Posts filed under ‘Infecciones de transmision sexual’

Sexually transmitted infections – Controversies and conundrums in screening, treatment and stigma

Current Opinion in Infect. Dis  Feb 2014  V.27  N.1 P.53–55

Rogstad, Karen

Sheffield Teaching Hospitals NHS Foundation Trust and Undergraduate Dean, University of Sheffield Medical School, Sheffield, UK

Correspondence to Karen Rogstad, Consultant in HIV and Sexual Health, Sheffield Teaching Hospitals, NHS Foundation Trust and Undergraduate Dean, University of Sheffield School of Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. Tel: +44 114 271 1900; e-mail: Karen.rogstad@sth.nhs.uk

The five review topics in this issue highlight some of the key controversies in sexually transmitted infections (STIs), and their control.

The authors are from all corners of the world and work in different healthcare systems, but all have an awareness of the internationality of STIs, which do not conform to national boundaries.

A problem in one country can rapidly spread to other continents, requiring a world view of STI treatment and control, and international collaboration and support.

There are some major areas of concern: in men who have sex with men (MSM), there is a resurgent syphilis epidemic, hepatitis C in HIV-positive men has an annual incidence of transmission of 2–4% [1], and there is no decrease in HIV incidence in MSM; gonorrhoea has increased globally by 21% over 3 years [2] and multidrug, extensively drug-resistant and potentially untreatable

FULL TEXT

http://journals.lww.com/co-infectiousdiseases/Fulltext/2014/02000/Sexually_transmitted_infections___controversies.8.aspx

PDF (CLIC on PDF)

 

June 5, 2014 at 8:39 am

Primary and Secondary Syphilis — United States, 2005–2013

MMWR My 9, 2014 V.63 N.18 P.402-406

Monica E. Patton, MD1, John R. Su, MD2, Robert Nelson, MPH2, Hillard Weinstock, MD2

1EIS officer, CDC; 2Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC (Corresponding author: Monica Patton, mepatton@cdc.gov, 404-718-8648) 

In 2013, based on data reported as of April 28, 2014, the rate of reported primary and secondary syphilis in the United States was 5.3 cases per 100,000 population, more than double the lowest-ever rate of 2.1 in 2000.

To characterize the recent epidemiology of syphilis in the United States, CDC analyzed data from the National Notifiable Diseases Surveillance System (NNDSS) for cases of primary and secondary syphilis diagnosed during 2005–2013 with a focus on states that reported the sex of sex partners during 2009–2012 to describe reported syphilis among gay, bisexual, and other men who have sex with men (collectively referred to as MSM).

During 2005–2013, primary and secondary syphilis rates increased among men of all ages and races/ethnicities across all regions of the United States.

Recent years have shown an accelerated increase in the number of cases, with the largest increases occurring among MSM. Among women, rates increased during 2005–2008 and decreased during 2009–2013, with different trends among different racial/ethnic groups.

Racial/ethnic disparities in reported syphilis persisted during 2005–2013, likely reflecting social determinants of health, such as socioeconomic status, that might contribute to the burden of syphilis in a community (1).

These findings underscore the need for continued syphilis prevention measures among MSM….

FULL TEXT

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6318a4.htm?s_cid=mm6318a4_w

PDF (see p.402)

http://www.cdc.gov/mmwr/pdf/wk/mm6318.pdf

June 4, 2014 at 3:11 pm

Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006

Emerging Infectious Diseases April 2014 V.20 N.4

Harrell W. ChessonComments to Author , Robert D. Kirkcaldy, Thomas L. Gift, Kwame Owusu-Edusei, and Hillard S. Weinstock

Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts.

In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level.

We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006.

We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection.

These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance.

PDF

http://wwwnc.cdc.gov/eid/article/20/4/pdfs/13-1288.pdf

March 29, 2014 at 11:11 am

Practice guidelines for the diagnosis and management of skin and soft-tissue infections.

Clin Infect Dis 2005 Nov 15; 41(10) :1373-406.

IDSA GUIDELINES

Stevens DL, Bisno AL, Chambers HF, et al.

