Frecuencia y detección molecular de Gardnerella vaginalis en una institución de tercer nivel / Frequency and molecular detection of Gardnerella vaginalis in a third level institute

Resumen Antecedentes: Los padecimientos vaginales son la razón más común para que las mujeres busquen atención médica, con una prevalencia global que oscila entre el 23 y el 29% en mujeres en edad reproductiva. La vaginosis bacteriana es una de las principales causas de estos padecimientos, y el agente etiológico más frecuentemente identificado es Gardnerella vaginalis, sin embargo su diagnóstico es difícil, ya que requiere de medios artificiales selectivos enriquecidos y diferenciales. Objetivo: Determinar la frecuencia de G. vaginalis mediante la amplificación de ácidos nucleicos empleando la reacción en cadena de la polimerasa (PCR) en muestras cervicovaginales de pacientes que asisten a un instituto de tercer nivel. Método: Se analizaron 121 muestras cervicovaginales para la detección molecular del ARN ribosomal 16S de G. vaginalis. Resultados: G. vaginalis. se detectó en 34 muestras, de estas, 23 fueron de mujeres embarazadas y 11 de no embarazadas. Conclusión: La PCR de punto final detectó tres veces más la presencia de G. vaginalis que el medio de cultivo artificial.

Abstract Background: Vaginal conditions are the most common reason for women to seek medical care, with an overall prevalence ranging from 23 to 29% in women of reproductive age. Bacterial vaginosis is one of the main causes of these conditions, and the most frequently identified etiological agent is Gardnerella vaginalis, however, its diagnosis is difficult since it requires enriched and artificial selective culture media. Objective: To determine the frequency of G. vaginalis by nucleic acid amplification using polymerase chain reaction (PCR) in cervicovaginal samples from patients attending a third level institute. Method: One hundred twenty-one cervicovaginal samples were analyzed for molecular detection of 16S ribosomal RNA from G. vaginalis. Results: G. vaginalis was detected in 34 samples, of these, 23 were from pregnant women and 11 from non-pregnant women. Conclusion: Endpoint PCR detected three times more the presence of G. vaginalis than artificial culture medium.

Análisis molecular y filogenético del genotipo F de Chlamydia trachomatis aislados en México en 2011 / Molecular and phylogenetic analysis of the F genotype of Chlamydia trachomatis isolated in Mexico in 2011

Resumen Antecedentes: Chlamydia trachomatis es la bacteria que se detecta con mayor frecuencia en las infecciones de transmisión sexual. Se han identificado 20 genotipos de C. trachomatis mediante el gen ompA y varias genovariantes mediante el análisis de polimorfismo de un solo nucleótido (SNP). En México, el genotipo F es el más frecuente. Objetivo: Identificar la existencia de subtipos del genotipo F. Método: Se analizaron siete cepas del genotipo F de C. trachomatis aisladas en 2011, mediante secuenciación de nucleótidos y mapeo con enzimas de restricción. Resultados: El análisis de SNP mostró dos cepas con el mismo SNP en el nucleótido 288 (C288T), mientras que con enzimas de restricción se identificó una variante con diferente RFLP (polimorfismo de la longitud de fragmentos de restricción) cuando se tratan con la mezcla de enzimas HinfI y TaqI. Conclusión: En México se encuentran dos subtipos del genotipo F y solo las enzimas de restricción HinfI y TaqI pueden identificar la existencia de uno de estos genotipos F.

Abstract Background: Chlamydia trachomatis is the most frequently identified bacterium in sexually transmitted infections. Twenty C. trachomatis genotypes have been determined using the ompA gene and several genovariants by single nucleotide polymorphism (SNP) analysis. In Mexico, the F genotype is the most frequent. Objective: To identify subtypes of the F genotype. Method: Seven C. trachomatis genotype F strains isolated in 2011 were analyzed by nucleotide sequencing and restriction enzyme mapping. Results: SNP analysis showed two strains with the same SNP at nucleotide 288 (C288T), while with res-triction enzymes, a variant with different RFLP (restriction fragment length polymorphism) was identified when treated with the mixture of HinfI and TaqI enzymes. Conclusion: In Mexico, there are two subtypes of F, and only with restriction enzymes HinfI and TaqI can identify one of the genovariants of the F genotype.

PCR múltiplex para el diagnóstico de microorganismos atípicos transmitidos sexualmente / Multiplex PCR testing for the atypical microorganisms diagnosis sexually transmitted

