The British Journal of Venereal Diseases最新文献

An open study was designed primarily to evaluate the efficacy of rosoxacin in the treatment of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains. A total of 199 patients (99 men and 100 women) satisfactorily completed follow up examinations, 50 men and 50 women having received rosoxacin 300 mg orally and the remainder having received kanamycin 2 g intramuscularly. Rosoxacin achieved an overall cure rate of 94% (96.7% for PPNG and 90% for non-PPNG strains). In patients treated with kanamycin the overall cure rate was 89.9% (92.7% for PPNG and 83.3% for non-PPNG strains). A correlation between treatment failures and minimum inhibitory concentrations (MICs) of rosoxacin was noted in non-PPNG strains but not in PPNG strains. Side effects which were mild and self limiting were noted in 15 of 100 patients treated with rosoxacin. The high failure rates associated with non-PPNG strains requiring MICs of 0.125 mg/l and the observation of a substantial rise in the MICs for isolates after treatment is of concern. Otherwise, rosoxacin in a single dose of 300 mg appears to be safe and effective for the treatment of uncomplicated gonorrhoea.

Our interest in the role of Haemophilus ducreyi in genital ulceration led us to examine the various media commonly used for the cultivation of the organism. We describe an improved medium for the routine isolation of H ducreyi. In comparative studies using 50 test strains originally isolated in the United Kingdom, Canada, the United States of America, and Kenya, the new medium proved superior to three standard media in requiring a shorter incubation period to first visible growth, giving larger colonies in the same period, and making possible a starch aggregation test which we have found helpful in the presumptive identification of H ducreyi from clinical material.

We measured the activity of rosoxacin, fosfomycin, cefotiam, and spectinomycin against 51 isolates of beta-lactamase producing Neisseria gonorrhoeae, all of which were susceptible to each drug at sufficient concentrations. The development of strains of penicillinase producing N gonorrhoeae (PPNG) which are resistant to spectinomycin can therefore be avoided, as there are alternative drugs.

We studied the prevalence of antibody to cytomegalovirus (CMV) in 262 men (132 homosexual, 20 bisexual, and 108 heterosexual) attending the sexually transmitted diseases (STD) clinic at this hospital. Antibody to CMV at a titre of 1/4 or more was found in 92% of the homosexuals, 80% of the bisexuals, and 56% of the heterosexuals (p less than 0.0001). Among heterosexuals, but not homosexuals, nationality and social class showed a significant association with antibody to CMV. In both heterosexuals and homosexuals a history of gonorrhoea was more common in patients with antibody to CMV than in those without it. A similar finding was seen in heterosexual men with a history of non-specific urethritis (NSU). Using a series of log linear models, sexual orientation was shown to be the most important determinant of antibody to CMV in this population.

I undertook a prospective study of the incidence of histologically confirmed cervical intraepithelial neoplasia (CIN) and cancer in women attending a sexually transmitted disease (STD) clinic, and correlated the findings to cervical cytology reports, age, and history of STD of the affected women. Of 2017 women screened, 75 (3.7%) had dyskaryotic cervical smears. Colposcopically directed biopsy tests gave an overall detection rate of 0.55% for CIN3, which was similar to the national average. The false negative rate was 2.9% and cytology tests alone underestimated the degree of pathological change in 12 (30%) of 40 women with mild dyskaryosis. Women under 20 years old made up 43% of those with CIN1 and 38% of those with CIN2. The detection rate of CIN3 was 0.65% for women aged 15-34, which was higher than the national average and suggested earlier onset of CIN3 in our clinic population. There was a high association between genital warts and cervical precancer. This preliminary study confirms the need for routine non-selective screening of women attending STD clinics by cervical cytology tests, colposcopic examination, and biopsy tests where indicated.

Contact tracing carried out at this clinic was analysed as part of measures for control of sexually transmitted disease (STD). Results showed that 50% of 156 contacts could not be traced at all for various reasons, and that 47% of the contacts were brought in through persuasion by index patients who had been counselled at the clinic. Only four contacts were traced, and two of these attended the clinic. Index patient cooperation is thus identified as the most important factor in the success of contact tracing, because of the high level of illiteracy and poor communications facilities in Nigeria, compared with industrialised countries.