Trends and Risk Factors for Antimicrobial-Resistant Neisseria gonorrhoeae, Melbourne, Australia, 2007 to 2018

ABSTRACT Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health problem. Traditionally, AMR surveillance programs for N. gonorrhoeae have focused mainly on laboratory data to describe the prevalence and trends of resistance. However, integrating individual-level risk factors (e.g., sexual orientation or international travel) with laboratory data provides important insights into factors promoting the spread of resistant N. gonorrhoeae. Here, over a 12-year period, we assessed the trends and risk factors for resistant N. gonorrhoeae in individuals attending a large publicly funded sexual health center in Melbourne, Australia. A total of 7,588 N. gonorrhoeae isolates were cultured from 5,593 individuals between 1 January 2007 and 31 December 2018. The proportion of isolates with penicillin resistance decreased from 49.5% in 2007 to 18.3% in 2018 (ptrend < 0.001) and from 63.5% in 2007 to 21.1% in 2018 for ciprofloxacin resistance (ptrend < 0.001). In contrast, the proportion of isolates displaying decreased susceptibility to ceftriaxone increased from 0.5% in 2007 to 2.9% in 2018 (ptrend < 0.001), with a significant increase in low-level azithromycin resistance, from 2.5% in 2012 to 8.2% in 2018 (ptrend < 0.001). Multivariate analysis identified risk factors for multidrug-resistant (MDR) N. gonorrhoeae, namely, female sex and country of birth, with MDR isolates more common in individuals born in northeast Asia, further highlighting the importance of this region and international travel as factors in the cross-border transmission of MDR N. gonorrhoeae. Future surveillance work should incorporate additional epidemiological and genomic data to provide a comprehensive overview of the emergence and spread of resistant N. gonorrhoeae.

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Molecular Analyses of TEM Genes and Their Corresponding Penicillinase-Producing Neisseria gonorrhoeae Isolates in Bangkok, Thailand

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.05665-11 ◽

2011 ◽

Vol 56 (2) ◽

pp. 916-920 ◽

Cited By ~ 32

Author(s):

Shu-ichi Nakayama ◽

Chanwit Tribuddharat ◽

Sasiprapa Prombhul ◽

Ken Shimuta ◽

Somporn Srifuengfung ◽

...

Keyword(s):

Neisseria Gonorrhoeae ◽

Public Health Problem ◽

Major Public Health Problem ◽

Sexual Network ◽

Genetic Event ◽

Content Type ◽

Extended Spectrum ◽

Resistance To Penicillin ◽

High Level ◽

International Awareness

ABSTRACTNeisseria gonorrhoeaeis a major public health problem globally, especially because the bacterium has developed resistance to most antimicrobials introduced for first-line treatment of gonorrhea. In the present study, 96N. gonorrhoeaeisolates with high-level resistance to penicillin from 121 clinical isolates in Thailand were examined to investigate changes related to their plasmid-mediated penicillin resistance and their molecular epidemiological relationships. A β-lactamase (TEM) gene variant,blaTEM-135, that may be a precursor in the transitional stage of a traditionalblaTEM-1gene into an extended-spectrum β-lactamase (ESBL), possibly causing high resistance to all extended-spectrum cephalosporins inN. gonorrhoeae, was identified. Clonal analysis using multilocus sequence typing (MLST) andN. gonorrhoeaemultiantigen sequence typing (NG-MAST) revealed the existence of a sexual network among patients from Japan and Thailand. Molecular analysis of theblaTEM-135gene showed that the emergence of this allele might not be a rare genetic event and that the allele has evolved in different plasmid backgrounds, which results possibly indicate that it is selected due to antimicrobial pressure. The presence of theblaTEM-135allele in the penicillinase-producingN. gonorrhoeaepopulation may call for monitoring for the possible emergence of ESBL-producingN. gonorrhoeaein the future. This study identified ablaTEMvariant (blaTEM-135) that is a possible intermediate precursor for an ESBL, which warrants international awareness.

