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Medicina (B.Aires) ; 81(5): 861-864, oct. 2021. graf
Article in Spanish | LILACS | ID: biblio-1351063


Resumen Se presenta un caso de endocarditis infecciosa por Neisseria gonorrhoeae, en un paciente masculino de 38 años, sin factores de riesgo cardiovascular ni otros antecedentes previos. La sospecha diagnóstica comienza por síndrome febril prolongado, astenia y pérdida de peso, confirmada con rescate de gonococo en los hemocultivos. Cumplió tratamiento antibiótico con ceftriaxona por 29 días. Evoluciona con insu ficiencia aórtica grave por lo cual se realiza cirugía de reemplazo valvular por prótesis mecánica bidisco exitosa, con una evolución favorable.

Abstract We report a case of infectious endocarditis due to Neisseria gonorrhoeae in a 38-year-old male patient with no cardiovascular risk factors or past medical history who presented with prolonged febrile illness, asthenia and weight loss. The blood cultures were positive for gonococcus. He received antibiotic treatment with ceftriaxone for 29 days. The patient developed severe aortic regurgitation and underwent surgical aortic valve replacement with a bileaflet mechanical prosthesis, with favorable outcome.

Humans , Male , Adult , Aortic Valve Insufficiency , Heart Valve Prosthesis/adverse effects , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/diagnostic imaging , Aortic Valve , Neisseria gonorrhoeae
Rev. chil. infectol ; 37(1): 32-36, feb. 2020. tab
Article in Spanish | LILACS | ID: biblio-1092719


Resumen Introducción: Los/as trabajadores/as sexuales, personas con adicción a drogas, población de inicio sexual precoz y población penal son considerados los grupos de mayor riesgo de contraer infecciones de transmisión sexual (ITS). Objetivo: Determinar prevalencia de infección por Neisseria gonorrhoeae, en reclusos del Centro de Detención Preventiva (CDP) de la Región de Arica y Parinacota, Chile. Este estudio contó con la aprobación del Cómité Ético Científico de la Universidad de Tarapacá. Material y Método: Participaron 140 reclusos, que aceptaron ser parte del estudio en forma voluntaria y firmaron un consentimiento informado. Se tomó una muestra del meato uretral para pesquisa de N. gonorrhoeae y se aplicó una encuesta epidemiológica que consignó edad, consumo de drogas, hacinamiento, entre otros. Resultados: La prevalencia del agente fue de 16,4% en reclusos del CDP de Arica, resultado menor a lo reportado en otros estudios similares. Conclusiones: Conocer la realidad de la prevalencia de esta ITS y algunos factores de riesgo asociados a la situación de privación de la libertad en una zona tri-fronteriza del norte de Chile, contribuye a las propuestas de programas de prevención en esta población vulnerable y de riesgo.

Abstract Background: Sex workers, people with drug addiction, early onset of sexual activity population, and criminal population, are considered the groups most at risk of contracting sexually transmitted infections (STIs). Aim: To determine the prevalence of infection by Neisseria gonorrhoeae in inmates of the Preventive Detention Center (CDP) at Arica and Parinacota Region, Chile. The Scientific Ethical Committee of Universidad de Tarapacá approved this study. Method: 140 inmates participated, who voluntarily agreed to be part of the study and signed an informed consent. A sample of urethral meatus was taken to investigate N. gonorrhoeae, and an epidemiological survey was applied, which included age, drug use, overcrowding, among others. Results: The prevalence of the agent was 16.4% in inmates of the Arica CDP, a result lower than that reported in other similar studies. Conclusion: Knowing the reality of the prevalence of this STI and some risk factors associated with the situation of deprivation of freedom in a tri-border area of northern Chile, contributes to the proposals for prevention programs in this vulnerable and at-risk population.

Humans , Prisoners/statistics & numerical data , Gonorrhea/prevention & control , Gonorrhea/epidemiology , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , Chile/epidemiology , Prevalence , Risk Factors , Sex Workers , Neisseria gonorrhoeae/isolation & purification
Article in English | WPRIM | ID: wpr-741141


BACKGROUND: Molecular epidemiological typing of Neisseria gonorrhoeae is crucial for monitoring the spread of resistant strains. As reference strains can be used for laboratory internal quality control, we genetically characterised the American Type Culture Collection (ATCC) gonococcal strains by Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) and porB sequence typing using public multilocus sequence typing (PubMLST). METHODS: Eight ATCC gonococcal reference strains (ATCC 19424, ATCC 31426, ATCC 35541, ATCC 43069, ATCC 43070, ATCC 49226, ATCC 49926, and ATCC 49981) from Culti-Loops (Thermo Fisher Scientific, USA) were cultured. After DNA extraction, porB and tbpB were amplified and sequenced. Sequence types (STs) and allele numbers were each determined by NG-MAST ( and porB sequence typing using PubMLST ( RESULTS: ATCC 19424 was identified as ST 266 by NG-MAST, and as Allele 946 by PubMLST. ATCC31426 was assigned a novel ST by NG-MAST, and was assigned Allele 958 with 1.2% mismatch by PubMLST. ATCC 35541 was identified as ST 12 by NG-MAST, and as Allele 624 by PubMLST. ATCC 43069 and ATCC 43070 were both identified as ST 681 by NG-MAST, and as Allele 984 by PubMLST. ATCC 49226 was identified as ST 1572 by NG-MAST, and as Allele 2110 by PubMLST. ATCC 49926 and ATCC 49981 were both identified as ST 16496 by NG-MAST, and as Allele 928 by PubMLST. CONCLUSIONS: The ST data obtained for ATCC gonococcal reference strains by NG-MAST and porB sequence typing using PubMLST can be used for quality assurance of molecular epidemiological typing in clinical microbiological laboratories.

