Management of sexually transmissible infections in the era of multiplexed molecular diagnostics: a primary care survey

Background Data regarding sexually transmissible infections (STI) often originate from STI clinics, screening programs or laboratory-based studies, thus are biased for specific risk groups or lack clinical details. This real-life observational study presents sample data of most young adult Israeli population by exploiting the centralised diagnostic and documentation platforms resulting from a mandatory military service at the age of 18 years for both genders. Methods: All STI diagnoses of Israeli Defence Forces soldiers during a 6-month period were reviewed. Patients with Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) (major-STI) and Ureaplasma urealyticum (UU), Ureaplasma parvum (UP) and Mycoplasma hominis (MH) (equivocal STI) were compared with STI-negative controls. Results: Sexually transmissible infection positivity rates (n = 2816) were as follows: CT 6.6%; MG 1.9%; NG 0.7%; TV 0.5%; UU 15.7%; UP 28.2%; and MH 6.2%. The CT+MG coinfection rate was 4.1%, yet CT+NG coinfections were rare (≈0.5%). More than half of the patients with ureaplasmas and/or MH were treated; 40% of them were recommended partner treatment. Most antibiotics were prescribed to patients with equivocal infections. Classic STI symptoms in males were linked to major-STI and UU, while females were asymptomatic or presented non-specific symptoms. Conclusions: The judicious use of antibiotics in the era of antimicrobial resistance necessitates re-evaluating the significance of equivocal pathogen detection and reporting (MH, UU, UP). Likewise, universal empiric treatment for NG should be reconsidered in light of its low rates in non-high-risk groups. Conversely, a high MG rate, a pathogen with potential resistance to common STI protocols, requires evaluation of guidelines adequacy.

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Molecular epidemiology of non-viral sexually transmitted infections in the central Alpine province of Bolzano, northern Italy from April 2016 to March 2017

Microbiologia Medica ◽

10.4081/mm.2018.7852 ◽

2018 ◽

Vol 33 (1) ◽

Author(s):

Richard Aschbacher ◽

Francesca Romagnoli ◽

Elisa Masi ◽

Valentina Pasquetto ◽

Franco Perino ◽

...

Keyword(s):

Molecular Epidemiology ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium ◽

Northern Italy ◽

Sexually Transmitted ◽

Ureaplasma Parvum ◽

One Year ◽

The One

Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium are established or presumed as (??) STI pathogens. The present study aims at ng describing the one-year molecular epidemiology of these seven pathogens in the Province of Bolzano, Northern Italy. From April 2016 to March 2017, a total of 2,949 patients, mainly females, were enrolled and 3,427 urine, vaginal, endocervical and/or urethral samples were subjected to simultaneous analysis of the seven pathogens by means of Real Time Polymerase Chain Reaction (AnyplexTM II STI-7 Detection Kit Seegene, Seoul, Korea). At least one of the seven microorganisms was detected in 40.7% of patients, with an uneven distribution: 43.1% in females (F) and 29.8% (p<0.001) in males (M). The prevalence of microorganisms was as follows: 30.3% U. parvum (F: 35.6%, M: 8.3%), 6.9% U. urealyticum (F: 6.8%, M: 7.0%), 4.9% M. hominis (F: 5.4%, M: 2.3%), 4.9% C. trachomatis (F: 3.4%, M: 11.4%), 1.1% M. genitalium (F: 1.0%, M: 1.2%), 1.2% N. gonorrhoeae (F: 0.17%, M: 5.6%) and 0.40% T. vaginalis (F: 0.38%, M: 0.53%). Mixed infections were detected in 7.4% of patients. The highest prevalence was observed for U. parvum, followed by U. urealyticum and M. hominis and a significant presence of multi-pathogen infections was registered.

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INCIDENCE OF SEXUALLY TRANSMITTED INFECTIONS: LOCAL STUDY IN UKRAINE

World Science ◽

10.31435/rsglobal_ws/30082018/6059 ◽

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.

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Frequency of Sexually Transmitted Pathogens in HIV- Positive Individuals

Türk Mikrobiyoloji Cemiyeti Dergisi ◽

10.5222/tmcd.2021.50469 ◽

2021 ◽

Author(s):

Tuğba Bozdemir ◽

Candan Çİçek ◽

Deniz Gökengin ◽

Sabire Şöhret Aydemir ◽

İmre Altuğlu ◽

...

