The British Journal of Venereal Diseases最新文献

The antimicrobial susceptibility of gonococci isolated in Singapore has been studied over several years. In 1983, the prevalence of penicillinase producing Neisseria gonorrhoeae (PPNG) was 33.5% and 64% of non-PPNG isolates had minimum inhibitory concentrations (MICs) of penicillin of greater than or equal to 0.5 mg/l. After a control programme, the isolation of the gonococcus from prostitutes was reduced and there was improvement in its susceptibility to antimicrobials. The incidence of PPNG strains was stabilised with a change in the treatment regimen. An influx of foreign prostitutes, however, had an unfavourable impact on these variables. Countries in South East Asia have a high prevalence of PPNG and non-PPNG strains that have reduced susceptibility to antimicrobials. In view of increased air travel the problem should be seen from a global perspective. Better treatment regimens and control strategies are urgently needed.

Eight strains of Gardnerella vaginalis were examined by electron microscopy for the presence of pili. Narrow pili ranging from 3.0 to 7.5 nm in diameter were seen on bacteria from five of the strains studied.

A case of multicentric pigmented Bowen's disease in a 45 year old woman with a previous history of carcinoma of the cervix is described. The two conditions may have a common pathogenesis, and a preceding viral infection with herpes simplex or human papillomavirus could be of aetiological relevance. Patients with multicentric pigmented Bowen's disease may be at risk of developing other tumours of the genital tract. Treatment with carbon dioxide laser proved effective.

Three swabs were taken from the cervix of each of 104 women for the detection of Chlamydia trachomatis. The processing of three swabs instead of one increased the isolation rate by only 2%, and later swabs did not result in the production of more chlamydial inclusions than first swabs. In most clinics, therefore, a single cervical swab is adequate to detect chlamydial infection.

The prevalence of self reported psychosexual problems in 265 men and 160 women who attended the genitourinary clinic at this hospital was assessed. Twenty-six (10.6%) men and 13 (9.0%) women had sexual problems either as an individual or within their regular relationship. The highest prevalence of problems was in married or cohabiting women and men, both homosexual and heterosexual, over 30.

Sixty three patients presumed to have genital gonorrhoea who gave histories of extragenital sexual practices were randomly treated with amoxycillin 3 g or bacampicillin 4.8 g (equivalent to 3.5 g ampicillin) with probenecid 1 g to compare the efficacy of the drugs in treating gonorrhoea at all sites. Three patients were initially culture negative, and seven failed to return for follow up. Twenty seven of 28 patients receiving bacampicillin and all 25 receiving amoxycillin gave negative genital cultures for Neisseria gonorrhoeae five to nine days after treatment. Twenty two of 60 patients had extragenital gonorrhoea. One failed to return, but all eight who had received amoxycillin and 12 of 13 who had received bacampicillin gave negative pharyngeal and anorectal cultures after treatment. N meningitidis was isolated from the pharynx in 17 of 60 patients on initial attendance. Three of 14 were still colonised with the meningococcus after treatment. Two of 32 patients receiving amoxycillin and 12 of 31 receiving bacampicillin reported experiencing gastrointestinal side effects.

The prevalence of sexually transmitted disease (STD) in adolescent girls aged 15-19 attending a department of genitourinary medicine was compared for the years 1972 and 1982. Data were obtained from the confidential register using the coding of the clinic returns to the Department of Health (form SBH 60). There were 1373 patients in 1972 and 1799 in 1982, 6.4% and 7% respectively of the total female clinic population. The prevalence of syphilis, gonorrhoea, and infection with Trichomonas vaginalis, herpes simplex virus, and warts was almost unchanged. Other conditions, which are not classified as STD, were largely responsible for the increase in new attendances, the prevalence of these conditions having nearly doubled over the ten year period. Thus an epidemic of STD has not been shown in this adolescent female population over the past decade.

We studied the course of a case of lymphogranuloma venereum (LGV) over two years. The comparative histological, immunological, and ultrastructural studies showed the existence of characteristic granulations within the macrophages of the granuloma. We suggest that direct immunofluorescence is a specific method for diagnosing cutaneous LGV. Some ultrastructural aspects lead us to believe that different chlamydial bodies exist inside the granuloma.