Alleles , DNA , Multilocus Sequence Typing , Neisseria gonorrhoeae , Neisseria , Quality Control
Article in English | WPRIM | ID: wpr-763370


PURPOSE: Neisseria meningitidis and Neisseria gonorrhoeae share between 80% and 90% of their genetic sequence. Meningococcal serogroup B vaccines based on outer membrane vesicles—such as VA-MENGOC-BC—could cross-protect against gonorrhea. The aim of this study was to analyze the incidence rates of gonorrhea and other sexually transmitted diseases with respect to the use of the VA-MENGOC-BC vaccine. MATERIALS AND METHODS: Health statistics between 1970 and 2017 were reviewed and the incidence of meningococcal disease and sexually transmitted diseases (gonorrhea, syphilis, condyloma acuminatum, hepatitis B and human immunodeficiency virus infection) were analyzed during the pre- and post-vaccination periods. Gonorrhea incidence was also analyzed by age groups. RESULTS: VA-MENGOC-BC was successfully used to control a meningococcal epidemic in Cuba. The strategy to combat the epidemic was carried out in two stages. The first one was a nationwide mass-vaccination campaign from 1989 to 1990, targeting the population at highest-risk aged 3 months to 24 years. During the second stage, begun in 1991, it was included in the Expanded Immunization Program. Gonorrhea incidence increased from 1970 to 1989. However, after the VA-MENGOC-BC massive vaccination campaign a sharp decrease of gonorrhea incidence was observed. It lasted between 1989 and 1993. A second incidence peak was detected in 1995, but it dropped again. Data clearly show a decline in the incidence of gonorrhea following massive vaccination, in contrast with other sexually transmitted diseases. Incidence rates in unvaccinated age groups also decreased, probably due to herd immunity. CONCLUSION: There is evidence that VA-MENGOC-BC could induce a moderate protection against gonorrhea.

Cuba , Gonorrhea , Hepatitis B , HIV , Humans , Immunity, Herd , Immunization Programs , Incidence , Membranes , Neisseria gonorrhoeae , Neisseria meningitidis , Serogroup , Sexually Transmitted Diseases , Syphilis , Vaccination , Vaccines
Mem. Inst. Oswaldo Cruz ; 114: e190079, 2019. graf
Article in English | LILACS | ID: biblio-1040613


A total of 124 Neisseria gonorrhoeae isolates recovered during a 12-year period (2003-2015) from outpatients assisted at Centro de Referência e Treinamento DST/AIDS-CRT of São Paulo city, Brazil, were analysed. The following resistance rates were observed: penicillin-59.6%, ciprofloxacin-15.3%, and azithromycin-6.7%. Although reduced susceptibility to these drugs was observed since 2003, no ceftriaxone-resistant isolates were detected. Ciprofloxacin- and azithromycin non-susceptible isolates were grouped in 11 clusters. Mutations were detected in GyrA and ParC of isolates 124 and 260, and a C2611T substitution on 23S rRNA alleles was also observed in isolate 260. Both isolates belonged to ST1901/ST6210 (MSLT/NG-MAST schemes).

Humans , Drug Resistance, Multiple, Bacterial/genetics , Anti-Bacterial Agents/pharmacology , Neisseria gonorrhoeae/drug effects , Neisseria gonorrhoeae/genetics , Time Factors , Urban Population , Microbial Sensitivity Tests , Drug Resistance, Multiple, Bacterial/drug effects , Mutation
Adv Rheumatol ; 59: 50, 2019. tab
Article in English | LILACS | ID: biblio-1088605


Abstract Background: To evaluate human papillomavirus (HPV), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in juvenile idiopathic arthritis (JIA) patients. Methods: After exclusion, 33 female adolescent and young JIA patients (ILAR criteria) and 28 healthy controls were selected for this study. Demographic data, gynecological, sexual function, cervical cytology and histological abnormalities were evaluated. JIA clinical/laboratorial parameters and treatment were also assessed. HPV-DNA, CT-DNA and NG-DNA testing in cervical specimens were performed by Hybrid Capture 2 assays. Results: The mean current age was similar in JIA patients and controls (23.3 ± 6.24 vs. 26.1 ± 6.03 years, p = 0.09). The frequencies of sexual intercourse (76% vs. 89%, p = 0.201) and abnormal cervical cytology (24% vs. 11%, p = 0.201) were similar in JIA compared to controls. The higher frequency of HPV infection in JIA patients than controls (30% vs. 11%, p = 0.155) did not reach statistical significance. CT (0% vs. 7%, p = 0.207) and NG infections (0% vs. 4%, p = 0.459) were also alike in both groups. Further evaluation of JIA patients with abnormal and normal cervical cytology showed that the former group had a higher frequency of HPV infection (87% vs. 12%, p = 0.0002) with a low frequency of HPV vaccination (0% vs. 8%, p = 1.0). No differences were evidenced between these two JIA groups regarding demographic data, sexual function and clinical/laboratorial parameters. The frequencies of methotrexate (p =0.206) and biological agent use (p =0.238) were similar in both JIA groups. Conclusions: To our knowledge, this was the first study to assess lower genital infections in JIA patients allowing the identification of HPV as main cause of cervical dysplasia. Methotrexate and biological agents do not seem to increase risk of lower genital tract infections in JIA patients.

