| 1. |
- Björnelius, E, et al.
(författare)
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Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial.
- 2008
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Ingår i: Sexually transmitted infections. - : BMJ. - 1472-3263 .- 1368-4973. ; 84:1, s. 72-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the microbiological cure rate after treatment with tetracyclines or azithromycin in patients infected with M genitalium. METHODS: One hundred and fifty-two men and 60 women positive for M genitalium were recruited. Patients treated either with doxycyline for 9 days or with azithromycin 1 g stat. were compared. Those still positive for M genitalium after primary doxycycline treatment received an extended course of azithromycin 500 mg on day 1 followed by 250 mg daily for the following 4 days, whereas those with treatment failure after azithromycin received doxycycline 100 mg twice daily for 15 days. RESULTS: The eradication rate after azithromycin 1 g stat. was 85% (95% CI 69 to 94) in men (n = 39) and 88% (95% CI 64 to 99) in women (n = 17) and after doxycycline 17% (95% CI 9 to 27) in men (n = 76) and 37% (95% CI 19 to 58) in women (n = 27). Extended azithromycin eradicated M genitalium from 96% (95% CI 85 to 99) of the men (n = 47) and from all six women who failed on doxycycline. Extended doxycycline treatment was insufficient. Persistent urethral inflammation was seen in a substantial portion of the men after eradication of M genitalium regardless of the antibiotic drug, indicating a poor predictive value of urethral smears in evaluation of persistent or recurrent infection. CONCLUSIONS: Azithromycin was more effective than doxycycline in treating patients infected with M genitalium. The extended course of azithromycin was highly effective but was given after the initial treatment with doxycycline. Randomised clinical trials are needed to compare the different dosages of azithromycin.
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| 2. |
- Carré, Helena, 1979-, et al.
(författare)
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Improved contact tracing for Chlamydia trachomatis with experienced tracers, tracing for one year back in time and interviewing by phone in remote areas
- 2008
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Ingår i: Sexually Transmitted Infections. - : BMJ publishing. - 1368-4973 .- 1472-3263. ; 84:3, s. 239-242
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the Swedish model for contact tracing and especiallythe "Västerbotten model" with centralised, extended contactinterview periods, sometimes by telephone.Methods: Using questionnaires, the contact tracing and interview procedurewas evaluated during 2002, followed by an evaluation of contactinterviewing by phone in 2005–6.Results: Patients with diagnosed Chlamydia trachomatis infection reportedon average 2.5 sexual contacts, 3.0 contacts when contact interviewingwas performed at the clinic, and 2.3 contacts when performedby phone. 65% of the sexual contacts with a known test resultwere infected.Conclusion: Centralised contact tracing, exploring the sexual history forat least 12 months back in time, shows good results. Combinedwith screening of certain risk groups it is probably one effectiveway of preventing C trachomatis infections. Preventing C trachomatisby primary prevention such as information and counselling is,however, still of great importance.
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| 3. |
- Falk, Lars, et al.
(författare)
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Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection
- 2005
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Ingår i: Sexually Transmitted Infections. - : BMJ. - 1368-4973 .- 1472-3263. ; 81:1, s. 73-78
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme.Methods: A cross sectional study among female STD clinic attendees in Örebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis.Results: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80).Conclusions:M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection.
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| 4. |
- Hadad, Ronza, et al.
(författare)
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Evaluation of the new COBAS TaqMan CT test v2.0 and impact on the proportion of new variant Chlamydia trachomatis by the introduction of diagnostics detecting new variant C trachomatis in Örebro county, Sweden
- 2009
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Ingår i: Sexually Transmitted Infections. - London : BMJ Publishing Group. - 1368-4973 .- 1472-3263. ; 85, s. 190-193
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Tidskriftsartikel (refereegranskat)abstract
- Background: The new variant of Chlamydia trachomatis (nvCT), discovered in Sweden in 2006, contains a 377-bp cryptic plasmid deletion, which includes the targets for the COBAS Amplicor/TaqMan C trachomatis/Neisseria gonorrhoea and Abbott m2000rt C trachomatis/N gonorrhoea tests.Objectives: To evaluate the new real-time COBAS TaqMan CT test v2.0 (CTM CT v2.0) for C trachomatis diagnostics and to investigate whether the proportion of nvCT was affected by the introduction of genetic diagnostics detecting nvCT (LightMix 480HT) in Örebro county, Sweden.Methods: CTM CT v2.0 compared with LightMix 480 HT PCR for the diagnosis of C trachomatis was evaluated. Discrepant samples were analysed using BD ProbeTec ET and Abbott m2000rt RealTime CT II. All previously LightMix and cell culture-positive samples were analysed using an nvCT-specific PCR.Results: The sensitivity, specificity, negative predictive value and positive predictive value of CTM CT v2.0 for examined samples (n = 1058) was 100%, 99.8%, 100% and 98.2%, respectively. Of 11 577 consecutive PCR samples, 9.4% (n = 1084) were positive and 34.3% (n = 372) of these were nvCT. Of 2306 consecutive culture samples, 5.0% (n = 116) were C trachomatis positive and 38.8% (n = 45) of these were nvCT.Conclusions: CTM CT v2.0 is a sensitive and specific method for C trachomatis detection. Studies including larger numbers of symptomatic and asymptomatic patients as well as genital and extragenital samples, and in comparison with other internationally validated and, ideally, US Food and Drug Administration-approved C trachomatis nucleic acid amplification tests are imperative. The proportion of nvCT remains high in Örebro county, Sweden, despite the introduction of genetic diagnostics to detect the mutant.
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| 5. |
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| 6. |
- Kubanova, A., et al.