Resumen Antecedentes: Las infecciones de transmisión sexual son un problema de salud pública mundial. El análisis rutinario incluye solo pruebas microbiológicas y serológicas para el diagnóstico de patógenos. Los microorganismos atípicos como Chlamydia trachomatis y micoplasmas no son identificados debido a los requerimientos. Además, no es incluida Gardnerella vaginalis, aunque se asocia a la vaginosis bacteriana. Objetivo: Desarrollar una PCR múltiplex para el diagnóstico de C. trachomatis, micoplasmas y G. vaginalis. Método: Se estandarizó la PCR múltiplex utilizando oligonucleótidos para C. trachomatis (gen ompA, orf6 plasmídico), Mycoplasma/Ureaplasma y G. vaginalis (genes rRNA16s). Resultados: Se estandarizaron pruebas de PCR múltiplex para los microorganismos estudiados, optimizándose las concentraciones y condiciones de las reacciones múltiplex. Se obtuvieron PCR dúplex para C. trachomatis (ompA, orf6), Chlamydia/Gardnerella y Chlamydia/micoplasmas y tríplex para Chlamydia/Mycoplasma/Ureaplasma. También un cuádruplex para Chlamydia/Mycoplasma/Ureaplasma/Gardnerella. Los resultados fueron verificados por PCR e hibridación automática (HybriSpot 12) y análisis in silico. Conclusión: Se desarrollaron pruebas de PCR múltiplex con una alta sensibilidad y especificidad para la identificación de C. trachomatis, micoplasmas y G. vaginalis.

Abstract Background: Sexually transmitted infections are a global public health problem. Routine analysis includes microbiological and serological tests for the diagnosis of pathogens. Atypical microorganisms such as Chlamydia trachomatis and mycoplasmas are not determined due to the requirements for their identification. Furthermore, Gardnerella vaginalis is not included despite being associated with bacterial vaginosis. Objective: To develop a multiplex PCR to diagnose Chlamydia, mycoplasmas, and Gardnerella. Method: Standardization of multiplex PCR tests was carried out using oligonucleotides for the identification of Chlamydia (ompA gene, plasmid orf6), Mycoplasma/Ureaplasma and Gardnerella (rRNA16s genes). Results: Multiplex PCR tests were standardized for the microorganisms studied, optimizing the concentrations and conditions of the multiplex reactions. Duplex PCR was obtained for Chlamydia (ompA, orf6), Chlamydia/Gardnerella, and Chlamydia/mycoplasmas, and triplex PCR for Chlamydia/mycoplasmas. Also, a quadruplex for Chlamydia, Mycoplasma/Ureaplasma and Gardnerella. PCR and automatic hybridization verified the results obtained (HybriSpot 12) and in silico analysis. Conclusion: Multiplex PCR tests with high sensitivity and specificity were developed to identify C. trachomatis, mycoplasmas, and G. vaginalis.

Association of Blood Calcidiol Levels and Metabolic Syndrome in Children and Adolescents With Vitamin D Deficiency.

This retrospective cohort study aimed to determine whether severe calcidiol deficiency [25-hydroxyvitamin (OH)D <30 nmol/L] improvement has a beneficial effect on cardiometabolic parameters in children and adolescents (5-17 years) with or without metabolic syndrome (MetS). Logistic regression analysis was performed to test for multivariate associations between potential confounders and changes in vitamin D (VD) status from baseline to follow-up care when predicting binary categorical outcomes. Of 562 participants, 146 (26%) had MetS. Individuals with severe VD deficiency (VDD) were more likely to have MetS with elevated blood pressure than those with sufficient (≥75 nmol) VD levels (adjusted odds ratio [AOR], 4.46; 1.08-18.43; p < .05) at follow-up. In the logistic regression model, every unit increase in VD across time decreased the odds of MetS (AOR, 0.98; 95% confidence interval: [0.96, 0.99]; p < .05). Improvement in VD status demonstrated a beneficial metabolic effect in children and adolescents with severe VDD.

Modelling the Unidentified Abortion Burden from Four Infectious Pathogenic Microorganisms (Leptospira interrogans, Brucella abortus, Brucella ovis, and Chlamydia abortus) in Ewes Based on Artificial Neural Networks Approach: The Epidemiological Basis for a Control Policy.

Unidentified abortion, of which leptospirosis, brucellosis, and ovine enzootic abortion are important factors, is the main cause of disease spread between animals and humans in all agricultural systems in most developing countries. Although there are well-defined risk factors for these diseases, these characteristics do not represent the prevalence of the disease in different regions. This study predicts the unidentified abortion burden from multi-microorganisms in ewes based on an artificial neural networks approach and the GLM. METHODS: A two-stage cluster survey design was conducted to estimate the seroprevalence of abortifacient microorganisms and to identify putative factors of infectious abortion. RESULTS: The overall seroprevalence of Brucella was 70.7%, while Leptospira spp. was 55.2%, C. abortus was 21.9%, and B. ovis was 7.4%. Serological detection with four abortion-causing microorganisms was determined only in 0.87% of sheep sampled. The best GLM is integrated via serological detection of serovar Hardjo and Brucella ovis in animals of the slopes with elevation between 2600 and 2800 meters above sea level from the municipality of Xalatlaco. Other covariates included in the GLM, such as the sheep pen built with materials of metal grids and untreated wood, dirt and concrete floors, bed of straw, and the well water supply were also remained independently associated with infectious abortion. Approximately 80% of those respondents did not wear gloves or masks to prevent the transmission of the abortifacient zoonotic microorganisms. CONCLUSIONS: Sensitizing stakeholders on good agricultural practices could improve public health surveillance. Further studies on the effect of animal-human transmission in such a setting is worthwhile to further support the One Health initiative.