Humans , Female , Arthritis, Juvenile/physiopathology , Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , Papillomaviridae/isolation & purification , Chlamydia trachomatis/isolation & purification , Neisseria gonorrhoeae/isolation & purification
Afr. j. lab. med. (Online) ; 8(1): 1-6, 2019. tab
Article in English | AIM, AIM | ID: biblio-1257327


Background: The Presto combined qualitative real-time assay for Chlamydia trachomatis and Neisseria gonorrhoeae (Presto CT/NG PCR assay) is appealing for developing countries, because it can be used with multiple DNA extraction methods and polymerase chain reaction (PCR) platforms.Objectives: The objective of the study was to implement and evaluate the Presto CT/NG PCR assay at the National Reference Laboratory (NRL) in Kigali, Rwanda, where no real-time PCR assays for the detection of C. trachomatis or N. gonorrhoeae were available.Methods: The Presto CT/NG PCR assay was first evaluated at the Institute of Tropical Medicine (ITM) in Antwerp, Belgium. Next, NRL laboratory technicians were trained to use the assay on their ABI PRISM 7500 real-time PCR instrument and their competencies were assessed prior to trial initiation. During the trial, endocervical swabs were tested at the NRL, with bi-monthly external quality control testing monitored by the ITM. The final NRL results were evaluated against extended gold standard testing at the ITM, consisting of the Abbott m2000 RealTime System with confirmation of positive results by an in-house real-time PCR assay for C. trachomatis or N. gonorrhoeae.Results: Of the 192 samples analysed using the Presto assay at the NRL, 16 samples tested positive for C. trachomatis and 17 tested positive for N. gonorrhoeae; four of these were infected with both. The sensitivity and specificity of the Presto assay were 93.3% (95% confidence interval [CI]: 68.1% ­ 99.8%) and 99.4% (95% CI: 96.8% ­ 100%) for C. trachomatis and 100% (95% CI: 76.8% ­ 100%) and 98.8% (95% CI: 95.8% ­ 99.9%) for N. gonorrhoeae.Conclusion: C. trachomatis and N. gonorrhoeae testing with the Presto assay was feasible in Kigali, Rwanda, and good performance was achieved

Biological Assay , Chlamydia trachomatis , Molecular Diagnostic Techniques/methods , Neisseria gonorrhoeae
Esc. Anna Nery Rev. Enferm ; 23(1): e20180212, 2019.
Article in English | LILACS, BDENF | ID: biblio-975238


Abstract Objective: To analyze the knowledge and practice of nursing professionals about the prophylaxis of ophthalmia neonatorum. Method: Descriptive study, of qualitative approach, carried out in the first semester of 2018, in a city hall hospital located in the lake area of the Rio de Janeiro's state, through semi-structured interviews with 14 Nursing professionals participating in the care of the newborn, whose data were submitted to the Thematic Analysis. Results: From the three emerging thematic categories, there are gaps in knowledge related to ophthalmia neonatorum, silver nitrate and the instillation procedure of this prophylactic solution, as well as differences in care practice regarding care before, during and after the procedure. Conclusion and implications for practice: The data point to the importance of training the Nursing team in the prophylaxis of ophthalmia neonatorum, the revision of guidelines and procedures aimed at standardizing the procedure, as well as emphasizing the need for adequate follow-up of pregnant women in prenatal care.

Resumen Objetivo: Analizar el conocimiento y la práctica de los profesionales de Enfermería sobre la profilaxis de la oftalmía neonatal. Método: Estudio descriptivo, de naturaleza cualitativa, realizado en el primer semestre de 2018, en un hospital municipal ubicado en la bajada costera del estado de Río de Janeiro, a través de entrevistas semiestructuradas desarrolladas con 14 profesionales de Enfermería, que participan en la asistencia al recién nacido, cuyos datos se sometieron al análisis temático. Resultados: A partir de las tres categorías temáticas emergentes se evidencian lagunas en el conocimiento relacionadas a la oftalmía neonatal, al nitrato de plata y al procedimiento de instilación de esa solución profiláctica, además de divergencias en la práctica asistencial en cuanto a los cuidados antes, durante y después de la realización del procedimiento. Conclusión y las implicaciones para la práctica: Los datos apuntan a la importancia de la capacitación del equipo de Enfermería para la realización de la profilaxis de la oftalmia neonatal, de la revisión de directrices y conductas que visen la estandarización del procedimiento, además de resaltar la necesidad de un acompañamiento adecuado de las gestantes en el prenatal.

Resumo Objetivo: Analisar o conhecimento e a prática de profissionais de Enfermagem sobre profilaxia da oftalmia neonatal. Método: Estudo descritivo, de natureza qualitativa, realizado no primeiro semestre de 2018, em um hospital municipal localizado na baixada litorânea do estado do Rio de Janeiro, por meio de entrevistas semiestruturadas com 14 profissionais de Enfermagem, que participam da assistência ao recém-nascido, cujos dados foram submetidos à Análise Temática. Resultados: A partir das três categorias temáticas emergentes evidenciaram-se lacunas no conhecimento relacionadas à oftalmia neonatal, ao nitrato de prata e ao procedimento de instilação dessa solução profilática, além de divergências na prática assistencial quanto aos cuidados antes, durante e após a realização do procedimento. Conclusão e implicações para a prática: Os dados apontam para a importância da capacitação da equipe de Enfermagem para a realização da profilaxia da oftalmia neonatal, da revisão de diretrizes e condutas que visem a padronização do procedimento, além de ressaltar a necessidade de um acompanhamento adequado das gestantes no pré-natal.

