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  • 1.
    Chen, Shao-Chun
    et al.
    China CDC, National Center STD Control, Nanjing, Peoples R China; Chinese Academy of Medical Science, Inst Dermatol, Nanjing, Peoples R China; Peking Union Med Coll, Nanjing, Peoples R China; Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Yin, Yue-Ping
    China CDC, Natl Ctr STD Control, Nanjing, Peoples R China; Chinese Acad Med Sci, Inst Dermatol, Nanjing, Peoples R China;Peking Union Med Coll, Nanjing, Peoples R China; Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Dai, Xiu-Qin
    China CDC, Natl Ctr STD Control, Nanjing, Peoples R China;Chinese Acad Med Sci, Inst Dermatol, Nanjing, Peoples R China;Peking Union Med Coll, Nanjing, Peoples R China;Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Yu, Rui-Xing
    China CDC, Natl Ctr STD Control, Nanjing, Peoples R China;Chinese Acad Med Sci, Inst Dermatol, Nanjing, Peoples R China;Peking Union Med Coll, Nanjing, Peoples R China;Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Han, Yan
    China CDC, Natl Ctr STD Control, Nanjing, Peoples R China;Chinese Acad Med Sci, Inst Dermatol, Nanjing, Peoples R China;Peking Union Med Coll, Nanjing, Peoples R China;Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Sun, Hou-Hua
    China CDC, Natl Ctr STD Control, Nanjing, Peoples R China;Chinese Acad Med Sci, Inst Dermatol, Nanjing, Peoples R China;Peking Union Med Coll, Nanjing, Peoples R China;Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Ohnishi, Makoto
    National Institute Infection Diseases (国立感染症研究所), Tokyo, Japan..
    Unemo, Magnus
    Örebro University Hospital. Dept Lab Med, WHO Collaborating Ctr Gonorrhoea & Other STIs, Örebro University Hospital, Örebro, Sweden.
    Chen, Xiang-Sheng
    China CDC, Natl Ctr STD Control, Nanjing, Peoples R China;Chinese Acad Med Sci, Inst Dermatol, Nanjing, Peoples R China;Peking Union Med Coll, Nanjing, Peoples R China;Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing, Peoples R China.
    Prevalence and Molecular Epidemiological Typing of Penicillinase-Producing Neisseria gonorrhoeae and Their bla(TEM-135) Gene Variants in Nanjing, China2013In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 40, no 11, p. 872-876Article in journal (Refereed)
    Abstract [en]

    Background: This study aimed to investigate the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) and their bla(TEM-135) gene variant in 2007 and 2012 in Nanjing, China. In addition, molecular epidemiological typing of all isolates was performed to elucidate the genetic relationships of the PPNG strains. Methods: A total of 199 and 77 N. gonorrhoeae isolates were collected at the National Center for STD Control in 2007 and 2012, respectively. Nitrocefin tests were performed to identify PPNG. Mismatch amplification mutation assay was used to identify bla(TEM-135). All isolates were genotyped using N. gonorrhoeae multiantigen sequence typing (NG-MAST), and additionally, porB-based phylogenetic analysis was performed for the PPNG isolates. Results: The total prevalence of PPNG isolates was 41% (114/276) and 58% (66/114) of these PPNG isolates possessed bla(TEM-135). In 2007, 45% (90/199) produced beta-lactamase, and of those PPNG, 58% (52/90) possessed bla(TEM-135). In 2012, 31% (24/77) were PPNG, and 58% (14/24) of those isolates contained bla(TEM-135). There were 162 NG-MAST STs among the 276 isolates, and 89 of those were novel STs. A strong association between specific NG-MAST STs and bla(TEM-135) was found, and the porB-based phylogenetic analysis showed a distant evolutionary relationship between isolates in 2007 and isolates in 2012. Conclusions: A high prevalence of PPNG and bla(TEM-135) was found in Nanjing, China. bla(TEM-135) might be a precursor in the evolution into an extended-spectrum beta-lactamase that can degrade ceftriaxone, which stresses the need to continuously monitor PPNG, bla(TEM-135), and additional evolving bla(TEM) gene variants.