Identificación de genotipos de Chlamydia trachomatis en neonatos con distrés respiratorio / Identification of Chlamydia trachomatis genotypes in newborns with respiratory distress

Introducción: Cada año se notifican ciento treinta millones de infecciones por Chlamydia trachomatis en todo el mundo. Diecinueve serotipos de este patógeno pueden causar infecciones en mujeres embarazadas y recién nacidos. En México se desconoce la distribución de estos genotipos en recién nacidos con infecciones respiratorias. Material y métodos: Se analizaron mil sesenta y dos muestras de lavado bronquial de neonatos con síndrome de dificultad respiratoria para detección de infección por clamidia. El diagnóstico de clamidia se realizó mediante la detección de plásmidos con un ensayo PCR interno y los genotipos se identificaron mediante un ensayo PCR-RFLP del gen ompA. Resultados: El genotipado de 40 cepas identificó a 14 como I/Ia (35%), 13 como E (32,5%), 7 como D (17,5%), 5 como F (12,5%) y 1 como L2 (2,5%). El análisis de riesgo relativo mostró que el genotipo D se asoció con sepsis neonatal (RR=5,83; IC 95%: 1,51-25,985; p <0,02), mientras que el genotipo I/Ia mostró asociación significativa con madres que desarrollaron corioamnionitis (2,8; IC 95%: 1,4-5,5; p <0,05). Conclusiones: Si bien los genotipos I/Ia y E de Chlamydia trachomatis fueron la causa más frecuente de infección respiratoria en neonatos mexicanos, el 80% de los genotipos F produjeron este padecimiento. En cambio, el genotipo D se asoció con el desarrollo de sepsis neonatal y el genotipo I/Ia con corioamnionitis. (AU)

Introduction: One hundred thirty million Chlamydia trachomatis infections are reported worldwide each year. Nineteen serotypes of this pathogen can cause infection in pregnant women and neonates. The distribution of these genotypes in newborns with respiratory infections in Mexico is unknown. Material and methods: We tested 1062 bronchial lavage samples from neonates with respiratory distress syndrome for Chlamydia infection. The diagnosis of Chlamydia was made by plasmid detection with an in-house PCR assay, and genotypes were identified using a PCR-RFLP assay for the ompA gene. Results: The genotyping of 40 strains identified 14 as I/Ia (35%), 13 as E (32.5%), 7 as D (17.5%), 5 as F (12.5%), and 1 as L2 (2.5%). The relative risk analysis showed that genotype D was associated with neonatal sepsis (RR, 5.83; 95% confidence interval [CI], 1.51-25.985; P<.02), while the I/Ia genotype was significantly associated with chorioamnionitis in the mother (2.8; 95% CI, 1.4–5.5; P<.05). Conclusions: Although Chlamydia trachomatis genotypes I/Ia and E of were the strains involved most frequently in respiratory infections in Mexican neonates, 80% of patients with genotype F developed respiratory disease. In contrast, genotype D was associated with neonatal sepsis, and genotype I/Ia with chorioamnionitis. (AU)

Identification of Chlamydia trachomatis genotypes in newborns with respiratory distress.

INTRODUCTION: One hundred thirty million Chlamydia trachomatis infections are reported worldwide each year. Nineteen serotypes of this pathogen can cause infection in pregnant women and neonates. The distribution of these genotypes in newborns with respiratory infections in Mexico is unknown. MATERIAL AND METHODS: We tested 1062 bronchial lavage samples from neonates with respiratory distress syndrome for Chlamydia infection. The diagnosis of Chlamydia was made by plasmid detection with an in-house PCR assay, and genotypes were identified using a PCR-RFLP assay for the ompA gene. RESULTS: The genotyping of 40 strains identified 14 as I/Ia (35%), 13 as E (32.5%), 7 as D (17.5%), 5 as F (12.5%), and 1 as L2 (2.5%). The relative risk analysis showed that genotype D was associated with neonatal sepsis (RR, 5.83; 95% confidence interval [CI], 1.51-25.985; P < .02), while the I/Ia genotype was significantly associated with chorioamnionitis in the mother (2.8; 95% CI, 1.4-5.5; P < .05). CONCLUSIONS: Although C. trachomatis genotypes I/Ia and E of were the strains involved most frequently in respiratory infections in Mexican neonates, 80% of patients with genotype F developed respiratory disease. In contrast, genotype D was associated with neonatal sepsis, and genotype I/Ia with chorioamnionitis.

Evaluation of the goat cellular immune response to rBtuB-Hia-FlgK peptides from Brucella melitensis.