Humans , Male , Female , Infant, Newborn , Adult , Middle Aged , Ophthalmia Neonatorum/nursing , Neonatal Nursing , Professional Practice , Silver Nitrate/administration & dosage , Silver Nitrate/adverse effects , Silver Nitrate/toxicity , Silver Nitrate/therapeutic use , Sexually Transmitted Diseases/diagnosis , Chlamydia trachomatis , Ophthalmia Neonatorum/prevention & control , Ophthalmia Neonatorum/therapy , Conjunctivitis, Viral , Blindness/complications , Qualitative Research , Corneal Injuries/complications , Neisseria gonorrhoeae
Rev. chil. infectol ; 35(4): 403-412, ago. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978051


Resumen La gonorrea producida por Neisseria gonorrhoeae, es capaz de infectar diferentes tipos de mucosas dependiendo de las prácticas sexuales. Se ubica de preferencia en la uretra del hombre y en el cuello uterino de la mujer, también en el recto y la faringe. Su principal forma de transmisión es por relaciones sexuales no protegidas y, ocasionalmente, a través del conducto del parto en los recién nacidos. Este informe presenta la situación epidemiológica de la gonorrea hasta el año 2016 en Chile. Se realizó un análisis descriptivo de los casos que ingresaron a la vigilancia. Desde el año 2000, se observa una tendencia progresiva a la disminución de las tasas de gonorrea; sin embargo, en el año 2015 y 2016 se produjo un aumento de la tasa con relación al año 2014. En el año 2016 se presentaron 2.039 casos, lo que representa un incremento de 38% con respecto a la mediana del quinquenio anterior (1.473 casos). En relación con la edad de los casos, el mayor riesgo se encontró en el grupo de 15 a 24 años, destacándose que, a partir del año 2013, la tasa del grupo de 15 a 19 años superó al grupo de 25 a 29 años. Según distribución geográfica, las mayores tasas de notificación se presentaron en las regiones del extremo norte y sur del país, siendo las de mayor riesgo las regiones de Tarapacá, Antofagasta, Los Lagos y Aysén.

Gonorrhea is produced by the bacterium Neisseria gonorrhoeae, which is capable of infecting different types of mucous membranes depending on sexual practices. It is located preferably in the man's urethra and in the woman's cervix, also in the rectum and pharynx. Its main form of transmission is through unprotected sex and, occasionally, through the birth canal in newborns. This report presents the epidemiological situation of gonorrhea until 2016 in Chile. A descriptive analysis of the cases that entered the surveillance was carried out. Since 2000, there has been a progressive trend towards decreasing gonorrhea rates; However, in 2015 and 2016 there was an increase in the rate in relation to 2014. In 2016, 2,039 cases were presented, representing an increase of 38% with respect to the median of the previous five-year period (1,473 cases). Regarding the age of the cases, the greatest risk was found in the group of 15 to 24 years, highlighting that, as of 2013, the group rate of 15 to 19 years exceeded the group of 25 to 29 years. According to geographical distribution, the highest reporting rates were in the regions of the extreme north and south of the country, with the highest risk regions being Tarapacá, Antofagasta, Los Lagos and Aysén.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Gonorrhea/epidemiology , Sexual Behavior , Gonorrhea/prevention & control , Chile/epidemiology , Residence Characteristics , Incidence , Risk Factors , Age Factors , Emigrants and Immigrants , Research Report , Neisseria gonorrhoeae
DST j. bras. doenças sex. transm ; 30(1): 30-32, 30-03-2018.
Article in English | LILACS | ID: biblio-1122866


Introduction: Sexually transmitted infections (STIs) are a public health issue of global concern and frequently lead to important sequelae if not diagnosed and properly treated. Neisseria gonorrhoeae (NG) infection is one of the most prevalent STIs worldwide and recently presents increasing incidence and antimicrobial resistance rates. Apart from the neonatal period, NG infection during childhood is considered evidence of sexual violence (SV). However, defining perpetration of violence can be challenging in clinical practice. Objective: To report a case of conjunctivitis due to NG in a prepuberal girl and discuss possible means of infection acquisition and medical forensic implications. Case report: A 7-year-old female Caucasian student from São Paulo was referred to the Rape Care Center (Núcleo de Atendimento a Vítimas de Violência Sexual ­ NAVIS) outpatient clinic to investigate sexual violence in September 2013. At admission, she reported right ocular hyperemia for 10 days with no response to tobramycin eye drops. Personal history: nothing noteworthy. She lived with her mother and grandmother and visited her father every two weeks. Physical and gynecological examinations were normal. Eye examination: Left eye ­ nothing noteworthy. Right eye ­ palpebral edema, conjunctival hyperemia with purulent exudate and upper corneal perforation. Bacterioscopy of conjunctival secretion was positive for Gram-negative diplococci and NG was isolated in culture. The patient was submitted to suturing of right eye perforation and received 1g intravenous ceftriaxone per day for 10 days. During investigation at the NAVIS outpatient clinic, the mother denied any SV episode or school behaviour change. Multidisciplinary psychosocial care was provided to the child and her mother for over 6 months, but SV could not be characterized. STIs investigation for HIV, hepatitis B and C infections and syphilis resulted negative. Based on the literature, a hypothesis of accidental intra-familial non-sexual transmission of NG was then considered. Endocervical, vaginal and urethral secretions were collected from the mother and yielded isolation of endocervical beta-lactamase producing NG. Hygiene measures and contact isolation were recommended and the mother underwent treatment with ceftriaxone single dose 1G. During follow-up the child developed corneal opacity in her right eye. Conclusion: In prepuberal children presenting with unusual but compatible clinical manifestations, STIs should always be considered and investigated to enable prompt treatment and avoid sequelae. If gonococcal infection is diagnosed, the possibility of sexual violence should be thoroughly investigated, preferably in a comprehensive multidisciplinary approach to rule out non-sexual contamination and avoid emotional damage to the child and family. Clearly defining SV and proposing proper interventions in these circumstances is, however, challenging for healthcare providers.