(författare)
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National surveillance of antimicrobial susceptibility in Neisseria gonorrhoeae in 2005-2006 and recommendations of first-line antimicrobial drugs for gonorrhoea treatment in Russia
- 2008
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Ingår i: Sexually Transmitted Infections. - London : BMJ Publishing Group. - 1368-4973 .- 1472-3263. ; 84:4, s. 285-289
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate comprehensively the antimicrobial susceptibility and resistance of Neisseria gonorrhoeae during 2005-2006 in a national survey and to recommend effective antimicrobial drugs for the treatment of gonorrhoea in Russia.METHODS: The susceptibility of N gonorrhoeae isolates, cultured mainly from consecutive gonorrhoea patients (n = 1030) during the period January 2005 to December 2006 in Russia, to penicillin G, ceftriaxone, ciprofloxacin, tetracycline and spectinomycin was analysed using the agar dilution method. Nitrocefin discs were used for beta-lactamase detection.RESULTS: All isolates were susceptible to ceftriaxone. During 2005 and 2006, however, 5%, 50%, 70% and 77% displayed intermediate susceptibility or resistance to spectinomycin, ciprofloxacin, tetracycline and penicillin G, respectively. Furthermore, 4% of the isolates were beta-lactamase producing during these years. The different federal districts of Russia displayed substantial heterogeneities with regard to the prevalence of gonorrhoea and antimicrobial resistance among N gonorrhoeae isolates.CONCLUSIONS: In Russia, penicillins, ciprofloxacin, or tetracycline should definitively not be used in the empirical treatment of gonorrhoea. The recommended first-line antimicrobial drug should be ceftriaxone. If ceftriaxone is not available, spectinomycin ought to be used. Increasing levels of intermediate susceptibility and resistance to spectinomycin have, however, been observed during recent years and, accordingly, great care and monitoring should be undertaken when using this agent. Continuous local, national and international surveillance of N gonorrhoeae antimicrobial susceptibility, in order to reveal the emergence of new resistance, to monitor changing patterns of susceptibility and to be able to update treatment recommendations on a regular basis, is crucial.
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| 7. |
- Lan, P. T., et al.
(författare)
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Reproductive tract infections including sexually transmitted infections : a population-based study of women of reproductive age in a rural district of Vietnam.
- 2008
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Ingår i: Sexually Transmitted Infections. - London : BMJ Publishing Group. - 1368-4973 .- 1472-3263. ; 84:2, s. 126-132
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the prevalences of reproductive tract infections (RTI)/sexually transmitted infections (STI) among married women in a rural district of Vietnam, and analyse the influence of socioeconomic, sociodemographic, and other determinants possibly related to RTI/STI. Methods: A community-based cross-sectional study. Married women aged 18–49 years (n = 1012) were interviewed and underwent a gynaecological examination. Specimens were collected for laboratory diagnosis of chlamydia, gonorrhoea, trichomonas, bacterial vaginosis (BV), candidiasis, hepatitis B, HIV, and syphilis. Results: In total, 37% of the women were clinically diagnosed with an RTI/STI. Aetiologically confirmed RTI/STI was identified in 39% of the women (including 6% with STI). Endogenous infections were most prevalent (candidiasis 26%, BV 11%) followed by hepatitis B 8.3%, Chlamydia trachomatis 4.3%, Trichomonas vaginalis 1%, Neisseria gonorrhoeae 0.7%, genital warts 0.2%, and HIV and syphilis 0%. Fifty per cent of the STI cases were asymptomatic. Younger age and intrauterine devices were significantly associated with an increased risk of BV. Determinants of candidiasis were vaginal douching, high education level and low economic status, whereas a determinant of chlamydia was high economic status. Outmigration of the husband was associated with an increased risk of hepatitis B surface antigen seroposivity among women. Conclusions: RTI/STI were prevalent among married women in a rural population of Vietnam. Syndromic algorithms should be consistently supplemented by risk assessment in order to reduce under and overtreatment. Microscopic diagnosis could be applied in primary care settings to achieve more accurate diagnoses. The promotion of health education aimed at reducing RTI/STI prevalences is an important tool in STI/HIV control programmes. Vaccination to prevent hepatitis B for migrants should be considered.
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| 9. |
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| 10. |
- Mbwana, Judica, 1956, et al.
(författare)
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Prevalence of serum antibodies to human papilloma virus in patients with genital ulcer disease in an urban population of Tanzania.
- 2007
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Ingår i: Sexually transmitted infections. - : BMJ. - 1368-4973. ; 83:1, s. 64-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The epidemiology of human papillomavirus (HPV) in Tanzania is largely unknown both in risk groups and in the general population. OBJECTIVE: To determine the cumulative seroprevalence of selected HPV types in order to evaluate exposure to HPV in urban Tanzania. METHOD: In a cross-sectional study, sera of 200 patients of both sexes with genital ulcer disease (GUD) and sera of 60 male blood donors and 60 pregnant women were tested for antibodies to the oncogenic HPV types 16, 18, 31, 33, 35, 51 and 52 using an ELISA based on virus-like particles (VLP). RESULTS: The overall seroprevalence of HPV types for all patients with GUD was 83% and 77% for women and men, respectively. For pregnant women and male blood donors, the corresponding percentages were 55% and 15%, respectively. The most common HPV types were 16, 18 and 52. Infection with multiple types was more than 10 and 5 times more frequent than infection with a single type 16 in patients with GUD and in pregnant women, respectively. The seroprevalence to HPV types 16, 18, 51 and 52 was considerably higher in HIV-positive patients with GUD than in HIV-negative patients. CONCLUSIONS: Infections with the oncogenic HPV types 16, 18 and 52 are common among patients with GUD and pregnant women in urban Tanzania, emphasising the need for control, treatment and implementation of appropriate HPV vaccine programmes.
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