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Borràs J, Alonso-Tarrés C, Vives A, Palou J. [Neisseria meningitidis and the increase of oral sex. A case report]. Rev Int Androl 2023; 21:100323. [PMID: 36307367 DOI: 10.1016/j.androl.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/15/2020] [Accepted: 02/14/2021] [Indexed: 11/06/2022]
Abstract
Urethritis is an entity characterized by dysuria and purulent urethral discharge, generally acquired sexually. Neisseria gonorrhoeae is one of the most frequently responsible microorganisms. Neisseria meningitidis is a gram-negative diplococcus usually isolated in the pharynx, that occasionally causes meningococcal meningitis, being unusual it's isolation in the anogenital area where it could be a genitourinary pathogen. We present the case of a 25-years-old heterosexual male who, after a heterosexual intercourse with an occasional non-professional partner, including oral and vaginal sex, presented with symptoms of urethritis, orienting to a sexually transmitted infection. The bacteriological culture for N. gonorrhoeae was negative and the PCR for Chlamydia trachomatis was positive. Subsequently, the lab reported a positive bacteriological culture for sero-group C N. meningitidis, sensitive to ceftriaxone and a negative PCR for N. gonorrhoeae. N. meningitidis is the main cause of bacterial meningitis, but genomic studies have suggested that alleles of nitrate reductase, factor-H biding protein and capsule are associated with N. meningitidis isolation in genitourinary infections. Transmission from the oropharynx to the urethra through orogenital contact in unprotected oral sex has been widely proven. N. meningitidis prevalence as the cause of the urethritis is low, and the asymptomatic carriers in the urethra are extremely rare. PCR is a method for the N. gonorrhoeae and C.trachomatis diagnoses, but it does not detect N. meningitidis. The gonorrhoea diagnosis is based on an increased number of polymorphonuclear cells, with intracellular gram-negative diplococci in Gram' stain of urethral discharge. In our case, the gram-negative diplococcus seen in the stain was a meningococcus. Urethritis due to N. meningitidis is indistinguishable from the secondary to N. gonorrhoeae, mimicking it even microscopically, only the epidemiology varies. The conventional bacteriological culture continues to be essential for a correct diagnosis.
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Affiliation(s)
- Jaime Borràs
- Consulta de Atención Urgente, Fundació Puigvert, Barcelona, España.
| | | | - Alvaro Vives
- Servicio de Andrología, Fundació Puigvert, Barcelona, España
| | - Juan Palou
- Servicio de Urología, Fundació Puigvert, Barcelona, España
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de Korne-Elenbaas J, Bruisten SM, van Dam AP, Maiden MCJ, Harrison OB. The Neisseria gonorrhoeae Accessory Genome and Its Association with the Core Genome and Antimicrobial Resistance. Microbiol Spectr 2022; 10:e0265421. [PMID: 35604129 PMCID: PMC9241924 DOI: 10.1128/spectrum.02654-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/14/2022] [Indexed: 01/22/2023] Open
Abstract
The bacterial accessory genome provides the genetic flexibility needed to facilitate environment and host adaptation. In Neisseria gonorrhoeae, known accessory elements include plasmids which can transfer and mediate antimicrobial resistance (AMR); however, chromosomal accessory genes could also play a role in AMR. Here, the gonococcal accessory genome was characterized using gene-by-gene approaches and its association with the core genome and AMR were assessed. The gonococcal accessory gene pool consisted of 247 genes, which were mainly genes located on large mobile genetic elements, phage associated genes, or genes encoding putative secretion systems. Accessory elements showed similar synteny across genomes, indicating either a predisposition for particular genomic locations or ancestral inheritance that are conserved during strain expansion. Significant associations were found between the prevalence of accessory elements and core genome multi-locus sequence types (cgMLST), consistent with a structured gonococcal population despite frequent horizontal gene transfer (HGT). Increased prevalence of putative DNA exchange regulators was significantly associated with AMR, which included a putative secretion system, methyltransferases and a toxin-antitoxin system. Although frequent HGT results in high genetic diversity in the gonococcus, we found that this is mediated by a small gene pool. In fact, a highly organized genome composition was identified with a strong association between the accessory and core genome. Increased prevalence of DNA exchange regulators in antimicrobial resistant isolates suggests that genetic material exchange plays a role in the development or maintenance of AMR. These findings enhance our understanding of gonococcal genome architecture and have important implications for gonococcal population biology. IMPORTANCE The emergence of antimicrobial resistance (AMR) against third generation cephalosporins in Neisseria gonorrhoeae is a major public health concern, as these are antibiotics of last resort for the effective treatment of gonorrhea. Although the resistance mechanisms against this class of antibiotics have not been entirely resolved, resistance against other classes of antibiotics, such as tetracyclines, is known to be mediated through plasmids, which are known gonococcal extra-chromosomal accessory elements. A complete assessment of the chromosomal accessory genome content and its role in AMR has not yet been undertaken. Here, we comprehensively characterize the gonococcal accessory genome to better understand genome architecture as well as the evolution and mechanisms of AMR in this species.
