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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.
    Manjate, Alice
    et al.
    Örebro University, School of Medical Sciences.
    Andersson, Sören
    Public Health Agency of Sweden, Stockholm, Sweden; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
    Golparian, Daniel
    Örebro University, School of Medical Sciences. Department of Laboratory Medicine, Microbiology.
    Kenga, Darlene
    Universidade Eduardo Mondlane- Faculdade de Medicina, Maputo, Mozambique.
    Langa, Jose
    Universidade Eduardo Mondlane- Faculdade de Medicina, Maputo, Mozambique.
    Passanduca, Alfeu
    Universidade Eduardo Mondlane- Faculdade de Medicina, Maputo, Mozambique.
    Relvas, Ventura
    Universidade Eduardo Mondlane- Faculdade de Medicina, Maputo, Mozambique.
    Sacarlal, Jahit
    Universidade Eduardo Mondlane- Faculdade de Medicina, Maputo, Mozambique.
    Simbine, Samuel
    Universidade Eduardo Mondlane- Faculdade de Medicina, Maputo, Mozambique.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Assessment of the performance of a multiplex real-time PCR, AmpliSens Florocenosis/Bacterial Vaginosis-FRT, versus Nugent's criteria in the diagnosis of BV in women in Mozambique2024In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 51, no 1S, p. S433-S434, article id P469Article in journal (Other academic)
    Abstract [en]

    Background: Bacterial vaginosis (BV) is a common vaginal disorder among women of reproductive age, and BV can be associated with adverse pregnancy outcomes and enhanced acquisition and transmission of STIs/HIV. The present study aimed to determine the prevalence of BV using the Nugent score and sociodemographic factors associated with BV among women in Maputo, Mozambique, and to evaluate the performance of the AmpliSens® Florocenosis/Bacterial vaginosis-FRT PCR kit versus Nugent score for diagnosis of BV.

    Material and Methods: Vaginal swabs were collected from 886 non-pregnant symptomatic women during their visit to the Mavalane Health area in Maputo, Mozambique from February 2018 to January 2019. BV was diagnosed by Nugent score. The AmpliSens®Florocenosis/Bacterial vaginosis-FRT PCR kit (InterLabService, Moscow, Russia) was evaluated for BV diagnosis. HIV was detected using Determine HIV1/2 (Alere Medical Co. Ltd, Chiba, Japan) plus Uni-Gold HIV1/2 (Trinity Biotech, Ireland). The chisquare test was used to estimate associations between categorical variables.

    Results: The prevalence of BV by PCR, Nugent score, and HIV was 47.2%, 39.1%, and 22.5%, respectively. Of those with BV, 52% were HIV-positive and 48% HIV-negative (p < 0.001). The highest proportion of women was under 24 years old (38.1%), single (49.5%), with secondary education (53.5%), and living in rural areas (55.4%). BV was associated with young age at first sexual intercourse (44.5%) (χ2 = 17.47, p=< 0.001), condom use (43.3%) (χ2 =3.7, p= 0.05), and no use of contraceptives (49%) (χ2= 13.6, p=0.02). In real-time PCR, a higher proportion of BV cases (47.2%) were detected. However, 12.5% of women had an unknown vaginal dysbiosis. The sensitivity and specificity of the PCR were 99.6% and 82.2%, respectively. Using the PCR as a reference test, the sensitivity and specificity of the Nugent score were 86.2% and 99.4%, respectively. The concordance of both tests was κ=0.825 (95% CI, 0.78 - 0.86), p<0.001.

    Conclusions: A high prevalence of BV was associated with young age at first sexual intercourse, condom and contraceptive use among women in Maputo, Mozambique. The AmpliSens® Florocenosis/Bacterial vaginosis-FRT PCR assay detected more BV-positive cases than the Nugent score and needs further evaluation in other settings.

