Current concepts in bacterial sexually transmitted diseases

Prevalence and Molecular Characterization of Pharyngeal Gonorrhea in Korean Men With Urethritis

Background

Pharyngeal infection is more difficult to diagnose and treat than genital or rectal infection and can act as a reservoir for gonococcal infection. We determined the prevalence of pharyngeal gonorrhea in Korean men with urethritis and analyzed the molecular characteristics and antimicrobial susceptibility of the isolates.

Methods

Seventy-two male patients with symptoms of urethritis who visited a urology clinic in Wonju, Korea, between September 2016 and March 2018 were included. Urethral and pharyngeal gonococcal cultures, antimicrobial susceptibility testing, Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST), and multiplex real-time PCR (mRT-PCR) were performed.

Results

Among the 72 patients, 59 tested positive for gonococcus by mRT-PCR. Of these 59 patients, 18 (30.5%) tested positive in both the pharynx and urethra, whereas 41 tested positive only in the urethra. NG-MAST was feasible in 16 out of 18 patients and revealed that 14 patients had the same sequence types in both urethral and pharyngeal specimens, whereas two patients exhibited different sequence types between the urethra and pharynx. Of the 72 patients, 33 tested culture-positive. All patients tested positive only in urethral specimens, except for one patient who tested positive in both. All culture-positive specimens also tested positive by mRT-PCR. All isolates were susceptible to azithromycin and spectinomycin, but resistance rates to ceftriaxone and cefixime were 2.9% and 14.7%, respectively.

Conclusions

The prevalence of pharyngeal gonorrhea in Korean men with gonococcal urethritis is as high as 30.5%, highlighting the need for pharyngeal screening in high-risk groups. Ceftriaxone is the recommended treatment for pharyngeal gonorrhea.

Longitudinal genomic analysis of Neisseria gonorrhoeae transmission dynamics in Australia

N. gonorrhoeae, which causes the sexually transmissible infection gonorrhoea, remains a significant public health threat globally, with challenges posed by increasing transmission and antimicrobial resistance (AMR). The COVID-19 pandemic introduced exceptional circumstances into communicable disease control, impacting the transmission of gonorrhoea and other infectious diseases. Through phylogenomic and phylodynamic analysis of 5881 N. gonorrhoeae genomes from Australia, we investigated N. gonorrhoeae transmission over five years, including a time period during the COVID-19 pandemic. Using a novel cgMLST-based genetic threshold, we demonstrate persistence of large N. gonorrhoeae genomic clusters over several years, with some persistent clusters associated with heterosexual transmission. We observed a decline in both N. gonorrhoeae transmission and genomic diversity during the COVID-19 pandemic, suggestive of an evolutionary bottleneck. The longitudinal, occult transmission of N. gonorrhoeae over many years further highlights the urgent need for improved diagnostic, treatment, and prevention strategies for gonorrhoea.

Proportion of early treatment seeking for sexually transmitted infections and associated factors among patients attending youth friendly service in Bahir Dar City health centers, Northwest, Ethiopia

BACKGROUND

Sexually transmitted infection is a common public health issue of youths and is characteristically transmitted through sexual intercourse. Even though early treatment for sexually transmitted infection is very important to reduce further complications and economic burden, studies to identify the proportion and the possible factor of early treatment seeking is rare in Ethiopia.

OBJECTIVE

To assess the proportion of early treatment seeking for sexually transmitted infections and associated factors among patients attending youth friendly service in Bahir Dar city health centers, northwest, Ethiopia 2023.

METHOD

Institutional based Cross-sectional study was used among 407 participants from April 25 to May 24 /2023. A systematic random sampling technique was used to select the participants. An interview-administered questionnaire was used for data collection, whereas Epi-data version 4.6.0.2 and the statistical package for statistical science version 23 were used for data entry and analysis respectively. A frequency table and bar chart were used for descriptive analysis. Multiple binary logistic regression was employed to identify the factors at p-value of <0.05. The necessary assumption of the model was also checked by the Hosmer and Lemishow test.

