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Hadad, R., Skov Jensen, J., Westh, H., Grønbaek, I., Jessen Schwartz, L., Nielsen, L., . . . Hoffmann, S. (2020). A Chlamydia trachomatis 23S rRNA G1523A variant escaping detection in the Aptima Combo 2 assay (Hologic) was widespread across Denmark in July-September 2019. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS)
Open this publication in new window or tab >>A Chlamydia trachomatis 23S rRNA G1523A variant escaping detection in the Aptima Combo 2 assay (Hologic) was widespread across Denmark in July-September 2019
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2020 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463Article in journal (Refereed) Epub ahead of print
Abstract [en]

Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection globally, and nucleic acid amplification tests (NAATs) are recommended for highly sensitive and specific diagnosis. In early 2019, the Finnish new variant of Chlamydia trachomatis (FI-nvCT) was identified. The FI-nvCT has a C1515T mutation in the 23S rRNA gene, making it escaping detection in the Aptima Combo 2 (AC2; Hologic) NAAT, and the FI-nvCT has been subsequently reported in Sweden and Norway. In the present study, we investigated the presence of the FI-nvCT and other AC2 diagnostic-escape CT mutants in July-September 2019 in Denmark. The FI-nvCT was present but rare in Denmark. However, another AC2 diagnostic-escape CT mutant (with a 23S rRNA G1523A mutation) was found to be widespread across Denmark, accounting for 95% (76/80) of AC2 diagnostic-escape nvCT samples from five Danish CT-diagnostic laboratories. This nvCT-G1523A has previously only been detected in one single sample in the United Kingdom and Norway, respectively. It is vital to monitor the continued stability of the NAAT targets in local, national and international settings and monitor as well as appropriately analyse incidence, unexplained shifts in diagnostics rates, and/or annual collections of samples diagnosed as negative/equivocal using NAATs with different target(s). Furthermore, diagnostic CT NAATs with dual target sequences are crucial and fortunately, an updated Hologic AC2 assay including one additional target sequence is in advanced development.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2020
Keywords
Chlamydia trachomatis, 23S rRNA, Aptima Combo 2 assay, C1515T, Denmark, FI-nvCT, G1523A, New variant
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-80835 (URN)10.1111/apm.13043 (DOI)32202687 (PubMedID)
Available from: 2020-03-25 Created: 2020-03-25 Last updated: 2020-03-25Bibliographically approved
Unemo, M., Clarke, E., Boiko, I., Patel, C. & Patel, R. (2020). Adherence to the 2012 European gonorrhoea guideline in the WHO European Region according to the 2018-19 International Union against Sexually Transmitted Infections European Collaborative Clinical Group gonorrhoea survey. International Journal of STD and AIDS (London), 31(1), 69-76
Open this publication in new window or tab >>Adherence to the 2012 European gonorrhoea guideline in the WHO European Region according to the 2018-19 International Union against Sexually Transmitted Infections European Collaborative Clinical Group gonorrhoea survey
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2020 (English)In: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 31, no 1, p. 69-76Article in journal (Refereed) Published
Abstract [en]

Gonorrhoea is a major public health problem globally. Increasing incidence in many particularly developed countries and the emergence of resistance to the extended-spectrum cephalosporin ceftriaxone, the last option for empiric first-line monotherapy, are of serious concern. This paper evaluates the results of the 2018-19 International Union against Sexually Transmitted Infections European Collaborative Clinical Group survey on the diagnosis and treatment of gonorrhoea in Europe. Although high quality clinical care was reported in many European settings, in several countries the testing, diagnostics, antimicrobial treatment, and follow-up of gonorrhoea patients were evidently suboptimal. Increased adherence to evidence-based European and/or nationally-adapted management guidelines is essential in controlling the increasing incidence of gonorrhoea in many European settings and the spread of ceftriaxone-resistant, multidrug-resistant, and extensively drug-resistant gonorrhoea.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Europe, Neisseria gonorrhoeae, antimicrobial resistance, azithromycin, ceftriaxone, culture, nucleic acid amplification test, screening, testing
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-78824 (URN)10.1177/0956462419879278 (DOI)000502917900001 ()31842695 (PubMedID)2-s2.0-8507715949 (Scopus ID)
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-01-14Bibliographically approved
Pitt, R., Unemo, M., Sonnenberg, P., Alexander, S., Beddows, S., Cole, M. J., . . . Field, N. (2020). Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population. Sexually Transmitted Infections, Article ID sextrans-2019-054129.
Open this publication in new window or tab >>Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population
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2020 (English)In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, article id sextrans-2019-054129Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: among the sexually-active British general population.

