ABSTRACT
This paper reports survey-based data on the diagnosis and management of genital herpes simplex virus (HSV) infection in 14 countries of the Eastern European Network for Sexual and Reproductive Health (EE SRH). Only 43% of the countries could provide the number of genital HSV cases recorded at national level. Eighty-six percent of countries employed syndromic management in cases of genital ulcer disease. Most countries performed type-specific and/or non-type-specific enzyme immunoassays to detect HSV antibodies. Non-type-specific serology for diagnostic purposes should be actively discouraged. Direct detection methods for HSV, such as PCR, antigen detection and culture, are available in the region, but their usage was extremely low. Their use in Eastern European countries should be actively promoted. The availability of laboratory services must be improved, and countries in the region should implement consensus recommendations for the laboratory diagnosis of genital HSV infections in order to improve clinical practice.
Subject(s)
Clinical Laboratory Techniques/statistics & numerical data , Diagnostic Services/statistics & numerical data , Herpes Genitalis/diagnosis , Simplexvirus , Virology/methods , Antibodies, Viral/blood , Antigens, Viral/blood , Biomarkers/blood , Europe/epidemiology , Health Care Surveys , Herpes Genitalis/epidemiology , Herpes Genitalis/therapy , Herpes Genitalis/virology , Humans , Immunoenzyme Techniques/statistics & numerical data , Mandatory Testing , Polymerase Chain Reaction/statistics & numerical data , Predictive Value of Tests , Reagent Kits, Diagnostic/statistics & numerical data , Serologic Tests/statistics & numerical data , Simplexvirus/genetics , Simplexvirus/immunology , Simplexvirus/isolation & purification , Surveys and Questionnaires , Virology/statistics & numerical dataABSTRACT
OBJECTIVE: There are no data available on gonococcal susceptibility in the Caucasus region. We aimed to determine in vitro antimicrobial susceptibility of Neisseria gonorrheae in Armenia in order to update the national treatment protocol. METHODS: Isolates from men with urethral discharge presenting at 3 STI clinics in 3 different sites of Armenia were used to determine susceptibility of N. gonorrheae strains for 11 antimicrobials using the disc diffusion technique. RESULTS: Among the 101 isolates tested the susceptibility rate for penicillin, doxycycline, and kanamycin were 37.6, 25.7, and 80.2%, respectively. Sensitivity to quinolones was 95% for both ofloxacin and ciprofloxacin. All strains were susceptible to third-generation cephalosporins and to spectinomycin. Only 11% of strains were susceptible to all antibiotics tested. CONCLUSION: Third-generation cephalosporines and spectinomycin are suitable first-line regimens. Quinolones are not advisable as first-line treatment given current borderline susceptibility, known tendency for rapid resistance development in this class, and frequent over-the-counter use of this antibiotic in Armenia.