scholarly journals Practical approaches to examination of women with abnormal vaginal discharge: a review of evidence-based recommendations 2021

2021 ◽  
pp. 57-65
Author(s):  
O.A. Burka ◽  
A.V. Shumytskyi ◽  
L.M. Semeniuk ◽  
O.D. Koltok ◽  
V.Y. Dobosh ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Vaginal Discharge ◽  
Mycoplasma Genitalium ◽  
Asymptomatic Infection ◽  
Aerobic Vaginitis ◽  
Sexually Transmitted ◽  
Cultural Methods ◽  
Laboratory Component ◽  
Anatomical Localization ◽  
Abnormal Vaginal Discharge

Abnormal vaginal discharge (AVD) is a syndrome that combines conditions of different origin (microbial/non-microbial) and of different anatomical localization (limited to vagina and exocervix/spreading from the endocervix to the pelvic organs) that cause discomfort and changes in the characteristics of vaginal discharge.Review objective: to systematize modern approaches to the diagnosis of the most common causes of AVD – bacterial vaginosis (BV), trichomoniasis, aerobic vaginitis (AV), vulvovaginal candidiasis (VVC) – in a practical context. Laboratory component of diagnosing the AVD causes should be complex due to the not fully understood mechanisms of regulation of vaginal biocenosis and changes in the virulence of opportunistic and pathogenic flora, leading to an increase in the frequency of mixed forms of vaginosis and their atypical course. The tasks of laboratory tests in AVD are determination of the sexually transmitted infections (gonorrhea, chlamydia, Mycoplasma genitalium) more often as a concomitant asymptomatic infection in combination with BV or another cause of AVD; confirmation of the suspected cause of AVD (BV, trichomoniasis, AV, VVC); differential diagnosis with more rare microbial causes (cytolytic vaginosis) and non-microbial causes.Vaginal pH and microscopy of vaginal discharge with an assessment according to the diagnostic criteria for dysbiosis are first line of available diagnostic tests of BV, AV and VVC. They make it possible to differentiate typical AVD causes from non-microbial AVD causes and rare causes of microbial AVD. Additionally, complex modern molecular methods for assessing the vaginal biocenosis can be used. Cultural methods play an important role in the diagnosis and treatment of recurrent/complicated VVC and AV. PCR for chlamydia, gonorrhea, trichomoniasis and Mycoplasma genitalium is a mandatory component of a comprehensive test in patients with suspected BV, AV or mixed dysbiosis. Patients diagnosed with BV or trichomoniasis has to be tested for HIV and sexually transmitted infections.

High Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China

2021 ◽  
Author(s):  
Wei Tu ◽  
Yu-Ye Li ◽  
Yi-Qun Kuang ◽  
Rong-Hui Xie ◽  
Xing-Qi Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexually Transmitted Infections ◽  
Genital Tract ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Multiple Infections ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
High Prevalence

Abstract Background Yunnan has the highest rates of HIV in the country. Other treatable sexually transmitted infections (STIs) are associated with accelerated HIV transmission and poor ART outcomes, but are only diagnosed by syndromic algorithms. Methods We recruited 406 HIV-positive participants for a cross-sectional study (204 ART-naive and 202 ART). Blood samples and first-voided urine samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG). Syphilis and HSV-2 tests were also performed. Results Among 406 participants, the overall prevalence of STI was 47.0% and 45.1% in ART-naive individuals and 49.0% in ART individuals, respectively. Testing frequency was 11.6% (11.8% vs 11.4%), 33.2% (29.4% vs 37.1%), 3.2% (3.4% vs 3.0%), 2.0% (3.4% vs 0.5%) and 4.7% (6.4% vs 3.0%) for active syphilis, HSV-2, chlamydia, gonorrhoeae and genitalium. Percentage of multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants. Females, age between 18 to 35 years, ever injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART were identified as risk factors. Self-reported asymptom was not eliminating of having a laboratory-diagnosed STI. Conclusions STI prevalence was 47.0% (45.1% vs 49.0%), HSV-2, syphilis and MG were the most common STIs in HIV-infected individuals. We found high prevalence (6.4%) of Mycoplasma genitalium in ART-naive individuals. ART can reduce the diversity of STI-HIV coinfection but not the prevalence. HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort, thus we suggest strengthening STI joint screening and treatment services among HIV-infected individuals whether they describe genital tract discomfort or not.

