F, Francés-Cuesta C, García-González N

PMID: 31852242 [PubMed - indexed for MEDLINE]

Australian Gonococcal Surveillance Programme, 1 April to 30 June 2019.

Thu, 05/28/2020 - 07:55
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Australian Gonococcal Surveillance Programme, 1 April to 30 June 2019.

Commun Dis Intell (2018). 2020 May 18;44:

Authors: Lahra MM, Hogan TR, National Neisseria Network, Australia

Abstract

PMID: 32418509 [PubMed - indexed for MEDLINE]

The first wide-scale drug repurposing screen using the Prestwick Chemical Library (1200 bioactive molecules) against Neisseria gonorrhoeae identifies high in vitro activity of auranofin and many additional drugs.

Thu, 05/28/2020 - 07:55
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The first wide-scale drug repurposing screen using the Prestwick Chemical Library (1200 bioactive molecules) against Neisseria gonorrhoeae identifies high in vitro activity of auranofin and many additional drugs.

APMIS. 2020 Mar;128(3):242-250

Authors: Foerster S, Gustafsson TN, Brochado AR, Desilvestro V, Typas A, Unemo M

Abstract
Treatment options for gonorrhoea are scarce. Drug repurposing of bioactive molecules approved for other conditions might therefore be of value. We developed a method for wide-scale, systematic drug repurposing screen to identify molecules with activity against Neisseria gonorrhoeae and screened the Prestwick Chemical Library (1200 FDA-approved drugs). As a proof-of-concept, we further examined one promising and interesting screening hit (auranofin; antirheumatic agent). Three WHO gonococcal reference strains (WHO F, O, P) were used for the Library screening. The strains were grown in presence of a fixed concentration of the library drugs in 384-well plates for 12 h, and the remaining bacterial respiration, to reflect growth, was then quantitatively measured using optical density (OD) 450 nm and a resazurin assay. The activity of auranofin was further examined using in vitro susceptibility testing (minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)) against genetically diverse antimicrobial-resistant N. gonorrhoeae strains and time-kill assays. Sixty-eight molecules significantly inhibited bacterial growth of WHO F, O and P. Auranofin showed potent in vitro bactericidal activity (in MIC-, MBC- and time-kill assays) against four WHO reference strains. No cross-resistance between auranofin and any antimicrobial currently or previously used for gonorrhoea treatment was found when examining 51 selected antimicrobial-resistant gonococcal strains. In conclusion, this is the first wide-scale systematic screening effort for repurposing drugs for future treatment of gonorrhoea. Additional studies examining mechanism(s) of action, resistance development, in vivo anti-gonococcal activity and pharmacokinetics/pharmacodynamics for gonococcal infections of auranofin and several other significant screening hits would be valuable.

PMID: 31811739 [PubMed - indexed for MEDLINE]

Clinical evaluation of the ResistancePlus MG FleXible test on the GeneXpert Infinity-48s instrument: a near-patient assay for simultaneous detection of Mycoplasma genitalium and macrolide resistance.

Wed, 05/27/2020 - 07:53
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Clinical evaluation of the ResistancePlus MG FleXible test on the GeneXpert Infinity-48s instrument: a near-patient assay for simultaneous detection of Mycoplasma genitalium and macrolide resistance.

Diagn Microbiol Infect Dis. 2020 Apr 17;:115062

Authors: Fernández-Huerta M, Salmerón P, Silgado A, Espasa M, Pumarola T, Tulsiani-Drud S, Barberá MJ, Hoyos-Mallecot Y, Serra-Pladevall J

Abstract
Antibiotic resistance in Mycoplasma genitalium (MG) is rising globally, especially to macrolides. In response to this challenge, assays reporting both the detection of MG and macrolide resistance-mediating mutations (MRMM) allow therapy to be tailored to the individual. The study evaluated the performance of the ResistancePlus® MG FleXible assay for the detection of MG and MRMM. Overall, the test performed well for the detection of MG compared to the AllplexTM STI Essential assay, used as a reference, with a kappa value of 0.926 (95% CI, 0.863-0.990). The kit also performed well for the detection of MRMM when compared with Sanger sequencing of the 23S rRNA gene, with a kappa value of 0.901 (95% CI, 0.807-0.996). The rate of MRMM in MG among the study population was 41.8%. In conclusion, the ResistancePlus® MG FleXible is a rapid, simple, and accurate cartridge-based assay for simultaneous detection of MG and MRMM in clinical settings.

PMID: 32451118 [PubMed - as supplied by publisher]

A multifaceted intervention to improve syphilis screening and treatment in pregnant women in Kinshasa, Democratic Republic of the Congo and in Lusaka, Zambia: a cluster randomised controlled trial.

Tue, 05/26/2020 - 07:51
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A multifaceted intervention to improve syphilis screening and treatment in pregnant women in Kinshasa, Democratic Republic of the Congo and in Lusaka, Zambia: a cluster randomised controlled trial.