As infecções sexualmente transmissíveis (ISTs) são um problema de saúde pública global e com frequência deixam sequelas se não diagnosticadas e tratadas adequadamente. A infecção por Neisseria gonorrhoeae (NG) é uma das ISTs mais prevalentes em todo o mundo e, recentemente, tem apresentado crescentes taxas de incidência, além de resistência a antimicrobianos. Após o período neonatal, a infecção por NG na infância pode ser uma evidência de violência sexual (VS), no entanto a comprovação da violência é um desafio na prática clínica. Objetivo: Apresentar um caso de conjuntivite por NG em uma menina pré-púbere e discutir as possíveis vias de contaminação e implicações médicas forenses. Relato de caso: Trata-se de uma criança caucasiana de 7 anos de idade do sexo feminino, estudante, procedente de São Paulo, que, após uma internação, foi encaminhada ao Núcleo de Atendimento a Vítimas de Violência Sexual (NAVIS) para investigação de violência sexual, em setembro de 2013. Na admissão intra-hospitalar, houve relato de hiperemia ocular direita, iniciada havia 10 dias, sem resposta ao tratamento com colírio de tobramicina. Antecedentes pessoais: nada digno de nota. Ela morava com a mãe e a avó e visitava o pai a cada duas semanas. Os exames físico e ginecológico foram normais. Exame oftalmológico: olho esquerdo ­ nada digno de nota. Olho direito ­ edema palpebral, hiperemia conjuntival com exsudato purulento e perfuração da córnea superior. A bacterioscopia de secreção conjuntival foi positiva para diplococos gram-negativos e a NG foi isolada em cultura. A paciente foi submetida a sutura cirúrgica de perfuração do olho direito e, enquanto internada, recebeu 1 g de ceftriaxona endovenoso por dia, por um período de 10 dias. Durante a investigação no ambulatório de NAVIS, a mãe negou qualquer episódio de VS ou mudança de comportamento escolar. Foi oferecida assistência psicológica e social à criança e à mãe por mais de seis meses, mas a VS não pôde ser caracterizada. A investigação de IST para o HIV, infecções por hepatite B e C e sífilis resultou negativa. Com base na literatura, a hipótese de transmissão não sexual acidental de NG intrafamiliar foi então considerada. As secreções genitais da mãe (endocervical, vaginal e uretral) foram coletadas e o isolamento endocervical da NG produtora por betalactamase foi positivo. Medidas de higiene e isolamento de contato foram recomendados, além ser prescrito o tratamento com ceftriaxona em dose única de 1 g para a mãe. Durante o acompanhamento, a criança desenvolveu opacidade corneana em seu olho direito. Conclusão: Em crianças pré-púberes que apresentam manifestações clínicas incomuns, as ISTs devem sempre ser consideradas e investigadas para permitir o tratamento imediato e assim evitar sequelas. Se uma infecção gonocócica for diagnosticada, a possibilidade de (VS) deve ser minuciosamente investigada, de preferência com uma abordagem multidisciplinar abrangente para descartar a contaminação não sexual e evitar danos emocionais à criança e à sua família. Definir com precisão se houve VS e propor intervenções adequadas nessas circunstâncias mostra-se um desafio para os profissionais de saúde.

Humans , Rape , Sex Offenses , Neisseria gonorrhoeae , Gonorrhea , Sexually Transmitted Diseases , Neisseria
Article in English | WPRIM | ID: wpr-715662


BACKGROUND: We investigated the molecular epidemiological characteristics and antimicrobial susceptibility pattern of penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates to monitor the change in distribution of bla(TEM) in Korea. METHODS: We collected 804 PPNG isolates from diverse hospitals and clinics mainly located in Seoul, Korea, over a period of 11 years (2005–2015). Isolate susceptibility to seven antimicrobials was determined using the agar dilution test. The molecular epidemiological characteristics of the isolates were determined by Sanger sequencing of bla(TEM), N. gonorrhoeae multiantigen sequence typing (NG-MAST) and plasmid typing. RESULTS: Among 72 fully sequenced PPNG isolates, sixteen (22.2%) possessed TEM-135. All TEM-135 isolates had a common silent mutation (c.18C>T), which was previously unreported. We observed a pattern of continuous increase in the number of TEM-135 isolates since 2012. The median and 90% minimum inhibitory concentration of azithromycin were substantially lower in the TEM-135 group than in the non-PPNG and TEM-1 groups. All TEM-135 isolates showed different NG-MAST types and predominantly harbored Toronto/Rio (75%) plasmids. A comprehensive comparative analysis of PPNG with TEM-135 according to NG-MAST, plasmid type, and year of isolation revealed a wide distribution. CONCLUSIONS: The proportion of TEM-135 PPNG has continuously increased since 2012, in association with clonal spread. The difference at position 18 of the TEM-135 sequence can be interpreted as the existence of multiple clonal complexes. The possibility that TEM-135 was acquired via foreign plasmids requires careful follow-up and continuous monitoring of TEM-135 to ascertain whether it constitutes a step towards evolutionary change.