scholarly journals Pattern of Sexually Transmitted Infections: A Retrospective Study from a Tertiary Care Hospital in Central India

2021 ◽  
Author(s):  
Sushil Rathi ◽  
Sumit Ashok Hajare ◽  
Saurabh Jaiswal ◽  
Sandip Agrawal ◽  
Abhijit Kherde ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Vaginal Discharge ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Care Hospital ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Major Health ◽  
Sexually Transmitted

Introduction: Sexually Transmitted Infections (STIs) pose a major health, social and economic problem worldwide, predominantly in developing countries like India. It is essential to understand the current patterns of STIs in the various regions of the country in order to plan and implement strategies to control the spread of infection. Aim: To study the pattern of STIs among patients attending the STI clinic. Materials and Methods: This was a cross-sectional study of data obtained retrospectively from case records over last seven years (January 2013-December 2019) from STI clinic at a tertiary care hospital at Nagpur. The demographic details, detailed history, clinical findings were noted and relevant investigations were performed. The patients were diagnosed as per syndromic approach and subjected to serologic tests for syphilis and Human Immunodeficiency Virus (HIV). The data was analysed by using MS Excel and Epi Info software, and percentage, mean, standard deviation and proportions were calculated. Results: Out of the total 4471 cases, 2807 (62.8%) were males and 1664 (37.2%) were females. The most commonly observed STI was balanoposthitis, followed by cervico-vaginal discharge, Genital Ulcerative Disease- Herpetic (GUD-H), anogenital warts, molluscum contagiosum, GUD-nonherpetic, urethral discharge, lower abdominal pain and inguinal bubo. The proportion of viral STIs was 33.5% (1495 cases) and bacterial STIs were 4.3% (191 cases). The most commonly observed STI was balanoposthitis in males and cervico-vaginal discharge in females. Newly diagnosed cases of HIV were 1.4% (61 cases) of total cases. Conclusion: The proportion of viral STIs was higher compared to bacterial STIs. The prevalence of HIV among study population was 3.9%. Since STIs are indicators of high risk sexual behaviour in the community and a major health burden with risk of development of HIV, prompt diagnosis and adequate treatment of STIs is necessary.

Sexual health

2021 ◽  
pp. 187-240
Author(s):  
Victoria Mckenzie ◽  
Leila Frodsham ◽  
Debra Holloway
Keyword(s):  
Hepatitis B ◽  
Sexual Health ◽  
Sexually Transmitted Disease ◽  
Vaginal Discharge ◽  
Transmitted Disease ◽  
Partner Notification ◽  
Mycoplasma Genitalium ◽  
Well Being ◽  
New Developments ◽  
Sexually Transmitted

This chapter covers problems that can occur with sexual health in women. It starts with the definition, assessment, diagnosis, investigations, and treatment of different sorts of vaginal discharge. It provides information about sexual health in context, including its links with other forms of disease and psychological well-being. Protocols for partner notification in the cases of diagnosis with a sexually transmitted disease are explained. The signs, symptoms, and treatment for gonorrhea, chlamydia, and Mycoplasma genitalium are all covered. It also covers the definition, causes, diagnosis, and treatment of pelvic inflammatory disease. Hepatitis B and C are described, along with anogenital warts, genital herpes, and genital lumps and ulcers. Finally HIV and new developments such as PrEP and PEP are covered.