Keyword(s):

Human Papillomavirus ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium ◽

Hiv Positive ◽

Sexually Transmitted ◽

Ureaplasma Parvum ◽

Asymptomatic Individuals ◽

Simplex Virus

Objective: Sexually transmitted infections are frequently seen and significant infections for public health. Prevention, early diagnosis and treatment of sexually transmitted infections have an important role in controlling the transmission of Human Immunodeficiency Virus (HIV). The investigation of the frequency of other sexually transmitted pathogens in asymptomatic HIV- positive individuals was aimed in the present study. Method: Vaginal and urethral swab samples were collected by 90 HIV- positive asymptomatic individuals themselves aged between 20-69 (median=36, SD=10.48) years, between September 2015 and April 2016. The samples were assessed for the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum, Herpes simplex virus type 1 and 2, and Human papillomavirus using real-time polymerase chain reaction (PCR) method. Results: At least one or more than one sexually transmitted pathogen was identified in 49 (54.4%) of 90 HIV-positive individuals. Human Papillomavirus was found in 31 (34.4%), Ureaplasma urealyticum in 20 (22.2%), Ureaplasma parvum in 15 (16.6%), Mycoplasma genitalium in 8 (8.8%), Mycoplasma hominis in 8 (8.8%), Neisseria gonorrhoeae in 5 (5.5%) and Chlamydia trachomatis in 2 (2.2%) individuals. Trichomonas vaginalis, Herpes simplex virus type 1 and 2 were not detected in any of the clinical specimens. Conclusion: Approximately 55% of 90 HIV- positive individuals were found to be positive for sexually transmitted pathogens, and . Human Papillomavirus was the most frequently detected pathogen. This condition reveals the necessity of screening even asymptomatic individuals for the presence of this pathogen. Studies are needed to increase awareness in our country on this issue.

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Cervical Cytology of Samples with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, and Neisseria gonorrhoeae Detected by Multiplex PCR

BioMed Research International ◽

10.1155/2020/7045217 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Fabiana Pirani Carneiro ◽

Andersen Charles Darós ◽

Adriana Cysneiro Milhomem Darós ◽

Tércia Maria Mendes Lousa de Castro ◽

Marcos de Vasconcelos Carneiro ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Neisseria Gonorrhoeae ◽

Multiplex Pcr ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium ◽

Diagnostic Methods ◽

Pap Smears ◽

Ureaplasma Parvum

Introduction. Despite increasing application of molecular diagnostic methods for the detection of sexually transmitted infections, the cytological findings in pap smears of patients with pathogens that can be identified only by PCR are not yet well described. The aim of this study was to describe the most common cytological features in cervical pap smears of patients with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum detected by multiplex PCR. Methods. Cervical samples for conventional and liquid-based cytology and for multiplex PCR were collected from women ranging from 23 to 54 years old, who underwent routine screening at a gynecological Unit. Results. Multiplex PCR was positive in 36.2% of the samples: Ureaplasma parvum 14.9%, Chlamydia trachomatis 10.6%, Trichomonas vaginalis 10.6%, Mycoplasma hominis 8.5%, Ureaplasma urealyticum 4.2%, Neisseria gonorrhoeae 2.1%, and Mycoplasma genitalium (0). Multiple pathogens were observed in 12.8% of samples. Microscopic cervicitis (≥10 polymorphonuclear leukocytes/epithelial cell) and normal (predominantly lactobacillary) microbiota were the most frequent findings in the samples in which the pathogens were detected alone or in multiple infections, except for samples with Trichomonas vaginalis in which the coccobacillary microbiota was the most common. In samples with microscopic cervicitis and normal microbiota, those with at least one pathogen identified by multiplex PCR were significantly more frequent than those with no pathogen, 66.6% versus 33.3%. Conclusion. Failure to identify an inflammatory agent in pap smear with intense neutrophil exudate may suggest the presence of Ureaplasma parvum, Ureaplasma urealyticum, Chlamydia trachomatis, or Trichomonas vaginalis. A remark on the intensity of inflammation should be made in the reports of cervical pap smears so that this cytological finding can be correlated with clinical and PCR results.

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Microbiota do colo uterino por Gram em pacientes com infeção por papilomavírus humano e outras infecções sexualmente transmissíveis

10.5327/dst-2177-8264-202133p035 ◽

2021 ◽

Author(s):

Marina Mara Sousa de Oliveira ◽

Hyan Staytskowy Magalhães Martins ◽

Rafael Pereira de Vasconcelos ◽

Renata Mirian Nunes Eleutério ◽

José Eleutério Júnior

Keyword(s):

