Molecular screening in a longitudinal cohort of young men who have sex with men and young transgender women: associations with focus on the emerging sexually transmitted pathogen Mycoplasma genitalium

2020 ◽  
pp. sextrans-2020-054463
Author(s):  
Erik Munson ◽  
Ethan Morgan ◽  
Laura Sienkiewicz ◽  
Yazmine Thomas ◽  
Kathleen Buehler ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Young Men ◽  
Mycoplasma Genitalium ◽  
Transgender Women ◽  
Sexual Practice ◽  
Transmitted Infection ◽  
Urine Screening ◽  
Sexually Transmitted ◽  
Sex With Men

ObjectivesThis investigation sought to characterise risk factors associated with acquisition of traditional and emerging agents of sexually transmitted infection (STI) in a cohort of young men who have sex with men and transgender women.Methods917 participants provided urine and rectal swab submissions assessed by transcription-mediated amplification (TMA)-based assays for Chlamydia trachomatis and Neisseria gonorrhoeae and by off-label TMA-based Trichomonas vaginalis and Mycoplasma genitalium testing. A subset provided specimens at 6-month and 12-month follow-up visits.ResultsPrevalence of M. genitalium from rectal and urine specimens (21.7% and 8.9%, respectively) exceeded that of C. trachomatis (8.8% and 1.6%) and other STI agents. Black participants yielded higher prevalence of M. genitalium (30.6%) than non-black participants (17.0%; χ²=22.39; p<0.0001). M. genitalium prevalence from rectal specimens was 41.5% in HIV-positive participants vs 16.3% in HIV-negative participants (χ²=57.72; p<0.0001). Participant age, gender identity, condomless insertive anal/vaginal sexual practice and condomless receptive anal sexual practice were not associated with rectal C. trachomatis (p≥0.10), N. gonorrhoeae (p≥0.29), T. vaginalis (p≥0.18) or M. genitalium (p≥0.20) detection. While prevalence of T. vaginalis was calculated at ≤1.0%, baseline rectal and urine screening status was predictive of detection/non-detection at follow-up. A non-reactive M. genitalium baseline rectal or urine screening result was less predictive of non-reactive follow-up versus C. trachomatis, N. gonorrhoeae and T. vaginalis.ConclusionsRectal M. genitalium detection is associated with black race and HIV seropositivity. Baseline M. genitalium infection influences subsequent detection of the organism.

scholarly journals Improved molecular laboratory productivity by consolidation of testing on the new random-access analyzer Alinity m

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Martin Obermeier ◽  
Monia Pacenti ◽  
Robert Ehret ◽  
Francesco Onelia ◽  
Rory Gunson ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Random Access ◽  
Mycoplasma Genitalium ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
International Multicenter Study ◽  
Laboratory Productivity ◽  
Laboratory Workflow

AbstractObjectivesAutomated molecular analyzers have accelerated diagnosis, allowing earlier intervention and better patient follow-up. A recently developed completely automated molecular analyzer, Alinity™ m (Abbott), offers consolidated, continuous, and random-access testing that may improve molecular laboratory workflow.MethodsAn international, multicenter study compared laboratory workflow metrics across various routine analyzers and Alinity m utilizing assays for human immunodeficiency virus type 1 (HIV-1), hepatitis C virus (HCV), hepatitis B virus (HBV), high-risk human papillomavirus (HR HPV), and sexually transmitted infection (STI) (Chlamydia trachomatis [CT]/Neisseria gonorrhoeae [NG]/Trichomonas vaginalis [TV]/Mycoplasma genitalium [MG]). Three turnaround times (TATs) were assessed: total TAT (sample arrival to result), sample onboard TAT (sample loading and test starting to result), and processing TAT (sample aspiration to result).ResultsTotal TAT was reduced from days with routine analyzers to hours with Alinity m, independent of requested assays. Sample onboard TATs for standard workflow using routine analyzers ranged from 7 to 32.5 h compared to 2.75–6 h for Alinity m. The mean sample onboard TAT for STAT samples on Alinity m was 2.36 h (±0.19 h). Processing TATs for Alinity m were independent of the combination of assays, with 100% of results reported within 117 min.ConclusionsThe consolidated, continuous, random-access workflow of Alinity m reduces TATs across various assays and is expected to improve both laboratory operational efficiency and patient care.

