The British Journal of Venereal Diseases最新文献

Clinical investigations of the usefulness of routine epidemiological treatment of sexual contacts of men with non-gonococcal urethritis (NGU) have produced conflicting results that could have been due to the selection of patients. In this study, which was undertaken in a provincial city, 100 men with untreated sexual partners and 100 demographically similar men with treated sexual partners were reviewed for recurrences of NGU over 12 months. Prolonged courses of tetracyclines were found to be beneficial particularly when the sexual partner gave positive results to tests for chlamydiae. There was, however, no clinical evidence that the men benefited from routine epidemiological treatment of their sexual partners.

With coagglutination reagents prepared against W antigens, 205 clinical isolates of Neisseria gonorrhoeae were classified into three serogroups WI, WII, and WIII. Of 195 strains isolated from patients who acquired their infection in the Edinburgh area, 85 (44%) belonged to serogroup WI and 110 (56%) to serogroup WII. Serogroup WII accounted for 90% of all isolates from homosexual men and for 34% and 47% of isolates from heterosexual men and women respectively (p less than 0.001). In homosexual men serogroup WII predominated regardless of the anatomical site from which the strain was isolated, and accounted for 94% of rectal, 90% of urethral, and 81% of pharyngeal isolates.

One hundred randomly selected women attending a free government antenatal clinic in the town of Bakau, The Gambia, were examined. Vaginal swabs were taken for microscopical examination for Trichomonas vaginalis and for culture on Sabouraud's medium. Cervical swabs were taken for culture of Neisseria gonorrhoeae and Chlamydia trachomatis and, in 50 cases, Herpesvirus hominis; in addition, urethral swabs were taken for culture of N gonorrhoeae. Serum samples were tested for antibodies to Treponema pallidum by the Venereal Diseases Research Laboratory (VDRL) test and T pallidum haemagglutination assay (TPHA), and to C trachomatis and H hominis by microimmunofluorescence. The prevalence of infection with Candida albicans was found to be 35%, T vaginalis 32%, C trachomatis 6.9%, N gonorrhoeae 6.7%, T pallidum 1%, and H hominis 0%. IgG antibodies at a titre of at least 1/16 to C trachomatis serotypes D-K were found in 29.4%, and to serotypes A-C in a further 10.6%. IgG antibodies at a titre of at least 1/16 to H hominis type I were found in 94%, and to type II in 53%, although a proportion of the latter probably represent cross reacting antibodies to type I.

A previously described toxic factor associated with Treponema pallidum (Nichols) and found in extracts of syphilitic rabbit testes has now also been detected in syphilitic rabbit serum. The toxic factor, which inhibits DNA synthesis in baby rabbit genital organ (BRGO) cells in vitro, is present in rabbit serum up to 30 days after infection with T pallidum.

Past sexually transmitted disease (STD) control efforts in the United States of America have generally permitted a timely response to changes in intervention technology, antibiotic resistance, public funding, and media interest. Today, however, the expansion of STD organisms and syndromes at logarithmic rates has taxed our traditional labour intensive control approaches. We describe briefly the history of STD control strategies in the United States, discuss the seven components upon which current efforts are based, and speculate about our future programme initiatives.

An enzyme immunoassay (EIA) for the detection of immunoglobulin M (IgM) antibodies to Treponema pallidum was investigated for specificity and sensitivity. Using the results in serum from 1192 patients with successfully treated syphilis, the assay was calculated to be about 97% specific. As in any other IgM enzyme linked immunosorbent assay (ELISA), rheumatoid factor played an important part in causing false positive results. Pre-absorption of serum with aggregated IgG was therefore necessary to perform the test. Evaluation of the results in serum from 385 patients with untreated primary, secondary, and latent syphilis as well as patients with untreated reinfections showed that the sensitivity of the assay depended on the stage of infection and varied between 98% and 93%. IgM antibody titres were about ten times higher in the EIA than in the indirect immunofluorescence assay using the IgM fractions of serum. From the results it may be concluded that the EIA is an appropriate technique not only for rapid and sensitive measurement of IgM antibodies in most patients with untreated syphilis but also for selecting treponemal IgM non-reactive patients.

We took blood samples from 128 prostitutes visiting the outpatient venereology department of the University Hospital, Rotterdam-Dijkzigt to test for the presence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs). The prevalence of anti-HBs was found to be significantly higher in the group of prostitutes than in "normal populations", and we concluded that more of the former had been in contact with the hepatitis B virus (HBV). We recommend that the advice on vaccination of the hepatitis B committee of the Health Council of The Netherlands should be followed by screening prostitutes for the presence of HBsAg and anti-HBs in the blood, and vaccinating those who have no anti-HBs.