Sexually transmitted diseases of the anus and rectum: Causal agents, coinfections, HIV infection and high-risk sexual behaviour

INTRODUCTION AND OBJECTIVE

Sexually transmitted infections of the rectum and anus (STI-RA) mainly affect men who have sex with men (MSM). The incidence of STI-RA among them has increased in recent years.

MATERIAL AND METHODS

Retrospective study in patients with diagnoses of STI-RA in an STI unit during the years 2014 and 2015. Epidemiological, clinical and microbiological data were collected.

RESULTS

We included 95 patients, all of whom were MSM; 88.42% were HIV+; 67.17% did not use a condom during their most recent sexual intercourse; 17.91% had had sex with sex workers and 72.22% had used drugs during sexual intercourse during the previous year. A percentage of 32.92 reported symptoms that had lasted longer than 30 days. Lymphogranuloma venereum (LGV) was diagnosed in 54.73% of the patients. All patients who presented with proctitis and perianal ulcers were diagnosed with LGV infection. All those who presented perianal ulcers without proctitis were diagnosed with syphilis.

CONCLUSIONS

All the patients affected by STI-RA were MSM, most of them HIV+, had engaged in high-risk sexual behaviour and had suffered prolonged symptomatology. Clinical and microbiological characteristics of STI-AR could help adjust the empiric therapy.

Risk factors for antimicrobial-resistant Neisseria gonorrhoeae and characteristics of patients infected with gonorrhea

BACKGROUND

There are very few data available regarding risk factors associated with antibiotic resistant-Neisseria gonorrhoeae.

METHODS

A study was conducted on 110 samples from 101 patients with gonococcal infection, in order to describe their characteristics and compare them with the antimicrobial susceptibility profile of their samples.

RESULTS

An association was observed between resistant infections and heterosexual men, older age, concurrent sexually transmitted infection, and unsafe sexual behaviors.

CONCLUSION

There is a need for improved data on the risk factors associated with antibiotic resistant gonococcal infection in order to identify risk groups, and to propose public health strategies to control this infection.

[Toxoplasmosis and pregnancy. Multicenter study of 16,362 pregnant women in Barcelona]

BACKGROUND AND OBJECTIVE

The aim of this study was to know: 1) the prevalence of antibodies against toxoplasma in pregnant women, 2) the incidence of primary infection during pregnancy and 3) the prevalence of congenital toxoplasmosis.

SUBJECTS AND METHOD

Seroprevalence was prospectively analyzed in 16,362 pregnant women visited in 8 hospitals and 2 day care centers in Barcelona during 1999. Each participant laboratory included their own assays to detect toxoplasma-specific immunoglobulins IgM, IgA, IgG and IgG avidity antibodies. In case of positive specific IgM, a second serum sample was requested, which was processed in parallel with the first one. Three infection stages were defined: acute, possible and past (latent). Congenital infection was determined prenatally by polymerase chain reaction (PCR) in amniotic fluid or postnatally by serology in the newborn.

RESULTS

Seroprevalence was 28.6%. The incidence of primary infection during pregnancy was 1.02/1,000 susceptible pregnant women. Nine women out of 12 with an acute toxoplasma infection became seroconverted during their pregnancies and five of them had infants with congenital toxoplasmosis (vertical transmission: 41.6%). All four children born alive had no symptoms during their follow-up.

CONCLUSIONS

In this study, the prevalence of toxoplasmosis was low. Acute toxoplasmosis was detected mainly by seroconversion during pregnancy. The frequency of maternal-fetal transmission was near half of cases.