RESULTS

The response rate of this study was 391 (96.1%) and the proportion of early treatment for sexually transmitted infection was 108 (27.6%, 95%CI; 23-32). Good knowledge about sexually transmitted infection (AOR=1.98, 95CI%; 1.13-3.47) know about their HIV status (AOR=1.95, 95%CI; 1.13-3.36), perceive severity of sexually transmitted infection (AOR=11.23, 95%CI; 6.15-20.45), and not fear the stigma about being infected with sexually transmitted infection (AOR=2.29, 95%CI; 1.32-3.96) were the significantly associated factors for early treatment of sexually transmitted infection. CONCLUSION AND RECOMMENDATION: The proportion of early treatment for sexually transmitted infection in Bahir Dar city was low. Knowledge about STIs, testing/ knowing HIV status, perception of the severity about sexually transmitted infection, and fear of stigma about sexually transmitted infection were the statistically significant factors for early treatment of sexually transmitted infection. So the government better give attention to health education and other health promotion activities to increase the knowledge of youths about sexually transmitted infection and to change their perception of sexually transmitted infection.

Study of gonococcal and chlamydial urethritis: Old culprits with a new story

Introduction

Neisseria gonorrhoeae and Chlamydia trachomatis are the primary pathogens causing urethritis. A cross-sectional study was carried out in the Department of Microbiology in conjunction with the Department of Dermatology and STD of our hospital. The aim of the study was to detect N. gonorrhoeae and C. trachomatis among men with urethritis and to determine the anti-microbial susceptibility of the N. gonorrhoeae isolates.

Material and Methods

All cases were subjected to direct Gram's smear examination and culture of urethral discharge (N. gonorrhoeae), real-time polymerase chain reaction and direct fluorescent antibody test (C. trachomatis). All N. gonorrhoeae isolates were subjected to anti-microbial susceptibility testing and were tested for ß-lactamase production by chromogenic cephalosporin test.

Statistical Analysis Used

Data were expressed as percentages. Fisher's exact test was used to evaluate statistical significance in the case of unpaired categorical data. Agreement between the methods was assessed by using kappa statistics.

Results

Gonococcal infection was detected in 58.1% cases, and C. trachomatis was detected in 14% cases. However, both were detected in 12% cases. The sensitivity, specificity, positive predictive value, and negative predictive value of direct Gram's smear examination and culture of urethral discharge were found to be 100% when compared to culture for N. gonorrhoeae. Direct fluorescent antibody (DFA) test proved to be a valuable test aiding in the diagnosis of chlamydial urethritis with a majority of positive cases showing 20-30 elementary bodies. We detected our first gonococcal isolate with decreased susceptibility to third-generation cephalosporins, ceftriaxone, cefixime, and cefpodoxime (MIC for ceftriaxone = 0.19 mg/ml).

Conclusions

Optimal management of urethritis and strategies to prevent its transmission depend on accurate detection of infected persons. Our study demonstrates the utility and limitations of different laboratory tests including anti-microbial sensitivity testing for N. gonorrhoeae and C. trachomatis.

Diagnostic value of the QuickStripe™ chlamydia rapid test among high-risk women in Jakarta

BACKGROUND

Difficulty in diagnosing Chlamydia trachomatis infections, including chlamydial cervicitis, is a notable challenge in managing sexually transmitted infections in Indonesia. Gram staining is usually done to make a presumptive diagnosis despite its low sensitivity and specificity. Polymerase chain reaction (PCR) is considered the gold standard, but it is costly, technically demanding, and difficult to be performed in low-resource settings. Thus, rapid point-of-care tests with high sensitivity and specificity are needed to diagnose chlamydial cervicitis.

METHODS

This cross-sectional study included symptomatic and asymptomatic high-risk women in the Mulya Jaya Sex Workers Rehabilitation Center in June to July 2020. Endocervical swabs from each participant were taken for QuickStripe™ chlamydia rapid test (CRT), Gram staining, and real-time PCR.