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Whole-Genome Shotgun Sequences of Three Multidrug-Resistant Mycobacterium tuberculosis Strains Isolated from Morocco

Genome Announcements ◽

10.1128/genomea.01275-17 ◽

2017 ◽

Vol 5 (46) ◽

Cited By ~ 1

Author(s):

Lamiaa Lahlou ◽

Nadia El Mrimar ◽

Meriem Laamarti ◽

Tarek Alouane ◽

Mohammed A. Bendahou ◽

...

Keyword(s):

Public Health ◽

Mycobacterium Tuberculosis ◽

Health Problem ◽

Public Health Problem ◽

Multidrug Resistant ◽

Whole Genome Shotgun ◽

The Body ◽

Major Public Health Problem ◽

Whole Genome ◽

Content Type

ABSTRACT Tuberculosis is a contagious disease that usually attacks the lungs but sometimes attacks other parts of the body, such as the kidneys, glands, and bones. It is an endemic and major public health problem in Morocco. Tuberculosis is transmitted through the airways via the inhalation of microdroplets containing Mycobacterium tuberculosis. We present here the whole-genome shotgun sequences of three multidrug-resistant M. tuberculosis strains isolated from Morocco.

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Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽

10.1027//0227-5910.20.1.28 ◽

1999 ◽

Vol 20 (1) ◽

pp. 28-35 ◽

Cited By ~ 29

Author(s):

Annie Mino ◽

Arnaud Bousquet ◽

Barbara Broers

Keyword(s):

Public Health ◽

Risk Factors ◽

Substance Abuse ◽

Suicidal Ideation ◽

Family Support ◽

Drug Users ◽

Suicide Attempts ◽

Public Health Problem ◽

Major Public Health Problem ◽

Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

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MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

Pakistan Journal of Public Health ◽

10.32413/pjph.v7i4.78 ◽

2018 ◽

Vol 7 (4) ◽

pp. 197-201

Author(s):

Mir M Hassan Bullo ◽

Mirza Amir Baig ◽

Jawad Faisal Malik ◽

Ejaz Ahmad Khan ◽

Muazam Abbas Ranjha ◽

...

Keyword(s):

Risk Factors ◽

Vaccine Coverage ◽

Significant Risk ◽

Public Health Problem ◽

Maculopapular Rash ◽

Healthcare Facility ◽

Control Measures ◽

Major Public Health Problem ◽

District Health ◽

Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

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Nearly Identical Plasmids Encoding VIM-1 and Mercury Resistance in Enterobacteriaceae from North-Eastern Germany

Microorganisms ◽

10.3390/microorganisms9071345 ◽

2021 ◽

Vol 9 (7) ◽

pp. 1345

Author(s):

Stefan E. Heiden ◽

Katharina Sydow ◽

Stephan Schaefer ◽

Ingo Klempien ◽

Veronika Balau ◽

...

Keyword(s):

Resistance Gene ◽

Bacterial Species ◽

Genomic Analysis ◽

Public Health Problem ◽

Multidrug Resistant ◽

Mercury Resistance ◽

Major Public Health Problem ◽

Eastern Germany ◽

North Eastern ◽

Resistance Plasmids

The emergence of carbapenemase-producing Enterobacteriaceae limits therapeutic options and presents a major public health problem. Resistances to carbapenems are mostly conveyed by metallo-beta-lactamases (MBL) including VIM, which are often encoded on resistance plasmids. We characterized four VIM-positive isolates that were obtained as part of a routine diagnostic screening from two laboratories in north-eastern Germany between June and August 2020. Whole-genome sequencing was performed to address (a) phylogenetic properties, (b) plasmid content, and (c) resistance gene carriage. In addition, we performed phenotypic antibiotic and mercury resistance analyses. The genomic analysis revealed three different bacterial species including C. freundii, E. coli and K. oxytoca with four different sequence types. All isolates were geno- and phenotypically multidrug-resistant (MDR) and the phenotypic profile was explained by the underlying resistance gene content. Three isolates of four carried nearly identical VIM-1-resistance plasmids, which in addition encoded a mercury resistance operon and showed some similarity to two publicly available plasmid sequences from sources other than the two laboratories above. Our results highlight the circulation of a nearly identical IncN-type VIM-1-resistance plasmid in different Enterobacteriaceae in north-eastern Germany.

