scholarly journals Disseminated Gonococcal Infections in Patients Receiving Eculizumab: A Case Series

2018 ◽  
Vol 69 (4) ◽  
pp. 596-600 ◽  
Author(s):  
Page E Crew ◽  
Winston E Abara ◽  
Lynda McCulley ◽  
Peter E Waldron ◽  
Robert D Kirkcaldy ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Medical Literature ◽  
Treatment Guidelines ◽  
Antimicrobial Prophylaxis ◽  
Case Series ◽  
The United States ◽  
Underlying Disease ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Terminal Complement

Abstract Background Gonorrhea is the second most commonly reported notifiable condition in the United States. Infrequently, Neisseria gonorrhoeae can cause disseminated gonococcal infection (DGI). Eculizumab, a monoclonal antibody, inhibits terminal complement activation, which impairs the ability of the immune system to respond effectively to Neisseria infections. This series describes cases of N. gonorrhoeae infection among patients receiving eculizumab. Methods Pre- and postmarketing safety reports of N. gonorrhoeae infection in patients receiving eculizumab worldwide were obtained from US Food and Drug Administration safety databases and the medical literature, including reports from the start of pivotal clinical trials in 2004 through 31 December 2017. Included patients had at least 1 eculizumab dose within the 3 months prior to N. gonorrhoeae infection. Results Nine cases of N. gonorrhoeae infection were identified; 8 were classified as disseminated (89%). Of the disseminated cases, 8 patients required hospitalization, 7 had positive blood cultures, and 2 required vasopressor support. One patient required mechanical ventilation. Neisseria gonorrhoeae may have contributed to complications prior to death in 1 patient; however, the fatality was attributed to underlying disease per the reporter. Conclusions Patients receiving eculizumab may be at higher risk for DGI than the general population. Prescribers are encouraged to educate patients receiving eculizumab on their risk for serious gonococcal infections and perform screening for sexually transmitted diseases (STDs) per the Centers for Disease Control and Prevention STD treatment guidelines or in suspected cases. If antimicrobial prophylaxis is used during eculizumab therapy, prescribers should consider trends in gonococcal antimicrobial susceptibility due to emerging resistance concerns.

Diagnostic tests for detecting Chlamydia trachomatis and Neisseria gonorrhoeae in rectal and pharyngeal specimens

2021 ◽  
Author(s):  
Paul C. Adamson ◽  
Jeffrey D. Klausner
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Bacterial Infections ◽  
Point Of Care ◽  
High Sensitivity ◽  
Population Level ◽  
The United States ◽  
Nucleic Acid Amplification ◽  
Point Of Care Test ◽  
Control And Prevention

Chlamydia trachomatis and Neisseria gonorrhoeae are two of the most often reported bacterial infections in the United States. The rectum and oropharynx are important anatomic sites of infection and can contribute to ongoing transmission. Nucleic acid amplification tests (NAATs) are the mainstays for the detection of C. trachomatis and N. gonorrhoeae infections owing to their high sensitivity and specificity. Several NAATs have been evaluated for testing in rectal and pharyngeal infections. A few assays recently received clearance by the Food and Drug Administration, including one point-of-care test. Those assays can be used for testing in symptomatic individuals, as well as for asymptomatic screening in certain patient populations. Routine screening for C. trachomatis in pharyngeal specimens is not recommended by the Centers for Disease Control and Prevention, though is often performed due to the use of multiplex assays. While expanding the types of settings for screening and using self-collected rectal and pharyngeal specimens can help to increase access and uptake of testing, additional research is needed to determine the potential benefits and costs associated with increased screening for rectal and pharyngeal C. trachomatis and N. gonorrhoeae infections on a population level.

Sexually Transmitted Infections in the U.S. Military: A Sexual Health Paradigm to Address Risk Behaviors, Unintended Pregnancy, Alcohol Use, and Sexual Trauma

2021 ◽  
Author(s):  
Cherrie B Boyer ◽  
Charlotte A Gaydos ◽  
Amy B Geller ◽  
Eric C Garges ◽  
Sten H Vermund
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Health Care Access ◽  
The United States ◽  
Universal Health Care ◽  
Sexually Transmitted ◽  
Care Access ◽  
Control And Prevention ◽  
The Military ◽  
Universal Health