RESULTS

A total of 41 participants were enrolled. The sensitivity and specificity for QuickStripe™ CRT were 73.6% (95% CI: 48.80%-90.85%) and 81.82% (95% CI: 59.72%-94.81%). Positive and negative predictive values were 77.78% (95% CI: 58.09%-89.84%) and 78.05% (95% CI: 62.39%-89.44%). Proportion of chlamydial cervicitis in study participants based on real-time PCR was 46.3%.

CONCLUSIONS

We concluded that QuickStripe™ CRT can be recommended as an alternative diagnostic test for high-risk populations in Jakarta.

Comparative Analysis of the Incidence of Selected Sexually Transmitted Bacterial Infections in Poland in 2010-2015: A Retrospective Cohort Study

Sexually transmitted infections are common infectious diseases. The main aim of this study was to perform a comparative analysis of the incidence of bacterial sexually transmitted infections in 2010-2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and constituted information being the epidemiological surveillance system in Poland. The analysis included data on the incidence of primary and secondary syphilis, gonorrhoea and non-gonococcal urethritis and genital infections. The overall incidence rates were disproportionately lower than European rates and those presented in studies from other countries. Young people, between 20 and 29 years of age, were the key groups at the highest risk of infection. The incidence rate of primary and secondary syphilis was lower in Poland than in Europe or America, but some regions, such as Mazovia and Lodz provinces, were found to have a higher incidence rate than other European rates. The reported incidence of gonorrhoea in Poland was also significantly lower compared with other countries, with a significantly higher number of infections in males than in females, and this was also one of the highest rates in EU countries. During the study period, the number of non-gonococcal genital infections systematically decreased, while in other countries of the European region, the incidence was among the highest of all sexually transmitted infections.

Systematic Evolution of Ligands by Exponential Enrichment Technologies and Aptamer-Based Applications: Recent Progress and Challenges in Precision Medicine of Infectious Diseases

Infectious diseases are considered as a pressing challenge to global public health. Accurate and rapid diagnostics tools for early recognition of the pathogen, as well as individualized precision therapy are essential for controlling the spread of infectious diseases. Aptamers, which were screened by systematic evolution of ligands by exponential enrichment (SELEX), can bind to targets with high affinity and specificity so that have exciting potential in both diagnosis and treatment of infectious diseases. In this review, we provide a comprehensive overview of the latest development of SELEX technology and focus on the applications of aptamer-based technologies in infectious diseases, such as targeted drug-delivery, treatments and biosensors for diagnosing. The challenges and the future development in this field of clinical application will also be discussed.

Magnitude of Self-Reported Syndromes of Sexually Transmitted Infections and Its Associated Factors Among Young Incarcerated Persons (18-29 Years) in Correctional Facilities of Gamo Gofa Zone, Southern Ethiopia

BACKGROUND

Sexually transmitted infection is an infection that is typically transmitted by sexual contact and may either end or develop into a sexually transmitted disease. Today, young people are recognized as groups with special health-related vulnerabilities like drug use, unprotected sex and sexually transmitted infections. Despitea number of strategies which focused on young people's health, there was limited evidence of sexually transmitted infection among young incarcerated persons. Thus, the aim of this study was to assess the self-reported syndromes of sexually transmitted infections and associated factors among young incarcerated persons (18-29 years) in correctional facilities of the Gamo Gofa Zone, Southern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted from March 1 to 15, 2019. Simple random sampling was used to select a total of 414 prisoners. The data were entered into Epi.info version 7 and exported and analyzed using SPSS version 20. Bivariate and multivariate logistic regression analysis were carried out. Statistical significance was declared by using the p value of <0.05 at 95% confidence interval.

