Prevalence of Urogenital Mycoplasma genitalium Infection at 2 US Army Medical Facilities

BACKGROUND

Sexually transmitted infections (STIs) have a high incidence in the US Armed Forces and can adversely impact service members' ability to perform their duties. Better knowledge of Mycoplasma genitalium (MG) epidemiology in the military is needed to understand the potential impact of this emerging pathogen on force readiness.

METHODS

We conducted cross-sectional analyses of data from US Army service members and other Military Health System beneficiaries participating in a trial of an STI/HIV behavioral intervention at Fort Liberty, NC, and Joint Base Lewis-McChord, WA. At enrollment, participants completed questionnaires and provided biological specimens for nucleic acid amplification testing for MG, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG). We used principal component analysis and robust Poisson regression to examine associations between participant characteristics and prevalent urogenital MG.

RESULTS

Among 432 participants enrolled between November 2020 and February 2023, 43 had MG (prevalence, 10.0%), of whom 13 had coinfection with another bacterial STI (all 13 were positive for CT, with 1 also positive for NG). The prevalence of MG was significantly higher among female (13.5%) versus male (7.6%; P = 0.048) participants and non-Hispanic Black (14.9%) versus non-Hispanic White participants (6.6%; P = 0.045). Single relationship status and increased number of recent sexual partners were correlated, and their component was associated with higher MG prevalence (adjusted prevalence ratio, 2.11; 95% confidence interval, 1.29-3.48).

CONCLUSIONS

The high prevalence of urogenital MG among Military Health System beneficiaries highlights the importance of understanding the potential clinical sequelae of MG and conducting additional epidemiologic research in military settings.

Clinical, molecular, and drug resistance epidemiology of HIV in Jordan, 2019-2021: a national study

BACKGROUND

Limited epidemiologic studies have been conducted in Jordan describing the HIV epidemic. This study aimed to address this gap to inform HIV prevention and control.

METHODS

A nationally-representative cross-sectional study was conducted among adults living with HIV in Jordan. Laboratory testing included HIV viral load and next-generation-sequencing-based clinical genotype. Log-binomial regression estimated risk ratios (RRs) and 95% confidence intervals (CIs).

RESULTS

Among 231 (70%) participants, most were male (184/80%), and from Jordan (217/94%). Among 188 treatment-experienced-participants (>6 months), 165 (88%) were virally suppressed. High level resistance was most frequent against nucleoside reverse transcriptase inhibitor (13/81%), and integrase-strand transfer inhibitor (INSTI) (10/62%) drugs among viremic (≥1,000 HIV copies/mL) treatment-experienced participants with drug resistant mutations (DRMs, n=16). Common HIV subtypes (n=43) were B (6/14%), A1 (5/12%), and CRF01_AE (5/12%); additionally, novel recombinant forms were detected. In multivariate analysis, independently higher risk for late diagnosis (n=49) was observed with diagnosis through blood donation (vs check-up: RR 2·20, 95%CI 1·16-4·17) and earlier time-period of diagnosis (1986-2014 vs 2015-2021: RR 2·87, 95%CI 1·46-5·62).

CONCLUSIONS

Late diagnosis and INSTI resistance endanger national HIV prevention and treatment in Jordan - high-level resistance to INSTI suggests therapeutic drug monitoring is needed for treatment efficacy, and conservation of treatment options.

Sodium butyrate and monensin supplementation to postweaning heifer diets: Effects on growth performance, nutrient digestibility, and health