Prevalence of co-infections with other sexually transmitted infections in patients newly diagnosed with anogenital warts in Guangzhou, China

2020 ◽  
Vol 31 (11) ◽  
pp. 1073-1081
Author(s):  
Liuyuan Wang ◽  
Bin Yang ◽  
Lai S Tso ◽  
Peizhen Zhao ◽  
Wujian Ke ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Mycoplasma Genitalium ◽  
Risk Groups ◽  
Health Clinic ◽  
Surveillance Systems ◽  
Newly Diagnosed ◽  
Anogenital Warts ◽  
Sexually Transmitted ◽  
Medical Histories

Prevalence of co-infecting sexually transmitted infections (STIs) among patients newly diagnosed with anogenital warts is under-reported. Our objective is to determine the prevalence of six common STIs, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), genital herpes (herpes simplex virus type 2 [HSV-2]), HIV, and syphilis for patients visiting a sexual health clinic in Guangzhou, China. Demographics, sexual health, and medical histories were collected at patient intake. Patients diagnosed with anogenital warts (N = 200) were invited to participate. We collected urine samples, and urethral, cervical, and rectal swabs to test for CT, NG, and MG, and blood samples for serological detection of HSV-2, syphilis, and HIV. Overall 49 (24.5%) had a co-infection (22.2% of men and 27.7% of women). All six STIs were observed among men: CT (6.8%), NG (3.4%), MG (5.1%), HIV (4.3%), HSV-2 (4.3%), and syphilis (1.7%). Women had fewer STIs, but at higher rates: CT (13.3%), MG (6.0%), and HSV-2 (8.4%). Individual men had up to two co-infections, while women had no more than one co-infection. Chlamydia was the most common STI. Patients aged 18–25 years (35.4%) had the highest prevalence. Although opportunistic screening is often applied for high-risk groups, expansion to patients with anogenital warts in all health-care settings would improve detection of problematic asymptomatic co-infections, thereby increasing China’s capacity to contribute toward global surveillance systems.

scholarly journals INCIDENCE OF SEXUALLY TRANSMITTED INFECTIONS: LOCAL STUDY IN UKRAINE

World Science ◽  
2018 ◽  
Vol 2 (8(36)) ◽  
pp. 4-7
Author(s):  
Fedorych P. V. ◽  
Mavrov G. I.
Keyword(s):  
Human Papillomavirus ◽  
Chlamydia Trachomatis ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Ureaplasma Urealyticum ◽  
Mycoplasma Hominis ◽  
Mycoplasma Genitalium ◽  
Local Study ◽  
Sexually Transmitted ◽  
Clinically Significant

Introduction.The structure of incidence of sexually transmitted infections is changing constantly. Information on such changes supports correct planning of clinical and diagnostic activities of institutions providing specialized medical care by qualified specialists.Objective:to investigate the prevalence of sexually transmitted infections with pathogens clinically significant to the genitourinary system in Ukraine and at the local level.Materials and methods. Polymerase chain reaction was used to test the biological material obtained from the genitourinary clinical specimens from subjects with sexually transmitted infections, who underwent clinical and laboratory examinations in Oleksandrivsk Clinical Hospital (Kyiv, Ukraine) for Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis, Human papillomavirus, and Neisseria gonorrhoea. During 2017, 607 subjects of both genders, including 295 (48.6%) females and 312 (51.4%) males, were examined. Their mean age was 32±3.5.Findings. Chlamydia trachomatis was found in 159 (26.2%) of 607 examined subjects – 85 males and 74 females. Mycoplasma hominis was found in 122 of 585 (21.1%) examined subjects – 64 males and 58 females. Mycoplasma genitalium, respectively, in 17 (6.62%) of 258 subjects – 6 males and 11 females. Ureaplasma urealyticum was found in the largest number of subjects (305, i.e. in 48.77% of 601 examined subjects) – 157 males and 148 females. Trichomonas vaginalis was found in 28 (5.23%) of 535 subjects – 15 males and 13 females. Human papillomavirus was found in 158 of 297 (53.2%) examined subjects – 88 males and 70 females. Neisseria gonorrhea was found in 33 of 297 (8.45%) subjects – 8 males and 25 females.Conclusions. As suggested by the local study of the sexually transmitted infections incidence in Ukraine, the most clinically significant for the genitourinary system are Human papillomavirus (53.2%), Ureaplasma urealyticum (48.77%), Chlamydia trachomatis (26.2%) and Mycoplasma hominis (21.1%). Therefore, tests for these pathogens in the specified region is currently the most appropriate during diagnostic examinations and counselling of subjects with genitourinary infections.