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Affiliation(s)
- Jolinda de Korne-Elenbaas
- Public Health Laboratory, Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Amsterdam Institute for Infection and Immunity (AI&II), Academic Medical Center, Amsterdam, the Netherlands
| | - Sylvia M. Bruisten
- Public Health Laboratory, Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam, the Netherlands
| | - Alje P. van Dam
- Public Health Laboratory, Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Amsterdam Institute for Infection and Immunity (AI&II), Academic Medical Center, Amsterdam, the Netherlands
| | - Martin C. J. Maiden
- Department of Zoology, Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Odile B. Harrison
- Department of Zoology, Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
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Rosales-Castillo A, Jiménez-Guerra G, Ruiz-Gómez L, Expósito-Ruíz M, Navarro-Marí JM, Gutiérrez-Fernández J. Emerging Presence of Culturable Microorganisms in Clinical Samples of the Genitourinary System: Systematic Review and Experience in Specialized Care of a Regional Hospital. J Clin Med 2022; 11:jcm11051348. [PMID: 35268439 PMCID: PMC8911399 DOI: 10.3390/jcm11051348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 11/16/2022] Open
Abstract
The detection of emerging pathogens responsible for genitourinary infections has increased with technological advances. We conducted a systematic review of publications on the involvement of these microorganisms in genitourinary samples, and we also investigated their presence and antibiotic susceptibility in samples from patients at our regional hospital (Granada, Spain). The MEDLINE database was searched up to 31 December 2020, and a cross-sectional descriptive study was performed of results obtained in urine samples and genital exudates from January 2016 through December 2019. The review highlighted the frequent involvement of Neisseria meningitidis in genital infections, while the data on other microorganisms were consistent with findings in our patient series. The emerging microorganisms most often responsible for urinary tract infections were Streptococcus bovis (58.5%) and Gardnerella vaginalis (23.6%) in females, and S. bovis (32.3%), Aerococcus urinae (18.6%), and Corynebacterium spp. (16.9%) in males; those most frequently reported in genital infections were S. viridans (36.4%) in females and C. glucuronolyticum (32.2%) and G. vaginalis (35.6%) in males. In general, emerging pathogens are resistant to conventional antibiotics such as penicillin. However, there has also been an increase in beta-lactam resistance by the S. bovis group and Corynebacterium spp. The systematic review showed that emerging microorganisms are responsible for only a small percentage of genitourinary infections but are of major clinical interest, with a predominance of the S. bovis group, G. vaginalis, Lactobacillus spp., Aerococcus spp., and Corynebacterium spp. in urine samples and of G. vaginalis and C. glucuronolyticum in genital samples. Given the increasing resistance to antibiotics empirically prescribed in patients with genitourinary infections, it is recommended to create an antibiogram in all cases.
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Affiliation(s)
- Antonio Rosales-Castillo
- Servicio de Medicina Interna, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain;
- Program in Clinical Medicine and Public Health, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain
| | - Gemma Jiménez-Guerra
- Laboratory of Microbiology, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain; (G.J.-G.); (J.M.N.-M.)
| | - Lara Ruiz-Gómez
- Department of Microbiology, School of Medicine, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de la Investigación 11, 18016 Granada, Spain;
| | - Manuela Expósito-Ruíz
- Unit of Biostatistics, Department of Statistics, School of Medicine, University of Granada, 18016 Granada, Spain;
| | - José María Navarro-Marí
- Laboratory of Microbiology, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain; (G.J.-G.); (J.M.N.-M.)
| | - José Gutiérrez-Fernández
- Program in Clinical Medicine and Public Health, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain
- Laboratory of Microbiology, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain; (G.J.-G.); (J.M.N.-M.)