scholarly journals Partner notification and treatment outcomes among South African adolescents and young adults diagnosed with a sexually transmitted infection via laboratory-based screening

2020 ◽  
Vol 31 (7) ◽  
pp. 627-636 ◽  
Author(s):  
Pooja Chitneni ◽  
Mags Beksinska ◽  
Janan J Dietrich ◽  
Manjeetha Jaggernath ◽  
Kalysha Closson ◽  
...  
Keyword(s):  
Young Adults ◽  
Sexually Transmitted Infection ◽  
Trichomonas Vaginalis ◽  
Partner Notification ◽  
Mycoplasma Genitalium ◽  
Adolescents And Young Adults ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Care Cascade ◽  
Essential Components

Partner notification and treatment are essential components of sexually transmitted infection (STI) management, but little is known about such practices among adolescents and young adults. Using data from a prospective cohort study (AYAZAZI) of youth aged 16–24 years in Durban, South Africa, we assessed the STI care cascade across participant diagnosis, STI treatment, partner notification, and partner treatment; index recurrent STI and associated factors; and reasons for not notifying partner of STI. Participants completed laboratory-based STI screening ( Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis) at enrollment and at 12 months. Of the 37/216 participants with STI (17%), 27/37 (73%) were women and 10/37 (27%) were men. Median age was 19 years (IQR: 18–20). Of the participants with STI, 23/37 (62%) completed a Treatment and Partner Tracing Survey within 6 months of diagnosis. All survey participants reported completing STI treatment (100%), 17/23 (74%) notified a partner, and 6/23 (35%) reported partner treatment. Overall, 4/23 (11%) participants had 12-month recurrent C. trachomatis infection, with no association with partner notification or treatment. Stigma and lack of STI knowledge were reasons for not notifying partner of STI. STI partner notification and treatment is a challenge among youth. Novel strategies are needed to overcome barriers along the STI care cascade.

scholarly journals Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis

2016 ◽  
Vol 55 (1) ◽  
pp. 321-325 ◽  
Author(s):  
Erik Munson ◽  
David Wenten ◽  
Sheila Jhansale ◽  
Mary Kay Schuknecht ◽  
Nicki Pantuso ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Trichomonas Vaginalis ◽  
Screening Program ◽  
Mycoplasma Genitalium ◽  
Transmitted Infection ◽  
Additional Specimen ◽  
Content Type ◽  
Sexually Transmitted ◽  
High Prevalence ◽  
Infection Clinic

ABSTRACTOf 1,493 encounters of males at a sexually transmitted infection (STI) clinic in a community with a high prevalence of STI,Chlamydia trachomatiswas detected in 8.7% andNeisseria gonorrhoeaewas detected in 6.6%. AdditionalTrichomonas vaginalisandMycoplasma genitaliumscreening found 17.4% and 23.9% of the encounters, respectively, to be positive for STI. STI agents were detected in 13.7% of urine specimens; addition of pharyngeal and rectal collections to the analysis resulted in detection of STI agents in 19.0% and 23.9% of encounters, respectively. A total of 101 (23.8%) encounters of identified STI involved sole detection ofM. genitalium. Expansion of the STI analyte panel (includingM. genitalium) and additional specimen source sampling within a comprehensive STI screening program increase identification of male STI carriers.

scholarly journals Resistance-Guided Antimicrobial Therapy Using Doxycycline–Moxifloxacin and Doxycycline–2.5 g Azithromycin for the Treatment of Mycoplasma genitalium Infection: Efficacy and Tolerability