Lancet Glob Health. 2019 05;7(5):e655-e663

Authors: Althabe F, Chomba E, Tshefu AK, Banda E, Belizán M, Bergel E, Berrueta M, Bertrand J, Bose C, Cafferata ML, Carlo WA, Ciganda A, Donnay F, García Elorrio E, Gibbons L, Klein K, Liljestrand J, Lusamba PD, Mavila AK, Mazzoni A, Nkamba DM, Mwanakalanga FH, Mwapule Tembo A, Mwenechanya M, Pyne-Mercier L, Spira C, Wetshikoy JD, Xiong X, Buekens P

Abstract
BACKGROUND: Despite international recommendations, coverage of syphilis testing in pregnant women and treatment of those found seropositive remains limited in sub-Saharan Africa. We assessed whether combining the provision of supplies with a behavioural intervention was more effective than providing supplies only, to improve syphilis screening and treatment during antenatal care.
METHODS: In this 18-month, cluster randomised controlled trial, we randomly assigned (1:1) 26 urban antenatal care clinics in Kinshasa, Democratic Republic of the Congo, and Lusaka, Zambia, to receive a behavioural intervention (opinion leader selection, academic detailing visits, reminders, audits and feedback, and supportive supervision) plus supplies for syphilis testing and treatment (intervention group) or to receive supplies only (control group). The primary outcomes were proportion of pregnant women who had syphilis screening out of the total who attended the clinic; and the proportion of women who had treatment with benzathine benzylpenicillin out of those who tested positive for syphilis at their first antenatal care visit. This trial is registered at ClinicalTrials.gov, number NCT02353117.
FINDINGS: The 18-month study period was Feb 1, 2016, to July 14, 2017. 18 357 women were enrolled at the 13 intervention clinics and 17 679 women were enrolled at the 13 control clinics at their first antenatal care visit. Syphilis screening was done in a median of 99·9% (IQR 99·0-100·0) of women in the intervention clinics and 93·8% (85·0-98·9) in the control clinics (absolute difference 6·1% [95% CI 1·1-14·1]; p=0·00092). Syphilis treatment at the first visit was done in a median of 100% (IQR 99·7-100·0) of seropositive women in intervention clinics and 43·2% (2·6-83·2) of seropositive women in control clinics (absolute difference 56·8% [12·8-99·0]; p=0·0028).
INTERPRETATION: A behavioural intervention, together with the provision of supplies, can lead to more than 95% of women being screened and treated for syphilis. The sole provision of supplies is sufficient to reach such levels of screening coverage but is not sufficient to ensure high levels of treatment.
FUNDING: Bill & Melinda Gates Foundation.

PMID: 30910531 [PubMed - indexed for MEDLINE]

Adolescent Trichomonas vaginalis in a high-burdened region of the southern United States.

Sat, 05/23/2020 - 07:45
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Adolescent Trichomonas vaginalis in a high-burdened region of the southern United States.

Sex Transm Dis. 2020 May 20;:

Authors: Nolan MS, Lynn MK, Lacroix R, Brownlee J, Kelly D

Abstract
BACKGROUND: We evaluated the clinical management and risk factors for Trichomonas vaginalis-positive adolescents in upstate South Carolina.
METHODS: An EPIC electronic medical record report was generated to identify any physician-ordered T. vaginalis test from February 2016 to December 2017 for patients aged 12-18 years within the Prisma Health Upstate system. Utilizing a case-control study design of patients with a documented T. vaginalis diagnostic result, we reviewed records of patients with physician-ordered T. vaginalis tests for demographics, clinical disease course, sexually transmitted infection test results, treatment order and dosage, infection risk factors, comorbidities, pregnancy term, and neonatal birth outcomes.
RESULTS: Of 789 male and female adolescents with physician-ordered T. vaginalis tests, 44% had a documented result. Of those with a document test result, 13% were T. vaginalis positive. Cases (n=45) and randomly selected negative controls (n=45) were all female. Cases were more likely to be African American, symptomatic, and present with vaginal discharge, pain, and vulvar itch. T. vaginalis patients were more likely to have documented histories of chlamydia (p<0.0001) and gonorrhea (p=0.0191), with 18% having concurrent triple infections (T. vaginalis, chlamydia, and gonorrhea). All 26 pregnant girls with T. vaginalis delivered full-term, healthy infants.
CONCLUSIONS: We identified a disproportionally high burden of T. vaginalis infection, with an alarmingly high rate of triple infections, among a population of suspected high-risk adolescents. Our results indicate the need to clarify infection prevalence, develop pediatrician-focused education campaigns, and elucidate potentially modifiable risk factors for these high-risk patients.

PMID: 32443082 [PubMed - as supplied by publisher]

Photoinactivation of Neisseria gonorrhoeae: A Paradigm-Changing Approach for Combating Antibiotic-Resistant Gonococcal Infection.

Fri, 05/22/2020 - 07:43
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Photoinactivation of Neisseria gonorrhoeae: A Paradigm-Changing Approach for Combating Antibiotic-Resistant Gonococcal Infection.

