Prevalence of sexually transmitted infections in female sex workers in Athens, Greece - 2005.

There is little data on the prevalence of STIs in female sex workers, Greek and immigrants, working in Athens, Greece, since most of them work without any form of official license. Our aim was to establish the prevalence of STIs in asymptomatic legal Greek and immigrant female sex workers in Athens, Greece. The study involved an evaluation of gonococcal and chlamydial infection, early infectious syphilis, HIV infection, HSV-2 infection, Hepatitis B and C in 299 female sex workers who applied for an official work permit between May 2005 and October 2005. HSV-2 infection was more common in the Greek sex workers. No difference was found for the other STIs. Prevalence was related to age. A significant association was found between HSV-2 and syphilis. No HIV infection was detected. We concluded that asymptomatic sex workers can be a source of STIs which points out the need for a better health system control in Greece.

Characterization of Neisseria gonorrhoeae strains with decreased susceptibility to fluoroquinolones isolated in Greece from 1996 to 1999.

Of the 331 Neisseria gonorrhoeae strains isolated in Greece from 1996 to 1999, 39 (11.8%) exhibited decreased susceptibility to quinolones due to gyrA and parC mutations. Conventional typing and pulsed-field gel electrophoresis showed that 34 of these isolates were clonally related. Epidemiological data indicated that the epidemic clone was sustained in a group of high-frequency transmitters.

Epidemiologic aspects of male gonococcal infection in Greece.

OBJECTIVE: To report male gonorrhea incidence trends between the years 1974 and 1996 and compare the epidemiologic characteristics of the affected population during periods of high and low incidence of the disease. STUDY DESIGN: Retrospective study of all available data for male gonorrhea cases recorded annually in a major STD hospital in Greece since 1974. RESULTS: An abrupt drop in gonorrhea relative incidence occurred in 1986, followed by low rates thereafter. In the context of the overall decline in the incidence of the disease, a shift to older ages, longer time elapsed before seeking medical assistance, and higher proportion of disease repeaters was noticed among the patients. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence presented erratic time fluctuations, indicating that they have not been established as endemic in the Greek population. CONCLUSION: The core group hypothesis in terms of nighttime sociosexual activity can be used to interpret most of the findings.

PIP: Trends in Neisseria gonorrhoeae incidence rates in men presenting to a major sexually transmitted disease hospital (Andreas Sygros) in Athens, Greece, in 1974-96 were evaluated and gonorrhea risk factors during periods of low and high incidence were compared. An abrupt drop in the relative incidence of gonorrhea occurred in 1986, followed by low rates thereafter. A comparison of the periods 1974-85 (high incidence) and 1986-96 (low incidence) revealed a 1.27-fold decrease in total attendance to the hospital and a 5-fold decrease in the number of gonorrhea cases detected. Observed over time was a shift to older ages, longer time elapsed before seeking medical assistance, and a higher proportion of disease repeaters. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence was characterized by erratic time fluctuations, suggesting that they have not become endemic in the Greek population. Changes observed in the features of the affected population indicate a trend toward increased risk in sexual behavior.

Antimicrobial susceptibility and types of Neisseria gonorrhoeae in Greece. Data for the period 1990 to 1993.

BACKGROUND: Surveillance of the rapidly changing patterns of antimicrobial resistance of Neisseria gonorrhoeae is imperative for monitoring gonococcal infection. GOAL: To describe the types and the antimicrobial susceptibility profile of a representative samples of gonococci isolated in Greece between 1990 and 1993. STUDY DESIGN: The antimicrobial susceptibilities, serovar/auxotypes classes, and plasmid contents of 263 consecutive isolates of N. gonorrhoeae, recovered from cases of male gonococcal urethritis, were determined. RESULTS: Penicillinase-producing N. gonorrhoeae (PPNG) were isolated at a rate of 6.1% and were mostly from imported cases of infection. Six (2.3%) of the isolates (one PPNG and five non-PPNG) were highly resistant to tetracycline, and one PPNG strain was resistant to norfloxacin and ciprofloxacin. Strains with chromosomal resistance to penicillin, tetracycline, erythromycin, and chloramphenicol accounted for 18.5%, 12.5%, 19%, and 16% of the isolates, respectively; much higher proportions of strains were intermediately susceptible to these antibiotics. Spectinomycin and cefotaxime were active against all gonococci studied. A shift to IB serovars and to sporadic types of strains was noted from previous years among the non-PPNG isolates. This is compatible with the marked increase in the rate of imported cases of infection caused by n on-PPNG strains. CONCLUSIONS: The emergence of high-level resistance to tetracycline and resistance to fluoroquinolones was ascertained. At the present, however, the main problem with gonococcal resistance in Greece seems to ensue from the increasing rates of chromosomally resistant strains. Moreover, the increasing frequency of imported gonococci underlines the necessity for continuous epidemiologic surveillance.