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Predictive risk factors towards liver fluke infection among the people in Kamalasai District, Kalasin Province, Thailand

SAGE Open Medicine ◽

10.1177/2050312119840201 ◽

2019 ◽

Vol 7 ◽

pp. 205031211984020 ◽

Cited By ~ 1

Author(s):

Woragon Wichaiyo ◽

Wirat Parnsila ◽

Wisit Chaveepojnkamjorn ◽

Banchob Sripa

Keyword(s):

Risk Factors ◽

Liver Fluke ◽

Public Health Problem ◽

Major Public Health Problem ◽

Cross Sectional ◽

The People ◽

Fluke Infection ◽

Raw Fish ◽

Predictive Risk ◽

Liver Fluke Infection

Background: Liver fluke disease caused by Opisthorchis viverrini remains a major public health problem with its crucial risk factors caused by some individual habits or false beliefs among the people in northeastern Thailand concerning the consumption of raw fish meat dishes. Objectives: This study explores the predictive risk factors for the infection of liver fluke disease. Methods: The sample consisted of 400 people aged 30 years and above in Thanya sub-district, Kamalasai district, Kalasin province. A cross-sectional analytic study, using the χ2 test, odds ratio and 95% confidence interval, was used to find the influence of each variable, along with the use of multiple logistic regression (p = 0.05). A questionnaire form was used as the research instrument. Results: Factors found in the results are as follows: households with a cat were 7.00 times more at risk than households without a cat; eating raw fish dishes prepared by themselves increases the risk of infection by 2.58 times; eating raw fish dishes prepared by family members increases the risk by 4.74 times; and raw fish dishes bought from a community market increases the risk by 2.33 times. Conclusion: A campaign should be launched to educate people not to eat raw or undercooked fish dishes, but to fully cook fish dishes before eating, as the food is still delicious, but also safe, healthy, and free from liver fluke infection.

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Sero-epidemiology and risk factors of syphilis in Makassar, Indonesia

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2019-0006 ◽

2019 ◽

Vol 11 (2) ◽

pp. 43-49

Author(s):

Maryam Kusumawaty ◽

Khairuddin Djawad ◽

Muh Nasrum Massi ◽

Andi Muhammad Adam ◽

Siswanto Wahab ◽

...

Keyword(s):

Risk Factors ◽

Hiv Transmission ◽

Treponema Pallidum ◽

Public Health Problem ◽

Sexual Relationships ◽

Capital City ◽

Major Public Health Problem ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Increased Risk

Abstract Introduction. Syphilis is an infectious disease caused by Treponema pallidum spirochete and is mainly transmitted by sexual contact. Syphilis has the potential to cause serious complications and is closely related to human immunodeficiency virus (HIV) infection thus making syphilis still a major public health problem. In Indonesia, surveys of high-risk populations in 2007 and 2011 reported an increase in the prevalence of syphilis, especially in men who have sexual relationships with other men (MSM). Moreover, studies have described risk factors for HIV transmission including MSM, heterosexual contacts, Intravenous (IV) drug use, and infected partners. Objectives. To assess the epidemiological aspects and risk factors for syphilis in Makassar, as well as the correlation with a coinfection of other sexually transmitted infections. Material and Methods. This study is a multi-centre cross-sectional descriptive study with consecutive sampling. We evaluated cases for eligibility by confirming the diagnosis based on the serological result using rapid plasma reagin assay (RPR), Treponema pallidum haemagglutination (TPHA), and HIV screening kit. The cases were analyzed based on epidemiological features, risk factors and clinical findings, co-infection with other sexually transmitted infection (ST), and stadium of the disease. Results. A total of 79 serologically confirmed syphilis cases were collected between January 2017 and December 2018 in Makassar, the capital city of South Sulawesi province in Indonesia. Of the 63 male subjects (79.7%), 38 (48.1%) were homosexual/MSM, and in 41 cases of HIV-infected subjects, 25 (60.9%) of them were also MSM. Conclusion. Our study showed there was a significant correlation between syphilis and an increased risk of HIV transmission in MSM groups. The higher number of cases of syphilis and HIV co-infection among MSM can increase transmission of both infections and should be considered a major risk factor for syphilis in Makassar.