  • 7.
    Matoga, Mitch
    et al.
    UNC Project Malawi, Lilongwe, Malawi.
    Chen, Jane S.
    Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA.
    Krysiak, Robert
    UNC Project Malawi, Lilongwe, Malawi; Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA.
    Ndalama, Beatrice
    UNC Project Malawi, Lilongwe, Malawi.
    Massa, Cecilia
    UNC Project Malawi, Lilongwe, Malawi.
    Bonongwe, Naomi
    UNC Project Malawi, Lilongwe, Malawi.
    Mathiya, Esther
    UNC Project Malawi, Lilongwe, Malawi.
    Kamtambe, Blessing
    Bwaila District Hospital, Lilongwe District Health Office, Lilongwe, Malawi.
    Jere, Edward
    UNC Project Malawi, Lilongwe, Malawi.
    Chikaonda, Tarsizio
    UNC Project Malawi, Lilongwe, Malawi.
    Golparian, Daniel
    Örebro University, School of Medical Sciences. WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital. WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden.
    Cohen, Myron S.
    Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Hobbs, Marcia M.
    Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Hoffman, Irving F.
    Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Gentamicin susceptibility in Neisseria gonorrhoeae and treatment outcomes for urogenital gonorrhea after twenty-five years of sustained gentamicin use in Malawi2022In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 49, no 4, p. 251-256Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gentamicin has been used for the treatment of gonorrhea in Malawi since 1993. However, declining clinical cure rates have been suspected. We evaluated current Neisseria gonorrhoeae susceptibility to gentamicin in vitro and clinically.

    METHODS: Men with acute urethritis were recruited at the Bwaila District Hospital STI Clinic in Lilongwe, Malawi, between January 2017 and August 2019. All men provided urethral swabs for etiological testing at enrollment and test of cure (TOC), one week later, using Gram-stained microscopy and culture. We used Etest to determine minimum inhibitory concentrations (MICs) of gentamicin, azithromycin, cefixime, ceftriaxone, ciprofloxacin, and spectinomycin, disc diffusion for tetracycline susceptibility and whole genome sequencing (WGS) to verify/refute treatment failure.

    RESULTS: Among 183 N. gonorrhoeae culture-positive men enrolled, 151 (82.5%) had a swab taken for TOC. Of these 151 men, 16 (10.6%) had a positive culture at TOC. 141 baseline isolates were tested for gentamicin susceptibility using Etest; 2 (1.4%) MIC = 2 μg/mL; 111 (78.7%) MIC = 4 μg/mL; and 28 (19.9%) MIC = 8 μg/mL. All isolates were susceptible to azithromycin, cefixime, ceftriaxone, and spectinomycin while 63.1% had intermediate susceptibility or resistance to ciprofloxacin. Almost all (96.1%) isolates were resistant to tetracycline. All examined isolates cultured at TOC (n = 13) had gentamicin MICs ≤8 μg/mL. Ten men had pre- and post-treatment isolates examined by WGS, 2 (20%) were verified new infections (4119 and 1272 single-nucleotide polymorphisms (SNPs)), while 8 (80%) were confirmed treatment failures (0-1 SNP).

    CONCLUSIONS: Gentamicin MICs poorly predict gonorrhea treatment outcome with gentamicin, and treatment failures are verified with gonococcal strains with in vitro susceptibility to gentamicin. The first-line treatment for gonorrhea in Malawi should be reassessed.

  • 8.
    Matthyssen, Tamara
    et al.
    University of Melbourne, Melbourne Vic, Australia.
    Celentano, Antonio
    University of Melbourne, Melbourne Vic, Australia.
    Hocking, Jane
    University of Melbourne, Melbourne Vic, Australia.
    Kong, Fabian Yuh Shiong
    University of Melbourne, Melbourne Vic, Australia.
    McCullough, Michael
    University of Melbourne, Melbourne Vic, Australia.
    Paolini, Rita
    University of Melbourne, Melbourne Vic, Australia.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Williamson, Deborah
    University of Melbourne, Melbourne Vic, Australia.
    Development of a novel human oral tissue model of gonorrhoea2024In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 51, no 1S, p. S123-S124, article id P73Article in journal (Other academic)
    Abstract [en]

    Background: Oropharyngeal Neisseria gonorrhoeae (NG) infections are common, increasing, and have a higher treatment failure compared with other infection sites. Due to antimicrobial resistance, NG has become a global public health threat as available treatments remain scarce. Little is known about where NG colonizes in the oral mucosa and therefore, where antibiotics need to be distributed to cure infection. A recent review also highlighted the lack of oral cell models available for investigating NG infection. We recently started creating an in-vitroco-culture model for NG strains with human oral epithelial cells to understand patterns of NG growth in the mouth and examine antibiotic uptake by oral cell types supporting NG growth.

