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

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)

2014 ◽  
Vol 26 (2) ◽  
pp. 209-215 ◽  
Author(s):  
George W. Rutherford ◽  
Andrew Anglemyer ◽  
Danstan Bagenda ◽  
Michael Muyonga ◽  
Christina P. Lindan ◽  
...  

Abstract Adolescents and young adults are at high risk of human immunodeficiency virus (HIV) infection in sub-Saharan Africa. Previous reports have found that university students in Africa comprise a sexually active population, although the prevalence of HIV or sexually transmitted infections (STI) has not been measured. We conducted a cross-sectional survey of students from five large universities in Kampala, Uganda, using respondent-driven sampling. We asked students to complete behavioral questionnaires and provide biological samples to test for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and bacterial vaginosis. We enrolled 649 students and obtained interpretable data from 640. Around 50% of the respondents were male, and the mean age was 22 years. An estimated 0.8% (95% CI 0.0–2.0) of male students had Chlamydia infection, approximately 4.3% (95% CI 2.0–7.0) had syphilis, 0.4% (95% CI 0.0–0.9) had HIV, and none had gonorrhea. An estimated 32.6% (95% CI 22.4–40.8) of women had bacterial vaginosis, 2.5% (95% CI 0.7–6.3) had Chlamydia infection, 1.7% (95% CI 0.5–3.6) had syphilis, 1.0% (95% CI 0.0–2.4) had gonorrhea, 0.9% (95% CI 0.0–4.2) had trichomoniasis, and 0.9% (95% CI 0.0–1.8) had HIV. We found no significant risk factors for HIV or other STI among males. We also found that not using a condom during the latest sexual intercourse was significantly associated with HIV infection, other STI, or bacterial vaginosis (OR 2.16; 95% 1.26–3.78) among females. We conclude that while university students are sexually active and there is substantial risk for syphilis, there is little evidence of substantially increased HIV risk among them.


2017 ◽  
Vol 29 (6) ◽  
pp. 531-539 ◽  
Author(s):  
Shaun L Barnabas ◽  
Smritee Dabee ◽  
Jo-Ann S Passmore ◽  
Heather B Jaspan ◽  
David A Lewis ◽  
...  

Adolescents in Africa are at high risk for HIV infection, other sexually transmitted infections (STIs) and bacterial vaginosis (BV). Since behavior and burden of STIs/BV may influence HIV risk, behavioral risk factors and prevalence of STIs/BV were compared in HIV-seronegative adolescent females (n = 298; 16–22 years) from two South African communities (Soweto and Cape Town). STIs ( Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1, HSV-2, Treponema pallidum, and Haemophilus ducreyi) were detected by multiplex polymerase chain reaction, human papillomavirus (HPV) by Roche Linear Array, and BV by Nugent scoring. Rates of BV (Nugent ≥7; 46.6%) and HPV (66.8%) were high in both communities. Prevalence of C. trachomatis and N. gonorrhoeae were >2-fold higher in Cape Town than Soweto (Chlamydia: 42% [62/149] versus 18% [26/148], p < 0.0001; gonorrhoea 11% [17/149] versus 5% [7/148], p = 0.05). Only 24% of adolescents with vaginal discharge-causing STIs or BV were symptomatic. In South African adolescents, clinical symptoms compatible with vaginal discharge syndrome had a sensitivity of 23% and specificity of 85% for the diagnosis of discharge-causing STI or BV. In a region with high HIV prevalence and incidence, >70% of young women with treatable conditions that could enhance HIV risk would have been missed because they lacked symptoms associated with syndromic management.


Author(s):  
Pedro Moregola Teixeira ◽  
Wendel Coura Vital ◽  
Angélica Alves Lima ◽  
Nayara Nascimento Toledo Silva ◽  
Cláudia Martins Carneiro ◽  
...  