ABSTRACT To address the ongoing epidemic of sexually transmitted infections (STIs) in the United States, the National Academies of Sciences, Engineering, and Medicine (National Academies) conducted a consensus study on STI control and prevention in the United States to provide recommendations to the Centers for Disease Control and Prevention and the National Association of County and City Health Officials. The culminating report identified military personnel as one of the priority groups that require special consideration given the high prevalence of STIs and their associated behaviors (e.g., concurrent sexual partners and infrequent condom use) that occur during active duty service. Universal health care access, the relative ease and frequency of STI screening, and the educational opportunities within the military are all assets in STI control and prevention. The report offers a comprehensive framework on multiple and interrelated influences on STI risk, prevention, health care access, delivery, and treatment. It also provides an overview of the multilevel risk and protective factors associated with STIs that could be applied using a sexual health paradigm. The military context must integrate the multilevel domains of influences to guide the effort to fill current gaps and research needs. The Department of Defense, with its large clinical and preventive medicine workforce and its well-established universal health care system, is well positioned to enact changes to shift its current approach to STI prevention, treatment, and control. STI control based on highlighting behavioral, social, cultural, and environmental influences on service members’ sexual health and wellness may well drive better STI care and prevention outcomes.

scholarly journals Mapping the study topics and characteristics of HIV pre-exposure prophylaxis research literature: a protocol for a scoping review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024212 ◽  
Author(s):  
Emiko Kamitani ◽  
Adebukola H Johnson ◽  
Megan Wichser ◽  
Yuko Mizuno ◽  
Julia B DeLuca ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Scoping Review ◽  
The United States ◽  
Research Literature ◽  
Population Characteristics ◽  
Sexually Transmitted ◽  
Research Areas ◽  
Control And Prevention ◽  
Study Characteristics ◽  
Exposure Prophylaxis

IntroductionThe research literature addressing pre-exposure prophylaxis (PrEP) has increased considerably over the last decade. To better understand the research areas and explore research gaps, we will conduct a scoping review to map study topics and describe study characteristics and populations in publications focused on PrEP. The purpose of this protocol is to describe planned methods for the scoping review.Methods and analysisWe will implement a comprehensive systematic literature search to identify PrEP citations in the United States Centres for Disease Control and Prevention HIV/AIDS Prevention Research Synthesis Project database that is unique and extensively focuses on HIV/sexually transmitted infections/hepatitis. We will screen and include studies that are (1) focused on HIV PrEP, (2) primary research with human participants and (3) published in English. Two reviewers will independently abstract data on authors’ names, study years, countries, population characteristics and design. To describe and summarise study topics, we will use 19 codes and five categories that were developed from a preliminary study. The five categories arecategory 1: potential PrEP user/prescriber(behaviours/issues for potential PrEP takers/healthcare professionals),category 2: considerations while on PrEP(experiences of and problems related to staying on or prescribing PrEP),category 3: PrEP efficacy and safety(biomedical aspects and medication efficacy),category 4: methods of and experiences with PrEP clinical trials(possesses/experiences of clinical trials) andcategory 5: cost-effectiveness or economic evaluation(cost studies). Data will be analysed with descriptive statistics.Ethics and disseminationThe findings will be presented at HIV-related conferences and published in peer-review journals.

scholarly journals Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Mackenzie Whitesell ◽  
Annette Bachand ◽  
Jennifer Peel ◽  
Mark Brown
Keyword(s):  
Substance Use ◽  
The United States ◽  
Adolescent Substance Use ◽  
Physical And Mental Health ◽  
Long Term Effects ◽  
Adolescent Substance ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Control And Prevention

Data from the National Institute on Drug Abuse (NIDA) and the Centers for Disease Control and Prevention (CDC) reveal high numbers of adolescent substance use in the United States. Substance use among adolescents can lead to increased risk of transmission of sexually transmitted infections, vehicular fatalities, juvenile delinquency, and other problems associated with physical and mental health. Adolescents are particularly susceptible to involvement in substance use due to the underdeveloped state of the adolescent brain, which can lead to reduced decision-making ability and increased long-term effects of drugs and alcohol. Understanding the causes of adolescent substance use is vital for successful prevention and intervention programs.

Review on the Outpatient Treatment for Pelvic Inflammatory Disease, what is the best for Hong Kong?

2005 ◽  
Vol 12 (3) ◽  
pp. 162-167
Author(s):  
SW Kung ◽  
MH Ng
Keyword(s):  
Risk Factor ◽  
Hong Kong ◽  
Neisseria Gonorrhoeae ◽  
Disease Control ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Outpatient Treatment ◽  
Chronic Pelvic Pain ◽  
Treatment Guidelines ◽  
Control And Prevention

Pelvic inflammatory disease is an important risk factor for infertility, ectopic pregnancy and chronic pelvic pain. Although the Centers for Disease Control and Prevention published treatment guidelines for pelvic inflammatory disease in 2002, the effectiveness of treatment has been affected by the emergence of quinolone-resistant Neisseria gonorrhoeae. The prevalence of quinolone-resistant Neisseria gonorrhoeae is highly variable with time and place. In Hong Kong, quinolone-resistant Neisseria gonorrhoeae is over 90%, thus ceftriaxone, doxycycline and metronidazole should be the treatment of choice. For patients sensitive to cephalosporins, azithromycin and metronidazole can be considered as alternative treatments.

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