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The Lst Sialyltransferase of Neisseria gonorrhoeae Can Transfer Keto-Deoxyoctanoate as the Terminal Sugar of Lipooligosaccharide: a Glyco-Achilles Heel That Provides a New Strategy for Vaccines to Prevent Gonorrhea

mBio ◽

10.1128/mbio.03666-20 ◽

2021 ◽

Vol 12 (2) ◽

Author(s):

Freda E.-C. Jen ◽

Margaret R. Ketterer ◽

Evgeny A. Semchenko ◽

Christopher J. Day ◽

Kate L. Seib ◽

...

Keyword(s):

Monoclonal Antibody ◽

Neisseria Gonorrhoeae ◽

Phase Variation ◽

Multidrug Resistant ◽

Content Type ◽

Acetylneuraminic Acid ◽

New Strategy ◽

Opsonophagocytic Killing ◽

Further Development

ABSTRACT The lipooligosaccharide (LOS) of Neisseria gonorrhoeae plays key roles in pathogenesis and is composed of multiple possible glycoforms. These glycoforms are generated by the process of phase variation and by differences in the glycosyltransferase gene content of particular strains. LOS glycoforms of N. gonorrhoeae can be terminated with an N-acetylneuraminic acid (Neu5Ac), which imparts resistance to the bactericidal activity of serum. However, N. gonorrhoeae cannot synthesize the CMP-Neu5Ac required for LOS biosynthesis and must acquire it from the host. In contrast, Neisseria meningitidis can synthesize endogenous CMP-Neu5Ac, the donor molecule for Neu5Ac, which is a component of some meningococcal capsule structures. Both species have an almost identical LOS sialyltransferase, Lst, that transfers Neu5Ac from CMP-Neu5Ac to the terminus of LOS. Lst is homologous to the LsgB sialyltransferase of nontypeable Haemophilus influenzae (NTHi). Studies in NTHi have demonstrated that LsgB can transfer keto-deoxyoctanoate (KDO) from CMP-KDO to the terminus of LOS in place of Neu5Ac. Here, we show that Lst can also transfer KDO to LOS in place of Neu5Ac in both N. gonorrhoeae and N. meningitidis. Consistent with access to the pool of CMP-KDO in the cytoplasm, we present data indicating that Lst is localized in the cytoplasm. Lst has previously been reported to be localized on the outer membrane. We also demonstrate that KDO is expressed as a terminal LOS structure in vivo in samples from infected women and further show that the anti-KDO monoclonal antibody 6E4 can mediate opsonophagocytic killing of N. gonorrhoeae. Taken together, these studies indicate that KDO expressed on gonococcal LOS represents a new antigen for the development of vaccines against gonorrhea. IMPORTANCE The emergence of multidrug-resistant N. gonorrhoeae strains that are resistant to available antimicrobials is a current health emergency, and no vaccine is available to prevent gonococcal infection. Lipooligosaccharide (LOS) is one of the major virulence factors of N. gonorrhoeae. The sialic acid N-acetylneuraminic acid (Neu5Ac) is present as the terminal glycan on LOS in N. gonorrhoeae. In this study, we made an unexpected discovery that KDO can be incorporated as the terminal glycan on LOS of N. gonorrhoeae by the alpha-2,3-sialyltransferase Lst. We showed that N. gonorrhoeae express KDO on LOS in vivo and that the KDO-specific monoclonal antibody 6E4 can direct opsonophagocytic killing of N. gonorrhoeae. These data support further development of KDO-LOS structures as vaccine antigens for the prevention of infection by N. gonorrhoeae.