The objective of this study was to evaluate growth and performance of postweaning heifers supplemented with monensin (MON), sodium butyrate (SB), or the combination of MON and SB (MSB) compared with heifers not receiving these feed additives. Forty Holstein heifers [mean age 84.2 ± 1.2 d; body weight (BW) 99.8 ± 10.8 kg (mean ± SD)] were housed in a freestall barn, blocked by birth date, and randomly assigned to 1 of 4 treatments in a randomized complete block design. Treatments were (1) 100 g of soybean meal carrier (control; CON); (2) 0.75 g of SB/kg of BW + carrier (SB); (3) 1 mg of MON/kg of BW + carrier (MON); (4) 1 mg of MON/kg of BW + 0.75 g of SB/kg of BW (MSB). Data were analyzed using single degree of freedom contrasts evaluating CON versus additives (ADD), SB versus MON, and SB and MON versus MSB. Treatments were hand-mixed daily. Feed and orts were measured daily and frozen at -20°C. Orts samples were subsampled for dry matter (DM) determination, and total mixed ration samples were taken weekly and composited monthly for DM and nutrient analysis. Initial BW, heart and paunch girths, body length, blood samples, and fecal coccidia counts were measured before the start and weekly during the 12-wk trial. Blood samples were analyzed for glucose, plasma urea nitrogen (PUN), and ketone concentrations. Apparent total-tract nutrient digestibility was determined from d 21 to 27 and from d 63 to 69 using acid detergent insoluble ash as a marker. Daily dry matter intake (DMI) and metabolizable energy intake were increased in ADD compared with CON, and average BW, final BW, and heart girth tended to increase. Whereas MSB tended to be greater than SB and MON for heart girth, feed efficiency was greater with MON compared with SB. Compared with CON, ADD decreased coccidia counts. No effect of treatment on PUN was detected. Monensin and SB tended to have greater plasma glucose than MSB did. Average blood ketone concentrations were greater with ADD versus CON, in SB versus MON, and in MSB versus SB and MON. During the wk-3 digestibility phase, DMI tended to be greater in heifers fed SB versus MON, as well as in heifers fed MSB versus SB and MON. Digestibility of nutrients were similar, except that starch digestibility was increased in heifers fed MSB versus SB and MON. During the wk-9 digestibility phase, DMI and digestibility of nutrients were similar, except NDF, which tended to be greater in CON than in ADD. Overall, ADD resulted in positive growth and reduced coccidia compared with CON.

Supplementation of sodium butyrate to postweaned heifer diets: Effects on growth performance, nutrient digestibility, and health

The objective of this study was to determine the effect of varying levels of sodium butyrate (SB) supplementation in feed on the growth, digestibility, and health of postweaned heifers. Forty Holstein dairy heifers with a mean age of 84 d and average body weight (BW) of 100.9 ± 11.2 kg were housed in a naturally ventilated freestall barn. Heifers were blocked by birth date and randomly assigned to 1 of 4 treatments in a completely randomized block design: (1) 100 g of soybean meal carrier (control), (2) 0.25 g of SB/kg of BW plus carrier, (3) 0.50 g of SB/kg of BW plus carrier, and (4) 0.75 g of SB/kg of BW plus carrier. Carrier with or without SB was top-dressed and hand-mixed into a total mixed ration once daily. Heifers were fed to provide 10% orts. Initial BW, hip and withers heights, heart girth, and body length were measured before the start of the study and every week thereafter until the 14-wk trial was over. Blood samples were obtained and plasma urea nitrogen, plasma glucose, and whole-blood β-hydroxybutyrate concentrations were determined before the start of treatment and weekly thereafter until the conclusion of the study. Fecal samples were taken before treatment and every other week from each heifer for coccidia counts. Apparent total-tract nutrient digestibility was determined using acid detergent insoluble ash as an internal marker. Each heifer underwent this phase from d 47 until d 54 of the study. Sodium butyrate had a positive effect on average BW and overall BW gain. Feed efficiency tended to improve as SB supplementation increased. Coccidia counts were lowest in the treatment with 0.25 g of SB/kg of BW plus carrier. Sodium butyrate had no effects on skeletal growth or plasma urea nitrogen concentration. Blood glucose concentration decreased linearly and β-hydroxybutyrate increased linearly with increasing levels of SB supplementation. Sodium butyrate supplementation did not affect apparent total-tract nutrient digestibility. Sodium butyrate supplementation offers positive results in the growth performance and feed efficiency of postweaned heifers.