- Department of Microbiology, School of Medicine, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de la Investigación 11, 18016 Granada, Spain;
- Correspondence:
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Neri A, Palmieri A, Prignano G, Giuliani M, Latini A, Fazio C, Vacca P, Ambrosio L, Ciammaruconi A, Fillo S, Anselmo A, Fortunato A, Lista R, Stefanelli P. Molecular characterisation and antibiotic susceptibility of meningococcal isolates from healthy men who have sex with men. Sex Transm Infect 2021; 98:420-426. [PMID: 34789510 PMCID: PMC9411889 DOI: 10.1136/sextrans-2021-055173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/31/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate and characterise meningococcal carriage among healthy men who have sex with men (MSM) within a screening programme for Neisseria gonorrhoeae infection at the San Gallicano Dermatological Institute, Italy. METHODS A total of 441 MSM attending the STI/HIV Centre of the San Gallicano Institute, Rome, Italy, in 2016 were routinely screened for N. gonorrhoeae infection by pharyngeal and rectal swabs. N. meningitidis isolates were evaluated for antibiotic susceptibility and characterised by whole genome sequencing. Genetic relationships among the meningococcal carriage isolates were determined using core genome multilocus sequence typing analysis. The soluble domain of AniA (sAniA) protein expression by western blotting was also evaluated. RESULTS A total of 62 (14.1%, 95% CI 11.1 to 17.6) carriage meningococci were found among 441 MSM. Forty-three viable N. meningitidis isolates were cultivated (42 from pharyngeal and 1 from rectal swabs). All the viable isolates were susceptible to cefotaxime, ceftriaxone, ciprofloxacin and rifampicin. Four isolates were penicillin G-resistant and 73% of those penicillin G-susceptible showed a minimum inhibitory concentration from 0.064 μg/mL to 0.25 μg/mL. Serogroup B was the most frequent (44.2%), followed by Z (16.3%), E (9.3%), and Y and W (2.3%), respectively. Multilocus sequence typing analysis identified 29 sequence types belonging to 12 clonal complexes. The sAniA protein was expressed in 8 out of 28 (29%) screened meningococcal carriage isolates. CONCLUSIONS Serogroup B meningococcal carriage identified from oral and anal specimens among healthy MSM was the most frequent serogroup identified in this study. Molecular evaluation revealed a degree of similarity among strains belonging to the same clonal complex.
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Affiliation(s)
- Arianna Neri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Annapina Palmieri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Grazia Prignano
- Clinical Pathology and Microbiology Unit, IRCC San Gallicano Institute, Rome, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Istituto Dermatologico San Gallicano, Roma, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Istituto Dermatologico San Gallicano, Roma, Italy
| | - Cecilia Fazio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Paola Vacca
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Luigina Ambrosio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Andrea Ciammaruconi
- Scientific Department, Army Medical Center, Centro Studi e Ricerche di Sanita' e Veterinaria dell' Esercito, Roma, Italy
| | - Silvia Fillo
- Scientific Department, Army Medical Center, Centro Studi e Ricerche di Sanita' e Veterinaria dell' Esercito, Roma, Italy
| | - Anna Anselmo
- Scientific Department, Army Medical Center, Centro Studi e Ricerche di Sanita' e Veterinaria dell' Esercito, Roma, Italy
| | - Antonella Fortunato
- Scientific Department, Army Medical Center, Centro Studi e Ricerche di Sanita' e Veterinaria dell' Esercito, Roma, Italy
| | - Romano Lista
- Scientific Department, Army Medical Center, Centro Studi e Ricerche di Sanita' e Veterinaria dell' Esercito, Roma, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
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Ladhani SN, Lucidarme J, Parikh SR, Campbell H, Borrow R, Ramsay ME. Meningococcal disease and sexual transmission: urogenital and anorectal infections and invasive disease due to Neisseria meningitidis. Lancet 2020; 395:1865-1877. [PMID: 32534649 DOI: 10.1016/s0140-6736(20)30913-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/15/2020] [Accepted: 04/09/2020] [Indexed: 01/08/2023]
Abstract
Neisseria meningitidis is an obligate human commensal bacterium that frequently colonises the upper respiratory tract. Person-to-person transmission occurs via direct contact or through dispersion of respiratory droplets from a carrier of the bacteria, and can lead to invasive meningococcal disease. Rare sporadic cases of meningococcal urogenital and anorectal infections, including urethritis, proctitis, and cervicitis, have been reported, typically following orogenital contact with an oropharyngeal meningococcal carrier. The resulting infections were clinically indistinguishable from infections caused by Neisseria gonorrhoeae. Over the past two decades, there have also been multiple outbreaks across North America and Europe of invasive meningococcal disease among men who have sex with men (MSM). The responsible meningococci belong to a highly virulent and predominantly serogroup C lineage, including strains that are able to express nitrite reductase and grow in anaerobic environments, such as the urogenital and anorectal tracts. More recently, a distinct clade within this lineage has expanded to cause urethritis predominantly among men who have sex with women. Evolutionary events giving rise to this clade included the loss of the ability to express a capsule, and acquisition of several gonococcal alleles, including one allele encoding a highly efficient gonococcal nitrite reductase. Members of the clade continue to acquire gonococcal alleles, including one allele associated with decreased antibiotic susceptibility. This evolution has implications for the clinical and public health management of those who are infected and their close contacts, in terms of both antibiotic treatment, and prevention through vaccination.
