Posts filed under ‘Infecciones de transmision sexual’

Increasing Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium.

Emerg Infect Dis. May, 2017 V.23 N.5 P.809-812.

Murray GL, Bradshaw CS, Bissessor M, Danielewski J, Garland SM, Jensen JS, Fairley CK, Tabrizi SN.

Abstract

Escalating resistance to azithromycin and moxifloxacin is being reported for Mycoplasma genitalium in the Asia-Pacific region.

Analyzing 140 infections, we found pretreatment fluoroquinolone-resistance mutations in parC (13.6%) and gyrA (5%). ParC S83 changes were associated with moxifloxacin failure.

Combined macrolide/fluoroquinolone-resistance mutations were in 8.6% of specimens, for which recommended therapies would be ineffective.

PDF

https://wwwnc.cdc.gov/eid/article/23/5/pdfs/16-1745.pdf

July 19, 2017 at 3:56 pm

Sexual transmission of American trypanosomiasis in humans: a new potential pandemic route for Chagas parasites

Memórias do Instituto Oswaldo Cruz June 2017 V.112 N.6

Perla F Araujo1, Adriana B Almeida1, Carlos F Pimentel1, Adriano R Silva1, Alessandro Sousa1, Sebastião A Valente2,

Vera C Valente2, Manuela M Britto1, Ana C Rosa1, Rozeneide M Alves1, Luciana Hagström1, Antonio RL Teixeira1  *  +

1Universidade de Brasília, Faculdade de Medicina, Laboratório Multidisciplinar de Pesquisa em Doença de Chagas, Brasília, DF, Brasil

2Instituto Evandro Chagas, Belém, PA, Brasil

BACKGROUND

The Trypanosoma cruzi infection endemic in Latin America has now spread to several countries across four continents; this endemic involves triatomine vector-free protists. We hypothesised that the sexual transmission of T. cruzi contributes to the ongoing spread of Chagas disease.

OBJECTIVES

A short-term longitudinal study was conducted to evaluate this hypothesis.

METHODS

The study population comprised 109 subjects from four families, among whom 21 had been diagnosed with acute Chagas disease by direct parasitological analysis. Blood mononuclear cells and serum samples were obtained from each study subject once per year for three consecutive years. Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence serological examinations were used to detect specific T. cruzi antibodies. Polymerase chain reaction of T. cruzi DNA revealed 188-nucleotide bands, which hybridised to a specific radiolabelled probe and were confirmed by cloning and sequencing.

RESULTS

Three independent assessments at different time points revealed T. cruzi nuclear DNA footprints in 76% (83/109) of the study population with active infection. In contrast, the ELISA and indirect immunofluorescence assays detected the T. cruzi antibody in 28.4% (31/109) of the study samples. Moreover, the semen from 82.6% (19/23) of subjects people revealed harboured the 188- bp base pair T. cruzi footprint. Interestingly, the ejaculates of nuclear DNA-positive Chagas patient transmitted the T. cruzi upon peritoneal injection or infusion in the vagina of mice, and amastigotes were detected in the skeletal muscle, myocardium, vas deferens, and uterine tube.

MAIN CONCLUSIONS

T. cruzi infections can be transmitted from females or males to naïve mates through intercourse, and progeny showed discrepancies between the ratios of nuclear DNA footprints and specific antibody that can be explained by the tolerance attained during early embryo growth. Additional studies are needed to develop drugs to eradicate the infections. Additionally, the importance of a vigorous education, information, and communication program to prevent sexually transmitted Chagas disease in humans cannot be underemphasised.

PDF

http://www.scielo.br/pdf/mioc/v112n6/0074-0276-mioc-112-6-0437.pdf

July 14, 2017 at 8:23 am

Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis.

Emerging Infectious Diseases. May 2017 V.23 N.5 P.827-829.

Katanami Y, Hashimoto T, Takaya S, Yamamoto K, Kutsuna S, Takeshita N, Hayakawa K, Kanagawa S, Ohmagari N.