  • 2. Falk, Lars
    et al.
    Lindberg, Margret
    Jurstrand, Margaretha
    Örebro University, Department of Clinical Medicine.
    Bäckman, Anders
    Örebro University, School of Medical Sciences.
    Olcén, Per
    Fredlund, Hans
    Örebro University, School of Health Sciences.
    Genotyping of Chlamydia trachomatis would improve contact tracing2003In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 30, no 3, p. 205-210Article in journal (Refereed)
    Abstract [en]

    Background: The reported number of genital Chlamydia trachomatis infections has increased 15% annually since 1997 in Sweden. Inaccurate partner notification might be one reason.

    Goal: The goals were to determine if genotyping of C trachomatis would improve partner notification and to study the duration of infection.

    Study Design: Sexual networks were constructed. C trachomatis isolates from 231 individuals attending the Örebro STD clinic during 1 year were typed by sequencing of the omp1 gene.

    Results: All individuals were traced and diagnoses were established in 30 of 161 networks. More than one genotype was seen in seven networks. The mean duration of C trachomatis infection in each network was calculated to be 23 weeks.

    Conclusion: Genotyping could be a useful tool in partner notification when there are discrepant or uncommon genotypes. Limited clinic catchment areas create information difficulties that obstruct accurate contact tracing.

  • 3.
    Golparian, Daniel
    et al.
    Natl Reference Lab Pathogen Neisseria, WHO Collaborating Ctr Gonorrhoea & Other STIs, Örebro University Hospital, Örebro, Sweden.
    Tabrizi, Sepehr N.
    Dept Microbiol & Infect Dis, Royal Womens Hosp, Parkville Vic, Australia.
    Unemo, Magnus
    Örebro University Hospital. Natl Reference Lab Pathogen Neisseria, WHO Collaborating Ctr Gonorrhoea & Other STIs, Örebro University Hospital, Örebro, Sweden; Dept Lab Med, WHO Collaborating Ctr Gonorrhoea & Other STIs, Örebro University Hosp, Örebro, Sweden.
    Analytical Specificity and Sensitivity of the APTIMA Combo 2 and APTIMA GC Assays for Detection of Commensal Neisseria Species and Neisseria gonorrhoeae on the Gen-Probe Panther Instrument2013In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 40, no 2, p. 175-178Article in journal (Refereed)
    Abstract [en]

    Genetic detection of Neisseria gonorrhoeae is replacing culture for increased diagnostic sensitivity. Specificity of several nucleic acid amplification tests is suboptimal. Herein, the Gen-Probe APTIMA Combo 2 and APTIMA GC assays had 100% specificity and 100% sensitivity after confirmatory testing, when testing 298 isolates of non-gonococcal Neisseria and related species and 205 gonococcal isolates.

  • 4.
    Herrmann, Björn
    et al.
    Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Eden, Desiree
    Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Hadad, Ronza
    WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden.
    Christerson, Linus
    Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Loré, Britta
    Department of Clinical Microbiology, Falu Lasarett, Falun, Sweden.
    Österlund, Anders
    Communicable Disease Prevention and Control, Sunderby Hospital, Luleå, Sweden.
    Larsson, Inger
    Department of Clinical Microbiology, Sunderby Hospital, Luleå, Sweden.
    Sylvan, Staffan
    Department of Communicable Diseases Control and Prevention, Uppsala County Council, Uppsala, Sweden.
    Fredlund, Hans
    Örebro University Hospital. WHO Collaborating Centre for Gonorrhoea and Other STIs , Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    Örebro University Hospital. WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden.
    Prevalence Trends of the New Variant of Chlamydia trachomatis in Four Counties of Sweden in 2007-20112012In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 39, no 8, p. 648-650Article in journal (Refereed)
    Abstract [en]

    A new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden in 2006, and it could not be detected by diagnostic systems from Abbott and Roche, whereas the third system used, from Becton Dickinson (BD), detects nvCT. We analyzed 3648 samples from 2 counties that used Roche and 2 counties that used BD methods from 2007 to 2011. After implementation of a Roche method that detects nvCT, its proportion has decreased and converged in the 4 counties but are still at different levels in Roche and BD counties. Future studies are needed to see if nvCT will decline further.