METHODS: genes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.

RESULTS: D87N/D87Y) in 3.3% (0.9%-11.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5 years) (44.4% (18.9%-73.3%) vs 10.6% (4.6%-22.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%-66.8%) vs 5.0% (1.4%-16.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5 years), but none reported recent symptoms.

CONCLUSIONS: reported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020
Keywords
Mycoplasma genitalium, antibiotic resistance, molecular epidemiology, mycoplasma, public health
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-78962 (URN)10.1136/sextrans-2019-054129 (DOI)31924741 (PubMedID)
Available from: 2020-01-14 Created: 2020-01-14 Last updated: 2020-01-14Bibliographically approved
Shipitsyna, E., Khusnutdinova, T., Budilovskaya, O., Krysanova, A., Shalepo, K., Savicheva, A. & Unemo, M. (2020). Bacterial vaginosis-associated vaginal microbiota is an age-independent risk factor for Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis infections in low-risk women, St. Petersburg, Russia. European Journal of Clinical Microbiology and Infectious Diseases
Open this publication in new window or tab >>Bacterial vaginosis-associated vaginal microbiota is an age-independent risk factor for Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis infections in low-risk women, St. Petersburg, Russia
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2020 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373Article in journal (Refereed) Epub ahead of print
Abstract [en]

The large majority of studies investigating associations between bacterial vaginosis (BV) and sexually transmitted infections (STIs) have been conducted among predominantly young women with high risk for STIs. Since a risky sexual behavior is a significant risk factor for both STIs and BV, this creates a bias toward an increased association between BV and STIs. This study evaluated associations between BV-associated vaginal microbiota and STIs (Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis, and Neisseria gonorrhoeae) in a population of women with low risk for STIs and investigated STI outcomes depending on the dominating Lactobacillus species. Repository cervicovaginal samples collected from reproductive-age women from January 2014 to February 2019 were characterized for vaginal microbiota types and the STIs using multiplex real-time PCR assays. In total, 95 STI-positive and 91 STI-negative samples were included. A significant, age-independent association between BV-associated vaginal microbiota and the presence of C. trachomatis, M. genitalium, and T. vaginalis infections was identified (age-adjusted odds ratios 2.92 [95% confidence interval (CI) 1.24-7.03], 2.88 [95% CI 1.19-7.16], and 9.75 × 107 [95% CI 13.03-∞], respectively). Normal vaginal microbiota dominated by Lactobacillus crispatus, L. gasseri, or L. jensenii was a strong protective factor against C. trachomatis and/or M. genitalium infections, whereas L. iners-dominated microbiota was not significantly associated with C. trachomatis and/or M. genitalium positivity. The results of the present study confirm that STI prevention strategies should include interventions that also reduce the incidence of BV and promote a protective vaginal microbiota in both high- and low-risk women.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Bacterial vaginosis, Chlamydia trachomatis, Low-risk women, Mycoplasma genitalium, Sexually transmitted infections, Trichomonas vaginalis
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-79931 (URN)10.1007/s10096-020-03831-w (DOI)000516056200001 ()32036466 (PubMedID)
Note

Funding Agencies:

Örebro University  

Ministry of Science and Higher Education of the Russian Federation  AAAA-A19-119-021290030-0

Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2020-03-10Bibliographically approved
Lan, P. T., Golparian, D., Ringlander, J., Van Hung, L., Van Thuong, N. & Unemo, M. (2020). Genomic analysis and antimicrobial resistance of Neisseria gonorrhoeae isolates from Vietnam in 2011 and 2015-16. Journal of Antimicrobial Chemotherapy, Article ID dkaa040.
Open this publication in new window or tab >>Genomic analysis and antimicrobial resistance of Neisseria gonorrhoeae isolates from Vietnam in 2011 and 2015-16
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2020 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, article id dkaa040Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: Antimicrobial resistance (AMR) in Neisseria gonorrhoeae, compromising gonorrhoea treatment, is a threat to reproductive health globally. South-East and East Asia have been major sources of emergence and subsequent international spread of AMR gonococcal strains during recent decades. We investigated gonococcal isolates from 2011 and 2015-16 in Vietnam using AMR testing, WGS and detection of AMR determinants.

METHODS: Two hundred and twenty-nine gonococcal isolates cultured in 2015-16 (n = 121) and 2011 (n = 108) in Vietnam were examined. AMR testing was performed using Etest and WGS with Illumina MiSeq.

RESULTS: Resistance among the 2015-16 isolates was as follows: ciprofloxacin, 100%; tetracycline, 79%; benzylpenicillin, 50%; cefixime, 15%; ceftriaxone, 1%; spectinomycin, 0%; and 5% were non-WT to azithromycin. Eighteen (15%) isolates were MDR. The MIC range for gentamicin was 2-8 mg/L. Among the 2015-16 isolates, 27% (n = 33) contained a mosaic penA allele, while no isolates had a mosaic penA allele in 2011. Phylogenomic analysis revealed introduction after 2011 of two mosaic penA-containing clones (penA-10.001 and penA-34.001), which were related to cefixime-resistant strains spreading in Japan and Europe, and a minor clade (eight isolates) relatively similar to the XDR strain WHO Q.

CONCLUSIONS: From 2011 to 2015-16, resistance in gonococci from Vietnam increased to all currently and previously used antimicrobials except ceftriaxone, spectinomycin and tetracycline. Two mosaic penA-containing clones were introduced after 2011, explaining the increased cefixime resistance. Significantly increased AMR surveillance, antimicrobial stewardship and use of WGS for molecular epidemiology and AMR prediction for gonococcal isolates in Vietnam and other Asian countries are crucial.

Place, publisher, year, edition, pages
Oxford University Press, 2020
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-80179 (URN)10.1093/jac/dkaa040 (DOI)32068837 (PubMedID)
Available from: 2020-02-25 Created: 2020-02-25 Last updated: 2020-02-25Bibliographically approved
Golparian, D., Harris, S. R., Sánchez-Busó, L., Hoffmann, S., Shafer, W. M., Bentley, S. D., . . . Unemo, M. (2020). Genomic evolution of Neisseria gonorrhoeae since the preantibiotic era (1928-2013): antimicrobial use/misuse selects for resistance and drives evolution. BMC Genomics, 21(1), Article ID 116.
Open this publication in new window or tab >>Genomic evolution of Neisseria gonorrhoeae since the preantibiotic era (1928-2013): antimicrobial use/misuse selects for resistance and drives evolution
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2020 (English)In: BMC Genomics, ISSN 1471-2164, E-ISSN 1471-2164, Vol. 21, no 1, article id 116Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Multidrug-resistant Neisseria gonorrhoeae strains are prevalent, threatening gonorrhoea treatment globally, and understanding of emergence, evolution, and spread of antimicrobial resistance (AMR) in gonococci remains limited. We describe the genomic evolution of gonococci and their AMR, related to the introduction of antimicrobial therapies, examining isolates from 1928 (preantibiotic era) to 2013 in Denmark. This is, to our knowledge, the oldest gonococcal collection globally.