Infectious Diseases Section, Veterans Affairs Medical Center, Boise, Idaho 83702, USA. dlsteven@mindspring.com

Soft-tissue infections are common, generally of mild to modest severity, and are easily treated with a variety of agents. An etiologic diagnosis of simple cellulitis is frequently difficult and generally unnecessary for patients with mild signs and symptoms of illness. Clinical assessment of the severity of infection is crucial, and several classification schemes and algorithms have been proposed to guide the clinician [1]. However, most clinical assessments have been developed from either retrospective studies or from an author’s own “clinical experience,” illustrating the need for prospective studies with defined measurements of severity coupled to management issues and outcomes….

PDF

http://cid.oxfordjournals.org/content/41/10/1373.full.pdf+html

UPDATE

Stevens et al. (2005; 41:1373–1406)

In a guideline published in the 15 November 2005 issue of the journal (Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the management of skin and soft-tissue infections. Clin Infect Dis 2005; 41:1373–1406), an error appeared in the first sentence of the Note Added in Proof, which stated that dalbavancin had been …

PDF

http://cid.oxfordjournals.org/content/41/12/1830.1.full.pdf+html

March 10, 2014 at 8:52 pm

Chlamydia and male lower urinary tract diseases.

Korean J Urol. 2013 Feb;54(2):73-7.

Lee YS, Lee KS.

Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Abstract

Of the chlamydia species that can cause infections in humans, C. trachomatis is responsible for lower urinary tract diseases in men and women. C. trachomatis infections are prevalent worldwide, but current research is focused on females, with the burden of disease and infertility sequelae considered to be a predominantly female problem.

However, a role for this pathogen in the development of male urethritis, epididymitis, and orchitis is widely accepted. Also, it can cause complications such as chronic prostatitis and infertility.

This review summarizes C. trachomatis infection in the male genitourinary tract, including urethritis, epididymitis, orchitis, and its complications, and addresses the microbiology, epidemiology, screening, clinical manifestations, diagnosis, and treatment.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580308/pdf/kju-54-73.pdf

February 20, 2014 at 12:43 pm

How can the treatment of bacterial vaginosis be improved to reduce the risk of preterm delivery?

Womens Health (Lond Engl). 2012 Sep;8(5):491-3.

Menard JP, Bretelle F.

PDF

http://www.futuremedicine.com/doi/pdfplus/10.2217/whe.12.32

November 30, 2013 at 2:18 pm

Mycoplasma genitalium: an emerging sexually transmitted pathogen.

Indian J Med Res. 2012 Dec;136(6):942-55.

Sethi S, Singh G, Samanta P, Sharma M.

Source

Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

Abstract

Mycoplasma genitalium is a member of genital mycoplasmas, which is emerging as an important causative agent of sexually transmitted infections both in males and females. The advent of polymerase chain reaction and other molecular methods have made studies on M. genitalium more feasible, which is otherwise a difficult organism to isolate. Besides Chlamydia trachomatis, M. genitalium is now an important and established cause of non gonococcal urethritis (NGU) in men, more so in persistent and recurrent NGU. Multiple studies have also shown a positive association of M. genitalium with mucopurulent cervicitis and vaginal discharge in females as well. The evidences for M. genitalium pelvic inflammatory diseases and infertility are quite convincing and indicate that this organism has potential to cause ascending infection. Lack of clear association with M. genitalium has been reported for bacterial vaginosis and adverse pregnancy outcomes. Diagnosis of M. genitalium infections is performed exclusively using nucleic acid amplification tests (NAATs), owing to poor or slow growth of bacterium in culture. Although there are no guidelines available regarding treatment, macrolide group of antimicrobials appear to be more effective than tetracyclines. The present review provides an overview of the epidemiology, pathogenesis, clinical presentation and management of sexually transmitted infections due to M. genitalium.

PDF

http://www.ijmr.org.in/temp/IndianJMedRes1366942-2277905_061939.pdf

FULL TEXT

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612323/

November 28, 2013 at 3:45 pm

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