scholarly journals 1354. Antibiotic Resistance and Coinfections Among Women with Sexually Transmitted Infections

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S764-S764
Author(s):  
Brittany L Carpenter ◽  
Jacqueline D Peacock ◽  
Kyle Dubiak ◽  
Heather Fecteau ◽  
Robert Carlson
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Vaginosis ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Resistance Testing ◽  
Lactobacillus Species ◽  
Herpes Simplex Virus 1 ◽  
Aerobic Vaginitis ◽  
Sexually Transmitted ◽  
Panel Testing

Abstract Background Sexually transmitted infections (STIs) represent a growing epidemic, particularly among America’s youth. Traditional single or dual organism STI testing is limited in its utility compared to PCR panel-based vaginitis testing. PCR panel testing can identify up to 99% of vaginitis associated organisms, while simultaneously providing information about antibiotic resistance. Methods We analyzed 10,011 vaginosis panel cases released between April 2020 and May 2021. The PCR-based vaginosis panel consists of organisms associated with bacterial vaginosis, aerobic vaginitis, yeast infections, STIs, and Lactobacillus species. This panel simultaneously detects evidence of antibiotic resistance for nine classes of drugs. Results Of 9405 cases from vaginal swabs, 618 (6.8%) were positive for at least one STI including Chlamydia trachomatis (CT), Haemophilus ducreyi, Herpes Simplex Virus 1 or 2 (HSV2), Neisseria gonorrhoeae (NG), and/or Trichomonas vaginalis. Of 603 urine samples, 7.6% were positive for at least one STI and represented a younger population. Patients younger than age 25 (33% of the cohort) were disproportionately affected by STIs, consistent with CDC findings. About 50% of all positive STI cases were in patients under 25. Evidence of bacterial vaginosis was also present in 89% of CT and NG cases, and 75% of HSV2 cases. Strikingly, we found the presence of an antibiotic resistant marker(s) to first line treatment in 76.2% of CT and 19.3% of NG cases. Conclusion Our data illustrates the advantages of utilizing a PCR-panel approach to STI detection over a targeted approach for individual organisms. Coinfections with bacterial vaginosis were common and if left unidentified, patients may receive incomplete treatment. Additionally, our data suggests that antibiotic resistance testing is imperative for effective treatment planning and antibiotic stewardship in suspected STI cases. Disclosures Brittany L. Carpenter, PhD, NxGen MDx (Employee) Jacqueline D. Peacock, PhD, MB(ASCP)CM, NxGen MDx (Employee) Kyle Dubiak, PhD, NxGen MDx (Employee) Heather Fecteau, MS, LCGC, NxGen MDx (Employee) Robert Carlson, MD, FCAP, NxGen MDx (Employee)

scholarly journals Introduction of a complementary screening system for the detection of sexually transmitted infections in patients with sterile pyuria

2021 ◽  
Author(s):  
Helena Gil-Campesino ◽  
◽  
Laura Sante ◽  
Enrique Callejas Castro ◽  
María Lecuona
Keyword(s):  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Mycoplasma Genitalium ◽  
Epidemiological Data ◽  
Screening System ◽  
Effective Screening ◽  
Sexually Transmitted ◽  
Work Routine ◽  
Sterile Pyuria ◽  
A Prospective Study

Objective. The aim of the study was to evaluate a complementary screening system for the detection of sexually transmitted infections in patients with sterile pyuria. Material and methods. A prospective study was conducted using Real-time multiplex qPCR in 300 consecutive urine samples with data on sterile pyuria. STI prevalence and patient epidemiological data were analyzed. Results. A total of 29 positive cases (9.67%) were found: 16 Chlamydia trachomatis, 5 Mycoplasma genitalium, 5 Trichomonas vaginalis and 3 co-infections. The group with sexually transmitted infections was mainly composed of women (65.5%), of which one third was pregnant. Conclusion. This study presents an effective screening system for the detection of sexually transmitted infections that can be integrated into the laboratories’ work routine.