METHODS: Lyophilised isolates were revived and examined using Etest (18 antimicrobials) and whole-genome sequencing (WGS). Quality-assured genome sequences were obtained for 191 viable and 40 non-viable isolates and analysed with multiple phylogenomic approaches.

RESULTS: Gonococcal AMR, including an accumulation of multiple AMR determinants, started to emerge particularly in the 1950s-1970s. By the twenty-first century, resistance to most antimicrobials was common. Despite that some AMR determinants affect many physiological functions and fitness, AMR determinants were mainly selected by the use/misuse of gonorrhoea therapeutic antimicrobials. Most AMR developed in strains belonging to one multidrug-resistant (MDR) clade with close to three times higher genomic mutation rate. Modern N. gonorrhoeae was inferred to have emerged in the late-1500s and its genome became increasingly conserved over time.

CONCLUSIONS: WGS of gonococci from 1928 to 2013 showed that no AMR determinants, except penB, were in detectable frequency before the introduction of gonorrhoea therapeutic antimicrobials. The modern gonococcus is substantially younger than previously hypothesized and has been evolving into a more clonal species, driven by the use/misuse of antimicrobials. The MDR gonococcal clade should be further investigated for early detection of strains with predispositions to develop and maintain MDR and for initiation of public health interventions.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Antimicrobial resistance, Evolution, Genomic epidemiology, Neisseria gonorrhoeae, Temporal analysis, Whole-genome sequencing
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-79946 (URN)10.1186/s12864-020-6511-6 (DOI)32013864 (PubMedID)2-s2.0-85078901790 (Scopus ID)
Available from: 2020-02-19 Created: 2020-02-19 Last updated: 2020-02-19Bibliographically approved
Rob, F., Klubalová, B., Nyčová, E., Hercogová, J. & Unemo, M. (2020). Gentamicin 240 mg plus azithromycin 2 g vs. ceftriaxone 500 mg plus azithromycin 2 g for treatment of rectal and pharyngeal gonorrhoea: a randomized controlled trial. Clinical Microbiology and Infection, 26(2), 207-212
Open this publication in new window or tab >>Gentamicin 240 mg plus azithromycin 2 g vs. ceftriaxone 500 mg plus azithromycin 2 g for treatment of rectal and pharyngeal gonorrhoea: a randomized controlled trial
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2020 (English)In: Clinical Microbiology and Infection, ISSN 1198-743X, E-ISSN 1469-0691, Vol. 26, no 2, p. 207-212Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to evaluate the efficacy and tolerability of gentamicin 240 mg plus azithromycin 2 g for treatment of uncomplicated rectal and pharyngeal gonorrhoea compared to ceftriaxone 500 mg plus azithromycin 2 g, the recommended European first-line gonorrhoea treatment.

Methods: A non-inferiority, open-label, single-centre randomized controlled trial was conducted in Prague, Czech Republic. Patients, 18-75 years of age, diagnosed with uncomplicated rectal or pharyngeal gonorrhoea by nucleic acid amplification test (NAAT) were randomized to treatment with gentamicin 240 mg intramuscularly plus azithromycin 2 g orally or ceftriaxone 500 g intramuscularly plus azithromycin 2 g orally. The primary outcome was negative culture and negative NAAT, i.e. 1 week and 3 weeks, respectively, after treatment.

Results: Both clinical cure and microbiological clearance was achieved by 100% (95% CI 0.95-1.00) of patients in the gentamicin/azithromycin arm (n = 72; 40 rectal, 17 pharyngeal and 15 rectal+pharyngeal infections both localizations) and 100% (95% CI 0.95-1.00) in ceftriaxone/azithromycin arm (n = 71; 38 rectal, 14 pharyngeal and 19 rectal+pharyngeal infections). The absolute difference between the two arms was 0.0% (CI95% -5.1 to 5.1), thus less than the pre-specified margin of 7%. Administration of gentamicin was not more painful than ceftriaxone according to the visual analogue scale (1.8 vs. 3.4; p <0.001). Gastrointestinal adverse events were similar in the ceftriaxone arm (33/71, 46.5%) and the gentamicin arm (29/72, 40.3%), and overall in most (52/62, 83.9%) cases they were mild.