Brucellosis is a zoonosis caused by Brucella; B. melitensis is the most prevalent species in goats and humans. Previously, three B. melitensis peptides, rBtuB-Hia-FlgK showed antigen-specific immune responses in rodent models. The goal of this study was to evaluate the goat Th1/Th2 immune response to B. melitensis peptides. Twenty-eight animals were separated into four groups and were immunized with the rBtuB-Hia-FlgK peptides cocktail, adjuvant, PBS and Rev-1 vaccine, respectively. Peripheral blood samples were collected on days 0, 15, and 80 post-inoculation. The CD4+ and CD8+ T cells proliferation, and cytokine production of the Th-1 (IL-2, IL-12, TNF-α, and IFN-γ) and Th-2 profiles (IL-4, IL-5, and IL-10) were evaluated. An increase of CD4+/CD8+ at 15 days post-vaccination was observed and continued until the 80th. In addition, the IFN-γ, TNF-α, and IL-2 mRNA expression were typically induced by the 15th day, but only IFN-γ levels were observed at day 80 post-immunization. Brucella pathogenesis is distinguished by the presence of a large amount of Th-1 cytokines. Although a reduced amount of IFN-γ in the culture supernatant was accurately detected compared with Rev-1 after 15 days, it could be influenced by the sampling schedule, as a higher cytokine production might be induced as early as the first-week post-vaccination. The results indicate that rBtuB-Hia-FlgK induced an immune response similar to the Rev-1 vaccine. The possible use of inert molecules with the unique ability to typically induce cellular response similar to attenuated vaccine represents an attractive option that should not be ruled out.

Identification of Chlamydia trachomatis genotypes in Mexican men with infertile women as sexual partners / Identificación de genotipos de Chlamydia trachomatis en hombres mexicanos con mujeres infértiles como parejas sexuales

Background: Chlamydia trachomatis is considered a public health problem due to the high prevalence in sexually active women and men. The distribution of genital Chlamydia genotypes among Mexican men is unknown. Objective: To assess the prevalence of Chlamydia genotypes in men with infertile women as sexual partners. Methods: A total of 659 urine samples were collected from men whose sexual partners were infertile women; the identifying Chlamydia infection was by means of a real-time nucleic acid amplification test (qPCR). OmpA gene PCR-RFLP and sequencing were used to confirm the genotypes of C. trachomatis. The association of genotypes with age, spermatic parameters and gynecological data of sexual partners was further analyzed. Results: Forty-nine urine samples were positive infection (7.4%). The Chlamydia infection was significantly associated with teratozoospermia, azoospermia, hypospermia, and oligozoospermia. Five genotypes (F 51%; 12.2% to D; 12.2% to E; 6.1% to L2 and 4.1% Ia) were correctly identified. None genotypes identified in this comparative study were positively associated with changes in some of the spermatic values because all of them typically produce some considerable damage to these cells. Conclusions: The F genotype was the most frequent genotype identified in infertile men from Mexico City and all genotypes play an important role in the seminal alteration of Mexican men whose female partners are infertile.(AU)

Antecedentes: Chlamydia trachomatis se considera un problema de salud pública debido a la alta prevalencia en mujeres y hombres sexualmente activos. Se desconoce la distribución de los genotipos genitales de Chlamydia entre los hombres mexicanos.Objetivo: Evaluar la prevalencia de los genotipos de Chlamydia en hombres con mujeres infértiles como parejas sexuales. Métodos: Se recogieron 659 muestras de orina de hombres cuyas parejas sexuales eran mujeres infértiles; la identificación de la infección por Chlamydia se realizó mediante una prueba de amplificación de ácido nucleico en tiempo real (qPCR). Se utilizaron la PCR-RFLP y la secuenciación del gen OmpA para confirmar los genotipos de C. trachomatis. Se analizó en mayor profundidad la asociación de los genotipos con la edad, los parámetros espermáticos y los datos ginecológicos de las parejas sexuales. Resultados: Cuarenta y nueve muestras de orina dieron positivo para la infección (7,4 %). La infección por Chlamydia se asoció significativamente con la teratozoospermia, la azoospermia, la hipospermia y la oligozoospermia. Se identificaron correctamente cinco genotipos (F 51 %; 12,2 % para D; 12,2 % para E; 6,1 % para L2 y 4,1 % Ia). Ninguno de los genotipos identificados en este estudio comparativo se asoció positivamente con cambios en algunos de los valores espermáticos porque todos ellos suelen producir algún daño considerable en estas células. Conclusiones: El genotipo F fue el más frecuente identificado en hombres infértiles de Ciudad de México y todos los genotipos desempeñan un papel importante en la alteración seminal de los hombres mexicanos cuyas parejas femeninas son infértiles.(AU)

Identification of Chlamydia trachomatis genotypes in Mexican men with infertile women as sexual partners.