scholarly journals Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy

2021 ◽  
Vol 18 (9) ◽  
pp. 4722
Author(s):  
Teresa Fasciana ◽  
Giuseppina Capra ◽  
Paola Di Carlo ◽  
Cinzia Calà ◽  
Marco Vella ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Behaviors ◽  
Mycoplasma Genitalium ◽  
Total Sample ◽  
Hpv Infection ◽  
Sex Behavior ◽  
Bisexual Men ◽  
Female Ratio ◽  
Behavioral Determinants ◽  
Sexually Transmitted

Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patients were tested for chlamydia, syphilis, Mycoplasma genitalium infection, genital herpes and HPV infection. A total of 294 subjects with STIs (male/female ratio about 2:1) were screened. Of the total sample, 79.6% of patients were Italian. MSM accounted for 34.3%, MSW for 29.6%, bisexual men for 5.8% and females for 30.3%. A total of 44.5% of patients had a high education level, 42.5% reported irregular use of condoms, 20.7% reported having had 5–10 partners in the six months prior to the visit and 32.9% were HIV-positive. HPV infection and syphilis were the most prevalent STIs. Conclusions: The most common profile of patients attending our clinic was that of an adult, Italian man with a high level of education, poor use of condoms and a high number of partners. MSM had the highest sex-behavior-related risk for STIs. In addition, our results suggest that all STD teams need to implement counselling topics and recommendations to share with patients, as well as tips on how to approach sexual health education/counselling, thereby promoting patient-centered approaches and educational programs.

scholarly journals The Role of HPV and Non-HPV Sexually Transmitted Infections in Patients with Oropharyngeal Carcinoma: A Case Control Study

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1192 ◽  
Author(s):  
Barbara Kofler ◽  
Johannes Laimer ◽  
Emanuel Bruckmoser ◽  
Teresa B. Steinbichler ◽  
Annette Runge ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Case Control Study ◽  
Mycoplasma Hominis ◽  
Mycoplasma Genitalium ◽  
Control Group ◽  
Oropharyngeal Carcinoma ◽  
Study Group ◽  
Sexually Transmitted ◽  
Ureaplasma Spp ◽  
Control Study

Background: Certain high-risk (hr) types of human papillomavirus (HPV) can cause cervical cancer in women and penile cancer in men. Hr-HPV can also cause cancers of the oropharynx and anus in both sexes. In the anal and cervical region, a contribution of co-infections with Ureaplasma spp. on the persistence of the hr-HPV infection by a profound inflammatory state is suggested. Here, we investigated if non-HPV sexually transmitted infections are associated with oropharyngeal carcinoma (OPC). Materials and Methods: In this case-control study, a brush test directly from the tumor surface of OPC patients (study group) and from the oropharynx of healthy volunteers (control group), both groups matching in age and sex, was performed. HPV subtypes were detected using a commercially available test kit. For non-HPV sexually transmitted infections (Ureaplasma spp., Chlamydia trachomatis, Mycoplasma hominis, and Mycoplasma genitalium), a multiplex nucleic acid amplification approach was performed. Results: In the study group, 96 patients (23 female/73 male), with histologically confirmed OPC and in the control group 112 patients (19 female/93 male), were included. Oropharyngeal hr-HPV-positivity was detected in 68% (65/96 patients) of the study group and 1.8% (2/112 patients) of the control group (p < 0.001). In three patients in the study group, Ureaplasma spp. was detected, whereas no patient was Ureaplasma spp. positive in the control group (p = 0.097). Chlamydia trachomatis, Mycoplasma hominis, and Mycoplasma genitalium were negative in both groups. Conclusion: Based on the current study, the prevalence of oropharyngeal Ureaplasma spp. among patients with OPC is low and does not support a role in oropharyngeal cancer. However, the detection of the pathogen only among OPC patients but not in the healthy individuals might indicate a potential role and needs further elucidation.

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