Agar , Azithromycin , Drug Resistance, Microbial , Follow-Up Studies , Incidence , Korea , Microbial Sensitivity Tests , Neisseria gonorrhoeae , Neisseria , Plasmids , Seoul , Silent Mutation
Article in English | WPRIM | ID: wpr-740176


OBJECTIVE: Human papillomavirus (HPV) testing is widely incorporated into cervical cancer screening strategies. Current screening requires pelvic examination for cervical sampling, which may compromise participation. The acceptance could be raised by introducing testing on vaginal swabs. We explored the interchangeability of vaginal swabs and cervical smears for HPV testing, by means of a prospective study conducted in female sex workers (FSWs). Besides, we report on the occurrence of 32 different HPV genotypes in FSW with low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). METHODS: Paired physician-collected vaginal swabs and cervical smears from 303 FSW were tested for HPV using the Abbott RealTime High-Risk HPV assay. Cervical cytology was examined on cervical smears. In case of HSIL/LSIL cytological classification (n=52), both samples were genotyped using INNO-LiPa HPV Genotyping Extra II. RESULTS: The overall prevalence of high-risk (HR)-HPV was 51%. In FSW with HSIL/LSIL cervical cytology, the sensitivity and specificity of vaginal samples for the detection of HR-HPV was 100% and 70% and for probable HR-HPV 100% and 91%. The mean number of genotypes identified in vaginal samples (mean=3.5; 95% confidence interval [CI]=2.8–4.2) was significantly higher than in cervical smear samples (mean=2.6; 95% CI=2.1–3.0) (p=0.001). The most frequently encountered HR-HPV genotypes were HPV16, 31, 51, and 52. CONCLUSION: As our study shows that vaginal swabs are equivalent to cervical smears for the detection of (probable) HR-HPV, vaginal swabs can be used for HPV testing in cervical cancer screening strategies. Given the acceptance of vaginal sampling, this finding offers an opportunity to boost screening coverage.

Chlamydia trachomatis , Classification , DNA , Female , Genotype , Gynecological Examination , Humans , Mass Screening , Mycoplasma genitalium , Neisseria gonorrhoeae , Papillomaviridae , Prevalence , Prospective Studies , Sensitivity and Specificity , Sex Workers , Sexually Transmitted Diseases , Squamous Intraepithelial Lesions of the Cervix , Trichomonas vaginalis , Uterine Cervical Neoplasms , Vaginal Smears
Keimyung Medical Journal ; : 101-105, 2018.
Article in Korean | WPRIM | ID: wpr-718504


Gonococcal conjunctivitis is rare in adults and, if not treated properly, can cause corneal perforation. Gonococcal conjunctivitis typically presents with a severe mucopurulent discharge, similar to that associated with viral conjunctivitis. Here, we describe a case of monocular gonococcal conjunctivitis, including its clinical characteristics and slit-lamp images, which was initially misdiagnosed as epidemic conjunctivitis. A 20-year-old man was referred to our hospital with no improvement in monocular infection and purulent ocular discharge after 2-wk treatment using antibiotic and 0.1% fluorometholone eye drops at the local ophthalmic clinic. Initially, 0.5% loteprednol eye drops were used since we suspected viral conjunctivitis. Following this treatment, conjunctival infection worsened and a yellow-white ocular discharge covered the conjunctiva and cornea surface. Additional history taking revealed that the patient had sexual contact with a prostitute 1 wk prior to symptom presentation and, after the encounter, he took antibiotics for genital discharge at the local urology clinic, but self-discontinued treatment. A Gram staining showed gram-negative diplococci and culture of collected ocular discharge from the palpebral conjunctiva revealed growth of Neisseria gonorrhoeae, confirming gonococcal conjunctivitis. Following this, the patient was systemically treated with 3rd generation cephalosporin antibiotics. After 3-d treatment, conjunctival infection and purulent ocular discharge had significantly improved. When clinical symptoms are aggravated following steroid eye drop treatment for suspected monocular viral conjunctivitis, gonococcal conjunctivitis must be considered as a differential diagnosis

Adult , Anti-Bacterial Agents , Cephalosporins , Conjunctiva , Conjunctivitis , Conjunctivitis, Viral , Cornea , Corneal Perforation , Diagnosis, Differential , Fluorometholone , Humans , Loteprednol Etabonate , Male , Neisseria gonorrhoeae , Ophthalmic Solutions , Sex Workers , Urology , Young Adult
Article in Chinese | WPRIM | ID: wpr-774013