BACKGROUND: Chlamydia trachomatis is considered a public health problem due to the high prevalence in sexually active women and men. The distribution of genital Chlamydia genotypes among Mexican men is unknown. OBJECTIVE: To assess the prevalence of Chlamydia genotypes in men with infertile women as sexual partners. METHODS: A total of 659 urine samples were collected from men whose sexual partners were infertile women; the identifying Chlamydia infection was by means of a real-time nucleic acid amplification test (qPCR). OmpA gene PCR-RFLP and sequencing were used to confirm the genotypes of C. trachomatis. The association of genotypes with age, spermatic parameters and gynecological data of sexual partners was further analyzed. RESULTS: Forty-nine urine samples were positive infection (7.4%). The Chlamydia infection was significantly associated with teratozoospermia, azoospermia, hypospermia, and oligozoospermia. Five genotypes (F 51%; 12.2% to D; 12.2% to E; 6.1% to L2 and 4.1% Ia) were correctly identified. None genotypes identified in this comparative study were positively associated with changes in some of the spermatic values because all of them typically produce some considerable damage to these cells. CONCLUSIONS: The F genotype was the most frequent genotype identified in infertile men from Mexico City and all genotypes play an important role in the seminal alteration of Mexican men whose female partners are infertile.

Acanthosis Nigricans Is a Strong Predictor of Low Blood Calcidiol Levels in Children and Adolescents.

Background: Clinical consensus differs as to when blood vitamin D (VD) levels should be measured in children. Obesity and metabolic syndrome are risk factors for low VD levels and are also associated with acanthosis nigricans (AN). Objectives: To test whether the clinical diagnosis of AN is a strong predictor for vitamin D deficiency (VDD) in children. Methods: Within the study period (2015-2020), we identified 677 consecutive individuals (age <18 years) with available calcidiol measurements and compared those with (n = 273) and without (n = 404) AN. Bivariate associations and the occurrence of AN were tested using the chi-squared test. Multivariate logistic regression was performed to control for confounding variables, and adjusted odds ratios with 95% confidence intervals (CI) were reported. Multiple regression analysis was performed, and unstandardized beta coefficients, standard errors, and standardized beta coefficients were reported. Results: Individuals with AN had 3.6 times higher odds of VDD than those without (95% CI: 1.38-9.51, P = 0.009). Males had 0.41 times lower odds of having AN than females (95% CI: 0.21-0.79, P = 0.008). Individuals with vitamin D sufficiency (VDS) were much less likely to be diagnosed with metabolic syndrome compared with those who were vitamin D deficient (P = 0.011), even after adjusting for body mass index z-scores. Conclusion: Children and adolescents with AN are at a higher risk of VDD and should likely be tested for low calcidiol levels.

Detección de Chlamydia spp. en leucocitos de sangre periférica de ovinos sin aborto previo / Detection of Chlamydia spp. In Peripheral Blood Leukocytes in Ewes without any Previous Abortion

Resumen El aborto enzootico ovino es una enfermedad causada por Chlamydia abortus. Es considerada una zoonosis y una de las principales causas de pérdidas económicas en estas explotaciones. Este trabajo se enfocó en utilizar el cultivo de leucocitos de animales sin signos de abortos y la detección de anticuerpos para determinar la posible presencia de C. abortus en explotaciones de traspatio. Se obtuvieron 42 muestras de sangre periférica de ovejas de diferentes poblaciones. La detección de Chlamydia abortus se realizó mediante la tinción de Giemsa y la técnica de PCR. La detección de anticuerpos anti-C. abortus se dio mediante una técnica de ELISA comercial. Los resultados mostraron 21 muestras positivas mediante la técnica de PCR, de las cuales solo 10 fueron positivas mediante la técnica de Giemsa, mientras que 22 sueros mostraron anticuerpos anti-C. abortus. En este estudio el 38,1 % de las muestras fueron positivas a la infección por C. abortus, como se confirmó mediante PCR y serología. En conclusión, los leucocitos de sangre periférica pueden ser útiles para detectar una infección por Chlamydia spp. en explotaciones sin historial de abortos, con lo que se puede conocer la prevalencia real del aborto enzootico ovino en México.

Abstract The Ewes Enzootic Abortion is a disease caused byChlamydia abortus. It is deemed a zoonosis and one of the leading causes of financial losses in this type of business. This article focuses on using the culture of leukocytes from animals without any abortion symptoms and antibody detection to determine the potential presence ofC. abortusin backyard exploitations. Forty-two samples of peripheral blood were obtained from ewes in different populations. The detection ofChlamydia abortuswas carried out by using the Giemsa dye and PCR technique. Anti-C. Abortusantibody detection was performed through a commercial ELISA technique. Results showed 21 positive samples using the PCR, and only ten were positive according to the Giemsa dye, while 22 serum samples showed anti-C. abortusantibody. In this study, 38.1% of the samples were positive for theC. abortusinfection, as verified with the PCR and serology. In conclusion, peripheral blood leukocytes can be helpful to detect an infection caused byChlamydiaspp. Animal exploitation without any previous abortion allows knowing the real prevalence of ewes' enzootic abortion in Mexico.