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Affiliation(s)
- Shamez N Ladhani
- Immunisation and Countermeasures Division, Public Health England, London, UK; Paediatric Infectious Diseases Research Group (PIDRG), St George's University of London, London, UK.
| | - Jay Lucidarme
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - Sydel R Parikh
- Immunisation and Countermeasures Division, Public Health England, London, UK
| | - Helen Campbell
- Immunisation and Countermeasures Division, Public Health England, London, UK
| | - Ray Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - Mary E Ramsay
- Immunisation and Countermeasures Division, Public Health England, London, UK
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Humbert MV, Christodoulides M. Atypical, Yet Not Infrequent, Infections with Neisseria Species. Pathogens 2019; 9:E10. [PMID: 31861867 PMCID: PMC7168603 DOI: 10.3390/pathogens9010010] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 12/24/2022] Open
Abstract
Neisseria species are extremely well-adapted to their mammalian hosts and they display unique phenotypes that account for their ability to thrive within niche-specific conditions. The closely related species N. gonorrhoeae and N. meningitidis are the only two species of the genus recognized as strict human pathogens, causing the sexually transmitted disease gonorrhea and meningitis and sepsis, respectively. Gonococci colonize the mucosal epithelium of the male urethra and female endo/ectocervix, whereas meningococci colonize the mucosal epithelium of the human nasopharynx. The pathophysiological host responses to gonococcal and meningococcal infection are distinct. However, medical evidence dating back to the early 1900s demonstrates that these two species can cross-colonize anatomical niches, with patients often presenting with clinically-indistinguishable infections. The remaining Neisseria species are not commonly associated with disease and are considered as commensals within the normal microbiota of the human and animal nasopharynx. Nonetheless, clinical case reports suggest that they can behave as opportunistic pathogens. In this review, we describe the diversity of the genus Neisseria in the clinical context and raise the attention of microbiologists and clinicians for more cautious approaches in the diagnosis and treatment of the many pathologies these species may cause.
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Affiliation(s)
- Maria Victoria Humbert
- Molecular Microbiology, School of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine, Southampton General Hospital, Southampton SO16 6YD, UK;
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7
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Harrison OB, Cole K, Peters J, Cresswell F, Dean G, Eyre DW, Paul J, Maiden MC. Genomic analysis of urogenital and rectal Neisseria meningitidis isolates reveals encapsulated hyperinvasive meningococci and coincident multidrug-resistant gonococci. Sex Transm Infect 2017; 93:445-451. [PMID: 28137933 PMCID: PMC5574384 DOI: 10.1136/sextrans-2016-052781] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/11/2016] [Accepted: 12/10/2016] [Indexed: 01/30/2023] Open
Abstract
Objective Invasive meningococcal disease (IMD) outbreaks in men who have sex with men (MSM) have been associated with meningococcal colonisation of the urethra and rectum, but little is known about this colonisation or co-colonisation with the closely related gonococcus. Whole genome sequencing (WGS) was employed to explore these phenomena. Methods Meningococci isolated from the urogenital tract and rectum (n=23) and coincident gonococci (n=14) were analysed by WGS along with contemporary meningococci from IMD (n=11). All isolates were obtained from hospital admissions in Brighton, UK, 2011–2013. Assembled WGS were deposited in the PubMLST/neisseria database (http://pubmlst.org/neisseria) and compared at genomic loci common to gonococci or meningococci. Results As expected, most meningococci from IMD were encapsulated and belonged to hyperinvasive lineages. So too were meningococci found in the urogenital tract and rectum, contrasting to those asymptomatically carried in the nasopharynx where such meningococci are rare. Five hyperinvasive meningococcal lineages and four distinct gonococcal genotypes were recovered, including multiresistant ST-1901 (NG MAST-1407) gonococci. Conclusions These data were consistent with a predisposition for potentially virulent encapsulated hyperinvasive meningococci to colonise the urethra and rectum, which suggests their involvement in MSM IMD outbreaks. The coincidence of multiresistant gonococci raises wider public health concerns.