Objective To analyze the infection status of human papilloma virus (HPV),Ureaplasma urealyticum (UU),Chlamydia trachomatis (CT),and Neisseria gonorrhoeae (NG) in clinical patients.Methods The laboratory specimens including urine,urethral swabs,and cervical swabs from 870 patients from January 1st 2014 to December 31st 2017 were retrospectively analyzed. HPV-DNA was detected by multiplex fluorescent PCR,and the UU-RNA,CT-RNA,and NG-RNA were determined by isothermal nucleic acid amplification. The positive rate of each pathogen and the distribution of positive rate between male and female patients were calculated. The samples were further divided into HPV-positive group and HPV-negative group,and the positive rates of UU-RNA,CT-RNA,and NG-RNA in these two groups were compared.Results The highest positive rate was 53.68%(467/870) for UU-RNA,followed by HPV-DNA [32.41%(282/870) ]and NG-RNA [2.18%(19/870)]. The total positive rate of high-risk (HR)-HPV(subtypes:16,18,31,33,35,39,45,51,52,56,58,59,and 68) [31.52%(209/663)]and UU in female patients [60.93%(404/663)] was significantly higher than that in male patients [17.39%(36/207),30.34%(63/207)](both P<0.001). The male patients had significantly higher CT positive rate in HR-HPV-positive group than in HR-HPV-negative group [22.58%(7/31) vs. 4.54%(8/176)](P<0.001). The female patients had significantly higher CT positive rate in HR-HPV-positive group than in HR-HPV-negative group [10.5%(21/200) vs. 5.61%(26/463)](P=0.024). The UU-RNA positive rate of females in the low-risk (LR)-HPV (subtypes:6 and 11) positive group was significantly higher than that in LR-HPV negative group [70.83%(34/48) vs.2.11%(13/615)](P<0.001).Conclusions Women are more susceptible to HR-HPV and UU infections. HR-HPV-positive patients are more likely to experience CT infection. In contrast,co-infection with UU is more common in LR-HPV-positive females.

Chlamydia Infections , Diagnosis , Epidemiology , Chlamydia trachomatis , Female , Gonorrhea , Diagnosis , Epidemiology , Humans , Male , Neisseria gonorrhoeae , Papillomaviridae , Papillomavirus Infections , Diagnosis , Epidemiology , Retrospective Studies , Ureaplasma Infections , Diagnosis , Epidemiology , Ureaplasma urealyticum
National Journal of Andrology ; (12): 452-456, 2018.
Article in Chinese | WPRIM | ID: wpr-689734


Neisseria gonorrhoeae (NG), as a pathogen of gonorrhea, is strictly limited to growth on the human host. In case of gonococcal infection, the body may recruit such inflammatory cells as neutrophils to resist the invasion of NG or initiate its adaptive immune response by antigen presentation to eliminate the pathogen. However, a series of immune escape mechanisms of NG make it difficult to clear up the infection. In the innate immune system, NG can not only secrete thermonuclease to degrade neutrophile granulocytes, inhibit respiratory burst to resist killing by neutrophils, activate NLRP3 to prompt the pyronecrosis of inflammatory cells, but also regulate the differentiation of macrophages to reduce the inflammatory response, combine with factor H to evade complement-mediated killing. NG infection can hardly give rise to effective adaptive immune response and immune memory, but can promote TGF-β production to inhibit Th1/Th2-mediated adaptive immune response, bind to CEACAM1 on the B cell surface to promote apoptosis in B cells, and combine with CEACAM1 on the T cell surface to inhibit helper T cell proliferation, which makes it difficult for B cells to produce high-affinity specific antibodies. With the increasing drug-resistance of NG, immunological studies may play a significant role in the development of novel therapies and effective vaccines against the infection.

Adaptive Immunity , Antibodies , Allergy and Immunology , Antigens, CD , Allergy and Immunology , Cell Adhesion Molecules , Allergy and Immunology , Complement Factor H , Allergy and Immunology , Gonorrhea , Allergy and Immunology , Humans , Immune Evasion , Allergy and Immunology , Immunity, Innate , Allergy and Immunology , Neisseria gonorrhoeae , Allergy and Immunology
Braz. j. microbiol ; 48(4): 617-628, Oct.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-889182


ABSTRACT Neisseria gonorrhoeae is the agent of gonorrhea, a sexually transmitted infection with an estimate from The World Health Organization of 78 million new cases in people aged 15-49 worldwide during 2012. If left untreated, complications may include pelvic inflammatory disease and infertility. Antimicrobial treatment is usually effective; however, resistance has emerged successively through various molecular mechanisms for all the regularly used therapeutic agents throughout decades. Detection of antimicrobial susceptibility is currently the most critical aspect for N. gonorrhoeae surveillance, however poorly structured health systems pose difficulties. In this review, we compiled data from worldwide reports regarding epidemiology and antimicrobial resistance in N. gonorrhoeae, and highlight the relevance of the implementation of surveillance networks to establish policies for gonorrhea treatment.

Humans , Animals , History, 20th Century , History, 21st Century , Drug Resistance, Bacterial , Gonorrhea/microbiology , Neisseria gonorrhoeae/drug effects , Gonorrhea/epidemiology , Gonorrhea/history , Neisseria gonorrhoeae/classification , Neisseria gonorrhoeae/genetics , Neisseria gonorrhoeae/isolation & purification
An. bras. dermatol ; 92(6): 779-784, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-887127


