scholarly journals Association of sexually-transmitted infection and African–American race with Streptococcus agalactiae colonization in pregnancy

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Gerald A. Capraro ◽  
Sajel Lala ◽  
Khaldia Khaled ◽  
Elizabeth Gosciniak ◽  
Brianna Saadat ◽  
...  
Keyword(s):  
Risk Factors ◽  
African American ◽  
Pregnant Women ◽  
Sexually Transmitted Infection ◽  
Antibiotic Exposure ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Independent Risk Factors ◽  
African American Race ◽  
In Pregnancy

Abstract Background Group B Streptococcus (GBS) remains a significant cause of neonatal infection, but the maternal risk factors for GBS colonization remain poorly defined. We hypothesized that there may be an association between antibiotic exposure during pregnancy and GBS colonization and/or the presence of inducible clindamycin resistance (iCLI-R) in GBS isolates from GBS-colonized pregnant women. Methods A retrospective cohort study was performed at Louisiana State University Health Sciences Center – Shreveport including demographic and clinical data from 1513 pregnant women who were screened for GBS between July 1, 2009 and December 31, 2010. Results Among 526 (34.8%) women who screened positive for GBS, 124 (23.6%) carried GBS strains with iCLI-R (GBS-iCLI-R). While antibiotic exposure, race, sexually-transmitted infection (STI) in pregnancy, GBS colonization in prior pregnancy and BMI were identified as risk factors for GBS colonization in univariate analyses, the only independent risk factors for GBS colonization were African–American race (AOR = 2.142; 95% CI = 2.092–3.861) and STI during pregnancy (AOR = 1.309; 95% CI = 1.035–1.653). Independent risk factors for GBS-iCLI-R among women colonized with GBS were non-African–American race (AOR = 2.13; 95% CI = 1.20–3.78) and younger age (AOR = 0.94; 95% CI = 0.91–0.98). Among GBS-colonized women with an STI in the current pregnancy, the only independent risk factor for iCLI-R was Chlamydia trachomatis infection (AOR = 4.31; 95% CI = 1.78–10.41). Conclusions This study identified novel associations for GBS colonization and colonization with GBS-iCLI-R. Prospective studies will improve our understanding of the epidemiology of GBS colonization during pregnancy and the role of antibiotic exposure in alterations of the maternal microbiome.

scholarly journals What Is the Optimal Testing Strategy for Oropharyngeal Neisseria gonorrhoeae in Men Who Have Sex With Men? Comparing Selective Testing Versus Routine Universal Testing From Dutch Sexually Transmitted Infection Clinic Data (2008–2017)

2019 ◽  
Vol 71 (4) ◽  
pp. 944-951 ◽  
Author(s):  
Geneviève A F S van Liere ◽  
Nicole H T M Dukers-Muijrers ◽  
Sophie Kuizenga-Wessel ◽  
Hannelore M Götz ◽  
Christian J P A Hoebe
Keyword(s):  
Risk Factors ◽  
Neisseria Gonorrhoeae ◽  
Sexually Transmitted Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Universal Testing ◽  
Testing Data ◽  
Independent Risk Factors ◽  
Sex With Men ◽  
Infection Clinic

Abstract Background Most oropharyngeal Neisseria gonorrhoeae infections are asymptomatic, and many infections remain undetected, creating a reservoir for ongoing transmission and potential drug resistance. It is unclear what the optimal testing policy is in men who have sex with men (MSM), as routine universal testing data are lacking. Methods Surveillance data from all Dutch sexually transmitted infection (STI) clinics between 2008 and 2017 were used (N = 271 242 consultations). Oropharyngeal testing policy was defined as routine universal testing when ≥85% of consultations included oropharyngeal testing or as selective testing (<85% tested). Independent risk factors for oropharyngeal N. gonorrhoeae were assessed among MSM routinely universally screened using backward multivariable logistic regression analyses. Results Routine universal testing was performed in 90% (238 619/265 127) of consultations. Prevalence was higher using routine universal testing (5.5%; 95% CI, 5.4–5.6; 12 769/233 476) than with selective testing (4.7%; 95% CI, 4.4–5.0; 799/17 079; P < .001). Proportions of oropharyngeal-only infections were 55% and 47%, respectively. Independent risk factors were age <31 years (OR, 2.1; 95% CI, 1.9–2.3), age 31–43 years (OR, 1.7; 95% CI, 1.6–1.9, compared with >43 years), being notified for any STI (OR, 2.0; 95% CI, 1.9–2.1), concurrent urogenital N. gonorrhoeae (OR, 2.4; 95% CI, 2.1–2.7), and concurrent anorectal N. gonorrhoeae (OR, 11.4; 95% CI, 10.6–12.3). When using any of the risk factors age, notified, or oral sex as testing indicators, 98.4% (81 022/82 332) of MSM would be tested, finding 99.5% (4814/4838) of infections. Conclusions Routine universal testing detected more oropharyngeal N. gonorrhoeae infections than selective testing, of which more than half would be oropharyngeal only. Using independent risk factors as testing indicator is not specific. Therefore, routine universal oropharyngeal testing in MSM is feasible and warranted, as currently advised in most guidelines.

scholarly journals The Risk of Sexually Transmitted Infection and Its Influence on Condom Use among Pregnant Women in the Kintampo North Municipality of Ghana

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Martha Ali Abdulai ◽  
Frank Baiden ◽  
Samuel Afari-Asiedu ◽  
Lawrence Gyabaa-Febir ◽  
Kwame Kesse Adjei ◽  
...  
Keyword(s):  
High Risk ◽  
Condom Use ◽  
Pregnant Women ◽  
Sexually Transmitted Infection ◽  
Secondary Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Survey ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted

Sexually transmitted infection (STI) affects the reproductive health of both men and women worldwide. Condoms are important part of the available preventive strategies for STI control. The lack of proper risk-perception continues to impede women’s ability to negotiate condom use with their partners. This paper is the outcome of secondary analysis of data collected in a cross-sectional survey that explored the perception of risk of STI and its influence on condom use among 504 pregnant women attending antenatal clinic at two health facilities in the Kintampo North Municipality. Consecutively, three Focus Group Discussions were conducted among 22 pregnant women which was analyzed using thematic analysis technique. Multivariate logistic regression analysis was used to identify possible predictors of condom use and risk of STI. Respondents mean age was 26.0±5.9 years. 47% of respondents self-identified themselves as high risk for contracting STI, 50% of whom were married. High risk status (OR = 2.1, 95% CI: 1.1–4.4), ability to ask for condoms during sex (OR = 0.3, 95% CI: 0.1–0.73), and partner’s approval of condom use (OR = 0.2, 95% CI: 0.01–0.05) were independent predictors of condom use. Condom use (OR 2.9 (1.5–5.7); p=0.001) and marital status (engaged, OR 2.6 (1.5–4.5); p=0.001) were independent predictors of risk of STI. Women who self-identified themselves as high risk for STI successfully negotiated condom use with their partners. This is however influenced by partner’s approval and ability to convince partner to use condoms. Self-assessment of STI risk by women and the cooperation of male partners remain critical.

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