Chlamydia Trachomatis ◽

Neisseria Gonorrhoeae ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium

Introdução: A microbiota vaginal é um complexo sistema com diversidade de microrganismos. A disbiose parece aumentar o risco de infecções, principalmente as sexualmente transmissíveis, entre as quais por papilomavírus humano, agente associado a lesões cervicais. Objetivo: Avaliar os diferentes tipos de microbiota cervical e as suas características no esfregaço de material residual de citologia em meio líquido, associando com o papilomavírus humano e com Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis. Métodos: O estudo analisou 179 casos que tinham material residual de citologia em meio líquido. Alíquota do material foi colocado em lâmina adequada, fixado a seco e corado por método de Gram para leitura em microscópio óptico. Outra alíquota foi utilizada para estudo em reação em cadeia da polimerase - transcriptase reversa e multiplex para pesquisas dos microorganismos associados a infecções sexualmente transmissíveis. O teste exato de Fisher com intervalo de confiança foi utilizado para significância estatística. O projeto foi aprovado em comitê de ética sob número 24071519.9.0000.5049 (UniChristus). Resultados: Os casos foram divididos conforme o escore de Nugent aplicado a esfregaços corados pelo método de Gram. Em microbiota cervical normal (escores de 0 a 3), 100 casos (55,86%); em microbiota intermediária (escore de 4 a 6), 51 casos (28,5%); em sugestivo de disbiose (escore de 7 a 10), 28 casos (15,64%). Nos casos de disbiose, foram observados: Chlamydia trachomatis (1[3,57%]), Mycoplasma hominis (7[25%]), Ureaplasma urealyticum (1[3,57%]), papilomavírus humano 16/45 (1[3,57%]), papilomavírus humano de alto risco (AR) (3[10,71%]) e AR e 16/45 (1[3,57%]). No grupo normal, foi a seguinte distribuição: Ureaplasma urealyticum (1[1%]), papilomavírus humano 16 (2[2%]), papilomavírus humano 18/45 (3[3%]), AR (13[13%]). No grupo intermediário, a distribuição foi: Ureaplasma urealyticum (2[3,9%]), papilomavírus humano AR (5[9,8%]) e papilomavírus humano AR, 16 (1[3,9%]). A única diferença significativa foi de Mycoplasma hominis na disbiose (p<0,0001). Conclusão: O estudo não evidenciou uma associação maior no grupo de disbiose com a maioria das infecções sexualmente transmissíveis, no entanto, com Mycoplasma hominis, foi significativo.

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Diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium: an observational study of testing patterns, prevalence and co-infection rates in northern New Zealand

Sexual Health ◽

10.1071/sh17110 ◽

2018 ◽

Vol 15 (3) ◽

pp. 232 ◽

Cited By ~ 4

Author(s):

Arlo Upton ◽

Liselle Bissessor ◽

Peter Lowe ◽

Xiaoying Wang ◽

Gary McAuliffe

Keyword(s):

New Zealand ◽

Chlamydia Trachomatis ◽

Neisseria Gonorrhoeae ◽

Trichomonas Vaginalis ◽

Social Deprivation ◽

Mycoplasma Genitalium ◽

Risk Groups ◽

Increased Risk ◽

Sexually Transmissible Infections ◽

Testing Patterns

Background This study sought to determine community prevalence, epidemiology and testing patterns for sexually transmissible infections (STI) in northern New Zealand. Methods: A total of 2643 samples submitted for STI testing between 26 November 2015 and 7 December 2015 underwent analysis by Aptima Combo 2 (Hologic, San Diego, CA, USA), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG) assays. Results were analysed by patient demographics. Results: Four hundred and eleven pathogens were detected from 359 patients, with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), TV, and MG detected in 178 (6.7%), 19 (0.7%), 80 (3%) and 134 (5.1%) samples respectively. With the exception of TV, STI prevalence was highest in people <25 years of age. Infection was more common in men for NG (odds ratio (OR) 5.05, P < 0.001) and CT (OR 2.72, P < 0.001). Māori and Pacific ethnicity were associated with increased risk of MG (OR 1.82, P = 0.006,) TV (OR 6.1, P < 0.001) and CT (OR 3.31, P < 0.001) infection, and TV and NG infections were more prevalent as social deprivation increased. A mismatch between testing rates and prevalence of infection was seen, with fewer tests performed for males (OR 0.2, P < 0.001) than females and no difference in testing of Māori and Pacific men (3064/100 000) compared with men of European background (3181/100 000, OR 0.96, P = 0.76), despite an increased risk of disease. Conclusions: There are disparately low testing rates for STIs in certain high-risk groups in northern New Zealand.

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Prevalence Rates of Chlamydia Trachomatis and Other Sexually Transmitted Organisms in Infertile Couples Attending a Tertiary Medical Centre in Malaysia

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v19i1.1333 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Umi Kalsom A ◽