Prevalencia de Chlamydia trachomatis en mujeres del Hospital General de Zona No. 29 / Chlamydia trachomatis prevalence in women from the Hospital General de Zona No. 29

Introducción: la Chlamydia trachomatis es la principal causa de infecciones bacterianas de transmisión sexual a nivel mundial. Se estima que cada año se producen 131 millones de casos. Cursa de manera asintomática, pero la infección ascendente en mujeres puede conducir a la enfermedad inflamatoria pélvica, embarazo ectópico e infertilidad. Objetivo: determinar la prevalencia de C. trachomatis en mujeres de población abierta que acuden al Hospital General de Zona No. 29. Material y métodos: se realizó la identificación de C. trachomatis por pruebas de PCR a 200 muestras de exudado vaginal y se determinó su genotipo. Paralelamente, se realizó el diagnóstico microbiológico de rutina. Resultados: la prevalencia de C. trachomatis fue del 8.5% (17/200) con una concomitancia significativa de p = 0.006 con Gardnerella vaginalis (riesgo relativo de 2.871, IC95%: 1.574-5.236). Asimismo, se identificó C. trachomatis en cinco muestras como el único agente etiológico. Dieciséis cepas de C. trachomatis pertenecieron al genotipo F. Una cepa identificada de C. trachomatis presentó motivos genéticos similares a la variante mexicana reportada en 2019. Conclusiones: la prevalencia de C. trachomatis en la población estudiada nos indica la necesidad de implementar técnicas de diagnóstico para esta bacteria. El uso de la PCR permite realizar una determinación genotípica rápida, que explicaría el comportamiento epidemiológico de la C. trachomatis y representaría una mejora significativa de la calidad de vida de la paciente.

Background: Chlamydia trachomatis is the main cause of sexually transmitted bacterial infections worldwide. An estimated of 131 million cases occur each year. It is asymptomatic, but ascending infection in women can lead to pelvic inflammatory disease, ectopic pregnancy, and infertility. Objective: To determine the prevalence of C. trachomatis in open population women who attend the Hospital General de Zona No. 29. Material and methods: Identification of C. trachomatis was carried out by PCR testing of 200 vaginal exudate samples and its genotype was determined. In parallel, a routine microbiological diagnosis was carried out. Results: The prevalence of C. trachomatis was 8.5% (17/200) with a significant concomitance of p = 0.006 with Gardnerella vaginalis (relative risk of 2.871, 95%CI: 1.574- 5.236). Likewise, C. trachomatis was identified in 5 samples as the only etiological agent. Sixteen strains of C. trachomatis belong to genotype F. An identified strain of C. trachomatis presented genetic motifs similar to the Mexican variant repor- ted in 2019. Conclusions: The prevalence of C. trachomatis in the studied population indicates the need to implement diagnostic techniques for this bacterium. The use of PCR allows a rapid genotypic determination that would explain the epidemiological behavior of C. trachomatis and would represent a sig- nificant improvement in the quality of life of the patient.

Identification of Chlamydia trachomatis genotypes in Mexican men with infertile women as sexual partners.

BACKGROUND: Chlamydia trachomatis is considered a public health problem due to the high prevalence in sexually active women and men. The distribution of genital Chlamydia genotypes among Mexican men is unknown. OBJECTIVE: To assess the prevalence of Chlamydia genotypes in men with infertile women as sexual partners. METHODS: A total of 659 urine samples were collected from men whose sexual partners were infertile women; the identifying Chlamydia infection was by means of a real-time nucleic acid amplification test (qPCR). OmpA gene PCR-RFLP and sequencing were used to confirm the genotypes of C. trachomatis. The association of genotypes with age, spermatic parameters and gynecological data of sexual partners was further analyzed. RESULTS: Forty-nine urine samples were positive infection (7.4%). The Chlamydia infection was significantly associated with teratozoospermia, azoospermia, hypospermia, and oligozoospermia. Five genotypes (F 51%; 12.2% to D; 12.2% to E; 6.1% to L2 and 4.1% Ia) were correctly identified. None genotypes identified in this comparative study were positively associated with changes in some of the spermatic values because all of them typically produce some considerable damage to these cells. CONCLUSIONS: The F genotype was the most frequent genotype identified in infertile men from Mexico City and all genotypes play an important role in the seminal alteration of Mexican men whose female partners are infertile.

Awareness and utilisation of advanced gynaecological ultrasound in the preoperative work-up of women planning surgery for endometriosis: A survey of RANZCOG fellows and trainees.

BACKGROUND: Endometriosis-specific (advanced gynaecological) ultrasound is recommended as part of preoperative work-up of women with suspected endometriosis. AIM: To evaluate the awareness and utilisation of advanced gynaecological ultrasound in the preoperative work-up of women with suspected endometriosis among active RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) fellows and trainees. MATERIALS AND METHODS: Anonymous online survey invitations were emailed to all active RANZCOG fellows in Australia and New Zealand. Descriptive analysis of responses and multivariate analysis where appropriate were performed. P < 0.05 was considered statistically significant. RESULTS: A 17% (437/2567) survey response rate and 93% (409/437) completion rate were recorded; 59% (248/421) of respondents identified as generalists, whereas 15% (63/421) identified as advanced laparoscopic surgeons. Routine pelvic ultrasound (88.9%, 361/406) was the most common imaging modality requested by respondents; 32% (128/405) of respondents would also always request advanced gynaecology ultrasound. Respondents' self-reported practice type was significantly associated with utilisation of advanced gynaecological ultrasound (P = 0.03); 79.6% (348/437) agreed with our proposed definition of advanced gynaecological ultrasound for endometriosis. A major limitation to the utilisation of advanced gynaecological ultrasound for endometriosis was the lack of local expertise (63.8%, 233/356). CONCLUSION: The utilisation of advanced gynaecological ultrasound for endometriosis is significantly influenced by respondents' self-reported practice type and limited by the lack of local expertise.