Abstract

There is no proven alternative to penicillin for treatment of maternal syphilis. We report 2 case-patients with maternal syphilis who were successfully treated without penicillin.

We used amoxicillin and probenecid for the first case-patient and amoxicillin, probenecid, and ceftriaxone for the second case-patient.

PDF

https://wwwnc.cdc.gov/eid/article/23/5/pdfs/16-1936.pdf

July 12, 2017 at 3:26 pm

Therapeutic Vaccine for Genital Herpes Simplex Virus-2 Infection: Findings From a Randomized Trial

J Infect Dis 2017 March  215 (6): 856-864.

EDITOR’S CHOICE

David I. Bernstein  Anna Wald  Terri Warren  Kenneth Fife  Stephen Tyring  Patricia Lee Nick Van Wagoner  Amalia Magaret  Jessica B. Flechtner  Sybil Tasker 

Background.

Genital herpes simplex virus type 2 (HSV-2) infection causes recurrent lesions and frequent viral shedding. GEN-003 is a candidate therapeutic vaccine containing HSV-2 gD2∆TMR and ICP4.2, and Matrix-M2 adjuvant.

Methods.

Persons with genital herpes were randomized into 3 dose cohorts to receive 3 intramuscular doses 21 days apart of 10 µg, 30 µg, or 100 µg of GEN-003, antigens without adjuvant, or placebo. Participants obtained genital swab specimens twice daily for HSV-2 detection and monitored genital lesions for 28-day periods at baseline and at intervals after the last dose.

Results.

One hundred and thirty-four persons received all 3 doses. Reactogenicity was associated with adjuvant but not with antigen dose or dose number. No serious adverse events were attributed to GEN-003. Compared with baseline, genital HSV-2 shedding rates immediately after dosing were reduced with GEN-003 (from 13.4% to 6.4% for 30 μg [P < .001] and from 15.0% to 10.3% for 100 µg [P < .001]). Lesion rates were also significantly (P < .01) reduced immediately following immunization with 30 µg or 100 µg of GEN-003. GEN-003 elicited increases in antigen binding, virus neutralizing antibody, and T-cell responses.

Conclusions.

GEN-003 had an acceptable safety profile and stimulated humoral and cellular immune responses. GEN-003 at doses of 30 µg and 100 µg reduced genital HSV shedding and lesion rates.

Clinical Trials Registration. NCT01667341 (funded by Genocea).

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/jid/215/6/10.1093_infdis_jix004/2/jix004.pdf?Expires=1497965455&Signature=LauwpzltUYdtPj-H4tzcv2QzeU0yI3QyDcTqjGRLhjT~-XCUpAxn5BbzFiTp0ULZNyAvV-WM1DB1W0yaAhUFMS-IBk9m5ZwRyCmL~4xJE2-Lv2rP3ulYPSwj7pBBulLdtF8uAioy6Ux3qfPWSaVsQuvODlSK-jCGvf3xNmq28536uP8sr3mUO12YEXNss8BjjdigOEPGWz8rNL64V5vYHXgBmfSvLArPryGPTLn3gNgPKqU8JHQVUJ~obkccGjIAOfn-XRd8KwzbzLHhlxj0lUZQvqLpNnJs-n~DMe8N9jY0WINI4-gehCrKkfzY3Y4mwZVXXqPioYdoLhIgqqrkAA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

 

J Infect Dis. March 2017 15;215(6):844-846.             

EDITORIAL COMMENTARY – Vaccination to Reduce Reactivation of Herpes Simplex Virus Type 2.

Cohen JI1.