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Multidrug-resistant typhoid fever: a review

The Journal of Infection in Developing Countries ◽

10.3855/jidc.1405 ◽

2011 ◽

Vol 5 (05) ◽

pp. 324-337 ◽

Cited By ~ 45

Author(s):

Syed Ahmed Zaki ◽

Sunil Karande

Keyword(s):

Public Health ◽

Typhoid Fever ◽

English Language ◽

Public Health Problem ◽

Public Health Education ◽

Abdominal Distension ◽

Clinical Results ◽

Multidrug Resistant ◽

Major Public Health Problem ◽

Handling Practices

Introduction: Multidrug-resistant typhoid fever (MDRTF) is defined as typhoid fever caused by Salmonella enterica serovar Typhi strains (S. Typhi), which are resistant to the first-line recommended drugs for treatment such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole. Since the mid-1980s, MDRTF has caused outbreaks in several countries in the developing world, resulting in increased morbidity and mortality, especially in affected children below five years of age and those who are malnourished. Methodology: Two methods were used to gather the information presented in this article. First PubMed was searched for English language references to published relevant articles. Secondly, chapters on typhoid fever in standard textbooks of paediatric infectious diseases and preventive and social medicine were reviewed. Results: Although there are no pathognomonic clinical features of MDRTF at the onset of the illness, high fever ( > 104°F), toxaemia, abdominal distension, abdominal tenderness, hepatomegaly and splenomegaly are often reported. The gold standard for the diagnosis of MDRTF is bacterial isolation of the organism in blood cultures. Ciprofloxacin and ceftriaxone are the drugs most commonly used for treatment of MDRTF and produce good clinical results. Conclusion: MDRTF remains a major public health problem, particularly in developing countries. Mass immunization in endemic areas with either the oral live attenuated Typhi 21a or the injectable unconjugated Vi typhoid vaccine, rational use of antibiotics, improvement in public sanitation facilities, availability of clean drinking water, promotion of safe food handling practices and public health education are vital in the prevention of MDRTF.

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Obesity and Overweight in Relation to Hypertension and Associated Risk in School Children

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i431174 ◽

2021 ◽

pp. 80-86

Author(s):

Gorantla Naresh Babu ◽

P. Jameela ◽

S. Jafar Sharif ◽

A. Ramya ◽

K. Ziyaul Haq ◽

...

Keyword(s):

Risk Factors ◽

School Children ◽

Public Health Problem ◽

Overweight And Obesity ◽

Physical Activities ◽

Major Public Health Problem ◽

Healthy Weight ◽

Cardiovascular Risks ◽

Obesity And Overweight ◽

Associated Risk Factors

Aim: Hypertension is a major public health problem worldwide and is associated with high mortality and morbidity. The main aim of this study is to assess obesity and overweight in school children and their relationship to hypertension and associated risk factors. Study Design: Population based cross sectional study. Results and Discussion: A total number of 712 students with age group between 7-12 years from different school were screened for their height, weight and body mass index. The present study was aimed to assess obesity and overweight in school children and their relationship to hypertension and associated risk factors. Under weight and healthy weight children are engaged in physical activities like playing in ground and thus they are healthy where the children who found as overweight and obese were not engaged in physical activities regularly and thus this might be the reason for their overweight and obesity. At the same time the children who found as obese and overweight were said that they were having fast foods twice a day. Conclusion: In order to get rid of these risks and their associated cardiovascular risks, their food habits must be changed and physical activities needs to be improved.

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