Conclusions: Gentamicin 240 mg plus azithromycin 2 g is an effective alternative for treatment of extragenital gonorrhoea. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Azithromycin, Ceftriaxone, Gentamicin, Neisseria gonorrhoeae, Treatment
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-75822 (URN)10.1016/j.cmi.2019.08.004 (DOI)000508234200014 ()31419483 (PubMedID)2-s2.0-85072020199 (Scopus ID)
Note

Funding Agency:

Grant Agency of Czech Ministry of Health  17-31777A

Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2020-03-17Bibliographically approved
Hernando Rovirola, C., Spiteri, G., Sabidó, M., Montoliu, A., Gonzalez, V., Casabona, J., . . . Unemo, M. (2020). isolates from foreign-born population in the European Gonococcal Antimicrobial Surveillance Programme. Sexually Transmitted Infections, Article ID sextrans-2018-053912.
Open this publication in new window or tab >>isolates from foreign-born population in the European Gonococcal Antimicrobial Surveillance Programme
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2020 (English)In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, article id sextrans-2018-053912Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: infections worldwide. We compared the prevalence of AMR gonococcal isolates among native persons to foreign-born (reporting country different from country of birth) persons, and describe the epidemiological and clinical characteristics of foreign-born patients and their associations to AMR.

METHODS: We analysed isolates and patient data reported to the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) 2010-2014 (n=9529).

RESULTS: Forty-three per cent of isolates had known country of birth and 17.2% of these were from persons born abroad. Almost 50% of foreign-born were from the WHO European Region (13.1% from non-European Union [EU] and the European Economic Area [EEA] countries). Compared with isolates from natives, isolates from foreign-born had a similar level (p>0.05) of azithromycin resistance (7.5% vs 7.2%), ciprofloxacin resistance (50.0% vs 46.3%) and of decreased susceptibility to ceftriaxone (1.9% vs 2.8%); a lower rate of cefixime resistance (5.7% vs 3.6%, p=0.02), and a higher proportion of isolates producing penicillinase (8.4% vs 11.7%, p=0.02). Among isolates from persons born outside EU/EEA, the level of decreased susceptibility to ceftriaxone was higher (1.8% vs 3.5%, p=0.02), particularly in those from the WHO Eastern Mediterranean Region and non-EU/EEA WHO European countries (1.9% vs 9.6% and 8.7%, respectively, p<0.01). In multivariable analysis, foreign-born patients with AMR isolates were more likely to be from non-EU/EEA WHO European countries (adjusted OR [aOR]: 3.2, 95% CI 1.8 to 5.8), WHO Eastern Mediterranean countries (aOR: 1.8, 95% CI 1.1 to 3.3) and heterosexual males (aOR: 1.8, 95% CI 1.2 to 2.7).

CONCLUSIONS: Importation of AMR strains remains an important threat in the EU/EEA. Research to improve understanding of sexual networks within foreign born and sexual tourism populations could help to inform effective tailor-made interventions. The Euro-GASP demonstrates the public health value of quality-assured surveillance of gonococcal AMR and the need for strengthened AMR surveillance, particularly in the non-EU/EEA WHO European Region.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020
Keywords
Euro-GASP, Europe, antimicrobial resistance, ceftriaxone, gonorrhoea, migrants, surveillance, treatment
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-79942 (URN)10.1136/sextrans-2018-053912 (DOI)32019895 (PubMedID)
Available from: 2020-03-09 Created: 2020-03-09 Last updated: 2020-03-09Bibliographically approved
Kenyon, C., Buyze, J., Spiteri, G., Cole, M. J. & Unemo, M. (2020). Population-level antimicrobial consumption is associated with decreased antimicrobial susceptibility in Neisseria gonorrhoeae in 24 European countries: an ecological analysis. Journal of Infectious Diseases, 221(7), 1107-1116
Open this publication in new window or tab >>Population-level antimicrobial consumption is associated with decreased antimicrobial susceptibility in Neisseria gonorrhoeae in 24 European countries: an ecological analysis
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2020 (English)In: Journal of Infectious Diseases, ISSN 0022-1899, E-ISSN 1537-6613, Vol. 221, no 7, p. 1107-1116Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: There are substantial variations in Neisseria gonorrhoeae susceptibility to antimicrobials between different populations, and the reasons for this are largely unexplored. We aimed to assess if the population level consumption of antimicrobials is a contributory factor.