THE RESULTS

In this study, 403 respondents participated with the response rate of 97.3%. The overall prevalence of self-reported STIs was 35 (8.7%). STI syndromes before incarceration (AOR: 5.267 (95% CI: 1.863, 14.893)), not having family support (AOR; 6.645 (95% CI: 2.327, 18.975)), history of imprisonment (AOR; 2.871 (95% CI: 1.065, 7.42)), not always using condom (AOR; 7.417, (95% CI 2.526, 21.781)), alcohol use (AOR; 5.926, (95% CI 2.282, 15.392)), chat use (AOR; 4.736, (95% CI (1.387, 16.172)) and having sex with commercial sex workers (AOR; 2.764, (95% CI 1.034, 7.388)) were significantly and independently associated with self-reported STIs.

CONCLUSION

Prevalence of self-reported syndromes of STI was high. Attention is needed about sexually transmitted infections for incarcerated young people by concerned bodies, including governmental and non-governmental organizations.

Scientometric Analysis of Global Research on Trichomoniasis in Scopus Database (1922 -2018)

BACKGROUND

Trichomoniasis is a sexually transmitted disease (STD) prevalent in different parts of the world. The present study was designed to evaluate the scientific output and collaboration of researchers worldwide on trichomoniasis.

METHODS

In the present scientometric research, all papers conducted on Trichomonas vaginalis (T. vaginalis) published in the time period of 1922 to 2018 were extracted from the Scopus database and evaluated according to the aims of the research, using scientometric software.

RESULTS

The results of this search strategy were the retrieval of 12,596 scientific papers authored by a total of 28,822 people during 97 years (1922-2018). Research in this field has encountered success and failure over the years. The first article on trichomoniasis at the Scopus database was published by Musgrave W.E. (1922) in the "Journal of the American Medical Association". Most papers on this subject (352) were published in 2013; and the years 2017 and 2016 are ranked second and third. Researchers from the US Centers for Disease Control and Prevention have the highest number of papers in this field (210). Alderete J.F. with 111 papers is the most active researcher on trichomoniasis in Scopus. Also, researchers from the US ranked the first with 3,236 papers. In Iran, by the end of 2018, 138 papers on trichomoniasis have been registered in Scopus, which accounts for only one percent of the world's science production in this field.

DISCUSSION AND CONCLUSION

The results following about one century indicated that the number of publications on T. vaginalis is growing and that there is a high level of collaboration among researchers in this field. Moreover, many countries have collaborated internationally on trichomoniasis research with the US as the leading country.

Chlamydia trachomatis, Ureaplasma urealyticum and Neisseria gonorrhoeae among Chinese women with urinary tract infections in Shanghai: A community-based cross-sectional study

AIM

This study explored chlamydia trachomatis (CT), ureaplasma urealyticum (UU) and/or neisseria gonorrhoeae (NG) in 5893 women with urinary tract infections (UTIs) in Shanghai.

METHODS

From January 2009 to December 2014, 5893 women with UTIs in Shanghai were selected to undergo CT, UU and NG detection. Baseline characteristics including age, education level, occupation, reproductive history, sexual behavior and contraceptive method were obtained for epidemiological analysis.

RESULTS

The total CT, UU and/or NG infection rate in the urine samples of 5893 patients was 50.69% (2987/5893), while the infection rate in vaginal secretion samples was 56.22% (3313/5893). The two detection methods were consistent. Patients aged 21-30, service personnel and unemployed persons had the highest rates of CT, UU and/or NG infection, while patients with higher education levels exhibited lower rates. As the number of previous pregnancies, natural births, abortions, sexual partners and the frequency of sexual intercourse increased, the rates of CT, UU and/or NG infection were elevated. Sexual intercourse during the menstruation period, a lack of cleaning before sexual intercourse and the use of intrauterine devices could all lead to an increased rate of CT, UU and/or NG infection.

CONCLUSIONS

These data revealed that the rate of CT, UU and/or NG infection may be associated with age, education level, occupation, reproductive history, sexual behavior and type of contraceptive method in female patients with UTI in Shanghai.

One-pot synthesis of a polyaniline–gold nanocomposite and its enhanced electrochemical properties for biosensing applications

One pot synthesis of polyaniline–gold nanocomposite using chemical route in the presence of dodecyl benzene sulfonic acid.