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Affiliation(s)
| | - Kevin Cole
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Joanna Peters
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Fiona Cresswell
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Gillian Dean
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - David W Eyre
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - John Paul
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Kim HJ, Park JK, Park SC, Kim YG, Choi H, Ko JI, Kim MK, Jeong YB, Shin YS. The prevalence of causative organisms of community-acquired urethritis in an age group at high risk for sexually transmitted infections in Korean Soldiers. J ROY ARMY MED CORPS 2015; 163:20-22. [PMID: 26607860 DOI: 10.1136/jramc-2015-000488] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/24/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study was designed to evaluate the causative organisms in young male soldiers with clinical signs and symptoms after sexual contact that suggests a diagnosis of urethritis. METHODS Between June 2012 and January 2015, male patients with urethritis symptoms that had resulted from sexual contact within 3 months participated in this study. All patients were evaluated using urinalysis and were screened for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), herpes simplex virus (HSV) type II and Trichomonas vaginalis (TV) using multiplex PCR (mPCR) assay in order to detect sexually transmitted infections (STI) or pathogens. RESULTS A total of 436 male patients aged 18-28 years were included in the study. The median age was 22.0 years. The prevalence of STI pathogens were as follows: NG in 19.0%, CT in 36.6%, UU in 24.0%, MG in 21.5%, MH in 6.1%, HSV type II in 1.6%, TV in 0.2% and indeterminate STI pathogens in 9.4%. Coinfection of NG with non-NG was detected in 5.7% of the participants, while the coinfection rates for STI pathogens were: with CT in 3.4%, with UU in 2.7%, with MG in 0.2% and with MH in 0.2%. CONCLUSIONS CT was the most prevalent STI pathogen and coinfections of NG with non-NG appeared less frequently. The young male soldiers with urethritis should be administered suitable antibiotics for STI pathogens that were found by mPCR results, rather than an experimental combination of antibiotics for coinfections.
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Affiliation(s)
- Hyung Jin Kim
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - J K Park
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - S C Park
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
| | - Y G Kim
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - H Choi
- Department of Urology, Armed Forces Capital Hospital, Seongnam, Korea
| | - J I Ko
- Department of Urology, Armed Forces Capital Hospital, Seongnam, Korea
| | - M K Kim
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - Y B Jeong
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - Y S Shin
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.,Department of Urology, Armed Forces Capital Hospital, Seongnam, Korea
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Nihonyanagi S, Sunakawa K, Cui L, Masaki T, Wada T, Hoshiyama T, Nakamura M, Takayama Y, Kanoh Y, Ogawa A, Shichiri M, Hanaki H. A very rare case of primary meningococcal arthritis in an adult male. Clin Case Rep 2014; 3:76-80. [PMID: 25767700 PMCID: PMC4352356 DOI: 10.1002/ccr3.151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/05/2014] [Accepted: 08/24/2014] [Indexed: 11/25/2022] Open
Abstract
We report here a very rare case of primary meningococcal arthritis of the knee joint without clinical features associated with meningococcemia, meningitis, or meningococcal complications. The patient suffered from diabetes mellitus and had experienced two episodes of joint trauma. Intravenous infusion of ampicillin/sulbactam for 18 consecutive days was successful.
