Gonococcal infection: An unresolved problem. / Infección gonocócica: un problema aún sin resolver.

Gonococcal infection is a current public health problem worldwide, being the second most prevalent bacterial sexually transmitted infection. The etiologic agent is Neisseria gonorrhoeae, a gram-negative diplococcus, and mainly causes urethritis in men. In women up to 50% of infections can be asymptomatic. N. gonorrhoeae has a great ability to develop antibiotic resistance, so the last remaining therapeutic option are extended spectrum cephalosporins. Many guides recommend dual therapy with ceftriaxone and azithromycin, but in recent years the resistance to azithromycin is also increasing, so that dual treatment is being questioned by scientific societies.

Keeping an Eye on Chlamydia and Gonorrhea Conjunctivitis in Infants in the United States, 2010-2015.

Perinatal transmission of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) can result in conjunctivitis in infants. We examined national rates of reported CT/GC conjunctivitis among infants. Surveillance of these infections is heavily affected by the completeness of reported data on specimen source and age. Alternative data sources should be evaluated.

[Sexually transmitted diseases in Poland in 2004 and 2005]. / Choroby przenoszone droga plciowa w Polsce w 2005 roku w swietle danych z 2004 roku.

In 2005 year 809 cases of all forms of syphilis were notified in Poland; incidence 2.12 per 100,000 population (2004 year--784, incidence--2.05). The largest number of cases was in mazowiecke (205), slaskie (138), and dolnoslaskie (100) voivodeships. The lowest was registered in warminsko-mazurskie (8 cases), podkarpackie (10) swietokrzyskie(10) voivodeships. There were recognized 402 cases of gonorrhoea (in 2004 - 520). Epidemiological situation of sexually transmitted diseases was unfavourably due to growth of cases latent syphilis (early and tarda) in Poland. Its was diagnosed insufficiency due to decreases number of screening studies, particularly in blood donors and pregnant women. Prophylaxis and education actions was difficulty because money was lacking.

Sexually transmitted diseases in neonates and infants.

With the current resurgence of sexually transmitted diseases (STDs), familiarity with the clinical manifestations of STDs in neonates and infants is essential to minimize the tragic consequences. The recognized routes of transmission of the diseases include transplacental, intrapartum, and postpartum exposure. This discussion will be confined to infections caused by syphilis, herpes simplex virus, human papillomavirus, gonorrhea, and chlamydia emphasizing clinical aspects in this population.

Protección específica contra el gonococo / Specific protection against gonococcus

La gonorrea constituye actualmente un problema importante de salud pública, cuyo impacto se refleja en su morbilidad y a través de sus complicaciónes y secuelas crónicas. El agente causal es Neisseria gonorrhoeae, conocido comúnmente como gonococo, y su único hospedero es el humano. Su forma de transmisión es por el contacto sexual o perinatal. cuando en 1985 se realizó el ensayo clínico de una vacuna producida con pili de gonococo en unos 3,000 voluntarios, se pensaba que las investigaciones para producir una vacuna para gonococo estaban cercanas a lograr su propósito. Sin embargo, a partir de entonces se han debido enfrentar problemas inherentes a las complejidades fisiológicas, inmunoquímicas, moleculares y genéticas de la bacteria. La obtención de una vacuna eficaz puede analizarse desde tres puntos de vista: aspectos de la bacteria, del huésped y con los de la vacuna misma. La identificación de los posibles candidatos para una vacuna se han dirigido a seleccionar componentes que sean constantes entre cepas homólogas y cepas heterólogas, que no dañen el sistema inmunológico del huésped y que estén expuestos en la pared celular de las bacterias. Se ha considerado que los pili, la proteína I, la lipoproteína y la proteína receptora de hierro reúnen estas características. En caso de que la protección que otorgue la vacuna únicamente sea para las complicaciones ocacionadas por la diseminación de la bacteria, ésta será insuficiente para interrumpir la cadena de transmisión

Gonococcal infection of the newborn in Florida, 1984-1989.