2019 ◽  
Vol 71 (6) ◽  
pp. 1461-1468 ◽  
Author(s):  
Duygu Durukan ◽  
Tim R H Read ◽  
Gerald Murray ◽  
Michelle Doyle ◽  
Eric P F Chow ◽  
...  
Keyword(s):  
De Novo ◽  
Health Centre ◽  
Mycoplasma Genitalium ◽  
Evidence Base ◽  
Macrolide Resistance ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
European Guidelines ◽  
Sex With Men ◽  
Guided Therapy

Abstract Background Macrolide resistance in Mycoplasma genitalium (MG) exceeds 50% in many regions, and quinolone resistance is increasing. We recently reported that resistance-guided therapy (RGT) using doxycycline followed by sitafloxacin or 2.5 g azithromycin cured 92% and 95% of macrolide-resistant and macrolide-susceptible infections, respectively. We present data on RGT using doxycycline–moxifloxacin, the regimen recommended in international guidelines, and extend data on the efficacy of doxycycline–2.5 g azithromycin and de novo macrolide resistance. Methods Patients attending Melbourne Sexual Health Centre between 2017 and 2018 with sexually transmitted infection syndromes were treated with doxycycline for 7 days and recalled if MG-positive. Macrolide-susceptible cases received 2.5 g azithromycin (1 g, then 500 mg daily for 3 days), and resistant cases moxifloxacin (400 mg daily, 7 days). Test of cure was recommended 14–28 days post-antimicrobials. Results There were 383 patients (81 females/106 heterosexual males/196 men who have sex with men) included. Microbial cure following doxycycline–azithromycin was 95.4% (95% confidence interval [CI], 89.7–98.0) and doxycycline–moxifloxacin was 92.0% (95% CI, 88.1–94.6). De novo macrolide resistance was detected in 4.6% of cases. Combining doxycycline–azithromycin data with our prior RGT study (n = 186) yielded a pooled cure of 95.7% (95% CI, 91.6–97.8). ParC mutations were present in 22% of macrolide-resistant cases. Conclusions These findings support the inclusion of moxifloxacin in resistance-guided strategies and extend the evidence for 2.5 g azithromycin and presumptive use of doxycycline. These data provide an evidence base for current UK, Australian, and European guidelines for the treatment of MG.

scholarly journals MgpB Types among Mycoplasma genitalium Strains from Men Who Have Sex with Men in Berlin, Germany, 2016–2018

Pathogens ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 12 ◽  
Author(s):  
Roger Dumke ◽  
Marcos Rust ◽  
Tobias Glaunsinger
Keyword(s):  
Sexually Transmitted Diseases ◽  
Mycoplasma Genitalium ◽  
Clinical Samples ◽  
Genome Region ◽  
Sexually Transmitted ◽  
Gene Coding ◽  
A Cell ◽  
Different Populations ◽  
Sex With Men

Mycoplasma genitalium is a cell wall-less bacterium causing urethritis and other sexually transmitted diseases. Despite a strongly conserved genome, strains in clinical samples can be typed by different methods. To obtain data from the risk population of men having sex with men, we analyzed the typing region in the gene coding for the MgpB adhesin of M. genitalium first in 163 and 45 follow-up samples among patients of two specialized practices in Berlin, Germany. Strains belong to 43 different mgpB types emphasizing the diversity of the genome region. With respect to 133 types previously described, 27 new types were found. However, the majority of strains (64.4%) were assigned to types 4, 6, 113, and 108, respectively. A correlation between mgpB type and the occurrence of mutations associated with macrolide and quinolone resistance was not demonstrated. Investigation of follow-up samples from 35 patients confirmed the same mgpB and, additionally, MG_309 types in 25 cases. In 10 cases, differences between types in subsequent samples indicated an infection with a genetically different strain in the period between samplings. MgpB/MG_309 typing is a useful method to compare M. genitalium strains in samples of individual patients as well as those circulating in different populations

