Clinical Importance of Superior Sensitivity of the Aptima TMA-Based Assays for Mycoplasma genitalium Detection.

Mycoplasma genitalium (MG) is a common cause of nongonococcal cervicitis and urethritis. We investigated the demographic and clinical characteristics of patients tested in Denmark with the Conformité Européenne (CE)/in vitro diagnostics (IVD) Aptima Mycoplasma genitalium assay (CE/IVD AMG; Hologic) and examined the clinical significance of the higher sensitivity of the TMA-based MG assays. From March to June 2016, urogenital and extragenital specimens from consecutive attendees at a sexually transmitted infection clinic in Copenhagen, Denmark were tested with the CE/IVD AMG assay (TMA-based), the research-use-only MG Alt TMA-1 assay (Hologic), a laboratory-developed TaqMan mgpB quantitative real-time PCR (qPCR), and the Aptima Combo 2 (CT/NG; Hologic). Demographic characteristics and clinical symptoms were collected from the patient records. There were 1,245 patients included in the study. The MG prevalence among female subjects was 9.4%, and the MG prevalence among male subjects was 8.7%. Compared to the TMA-based assays, the sensitivity of the PCR-based MG assay was 64.52%, and 55 specimens from 48 individuals were missed in the mgpB qPCR. Of these, 26 individuals (54.2%) were symptomatic, whereas, among 64 individuals with concordant results, 30 individuals (46.9%) were symptomatic; no statistically significant difference was found between the groups (P = 0.567). The improved sensitivity of the TMA-based assays resulted in diagnoses of more patients with clinically relevant symptoms for which antibiotic treatment is indicated. However, approximately half of the MG-infected patients reported no symptoms, and future research is needed to investigate the pros and cons of diagnosing and treating MG in asymptomatic subjects.

[Corneal graft due to an overlooked gonorrhoeal conjunctivitis].

In this case report, a 42-year-old man who had sex with other men presented with conjunctivitis, which later was diagnosed as gonorrhoeal conjunctivitis. Gonorrhoeal conjunctivitis is associated with a high risk of severe eye infections and resulting complications. It is important to perform swabs for gonorrhoea from all relevant anatomical locations. Through complete microbiological diagnostics and treatment with recommended antibiotics, a gonorrhoeal conjunctivitis infection can be effectively treated.

[Early treatment of neurosyphilis is crucial].

This case report of a 36-year-old man, who had sex with men, illustrates, that early identification and diagnosis of neurosyphilis are crucial. Neurosyphilis, being a rare complication of syphilis, is associated with a high risk of severe neurological symptoms such as cranial nerve dysfunction, acute or chronic altered mental status and auditory abnormalities. Treatment with recommended antibiotic regimens can effectively cure neurosyphilis, though the risk of sequelae remains.

[Gonorrhoea].

Gonorrhoea, a condition on the rise, is associated with high morbidity, and the possibility of reproductive sequelae has become a public health problem in Denmark. It is important to perform swabs for gonorrhoea from all relevant anatomical locations, whether or not there are symptoms. Through complete microbiological diagnostics, treatment with recommended antibiotics and partner detection, infection chains can be broken. Whole-genome sequencing in real time will identify outbreaks in high-risk populations.

[Diagnosing and treating of onychomycosis].

Onychomycosis is a frequent disorder, which accounts for approximately 50% of nail changes. Many patients are treated for onychomycosis without a mycological verification being done. The patients may be in risk of being treated for a non-existent fungal infection with lack of effect and potential adverse events. This review highlights the importance of choosing the correct sampling and diagnostic methods, as genus and/or species identification is essential when choosing the optimal treatment strategies.

Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017.

We describe a multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Denmark, 2017. Whole genome sequencing of the strain GK124 identified MSLT ST1903, NG-MAST ST1614 and all relevant resistance determinants including similar penA resistance mutations previously described in ceftriaxone-resistant gonococcal strains. Although treatment with ceftriaxone 0.5 g plus azithromycin 2 g was successful, increased awareness of spread of gonococcal strains threatening the recommended dual therapy is crucial.