Effects of synthetic retinoids on the growth of bacteria and their susceptibility to antibiotics.

In patients treated with oral retinoids the recovery of Propionibacterium acnes and other anaerobic bacteria in the skin is markedly reduced, whereas an increased colonization of the skin and a significant rise in the incidence of cutaneous staphylococcal infections are observed. Since very little is known about the effects of retinoids on bacteria, in the present study we investigated the influence of 4 retinoids (isotretinoin, etretinate, arotinoid ethyl ester, arotinoid sulfone) in 15 different concentrations on the growth of 10 Gram-positive and Gram-negative bacteria in vitro and on their susceptibility to 10 antibiotics. It was found that all retinoids were not capable of affecting either the growth of bacteria or their susceptibility to antibiotics. It seems reasonable, therefore, to assume that the retinoid-induced changes in cutaneous bacterial flora in vivo are due to mechanisms other than to the direct action of these compounds on bacteria.

Antibiotic resistance, plasmid content and auxotypes of Neisseria gonorrhoeae in Greece.

The antibiotic resistance pattern, the plasmid content and the auxotypes of 27 PPNG and 200 non-PPNG isolates obtained in 1984-1985 were examined. The well-known plasmid patterns, the most frequent was the combination of 4.5 and well-known plasmid patterns, the most frequent was the combination of 4.5 and 2.6 Mdal plasmids. The strains with the Asian-type (4.5 Mdal) plasmid belonged to the auxotypes Pro and Zero, whereas those with the African type (3.2 Mdal) plasmid were of auxotypes Zero, Arg and Pro, Arg. All PPNG strains exhibited reduced sensitivity at least to one of the other antibiotics tested (cefotaxime, spectinomycin, thiamphenicol, tetracycline). Among non-PPNG strains, 19% harboured the conjugative and the cryptic plasmid, 67.5% only the cryptic, 1% only the conjugative and 12% were plasmid-free. The most frequent auxotypes of non-PPNG strains were Zero (65.5%) and Pro (21%), while the uncommon auxotype Pro, Arg degree, Ura was found only in plasmid-free strains with reduced sensitivity to penicillin. Susceptibility testing revealed a large number of non-PPNG strains with decreased sensitivity to antibiotics, the Pro and Zero isolates being less sensitive than those of other auxotypes.

Ketoconazole compared with griseofulvin in dermatophytoses: a randomized, double-blind trial.

50 patients with drug-resistant and/or extensive superficial mycoses and positive cultures for dermatophytes, were randomly assigned to treatment either with 200 mg ketoconazole (26 patients, mean age 31 years) or 500 mg griseofulvin (24 patients, mean age 32.5 years) daily, administered in identical capsules. Patients were evaluated before and during treatment, clinically, by direct microscopy and cultures in double-blind conditions. The maximum duration of treatment was 6 weeks. 26/26 patients in the ketoconazole group and 22/24 patients in the griseofulvin group had negative cultures after 2.5 and 3 weeks (median values) respectively. Clinical symptoms responded rapidly and completely to both treatments. Therapeutic results were statistically significant in both groups. 1 patient in each group relapsed during the next 3 months after the end of the treatment. No unwanted effects were reported. Although both treatments were effective, therapeutic results were slightly better and appeared earlier with ketoconazole.