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Affiliation(s)
- Shin Nihonyanagi
- Department of Medical Laboratory, Kitasato University Hospital 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan ; Kitasato Institute for Life Sciences and Laboratory for Antimicrobial Agents, Kitasato University 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Keisuke Sunakawa
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Longzhu Cui
- Kitasato Institute for Life Sciences and Laboratory for Antimicrobial Agents, Kitasato University 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Tsuguto Masaki
- Department of Endocrinology and Metabolism, Kitasato University School of Medicine 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Tatsuhiko Wada
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Takayuki Hoshiyama
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Masaki Nakamura
- Kitasato Institute for Life Sciences and Laboratory for Antimicrobial Agents, Kitasato University 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan ; Department of Microbiology, Kitasato University School of Allied Health Sciences 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Yoko Takayama
- Department of Infection Control and Prevention, Kitasato University Hospital 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Yuhsaku Kanoh
- Department of Medical Laboratory, Kitasato University Hospital 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan ; Department of Laboratory Medicine, Kitasato University Hospital 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Akifumi Ogawa
- Department of Endocrinology and Metabolism, Kitasato University School of Medicine 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Masayoshi Shichiri
- Department of Endocrinology and Metabolism, Kitasato University School of Medicine 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
| | - Hideaki Hanaki
- Kitasato Institute for Life Sciences and Laboratory for Antimicrobial Agents, Kitasato University 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan
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Description of an unusual Neisseria meningitidis isolate containing and expressing Neisseria gonorrhoeae-Specific 16S rRNA gene sequences. J Clin Microbiol 2013; 51:3199-206. [PMID: 23863567 DOI: 10.1128/jcm.00309-13] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
An apparently rare Neisseria meningitidis isolate containing one copy of a Neisseria gonorrhoeae 16S rRNA gene is described herein. This isolate was identified as N. meningitidis by biochemical identification methods but generated a positive signal with Gen-Probe Aptima assays for the detection of Neisseria gonorrhoeae. Direct 16S rRNA gene sequencing of the purified isolate revealed mixed bases in signature regions that allow for discrimination between N. meningitidis and N. gonorrhoeae. The mixed bases were resolved by sequencing individually PCR-amplified single copies of the genomic 16S rRNA gene. A total of 121 discrete sequences were obtained; 92 (76%) were N. meningitidis sequences, and 29 (24%) were N. gonorrhoeae sequences. Based on the ratio of species-specific sequences, the N. meningitidis strain seems to have replaced one of its four intrinsic 16S rRNA genes with the gonococcal gene. Fluorescence in situ hybridization (FISH) probes specific for meningococcal and gonococcal rRNA were used to demonstrate the expression of the rRNA genes. Interestingly, the clinical isolate described here expresses both N. meningitidis and N. gonorrhoeae 16S rRNA genes, as shown by positive FISH signals with both probes. This explains why the probes for N. gonorrhoeae in the Gen-Probe Aptima assays cross-react with this N. meningitidis isolate. The N. meningitidis isolate described must have obtained N. gonorrhoeae-specific DNA through interspecies recombination.
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Ballini A, Cantore S, Fatone L, Montenegro V, De Vito D, Pettini F, Crincoli V, Antelmi A, Romita P, Rapone B, Miniello G, Perillo L, Grassi FR, Foti C. Transmission of Nonviral Sexually Transmitted Infections and Oral Sex. J Sex Med 2012; 9:372-84. [DOI: 10.1111/j.1743-6109.2011.02515.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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An unexpected increase in Neisseria meningitidis genital isolates among sexual health clinic attendees, Hamilton, New Zealand. Sex Transm Dis 2008; 35:469-71. [PMID: 18360313 DOI: 10.1097/olq.0b013e3181659248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nathanson M, Tisseron B, de Pontual L. Vulvite à méningocoque chez une fillette impubère. Arch Pediatr 2005; 12:1732-3. [PMID: 16236488 DOI: 10.1016/j.arcped.2005.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2004] [Accepted: 09/07/2005] [Indexed: 11/27/2022]
Abstract
Neisseria meningitidis is an uncommon cause of vulvovaginitis in the prepubertal girl. The microorganism must not be mistaken for Neisseria gonorrhoeae, as the consequences of such an error may be serious. Colonization or infection by Neisseria meningitis is not uncommon in adolescents and adults. Vulvitis, even when it is recurrent, is not per se a good indicator of sexual abuse, but some microorganisms found by vaginal swab can make it possible, likely or certain. Sexual transmission of N. meningitidis has not been described in the prepubertal child.
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Affiliation(s)
- M Nathanson
- Service de pédiatrie, hôpital Jean-Verdier, Assistance-publique-Hôpitaux-de-Paris, avenue du 14-Juillet, 93143 Bondy cedex, France.
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