Abstract: Background: Urethral discharge syndrome (UDS) is characterized by the presence of purulent or mucopurulent urethral discharge.The main etiological agents of this syndrome are Neisseria gonorrhoeae and Chlamydia trachomatis. Objectives: To evaluate the effectiveness of the syndromic management to resolve symptoms in male urethral discharge syndrome cases in Manaus, Amazonas, Brazil. Methods: Retrospective cohort of male cases of urethral discharge syndrome observed at a clinic for sexually transmitted disease (STD) in 2013. Epidemiological and clinical data, as well as the results of urethral swabs, bacterioscopy, hybrid capture for C.trachomatis, wet-mount examination, and culture for N.gonorrhoeae, were obtained through medical chart reviews. Results: Of the 800 urethral discharge syndrome cases observed at the STD clinic, 785 (98.1%) presented only urethral discharge syndrome, 633 (79.1%) returned for follow-up, 579 (91.5%) were considered clinically cured on the first visit, 41(6.5 %) were considered cured on the second visit, and 13(2.0%) did not reach clinical cure after two appointments. Regarding the etiological diagnosis, 42.7% of the patients presented a microbiological diagnosis of N.gonorrhoeae, 39.3% of non-gonococcal and non-chlamydia urethritis, 10.7% of C.trachomatis and 7.3% of co-infection with chlamydia and gonococcus. The odds of being considered cured in the first visit were greater in those who were unmarried, with greater schooling, and with an etiological diagnosis of gonorrhea. The diagnosis of non-gonococcal urethritis reduced the chance of cure in the first visit. Study limitation: A study conducted at a single center of STD treatment. Conclusion: Syndromic management of male urethral discharge syndrome performed in accordance with the Brazilian Ministry of Health STD guidelines was effective in resolving symptoms in the studied population. More studies with microbiological outcomes are needed to ensure the maintenance of the syndromic management.

Humans , Male , Young Adult , Urethral Diseases/microbiology , Urethral Diseases/drug therapy , Chlamydia Infections/complications , Gonorrhea/complications , Disease Management , Socioeconomic Factors , Suppuration , Syndrome , Brazil , Chlamydia Infections/drug therapy , Gonorrhea/drug therapy , Chlamydia trachomatis/isolation & purification , Multivariate Analysis , Retrospective Studies , Treatment Outcome , Neisseria gonorrhoeae/isolation & purification
Article in English | WPRIM | ID: wpr-225697


There is limited research on sexually transmitted infections (STIs) among adolescents in Korea. The objective of this study was to explore the prevalence of and risk factors for STIs among Korean adolescents under probation. A cross-sectional analysis was conducted in one juvenile-delinquent center and five probation offices in Korea to determine the prevalence of STIs caused by the following pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus (HSV), human immunodeficiency virus (HIV), Treponema pallidum, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, and Ureaplasma parvum. Of the 237 (208 male and 29 female) participating adolescents, 152 (64.1%) had a history of coitus. Overall, 133 (56.1%) subjects tested positive for at least one microorganism in their genitourinary tract. The most prevalent pathogen was U. urealyticum (24.7%, n = 65), followed by U. parvum (24.1%, n = 57), M. hominis (17.3%, n = 41), C. trachomatis (13.9%, n = 33), N. gonorrhoeae (1.7%, n = 4), T. vaginalis (0.8%, n = 2), and HSV (0.8%, n = 2). The prevalence of syphilis was 0.8% (n = 2). There were no reported cases of HIV infection. Fifty-four participants (35.5%) were positive with more than two pathogens. We did not find any significant difference between STIs and socioeconomic factors, behavioral factors or sexual practices. In conclusion, the prevalence of STIs among adolescents under probation was high. Systematic screening programs, more practical sexual education, and adequate provision of treatment are essential for the prevention and management of STIs among adolescents, especially those under probation.

Adolescent , Chlamydia trachomatis , Coitus , Cross-Sectional Studies , Education , HIV , HIV Infections , Humans , Korea , Male , Mass Screening , Mycoplasma , Mycoplasma genitalium , Mycoplasma hominis , Neisseria gonorrhoeae , Prevalence , Risk Factors , Sexually Transmitted Diseases , Simplexvirus , Socioeconomic Factors , Syphilis , Treponema pallidum , Trichomonas vaginalis , Ureaplasma , Ureaplasma urealyticum
Article in Korean | WPRIM | ID: wpr-193199


BACKGROUND: The multiplex real-time PCR assay is a sensitive test for simultaneous detection of various pathogens of sexually transmitted infections (STIs). We evaluated the performance of two multiplex real-time PCR assays for six STI pathogens. METHODS: DNA samples after being used to conduct PCR for STI pathogens were stored below −70℃. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Trichomonas vaginalis (TV) were detected by multiplex real-time PCR with GeneFinder STD I (CT/NG/UU)/II (MG/MH/TV) Multiplex Real-time PCR Kits (Infopia, Korea; GeneFinder assay) and Real-Q CT&NG/MH&TV/MG&UU Kits (BioSewoom, Korea; Real-Q assay). Discrepant results were resolved by another multiplex real-time assay, Anyplex II STI-7 Detection (Seegene, Korea). Any two positive results for the assays were considered true positive. RESULTS: Among 81 samples, the GeneFinder assay detected 63 pathogens from 45 cases (16 CT, 2 NG, 6 MG, 20 MH, 18 UU, and 1 TV) and Real-Q assay detected 66 pathogens from 47 cases (16 CT, 2 NG, 8 MG, 20 MH, 19 UU, and 1 TV). For the results of positive cases and negative cases, the overall concordance rate between the two multiplex real-time assays was 93.8% (Kappa=0.87). For each pathogen, the agreement rates of the two assays ranged from 97.5 to 100% (Kappa>0.8). CONCLUSION: There was no significant difference between the results of GeneFinder assay and Real-Q assay. Both multiplex real-time PCR assays can be useful methods for the detection of STI pathogens in clinical laboratories.

Chlamydia trachomatis , DNA , Korea , Mycoplasma genitalium , Mycoplasma hominis , Neisseria gonorrhoeae , Polymerase Chain Reaction , Real-Time Polymerase Chain Reaction , Sexually Transmitted Diseases , Trichomonas vaginalis , Ureaplasma urealyticum