Author information

1 Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

A protein vaccine containing two herpes simplex antigens with adjuvant in patients with recurrent genital herpes appeared to be safe and modestly reduced viral shedding and lesion number, but the effect duration is uncertain.

abstract

https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jix006

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/jid/215/6/10.1093_infdis_jix006/2/jix006.pdf?Expires=1497965228&Signature=gwESX5NV2RD2GozSjrMAEFaEYaf3vIjFRiQC2XG8jcqqlijr94CfhTm7efRIQ9I69d77L2-XHMHtpU~1jBDeIib3jVulLhT71~HytY0YIP2Ya4ltHmgyxOiMw5ZJUmnaZUt1P-GXnnPetSISsZQSRAYNtyUqhxd0tBy5ss0sjeGprnnukP13Ea-YA7b~svo3w5gBf4bR8hb5R0Xa7EYbBwbxP1OejrExMz3USyJr2EHFs2igtcWng2HUNtVzwpGIC33SVRgu8EuC31S8afvMRtihFmhZch3iAWEYDtaYoRoAZoMa0BUhMceRIbkk993QeQpz8wioDFuxS7dbZW1GMQ__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

June 19, 2017 at 8:37 am

“Utilización de penicilina benzatínica como tratamiento para la prevención de sífilis congénita en el primer nivel de atención de la salud.” 36 pags

Organización Panamericana de la Salud

Ministerio de Salud de la Provincia de Buenos Aires – Argentina

Dirección Provincial de Programas Sanitarios

Dirección HIV/SIDA/ITS

Este documento fue escrito por Mariana Ceriotto (Médica especialista en Infectología y Salud Pública. Diplomada en Gestión Pública. Experta en prevención, diagnóstico y tratamiento de las infecciones perinatales).

La revisión técnica fue realizada por: Marcelo Vila (Asesor Subregional para el Cono Sur- Unidad de VIH, hepatitis, TBC e ITS- OPS/OMS); Adriana Duran (Directora de Programas Sanitarios- Ministerio de Salud de la Provincia de Buenos Aires) y Mónica Moyano (Directora de VIH-ITS y Hepatitis virales- Ministerio de Salud de la Provincia de Buenos Aires).

Avalan este documento:

  • Asociación Argentina de Alergia e Inmunología Clínica (AAAeIC)
  • Sociedad Argentina de Infectología (SADI)
  • Sociedad de Ginecología Y Obstetricia de la Provincia de Buenos Aires (SOGBA)
  • Dirección de SIDA y ETS- Ministerio de Salud de la Nación

Esta publicación contó con apoyo financiero de la OPS/OMS.

Contenido

  1. La persistencia del problema de la sífilis congénita como problema de salud pública en Argentina y la región de las Américas
  2. El tratamiento de la embarazada con diagnóstico de sífilis
  3. Alergia a beta-lactámicos
  4. Uso de penicilina benzatínica en el primer nivel de atención
  5. Recomendaciones
  6. Cuestionario para la evaluación de los factores de riesgo
  7. Evaluación de los factores de riesgo de alergia a penicilina
  8. Protocolo de diagnóstico y tratamiento inicial de reacciones anafilácticas
  9. Referencias bibliográficas

 

PDF

http://www.paho.org/arg/images/gallery/PenicilinaFinal.pdf

May 10, 2017 at 7:59 am

Genomic Epidemiology of Gonococcal Resistance to Extended-Spectrum Cephalosporins, Macrolides, and Fluoroquinolones in the United States, 2000–2013

Journal of Infectious Diseases November 15, 2016 V.214 N.10 P.1579-1587

Yonatan H. Grad, Simon R. Harris, Robert D. Kirkcaldy, Anna G. Green, Debora S. Marks, Stephen D. Bentley, David Trees, and Marc Lipsitch

1Department of Immunology and Infectious Diseases

2Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health

3Division of Infectious Diseases, Brigham and Women’s Hospital and Harvard Medical School

4Department of Systems Biology, Harvard Medical School, Boston, Massachusetts

5Centers for Disease Control and Prevention, Atlanta, Georgia

6Wellcome Trust Sanger Institute, Hinxton

7Department of Medicine, University of Cambridge and Addenbrookes Hospital, Cambridge, United Kingdom

Background

Treatment of Neisseria gonorrhoeae infection is empirical and based on population-wide susceptibilities. Increasing antimicrobial resistance underscores the potential importance of rapid diagnostic tests, including sequence-based tests, to guide therapy. However, the usefulness of sequence-based diagnostic tests depends on the prevalence and dynamics of the resistance mechanisms.