  • 5. Hjelmevoll, Stig Ove
    et al.
    Olsen, Merethe Elise
    Sollid, Johanna U. Ericson
    Haaheim, Håkon
    Melby, Kjetil K.
    Moi, Harald
    Unemo, Magnus
    Örebro University, School of Health and Medical Sciences.
    Skogen, Vegard
    Clinical validation of a real-time polymerase chain reaction detection of Neisseria gonorrheae porA pseudogene versus culture techniques2008In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 35, no 5, p. 517-520Article in journal (Refereed)
    Abstract [en]

    Background: Diagnosing Neisseria gonorrheae using nucleic acid amplification tests (NAATs) might increase the sensitivity, compared to cultivation. However, using NAATs has also been problematic mainly due to the close genetic relationships between different Neisseria species, resulting in false positive diagnoses. This study was conducted to clinically validate a previously published real-time polymerase chain reaction (PCR) method targeting the porA pseudogene in N. gonorrheae in comparison to culture techniques.

    Methods: In total, 360 samples, urethra (n = 109), rectum (n = 84), pharynx (n = 119), and cervix (n = 48) from 185 males and 57 females, were analyzed using porA pseudogene PCR and cultivation. Sequencing of the entire porA pseudogene and the 16S rRNA gene were used to resolve discrepant results.

    Results: Of the 360 samples, 37 were positive by both culture and PCR, however, the PCR identified 15 additional confirmed positive samples. The PCR method showed a sensitivity, specificity, positive predictive value, and negative predictive value of 100% in a preselected population. The preselected population had a true gonorrhea prevalence of 17.4%.

    Conclusions: The present porA pseudogene real-time PCR comprises a valuable supplement to the traditional culture techniques for diagnosis of N. gonorrheae, especially for samples from extragenital sites such as pharynx and rectum.

  • 6.
    Mulligan, Vanessa
    et al.
    Department of Microbiology, St James's Hospital, Ireland; Dublin Institute of Technology, Dublin, Ireland.
    Lynagh, Yvonne
    Department of Microbiology, St James's Hospital, Ireland.
    Clarke, Susan
    Gay Men's Health Service, Baggot Street Hospital, Dublin, Ireland.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital. WHO Collaborating Centre for Gonorrhoeae and Other STIs, Department of Laboratory Medicine.
    Crowley, Brendan
    Department of Virology, St James's Hospital, Dublin, Ireland.
    Prevalence, Macrolide Resistance, and Fluoroquinolone Resistance in Mycoplasma genitalium in Men Who Have Sex With Men Attending an Sexually Transmitted Disease Clinic in Dublin, Ireland in 2017-20182019In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 46, no 4, p. E35-E37Article in journal (Refereed)
    Abstract [en]

    This is the first prevalence study of Mycoplasma genitalium and antimicrobial resistance study in Ireland. In urine samples from men who have sex with men (n = 400) attending a sexually transmitted disease clinic in Dublin, the prevalence of M. genitalium was 3%(12 of 400 specimens; 95% confidence interval, 1.3-4.7%), and the prevalences of macrolide resistance (75%), fluoroquinolone resistance (33.3%), and multidrug resistance (33.3%) were very high.