An increase in neonatal gonococcal infections was recorded in Florida between 1984 and 1988. By reviewing Florida sexually transmitted disease surveillance case records between 1984 and 1989, 68 cases of neonatal gonococcal infections were identified state-wide. Those 68 cases included 55 (81%) cases of gonococcal ophthalmia neonatorum, 4 genital infections, 1 nasal infection, 1 ear infection, 1 skin infection, and 1 scalp infection. At birth, positive culture results were demonstrated in 3 gastric and 2 respiratory aspirate cultures. A case-control study using birth certificates as the source of information showed that mothers of infected infants were more likely to be younger, black (odds ratio [OR] = 6.2; 95% confidence interval [CI] 2.3, 16.2), and less educated (less than a high school education, OR = 2.9, CI 1.0,8.8) in comparison to mothers of control subjects. Although mothers of infected newborns were less likely to have received prenatal care than were mothers of control subjects, this difference was not statistically significant. Maternal substance abuse was documented among 19% of the mothers of the infected infants. The rate of clinical gonococcal ophthalmia neonatorum in Florida hospitals from which cases had been reported was 1.7 per 10,000 live births, and tended to be higher in hospitals using erythromycin than in hospitals using any other prophylactic eye treatment. This study suggests that the rate of neonatal gonococcal infection, in particular ophthalmia neonatorum, may have increased in Florida among high-risk populations between 1984 and 1988, and underscores the need for targeted prevention efforts and surveillance.

Perinatal transmission of bacterial sexually transmitted diseases. Part I: Syphilis and gonorrhea.

Sexually transmitted diseases (STDs) have reached epidemic proportions in the United States and have captured the attention of both laypersons and health professionals. Of special concern is that most STDs can be transmitted vertically to the offspring of infected mothers. Since the advent of acquired immunodeficiency syndrome, other STDs have been at risk of being relatively disregarded. This paper, the first of two parts, reviews issues of prevalence, morbidity, mortality, prevention and treatment of syphilis and gonorrhea as they affect the maternal-fetal dyad.

Maternal and infant sexually transmitted diseases.

Sexually transmitted infection may result in serious damage to the reproductive tract of the mother, damage to the fetus, wastage of pregnancy, or illness or death of the infant. The effects of gonorrhea, Chlamydia trachomatis infection, mycoplasmal infections, group B streptococcus infections, syphilis, and viral infections are discussed separately for both mother and infant.

Gonococcal ophthalmia neonatorum: the case for prophylaxis in tropical Africa.

PIP: During a period when silver nitrate prophylaxis against ophthalmia neonatorum was discontinued in the maternity ward of the Yaounde Central Hospital, a study was begun of the prevalence of gonorrheal infection among women and their newborns. Strains of oxidase-positive gonococci were isolated on modified Thayer-Martin agar from vaginal pool specimens of 40 (14%) of the 296 women studied and from the conjunctiva of 12 (4%) of their 297 liveborn children. The risk of transmission from and infected mother to her child was 30%. No specific symptoms of infection were observed by the mothers with positive cultures at the time of delivery, though 14 of them gave a history of having received treatment for a vaginal infection during pregnancy. Younger, low parity womenwere at a higher risk of infection. Since gonococcal ophthalmia neonatorum is a preventable cause of blindness, the increasing incidence of gonorrheal infection in Africa calls for an urgent reexamination of policies for the prevention of this infection among African women and their newborn children, the majority of whom are born without antenatal care or a trained birth attendant. (author's modified)^ieng

Gonococcal scalp abscess in a newborn.

We have described a 6-day-old male infant who presented with Neisseria gonorrhoeae conjunctivitis and a scalp abscess. Delivery was complicated by rupture of the membranes 24 hours before delivery and fetal monitoring for four hours. The rare scalp abscesses caused by gonococci cleared with penicillin therapy.