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Sökning: WFRF:(Sonnenberg Pam)

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  • Mesher, David, et al. (författare)
  • Population-level effects of human papillomavirus vaccination programs on infections with nonvaccine genotypes
  • 2016
  • Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 22:10, s. 1732-1740
  • Tidskriftsartikel (refereegranskat)abstract
    • We analyzed human papillomavirus (HPV) prevalences during prevaccination and postvaccination periods to consider possible changes in nonvaccine HPV genotypes after introduction of vaccines that confer protection against 2 high-risk types, HPV16 and HPV18. Our meta-analysis included 9 studies with data for 13,886 girls and women ≤19 years of age and 23,340 women 20–24 years of age. We found evidence of cross-protection for HPV31 among the younger age group after vaccine introduction but little evidence for reductions of HPV33 and HPV45. For the group this same age group, we also found slight increases in 2 nonvaccine high-risk HPV types (HPV39 and HPV52) and in 2 possible high-risk types (HPV53 and HPV73). However, results between age groups and vaccines used were inconsistent, and the increases had possible alternative explanations; consequently, these data provided no clear evidence for type replacement. Continued monitoring of these HPV genotypes is important.
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  • Pitt, Rachel, et al. (författare)
  • Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population
  • 2020
  • Ingår i: Sexually Transmitted Infections. - : BMJ Publishing Group Ltd. - 1368-4973 .- 1472-3263. ; 96:6, s. 464-468
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Mycoplasma genitaliumis a common sexually transmitted infection. Treatment guidelines focus on those with symptoms and sexual contacts, generally with regimens including doxycycline and/or azithromycin as first-line and moxifloxacin as second-line treatment. We investigated the prevalence of antimicrobial resistance (AMR)-conferring mutations inM. genitaliumamong the sexually-active British general population.Methods: The third national survey of sexual attitudes and lifestyles (Natsal-3) is a probability sample survey of 15 162 men and women aged 16-74 years in Britain conducted during 2010-12. Urine test results forM. genitaliumwere available for 4507 participants aged 16-44 years reporting>1 lifetime sexual partner. In this study, we sequenced regions of the 23S rRNA andparCgenes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.Results: 94% (66/70) of specimens were re-confirmed asM. genitaliumpositive, with successful sequencing in 85% (56/66) for 23S rRNA and 92% (61/66) forparCgenes. Mutations in 23S rRNA gene (position A2058/A2059) were detected in 16.1% (95%CI: 8.6% to 27.8%) and inparC(encodingParCD87N/D87Y) in 3.3% (0.9%-11.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5 years) (44.4% (18.9%-73.3%) vs 10.6% (4.6%-22.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%-66.8%) vs 5.0% (1.4%-16.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5 years), but none reported recent symptoms.Conclusions: This study highlights challenges inM. genitaliummanagement and control. Macrolide resistance was present in one in six specimens from the general population in 2010-2012, but no participants with AMRM. genitaliumreported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.
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