Surface Electrocardiographic Parameters of Children and Adolescents Diagnosed with Attention-Deficit/Hyperactivity Disorder in an Ambulatory Community Pediatric Center: A Focus on Cardiac Repolarization Electrocardiogram Intervals.

Objectives: Our research aims were to determine if repolarization measures (QTcF, QTcB, JTcF, and JTcB) in attention-deficit/hyperactivity disorder (ADHD) children and adolescents differ from normal subjects and determine if the JTc interval duration, as a purer repolarization measure than QTc, strengthens the differentiation between ADHD and normal children and adolescents. Methods: This study included 418 subjects aged 5-18 years who were diagnosed with ADHD, and 1948 subjects in a historical normal control group. One-way analysis of variance (ANOVA) was performed to compare the independent groups on normal continuous outcomes. Means and standard deviations (SDs) were reported and interpreted for the ANOVA. Logistic regression analysis was performed to test the ability of four variables (QTcB, QTcF, JTcB, and JTcF) to predict an ADHD diagnosis, with age and gender as independent covariates. The log odds with standard errors for each variable were reported and interpreted for the logistic models. Results: In the nominal logistic regressions with JTcF ≥322 or JTcB ≥335 (values 1 SD above the mean of the control group), age and sex were significant contributors to the models that showed that subjects with a JTcF ≥322 ms had a statistically and significantly higher probability to be diagnosed with ADHD in comparison with normal control subjects (odds ratio [OR]: 2.6, 95% confidence interval [95% CI] 2.02-3.33, p < 0.0001). Similarly, those subjects with a JTcB ≥335 ms were 2.7 times more likely to be diagnosed with ADHD than normal control subjects (OR: 2.7, 95% CI 2.1-3.45, p < 0.0001). Conclusions: JTc provided a clearer separation of the groups than QTc. JTcB and JTcF 1 SD above the control group means are strong predictors of ADHD diagnosis and remain so even when strong demographic predictors of longer QTc (age and sex) are included in the regression models. Consideration should be given to recording a pretreatment electrocardiogram in all children and adolescents with ADHD, and to measuring and monitoring JTc in patients with ADHD, especially when considering the addition of QT prolonging drugs.

[Chlamydia trachomatis prevalence in women from the Hospital General de Zona No. 29]. / Prevalencia de Chlamydia trachomatis en mujeres del Hospital General de Zona No. 29.

BACKGROUND: Chlamydia trachomatis is the main cause of sexually transmitted bacterial infections worldwide. An estimated of 131 million cases occur each year. It is asymptomatic, but ascending infection in women can lead to pelvic inflammatory disease, ectopic pregnancy, and infertility. OBJECTIVE: To determine the prevalence of C. trachomatis in open population women who attend the Hospital General de Zona No. 29. MATERIAL AND METHODS: Identification of C. trachomatis was carried out by PCR testing of 200 vaginal exudate samples and its genotype was determined. In parallel, a routine microbiological diagnosis was carried out. RESULTS: The prevalence of C. trachomatis was 8.5% (17/200) with a significant concomitance of p = 0.006 with Gardnerella vaginalis (relative risk of 2.871, 95%CI: 1.574-5.236). Likewise, C. trachomatis was identified in 5 samples as the only etiological agent. Sixteen strains of C. trachomatis belong to genotype F. An identified strain of C. trachomatis presented genetic motifs similar to the Mexican variant reported in 2019. CONCLUSIONS: The prevalence of C. trachomatis in the studied population indicates the need to implement diagnostic techniques for this bacterium. The use of PCR allows a rapid genotypic determination that would explain the epidemiological behavior of C. trachomatis and would represent a significant improvement in the quality of life of the patient.

INTRODUCCIÓN: la Chlamydia trachomatis es la principal causa de infecciones bacterianas de transmisión sexual a nivel mundial. Se estima que cada año se producen 131 millones de casos. Cursa de manera asintomática, pero la infección ascendente en mujeres puede conducir a la enfermedad inflamatoria pélvica, embarazo ectópico e infertilidad. OBJETIVO: determinar la prevalencia de C. trachomatis en mujeres de población abierta que acuden al Hospital General de Zona No. 29. MATERIAL Y MÉTODOS: se realizó la identificación de C. trachomatis por pruebas de PCR a 200 muestras de exudado vaginal y se determinó su genotipo. Paralelamente, se realizó el diagnóstico microbiológico de rutina. RESULTADOS: la prevalencia de C. trachomatis fue del 8.5% (17/200) con una concomitancia significativa de p = 0.006 con Gardnerella vaginalis (riesgo relativo de 2.871, IC95%: 1.574-5.236). Asimismo, se identificó C. trachomatis en cinco muestras como el único agente etiológico. Dieciséis cepas de C. trachomatis pertenecieron al genotipo F. Una cepa identificada de C. trachomatis presentó motivos genéticos similares a la variante mexicana reportada en 2019. CONCLUSIONES: la prevalencia de C. trachomatis en la población estudiada nos indica la necesidad de implementar técnicas de diagnóstico para esta bacteria. El uso de la PCR permite realizar una determinación genotípica rápida, que explicaría el comportamiento epidemiológico de la C. trachomatis y representaría una mejora significativa de la calidad de vida de la paciente.

