Sexually transmitted diseases最新文献

Abstract: National surveillance data show that early syphilis cases among women increased during 2014-2023, regardless of the sex of their sex partners. Certain characteristics that could affect syphilis transmission-including incarceration history, sexual behaviors, and substance use-were most common among women who have sex with both women and men.

Objective: To characterize computed tomography (CT) findings in women with pelvic inflammatory disease (PID) due to PCR-confirmed Chlamydia trachomatis or Neisseria gonorrhoeae, and to identify imaging patterns that may assist diagnosis in the emergency setting.

Methods: We conducted a retrospective study of 44 female patients who underwent abdominal or pelvic CT in the gynecology emergency department and tested positive for C.trachomatis, N. gonorrhoeae, or both. CT images were re-evaluated by two radiologists for signs consistent with PID. Imaging findings were compared across three analyses: (1) cases correctly vs. incorrectly diagnosed in the original radiology report, (2) concordant vs. discordant interpretations between original and retrospective reads, and (3) differences between infections caused by C.trachomatis and N.gonorrhoeae.

Results: CT features consistent with PID were present in 77.3% of cases. The most frequent findings were fat stranding (86.4%), free pelvic fluid (79.5%), and peritoneal thickening (72.7%). Tubo-ovarian abscesses (TOAs) occurred in 36.4% and were always correctly identified. Subtle peritoneal thickening was more frequent in discordant interpretations (100% vs 63%, p = 0.01). Fallopian-tube thickening was more common in C. trachomatis than N. gonorrhoeae infection (49% vs 11%, p = 0.013).

Conclusion: CT often reveals characteristic features of PID even when the condition is not clinically suspected. Subtle radiologic findings-particularly peritoneal thickening or enhancement and pelvic fat stranding- are often overlooked during emergency evaluation. Increased awareness of these signs may facilitate earlier recognition and management.

Abstract: This study assesses doxycycline post-exposure prophylaxis (doxyPEP) awareness, perceptions, and concerns among bathhouse-affiliated individuals. Antimicrobial resistance, adverse effects, and accessibility were primary concerns. Partnerships with bathhouses present opportunities to address these barriers through targeted education, enhancing acceptance and promoting doxyPEP's effectiveness in preventing sexually transmitted bacterial infections.

Abstract: This correspondence calls into question the research by Graves et al. that determines an in vitro minimal lethal concentration (MLC) of 12.5 μg/ml for secnidazole (SEC) as linked to clinical resolution in Trichomonas vaginalis [1]. Recognizing the significance of establishing SEC susceptibility thresholds with increasing metronidazole (MTZ) resistance, we highlight several critical limitations: (1) No pharmacokinetic-pharmacodynamic (PK-PD) validation correlating the MLC with attainable drug concentrations in genital tissue; (2) Omission of isolates from males even with their roles in morbidity/reservoirs; (3) Neglect of the impact of vaginal microbiota on drug-parasite dynamics; (4) Absence of analysis on molecular resistance mechanisms; and (5) Possible selection bias due to the low representation of clinical SEC failures (n = 5) and MTZ-resistant isolates (n = 1).

Abstract: Congenital syphilis (CS) can occur despite timely identification and adequate treatment of maternal syphilis (breakthrough CS). We examined associations between maternal characteristics and prevalence of breakthrough CS. Having primary/secondary syphilis, a higher maximum non-treponemal titer, and treatment initiation closer to delivery were associated with higher prevalence of breakthrough CS.

Abstract: We promoted home-based syphilis self-testing via social media to persons with factors linked to increased syphilis risk in Los Angeles County and San Bernardino. Users found the First to Know Syphilis Test easy and were likely to recommend it, indicating strong interest in self-testing and potential to enhance syphilis prevention.

Background: We evaluated human papillomavirus (HPV) vaccine effectiveness (VE) against prevalent anal HPV among men who have sex with men (MSM) by age, age at vaccination, and age at vaccination relative to age at first sex.

Methods: Residual anal specimens from 1092 MSM aged 18 to 45 years attending a Seattle, Washington, sexual health clinic in 2018 to 2020 were tested for 28 HPV types. Demographic, clinical, sexual behavioral, and HPV vaccination data were extracted from clinic and electronic medical records. We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between vaccination (≥1 dose of any HPV vaccine) and quadrivalent HPV vaccine (4vHPV)-type infection, by age group (18-26, 27-35, 36-45 years), vaccination age (among age groups 18-26, 27-35 years), and vaccination age relative to first sex (among those 18-26 years). Analyses were adjusted for race and ethnicity, preexposure prophylaxis use for HIV prevention, and lifetime number of sex partners. Vaccine effectiveness was calculated as (1 - aPR) × 100.

Results: Among persons aged 18 to 26 years, 4vHPV-type HPV prevalence was lower among those vaccinated before first sex (aPR, 0.12 [95% CI, 0.02-0.87]; VE, 88%) or at <18 years of age (aPR, 0.22 [95% CI, 0.07-0.68]; VE, 78%) versus unvaccinated, but no VE was observed in those vaccinated at 18 to 26 years of age. Among persons aged 27 to 35 years, 4vHPV-type HPV prevalence was lower among those vaccinated at 18 to 26 years of age versus unvaccinated (aPR, 0.56 [95% CI, 0.36-0.87]; VE, 44%). No VE was observed in persons aged 27 to 35 or 36 to 45 years who were vaccinated at >26 years of age.

Conclusions: Results highlight the importance of routine HPV vaccination in adolescence and support efforts to increase catch-up vaccination among MSM.

Abstract: This study evaluates hepatitis C testing and referral for treatment among patients attending a public sexual health clinic. In patients with hepatitis C infection, progression from linkage to care to sustained virologic response was low. Innovative approaches are needed to optimally integrate hepatitis C care in sexual health clinics.

Background: The rapidly evolving drug resistance of Neisseria gonorrhoeae to various drugs used in its treatment has posed significant challenges, especially in developing countries. A rise in cephalosporin minimum inhibitory concentrations (MIC) among N. gonorrhoeae was identified in parts of Asia, as early as the late 1990s. Drugs such as penicillin, tetracycline, and ciprofloxacin, which were effective in the past, are now almost never used in treating gonorrhea. This research aimed to study the resistance trends of N. gonorrhoeae over a temporal span of 5 years.

Methods: For 5 years, samples from STI clinic attendees were collected and processed for isolating N. gonorrhoeae . Confirmed isolates were subjected to antimicrobial susceptibility tests using the MIC E-strip method.

Results: A total of 231 isolates of N. gonorrhoeae were studied, with 97.5% from male patients. Decreased susceptibility to third-generation cephalosporins (cefixime and ceftriaxone) was 6.06%. Azithromycin resistance was reported in 13.4% of isolates, with three-fourths from the states of North India (Delhi and Chandigarh). Of these isolates, 22.5% showed high-level resistance to azithromycin. In addition, 16 isolates were multidrug-resistant, and 1 isolate was an extensively drug-resistant N. gonorrhoeae.

Conclusions: These findings highlight the urgent need for concerted efforts to address the burgeoning threat of antimicrobial resistance (AMR) in N. gonorrhoeae . Continued surveillance of drug resistance is crucial. Efforts should be made to explore novel, effective treatment options to resolve this issue.