Methods

We define the prevalence and dynamics of resistance markers to extended-spectrum cephalosporins, macrolides, and fluoroquinolones in 1102 resistant and susceptible clinical N. gonorrhoeae isolates collected from 2000 to 2013 via the Centers for Disease Control and Prevention’s Gonococcal Isolate Surveillance Project.

Results

Reduced extended-spectrum cephalosporin susceptibility is predominantly clonal and associated with the mosaic penA XXXIV allele and derivatives (sensitivity 98% for cefixime and 91% for ceftriaxone), but alternative resistance mechanisms have sporadically emerged. Reduced azithromycin susceptibility has arisen through multiple mechanisms and shows limited clonal spread; the basis for resistance in 36% of isolates with reduced azithromycin susceptibility is unclear. Quinolone-resistant N. gonorrhoeae has arisen multiple times, with extensive clonal spread.

Conclusions

Quinolone-resistant N. gonorrhoeae and reduced cefixime susceptibility appear amenable to development of sequence-based diagnostic tests, whereas the undefined mechanisms of resistance to ceftriaxone and azithromycin underscore the importance of phenotypic surveillance. The identification of multidrug-resistant isolates highlights the need for additional measures to respond to the threat of untreatable gonorrhea.

PDF

http://jid.oxfordjournals.org/content/214/10/1579.full.pdf+html

December 22, 2016 at 8:18 am

Correlation between pubic hair grooming and STIs: results from a nationally representative probability sample

BMJ Journals Sexually Transmitted Infections

E Charles Osterberg1,2, Thomas W Gaither1, Mohannad A Awad1, Matthew D Truesdale1, Isabel Allen3, Siobhan Sutcliffe4, Benjamin N Breyer1,3

Department of Urology, University of California—San Francisco, San Francisco, California, USA

Department of Surgery, University of Texas—Dell Medical School, Austin, Texas, USA

Department of Biostatistics and Epidemiology, University of California—San Francisco, San Francisco, California, USA

Division of Public Health Sciences, Department of Surgery, Washington University—St. Louis, Missouri, USA

Abstract

Objective

STIs are the most common infections among adults. Concurrently, pubic hair grooming is prevalent. Small-scale studies have demonstrated a relationship between pubic hair grooming and STIs. We aim to examine this relationship in a large sample of men and women.

Design

We conducted a probability survey of US residents aged 18–65 years. The survey ascertained self-reported pubic hair grooming practices, sexual behaviours and STI history. We defined extreme grooming as removal of all pubic hair more than 11 times per year and high-frequency grooming as daily/weekly trimming. Cutaneous STIs included herpes, human papillomavirus, syphilis and molluscum. Secretory STIs included gonorrhoea, chlamydia and HIV. We analysed lice separately.

Results

Of 7580 respondents who completed the survey, 74% reported grooming their pubic hair, 66% of men and 84% of women. After adjusting for age and lifetime sexual partners, ever having groomed was positively associated with a history of self-reported STIs (OR 1.8; 95% CI 1.4 to 2.2), including cutaneous STIs (OR 2.6; CI 1.8 to 3.7), secretory STIs (OR 1.7; CI 1.3 to 2.2) and lice (OR 1.9; CI 1.3 to 2.9). These positive associations were stronger for extreme groomers (OR 4.4; CI 2.9 to 6.8) and high-frequency groomers (OR 3.5; CI 2.3 to 5.4) with cutaneous STIs, and for non-extreme groomers (OR 2.0; CI 1.3 to 3.0) and low-frequency groomers (OR 2.0; CI 1.3 to 3.1) with lice.

Conclusions

Among a representative sample of US residents, pubic hair grooming was positively related to self-reported STI history. Further research is warranted to gain insight into STI risk-reduction strategies.

FULL TEXT

http://stibeta.bmj.com/content/early/2016/10/31/sextrans-2016-052687

December 12, 2016 at 7:54 am

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