METHODS: Using antimicrobial susceptibility data from 24 countries in the European Gonococcal Antimicrobial Surveillance Programme and antimicrobial consumption data from the IQVIA MIDAS database, we built mixed effects linear/logistic regression models with country-level cephalosporin, fluoroquinolone and macrolide consumption (standard doses/1000 population/year) as the explanatory variables (from 2009 to 2015) and 1-year lagged ceftriaxone, cefixime, azithromycin and ciprofloxacin geometric mean minimum inhibitory concentrations (MIC) as the outcome variables (2010 to 2016).

RESULTS: Positive correlations were found between the consumption of cephalosporins and geometric mean MIC of ceftriaxone and cefixime (both P's <0.05). Fluoroquinolone consumption was positively associated with the prevalence of resistance to ciprofloxacin (P<0.05).

CONCLUSIONS: Differences in population level consumption of particular antimicrobials may contribute to the variations in the level of antimicrobial resistance in N. gonorrhoeae in different settings. Further interventions to reduce misuse and overuse of antimicrobials in high-consumption populations and core-groups are required.

Place, publisher, year, edition, pages
Oxford University Press, 2020
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-73660 (URN)10.1093/infdis/jiz153 (DOI)30957153 (PubMedID)
Available from: 2019-04-11 Created: 2019-04-11 Last updated: 2020-03-23Bibliographically approved
Silveira, M. F., Bruni, M. P., Stauffert, D., Golparian, D. & Unemo, M. (2020). Prevalence and risk factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium among women in Pelotas, Southern Brazil. International Journal of STD and AIDS (London)
Open this publication in new window or tab >>Prevalence and risk factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium among women in Pelotas, Southern Brazil
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2020 (English)In: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052Article in journal (Refereed) Epub ahead of print
Abstract [en]

The frequently asymptomatic sexually transmitted infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) are poorly diagnosed in Brazil and can lead to severe complications/sequelae without timely detection and treatment. We investigated prevalence of CT, NG, and MG infections and associated demographic, behavioral, and clinical factors in consecutive women attending a gynecology and obstetrics outpatient clinic in Pelotas, Southern Brazil. Vaginal swab samples were prospectively obtained from asymptomatic and symptomatic women (n = 498) from August 2015 to December 2016 and tested with Aptima Combo2 and Aptima M. genitalium assays (Hologic). The prevalence of CT, NG, and MG was 6.8% (34/498), 1.0% (5/498), and 4.2% (21/498), respectively. Three (0.6%) cases of CT and NG co-infection and one (0.2%) case of CT and MG co-infection were identified. The risk factors associated with these bacterial STIs were youth (<30 years), no steady sexual partner, infection with additional STI, and lack of income. Bacterial STIs, particularly CT and MG, were prevalent among women, including pregnant women (60% of positive cases), in Pelotas, Brazil. Sensitive and specific diagnostic testing and early treatment are essential to control STIs, limit transmission chains, avoid future complications/sequelae, and reduce health and cost burdens on the population.

Place, publisher, year, edition, pages
Royal Society of Medicine Press, 2020
Keywords
Brazil, Sexually transmitted infections, diagnosis, screening, women
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:oru:diva-80805 (URN)10.1177/0956462419898982 (DOI)32192370 (PubMedID)
Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2020-03-23Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-1710-2081

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