  • 7.
    Tayimetha, Carolle Y.
    et al.
    Catholic University of Central Africa, Yaoundé, Cameroon; Medical Bacteriology Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital. WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine.
    Antimicrobial susceptibility of Neisseria gonorrhoeae isolates in Yaoundé, Cameroon from 2009 to 20142018In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 45, no 12, p. e101-e103Article in journal (Refereed)
    Abstract [en]

    We investigated the antimicrobial resistance in gonococci 2009-2014 in Yaoundé, Cameroon, and recommend revisions of the Cameroonian treatment guideline. We observed a high resistance to ciprofloxacin (17.6%) but no ceftriaxone resistance. Ceftriaxone should replace ciprofloxacin as the recommended first-line treatment for urethral/vaginal discharge. Enhanced resistance surveillance in Africa is essential.

  • 8.
    Unemo, Magnus
    et al.
    Örebro University Hospital. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Dillon, Jo-Anne R.
    Department of Microbiology and Immunology, College of Medicine, University of Saskatchewan, Saskatoon SK, Canada.
    Mitigating the Emergence and Spread of Multidrug- and Extensively Drug-Resistant Gonorrhea: Is There Sufficient Support in Resource-Poor Settings in Africa?2014In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 41, no 4, p. 238-239Article in journal (Refereed)
  • 9.
    Yéo, Alain
    et al.
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Kouamé-Blavo, Belinda
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire.
    Kouamé, Clarisse E.
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Ouattara, Abdoulaye
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Yao, Ahou C.
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Gbedé, Brigitte D.
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Bazan, Francis
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Faye-Ketté, Hortense
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire; Unité des Agents du Tractus Génital, Centre National de Référence des IST, Abidjan, République Côte d'Ivoire.
    Dosso, Mireille
    Département de Bactériologie-Virologie, Institut Pasteur de Côte, République de Côte d'Ivoire.
    Wi, Teodora
    Department of Reproductive Health, World Health Organization, Geneva, Switzerland.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital. World Health Organization Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine.
    Establishment of a Gonococcal Antimicrobial Surveillance Programme, in Accordance With World Health Organization Standards, in Côte d'Ivoire, Western Africa, 2014-20172019In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 46, no 3, p. 179-184Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is compromising the treatment of gonorrhea globally. Recent AMR data are extremely limited in Africa, and mainly totally lacking in Western Africa, including Côte d'Ivoire. This study (i) established a quality-assured gonococcal antimicrobial surveillance program, according to World Health Organization quality criteria, (ii) investigated the AMR to 8 therapeutic antimicrobials in gonococcal isolates from 2014 to 2017, and (iii) provided evidence for updating the National Sexually Transmitted Disease Syndromic Management Guidelines in Côte d'Ivoire.

    METHODS: During 2014 to 2017, gonococcal isolates were obtained from sexually active symptomatic or asymptomatic males and females in 14 sites in Côte d'Ivoire. It was a special focus on symptomatic males, and their sexual partners, due to the higher culture positivity rates in symptomatic males. Patient metadata were collected, including age, gender, sexual orientation, and symptoms. Minimum inhibitory concentrations of 8 antimicrobials were determined by Etest and interpreted using European Committee on Antimicrobial Susceptibility Testing breakpoints. β-lactamase production was detected using cefinase disks.

    RESULTS: The level of resistance, examining 212 gonococcal isolates, was as follows: 84.9% to tetracycline, 68.9% to benzylpenicillin, 62.7% to ciprofloxacin, 6.1% to azithromycin, and 1.4% to gentamicin. All isolates were susceptible to ceftriaxone, cefixime and spectinomycin.

    CONCLUSIONS: We provide the first gonococcal AMR data, quality assured according to World Health Organization standards, from Côte d'Ivoire since more than 20 years. The high ciprofloxacin resistance, which informed a revision of the national syndromic management guideline during study, and relatively high resistance to azithromycin demand an improved gonococcal antimicrobial surveillance program and increased awareness when prescribing treatment in Côte d'Ivoire.

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