Background and Objectives: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in the world. The study aimed to estimate the prevalence and to identify risk factors associated with bacterial vaginosis. Methods: A cross-sectional study was conducted in Ouro Preto, Brazil, between February and December 2017. Three hundred and forty-one women aged 18 years or older, users of the Brazilian Unified Health System, participated in this study. Women who used oral or topical antibiotics in the four weeks prior to the sample collection and women who had undergone a total hysterectomy were excluded from the study. After signing the Informed Consent Form and filling out a questionnaire containing sociodemographic, behavioral and sexual data, the participants were directed to the collection room, where the nurse collected the samples for the preventive examination of the cervix and also two vaginal swabs. Vaginal swabs and cervical samples were analyzed for cytological abnormalities and BV using Gram staining and cytology. Pathogens causing sexually transmitted infections (STIs) were identified by Polymerase Chain Reaction (PCR). For the analysis of the data, statistical package STATA version 10.0 was used. This study was approved by the Research Ethics Committee of the Federal University of Ouro Preto (UFOP). Results: During the study, 341 women were evaluated. The prevalence of BV using Gram staining (32.5% [CI95% 27.7=37.7%]) and cytology (27.7% [CI95% 23.0=32.8%]) was similar, however, the sensitivity of cytology was lower (77.8%). Risk factors associated with BV were smoking (IRR 1.5[CI95%: 1.1 = 2.1]), use of an intrauterine device (IRR 2.8 [CI95%: 1.2 = 6.5]), and past medical history of BV (IRR 1.5 [CI95%: 1.1 = 2.1]). Correlation between the presence of BV and Trichomonas vaginalis (TV) infection (r=0.24) was observed. Conclusion: The prevalence of BV was affected by life habits and was prevalent in women with TV. Thus, behavioral and social prevention approaches to women with diverse risk profiles may help mitigate TV/BV prevalence and recurrence of BV.


2021 ◽  
Vol 79 (1) ◽  
pp. 71-73
Author(s):  
Ângela Roda ◽  
João Borges-Costa

Trichomoniasis is one of the most common sexually transmitted infections worldwide. In women, Trichomonas vaginalis infection may present with vaginitis, cervicitis, or pelvic inflammatory disease, while in men it is mainly asymptomatic or causes mild and transient symptoms of urethritis, epididymitis, or prostatitis. In the past, little importance had been given to the impact of T. vaginalis infection on men’s health, since it was believed to be a self-limited condition without sequelae. However, there is growing evidence it is associated with more serious disorders in both men and women and efforts to diagnose and treat this parasitic infection have increased. Recent advances in testing for sexually transmitted diseases using multiplex molecular assays have increased diagnostic opportunities for T. vaginalis infection, especially in men, as detection of the parasite by traditional methods is much more challenging. We describe an unusual case of male urethritis caused by T. vaginalis observed in our consultation of Sexually Transmitted Infections.


2021 ◽  
Vol 21 (2) ◽  
pp. 585-592
Author(s):  
Alphonsus Isara ◽  
Aru-Kumba Baldeh

Background: Sexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa. Aim/Objective: To determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia. Materials and Methods: Blood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brika- ma District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test. Results: The overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Strep- tococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%). Conclusion: A high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia. Keywords: Sexually transmitted infections; pregnant women; antenatal clinics; The Gambia.


2021 ◽  
pp. 603-628
Author(s):  
Henrietta Williams

Why are sexually-transmitted infections important??, Syndromic management of sexually-transmitted infections?, Syphilis?, Gonorrhoea?, Chlamydial infections?, Chancroid?, Granuloma inguinale donovanosis?, Trichomoniasis?, Bacterial vaginosis?, Genital herpes?, Candida vaginitis?, Human papillomavirus and genital warts?


World Science ◽  
2018 ◽  
Vol 2 (8(36)) ◽  
pp. 4-7
Author(s):  
Fedorych P. V. ◽  
Mavrov G. I.

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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