Factors associated with sexually transmitted infection diagnosis in women who have sex with women, women who have sex with men and women who have sex with both

2020 ◽  
pp. sextrans-2020-054561
Author(s):  
Nazia Rahman ◽  
Khalil G Ghanem ◽  
Elizabeth Gilliams ◽  
Kathleen R Page ◽  
Susan Tuddenham
Keyword(s):  
Substance Use ◽  
Binge Drinking ◽  
Trichomonas Vaginalis ◽  
Transmitted Infection ◽  
Men And Women ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Lower Test ◽  
Sex With Men ◽  
Use Factors

IntroductionMany US women report same sex behaviour, yet data on risk factors and STIs in women who have sex with women (WSW), women who have sex with both men and women (WSB) and how these compare to women who have sex with men only (WSM) remain limited. Here we compared self-identified WSW, WSB and WSM attending two STI clinics in Baltimore, Maryland.MethodsThis was a retrospective analysis using a database of first clinic visits 2005–2016. WSW and WSB were compared with an age-matched random sample of WSM. Proportions were compared using the χ2 test. Acute STI (aSTI) was defined as gonorrhoea (Neisseria gonorrhoeae, GC), chlamydia (Chlamydia trachomatis, CT), trichomonas (Trichomonas vaginalis, TV) or early syphilis. Logistic regression was used to assess aSTI predictors. CT testing was not uniformly done, so a sensitivity analysis removing CT from the aSTI definition was conducted.ResultsVisits from 1095 WSW, 1678 WSB and 2773 WSM were analysed. WSB had equal or higher test positivity for all STIs except urogenital chlamydia, had more sexual partners, were more likely to engage in transactional sex and were more likely to report drug use and binge drinking than WSM (p≤0.01). WSW had lower test positivity for urogenital GC and CT than WSM or WSB, but comparable test positivity for TV, higher reported binge drinking and comparable reported substance use as WSM. Younger age and cocaine use predicted STI diagnosis only in WSM.ConclusionsWSB in these clinics bear an equal or higher burden of most STIs, have more partners and report more substance use than WSM. WSW carry a lower, but still substantial burden of STIs, and many report substance use. Factors predicting STI diagnosis differ between WSW, WSB and WSM suggesting that tailored STI prevention and testing approaches are needed in these groups.

scholarly journals Factors Predicting Uptake of Sexually Transmitted Infections Testing among Men Who Have Sex with Men Who Are “Pre-Exposure Prophylaxis Tourists”—An Observational Prospective Cohort Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3582
Author(s):  
Zixin Wang ◽  
Yuan Fang ◽  
Natthakhet Yaemim ◽  
Kai J. Jonas ◽  
Andrew Chidgey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Service Providers ◽  
Risky Behaviors ◽  
Service Planning ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Sex With Men ◽  
Exposure Prophylaxis

The term “Pre-exposure prophylaxis (PrEP) tourists” refers to individuals who obtain PrEP in other countries and use it in their home countries. A prospective observational cohort study was conducted among a group of men who have sex with men (MSM) who obtained PrEP in private clinics in Thailand and used it in Hong Kong. Participants completed two web-based self-administered surveys when obtaining PrEP in Thailand and three months afterwards. Out of 110 participants at baseline, 67 completed the follow-up. The prevalence of sexually transmitted infection (STI) testing was 47.8% during the follow-up period. Eleven participants received an STI diagnosis, and seven of them were incident infections in the past three months. Participants who perceived a higher chance for STI infection (adjusted odds ratios (AOR): 1.90, 95% CI: 1.00, 3.75) and reported higher intention to take up STI testing at baseline (AOR: 1.62, 95% CI: 1.05, 2.50) were more likely to receive STI testing during the follow-up period. Baseline perceptions that service providers would think they were having risky behaviors because of PrEP use was negatively associated with the dependent variable (AOR: 0.51, 95% CI: 0.31, 0.86). Service planning and health promotion related to STI testing is needed for MSM “PrEP tourists”.

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