Detección atípica de Chlamydia pneumoniae no humana en una muestra endocervical. Reporte de caso / Atypical detection of non-human Chlamydia pneumoniae in an endocervical sample. Case Report

Resumen ANTECEDENTES: Chlamydia trachomatis es uno de los principales microorganismos de trasmisión sexual asociado de manera importante con infertilidad femenina. La detección de genotipos y nuevas variantes de Chlamydia trachomatis permite conocer su prevalencia, distribución geográfica, identificar la aparición de resistencia antimicrobiana y las asociaciones clínicas o comportamientos sexuales y desarrollar vacunas. Este caso clínico es el primer informe de infección endocervical por una cepa diferente a C trachomatis. CASO CLÍNICO: Paciente de 25 años, con diagnóstico de infertilidad primaria de 2 años de evolución por factor endocrino-ovárico (sobrepeso e hipotiroidismo subclínico) y por factor masculino de hipospermia y teratozoospermia. El cultivo microbiológico endocervical detectó la infección por Ureaplasma spp y Chlamydia spp. La identificación de la cepa de Chlamydia mediante secuenciación del gen 16S del ARNr informó que era Chlamydia pneumoniae. La existencia de un plásmido en esta cepa de C pneumoniae confirmó que la infección endocervical fue por una cepa de Chlamydia pneumoniae no humana. CONCLUSIÓN: Este caso clínico sugiere la posibilidad de que una cepa de C pneumoniae no humana sea capaz de trasmitirse sexualmente a los humanos, estar circulando en la población mexicana y causar infertilidad, aunque aún se desconocen el origen y la dirección de la trasmisión.

Abstract BACKGROUND: Chlamydia trachomatis is one of the leading sexually transmitted microorganisms that is significantly associated with the development of female infertility. The detection of genotypes and new variants ofChlamydia trachomatisallows us to know their prevalence and geographic distribution, identify the appearance of antimicrobial resistance, clinical associations, or sexual behaviors, and develop vaccines. This clinical case reports for the first time endocervical infection by a strain other thanC. trachomatis. CLINICAL CASE: A 25-year-old woman with primary infertility of 2 years of evolution due to endocrine-ovarian factor (overweight and subclinical hypothyroidism) and male factor characterized by hypospermia and teratozoospermia. Endocervical microbiological culture detected infection byUreaplasma urealyticumandChlamydiaspp. Identification of theChlamydiastrain by sequencing the 16S rRNA gene reported that it wasChlamydia pneumoniae. The presence of plasmid in this strain ofC. pneumoniaeconfirmed that the endocervical infection was by a non-humanChlamydia pneumoniaestrain. CONCLUSION: This clinical case suggests that a non-human strain ofC. pneumoniaecan be sexually transmitted to humans, circulating in the Mexican population, and causing infertility, although the origin and direction of transmission are still unknown.

Co-infection between genotypes of the human papillomavirus and Chlamydia trachomatis in Mexican women.

Not all human papillomavirus (HPV) infections develop into cervical cancer (CC), so it is proposed that other factors may influence this, such as co-infection with Chlamydia trachomatis (CT). To identify the prevalence of co-infection, we included 189 women with suspicion of HPV. Viral typing was performed by carrying out the Roche HP Linear Array test, while CT detection was performed with the COBAS® TaqMan® 48 kit from Roche. Of the 189 women only 184 had an infection with HPV, CT or both: 56.6% were positive for one or several HPV genotypes, and 67.7% for CT. Clinical data showed an association between HPV and CIN I (n = 22; RR = 2.43; 95% CI 1.72-3.43, p < 0.05). CT infection was only associated with cervicitis (n = 40; RR = 1.73; 95% CI 1.34-2.23, p < 0.05). The CT-HPV co-infection rate was 28%. Co-infection revealed an association with CIN I (n = 31, RR= 3.33; 95% CI 2.08-5.34 p < 0.05), CIN III (n = 7; RR = 2.57; 95% CI 1.53-4.31, p < 0.05); and a significant risk of 2.3 (95% CI 1.08-4.90) times higher to develop CC; nevertheless, this risk was not statistically significant. CT/HPV co-infection was associated with the development of a high-grade lesion (CIN III) as well as an important risk for developing CC.

Riesgo de infección en recién nacidos expuestos a la colonización vaginal por Chlamydia trachomatis / Risk of infection in newborns exposed to vaginal colonisation by Chlamydia trachomatis

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