J Infect Dis. 2019 07 31;220(5):873-881

Authors: Wang Y, Ferrer-Espada R, Baglo Y, Goh XS, Held KD, Grad YH, Gu Y, Gelfand JA, Dai T

Abstract
Antimicrobial resistance in Neisseria gonorrhoeae is a major issue of public health, and there is a critical need for the development of new antigonococcal strategies. In this study, we investigated the effectiveness of antimicrobial blue light (aBL; wavelength, 405 nm), an innovative nonpharmacological approach, for the inactivation of N. gonorrhoeae. Our findings indicated that aBL preferentially inactivated N. gonorrhoeae, including antibiotic-resistant strains, over human vaginal epithelial cells in vitro. Furthermore, no aBL-induced genotoxicity to the vaginal epithelial cells was observed at the radiant exposure used to inactivate N. gonorrhoeae. aBL also effectively inactivated N. gonorrhoeae that had attached to and invaded into the vaginal epithelial cells in their cocultures. No gonococcal resistance to aBL developed after 15 successive cycles of inactivation induced by subtherapeutic exposure to aBL. Endogenous aBL-activatable photosensitizing porphyrins in N. gonorrhoeae were identified and quantified using ultraperformance liquid chromatography, with coproporphyrin being the most abundant species in all N. gonorrhoeae strains studied. Singlet oxygen was involved in aBL inactivation of N. gonorrhoeae. Together, these findings show that aBL represents a potential potent treatment for antibiotic-resistant gonococcal infection.

PMID: 30629196 [PubMed - indexed for MEDLINE]

Susceptibility patterns in Neisseria gonorrhoeae in Nuuk, Greenland, 2015-2018: a short communication.

Thu, 05/21/2020 - 07:42
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Susceptibility patterns in Neisseria gonorrhoeae in Nuuk, Greenland, 2015-2018: a short communication.

Int J Circumpolar Health. 2019 12;78(1):1557975

Authors: Berntsen S, Mulvad G, Jensen JS, Poulsen P, Hansen HL, Pedersen ML

Abstract
Antimicrobial resistance in Neisseria gonorrhoeae (GC) has made gonorrhoea control and treatment more complex globally. In Greenland, the incidence of gonorrhoea is high and there is a need for continued surveillance of antimicrobial susceptibility.This study investigated gonococcal isolates obtained in Greenland's capital Nuuk between January 2015 and June 2018. Subsequent to collection, isolates were tested for ciprofloxacin and ceftriaxone susceptibility in order to monitor the resistance pattern among GC strains. 150 GC strains were isolated in Nuuk during the observation period (139 males, 93%; 11 females, 7%). All strains were fully susceptible to ceftriaxone. 49% of the GC strains were susceptible to ciprofloxacin. The median minimal inhibitory concentration (MIC) for ceftriaxone among GC strains resistant to ciprofloxacin was higher than among GC strains susceptible to ciprofloxacin. No differences in ciprofloxacin susceptibility and median MICs for ceftriaxone were observed by collection year. In conclusion no ceftriaxone resistance has been found in Nuuk to date. Continued easy access to diagnostics and treatment combined with increased and more systematic surveillance of antimicrobial susceptibility in Nuuk is recommended. Further, it is advisable to investigate the possibilities for intermittent sampling in Greenland outside of Nuuk, if obstacles in relation to sending sampling material to Nuuk can be bypassed.

PMID: 31809690 [PubMed - indexed for MEDLINE]

An update on prevalence, diagnosis, treatment and emerging issues of genital mycoplasma infection in Indian women: A narrative review.

Thu, 05/21/2020 - 07:42
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An update on prevalence, diagnosis, treatment and emerging issues of genital mycoplasma infection in Indian women: A narrative review.

Indian J Dermatol Venereol Leprol. 2019 Sep-Oct;85(5):441-447

Authors: Tandon D, Munne K, Chauhan S, Patil AD

Abstract
Despite adequate treatment of reproductive tract infection, there is persistence of symptoms in some patients. This raises the possibility of existence of other silent microbes with pathogenic potential. Apart from the common sexually transmitted organisms such as Chlamydia trachomatis and Neisseria gonorrhoeae, there are other silent and emerging pathogens, like genital mycoplasma, which have been associated with cervicitis, pelvic inflammatory disease, infertility, and pregnancy-related complications in women. Although these organisms were identified decades ago, they are still overlooked or ignored. There is a need to understand the role played by these organisms in Asian populations and their susceptibility to the standard line of treatment. Data on genital mycoplasma infections in Indian women is heterogeneous, with limited evidence of pathogenicity. Although known for their wide spectrum of reproductive morbidities in western counterparts, these microorganisms are yet to gain the attention of Indian clinicians and microbiologists. There is paucity of adequate information in India regarding these infections, so Indian literature was compiled to get an overview of these pathogens, their association with reproductive morbidities, and their response to treatment. Thus, there is a need to explore genital mycoplasma infections in Indian women, especially in the arena of antimicrobial resistance among genital mycoplasma, which has the potential to become a major problem. A literature search with keywords focusing on "genital mycoplasma", "sexually transmitted infections India", "sexually transmitted mycoplasma", and "characteristic of mycoplasma" was carried out through computerized databases like PubMed, MEDLINE, Embase, and Google Scholar.

PMID: 31389367 [PubMed - indexed for MEDLINE]

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