Suvra B ◽

Zainul RMR ◽

Siti Norlia O ◽

Zalina I ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium ◽

Married Couples ◽

Prevalence Rates ◽

Sexually Transmitted ◽

Neisseria Gonorrhoea ◽

Infertile Couples

INTRODUCTION: Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG) infections are well recognized and prevalent sexually transmitted infections (STIs). The role of Mycoplasma spp and Ureaplasma spp are still controversial as some are commensals of genitourinary tract. OBJECTIVES: To estimate the prevalence rate of 7 organisms: Chlamydia trachomatis, Neisseria gonorrhoea, Mycoplasma genitalium, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in infertile married couples during infertility evaluation. MATERIALS & METHODS: A total of 274 samples from all of the 137 couples who attended the reproductive center from June to December 2014 were collected. Detection of the organisms was performed using multiplex polymerase chain reaction. RESULTS: STI-associated organisms were detected in 35.4% (97/274) of subjects. The prevalence rates of CT, MG, TV, UU, MH were 7.3%,1.1%, 0.4%,5.4% and 5.1% respectively. Twenty-one (7.7%) subjects were positive for more than one organism. 24/274 (8.8%) of subjects had history of urogenital tract-related symptoms and 50% (12/24) were tested positive to one or more organisms. The presence of symptoms in both male and female subjects were found to be 10% (2/20) in CT infection, 10% (7/67) in UP, 14% (2/14) in MH and 13% (2/15) in UU infections. CONCLUSION: Sexually transmitted organisms were detected in one third of subjects planning for fertility evaluation. The absence of symptom in most subjects particularly in CT infection emphasizes the need for microbiological screening during infertility evaluation. The presence of genital ureaplasmas and mycoplasmas in infertile couples should not be neglected. There is a growing need to clarify whether their roles are simply colonizers or pathogens implicated in infertility.

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Distribution of sexually transmitted diseases in a group of symptomatic male patients using urine samples and PCR technique / Distribuția bolilor cu transmitere sexuală într-un grup de barbați simptomatici utilizand probe de urina si tehnica PCR

Revista Romana de Medicina de Laborator ◽

10.1515/rrlm-2015-0029 ◽

2015 ◽

Vol 23 (3) ◽

pp. 323-331

Author(s):

Mihaela Laura Vica ◽

Lia Monica Junie ◽

Alecsandra Iulia Grad ◽

Alexandru Tataru ◽

Horea Vladi Matei

Keyword(s):

Sexually Transmitted Diseases ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Simultaneous Detection ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium ◽

Urine Samples ◽

Multiple Infections ◽

Sexually Transmitted ◽

Wide Scale

Abstract Sexually transmitted diseases (STDs) are a very important cause of illness worldwide and prolonged, untreated infections with STD pathogens may have serious consequences. Our study aims to evaluate the distribution of six different STDs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium) in male urine samples. First void urine samples from 52 symptomatic patients were collected between April 2014 and April 2015. DNA was extracted, purified and amplified via multiplex polymerase chain reaction (PCR) for the detection of the six STD pathogens, further identified using a 2% agarose gel electrophoresis with ethidium bromide as staining agent. STD frequency in the study group was 53.84 % (28 patients), mostly in the 20-29 years age group. Among positive patients, six presented multiple infections. 35 positive DNA samples were identified in the study: 17 of C. trachomatis, 9 of U. urealyticum, 7 of N. gonorrhoeae and 2 of M. genitalium. Wide scale application of the system based on the simultaneous detection of these six pathogens inducing STD may facilitate diagnosis, especially in multiple infections.

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Molecular evaluation of 7 sexually transmissible microorganisms in symptomatic and asymptomatic Italian childbearing age women: is Ureaplasma parvum a real innocent bystander?

Microbiologia Medica ◽

10.4081/mm.2016.5864 ◽

2016 ◽

Vol 31 (3) ◽

Author(s):

Manuela Avolio ◽

Maria Luisa Modolo ◽

Paola Stano ◽

Rita De Rosa ◽

Alessandro Camporese

Keyword(s):

Bacterial Vaginosis ◽

Trichomonas Vaginalis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Mycoplasma Genitalium ◽

Single Species ◽

Childbearing Age ◽

Pathogenic Potential ◽

Ureaplasma Parvum ◽

Childbearing Age Women

Background: Symptoms of most common bacterial and parasitic sexually transmitted infections tend to be non-specific and typically have a variety of different potential causal agents that may require different treatments. In this field the pathogenic potential of genital Ureaplasma species is still uncertain and debated. The goal of this study was to investigate the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in a cohort of symptomatic and asymptomatic childbearing age women and to assess the relationships between bacterial vaginosis and symptoms with both UU and UP. Materials and Methods: DNA of 2735 endocervical specimens was consecutively analysed by a commercial multiplex real-time polymerase chain reaction for detection of 7 multiple target sequences simultaneously: CT, NG, TV, MG, MH, UU and UP. Results: Out of the total number of population studied (n=2735), UP was found to be the species with highest prevalence (30.9%) followed by MH (6.5%), UU (6.3%), CT (2.6%), MG (0.8%) and TV (0.9%). UP single species detection was extremely significant in symptomatic women with normal flora (P<0.0001). The correlation of UP in symptomatic women with bacterial vaginosis was not significant (P=0.3387). Conclusions: Our results suggest a potential specific etiological role to UP, still considered rightly or wrongly innocent bystander, despite the lack so far of specific-species culture tests.

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