    Methods: NG strains were grown on Chocolate agar with IsoVitaleX and in modified Fastidious broth media in optimised conditions. NG colonies were assessed using a colony counter (Scan1200, Interscience technology). In a 2D model, NG were co-cultured with 4 human oral keratinocyte cell lines isolated from different anatomical subsites of theoral cavity. Intra- and extra-cellular NG was quantified, and intracellular spatial distribution was assessed with confocal microscopy and immunocytochemistry. Invasion into 3D spheroids was characterised with penetration depth assessed via histological analysis (haematoxylin and eosin staining) and immunocytochemistry with images taken on a Zeiss Axioscan7 slide scanner or LSM80 0confocal microscope. Real time invasion into spheroids was imaged using a MuviCyte live-cell imaging system. Lastly, host cell viability in response to NG infection was also assessed.

    Results: We created the first-of-its-kind in-vitro model for NG oral infection demonstrating that it is possible to co-culture NG with oral derived cells. NG survives and infects oral cells in an in vitro setting in both 2D and 3D models. Different strains of NG infected oral cells to significantly different degrees.

    Conclusion: Our presented model can be used to explore the interactions of NG with oral tissues and to investigate current and new therapeutics against oropharyngeal gonorrhoea. 

  • 9.
    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.

  • 10.
    Oeser, Clarissa
    et al.
    University College London, London, England.
    Beddows, Simon
    UKHSA, London, England.
    Chang, Gwendolyn
    University College London, London, England.
    Clifton, Soazig
    Natcen, London, England.
    Conolly, Anne
    Natcen, London, England.
    David, Alexandra
    University College London, London, England.
    Dema, Emily
    University College London, London, England.
    Field, Nigel
    University College London, London, England.
    Gibbs, Jo
    University College London, London, England.
    Hamilton, Rebecca
    Natcen, London, England.
    Light, Rebecca
    Natcen, London, England.
    Mercer, Catherine H.
    University College London, London, England.
    Panwar, Kavita
    UKHSA, London, England; Natcen, London, England.
    Roodt, Abraham
    TDL, London, England.
    Sadler, Katherine
    Natcen, London, England.
    Sonnenberg, Pam
    University College London, London, England.
    Unemo, Magnus
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Feasibility and acceptability of home-based self-collection of multiple vaginal swabs in a general population survey in Britain′s fourth National Survey of Sexual Attitudes and Lifestyles-4 (Natsal-4)2024In: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 51, no 1S, p. S318-S319, article id P325Article in journal (Other academic)
    Abstract [en]

    Background: Despite greater sensitivity of vaginal swabs compared to urine for detection of STIs and high acceptability in clinical settings, acceptability and feasibility of home-based self-collected vaginal swabs for research are less certain. We undertook development work to test these attributes for self-collected vaginal swabs for Natsal-4, a probability sample, interviewer-administered, survey of the ritish population aged 16-59 years.

    Methods: We conducted two pilot studies in 2021-22. After completing an interview, all participants identifying as cisgender women were invited to provide three self-collected vaginal swabs, with procedures for providing samples during or afte rface-to-face interviews or after remote interviews. Samples were posted to the laboratory. Consent was provided with the understanding of non-return of results. Participants declining vaginal swabs were invited to provide urine. Interviewers were not clinically trained. Qualitative follow-up interviews were conducted with participants and interviewers provided feedback.

    Results: Of the 153 cisgender women interviewed, 77 (50%) agreed to provide a vaginal swab, and 22 preferred to provide urine, resulting in an overall biosample consent rate of 65%. Of these, 60 swabs and 18 urine samples were received (Figure), resulting in an overall response of 51% (39% for vaginal swabs). Of the 77 who consented to provide swabs, 43 (56%) were during face-to-face interviews, of which 95% were received, compared to 13 (17%) agreeing to collection after face-to-face with 54% received, and 21 (27%) choosing remote interviews with 57% received. Fourteen participants (10 provided swabs) gave follow-up interviews and seven interviewers provided feedback. Participants conveyed their motivation to support research by giving samples. Interviewers were surprised at participants’ willingness to provide swabs. Reasons for not providing a swab included the belief that it was uncomfortable, too intimate or not relevant for their circumstances, or that urine was easier to collect.

    Conclusion: Our findings show that self-collection of vaginal swabs at home facilitated by non-clinically trained interviewers for a population-based probability survey is feasible and acceptable. Mode of interview and timing of sample collection are important as they affect response rate. Vaginal swab collection was incorporated into the main Natsal-4study with similar response to date.

  • 11.
    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.

  • 12.
    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)
  • 13.
    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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