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Maldonado-Barrueco A, Sanz-González C, Rico-Nieto A, Grandioso-Vas D, Ruiz-Bastián M, Falces-Romero I, Cacho-Calvo J, Quiles-Melero I. Increase in gonococcal arthritis in Madrid, Spain, 2022-2023. Int J STD AIDS 2024; 35:831-835. [PMID: 38748748 DOI: 10.1177/09564624241254877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2024]
Abstract
In recent years, there has been an increase in Neisseria gonorrhoeae infections in Europe and Spain. Disseminated gonococcal infection is an uncommon clinical presentation that includes gonococcal arthritis. Improved antibiotic treatment has reduced the incidence of gonococcal arthritis. However, the increase in gonococcal infections may have increased the frequency of this clinical entity in recent times. We report five cases of gonococcal arthritis in patients in a tertiary-care hospital in the northern area of Madrid (Spain) from October 2022 to October 2023. Major cases occurred in male patients with unprotected sex and polyarticular symptoms requiring hospital admission and treatment with ceftriaxone and cefixime. The use of molecular techniques has allowed the detection of a greater number of culture-negative cases of gonococcal arthritis, as well as the detection of mutations associated with resistance to fluoroquinolone for switching to oral treatment.
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Affiliation(s)
| | - Claudia Sanz-González
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Alicia Rico-Nieto
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
- Infectious Diseases Unit, Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
| | - David Grandioso-Vas
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Mario Ruiz-Bastián
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Juana Cacho-Calvo
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain
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Choi G, Song KS, Nimse SB, Kim T. Development of a DNA-Based Lateral Flow Strip Membrane Assay for Rapid Screening and Genotyping of Six High-Incidence STD Pathogens. BIOSENSORS 2024; 14:260. [PMID: 38785734 PMCID: PMC11118844 DOI: 10.3390/bios14050260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/06/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
Sexually transmitted diseases (STDs) are a global concern because approximately 1 million new cases emerge daily. Most STDs are curable, but if left untreated, they can cause severe long-term health implications, including infertility and even death. Therefore, a test enabling rapid and accurate screening and genotyping of STD pathogens is highly awaited. Herein, we present the development of the DNA-based 6STD Genotyping 9G Membrane test, a lateral flow strip membrane assay, for the detection and genotyping of six STD pathogens, including Trichomonas vaginalis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Mycoplasma genitalium. Here, we developed a multiplex PCR primer set that allows PCR amplification of genomic materials for these six STD pathogens. We also developed the six ssDNA probes that allow highly efficient detection of the six STD pathogens. The 6STD Genotyping 9G Membrane test lets us obtain the final detection and genotyping results in less than 30 m after PCR at 25 °C. The accuracy of the 6STD Genotyping 9G membrane test in STD genotyping was confirmed by its 100% concordance with the sequencing results of 120 clinical samples. Therefore, the 6STD Genotyping 9G Membrane test emerges as a promising diagnostic tool for precise STD genotyping, facilitating informed decision-making in clinical practice.
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Affiliation(s)
- Gunho Choi
- Biometrix Technology, Inc., 2-2 Bio Venture Plaza 56, Chuncheon 24232, Republic of Korea; (G.C.); (K.-S.S.)
| | - Keum-Soo Song
- Biometrix Technology, Inc., 2-2 Bio Venture Plaza 56, Chuncheon 24232, Republic of Korea; (G.C.); (K.-S.S.)
| | - Satish Balasaheb Nimse
- Institute of Applied Chemistry and Department of Chemistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - Taisun Kim
- Institute of Applied Chemistry and Department of Chemistry, Hallym University, Chuncheon 24252, Republic of Korea
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Aguilera-Franco M, Tarriño-León M, Olivares-Durán MJ, Espadafor B, Rodríguez-Granger J, Reguera JA, Cobo F, Sampedro A, Navarro JM. Evaluation of a new CT/NG/TV/MG Real-Time PCR Kit (Vircell) versus the Allplex STI Essential Assay (Seegene) for the diagnosis of sexually transmitted infections. J Med Microbiol 2024; 73. [PMID: 38591530 DOI: 10.1099/jmm.0.001797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Sexually transmitted infections (STI) are a public health problem. Real-time PCR assays are the most sensitive test for screening and diagnosis of these infections. The aim of this study was to evaluate a new CT/NG/TV/MG Real-Time PCR (RT-PCR) kit (Vircell) for the detection of Chamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis for the diagnosis of sexual transmitted infections using the Allplex STI Essential Assay (Seegene) as the reference's method. A total of 497 samples from different anatomical sites (endocervical, urethral, rectal, pharyngeal and urine) were analysed from October 2022 to February 2023. A total of 108 (21.73 %) and 106 (21.33 %) positive samples were found for any of the assays used. The most commonly detected pathogen was N. gonorrhoeae (52 samples; 10.46 %), and the least commonly detected was T. vaginalis (three samples; 0.60 %). The anatomical site with the highest prevalence of micro-organisms was a non-urogenital site, the pharynx (26 positive samples; 5.23 %). Using the Allplex STI Essential Assay (Seegene) as the reference method, the diagnosis performance showed that the average specificity of CT/NG/TV/MG RT-PCR Kit (Vircell) was 99.84 % and the sensitivity was 99.53 %. The overall concordance was k=0.98 (CI95 %; 0.96-1). In conclusion, the CT/NG/TV/MG RT-PCR Kit (Vircell) assay shows a good sensitivity and specificity and constitutes a promising and additional alternative to routine procedures for distinct types of clinical specimen in diagnosis STI.
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Affiliation(s)
| | - María Tarriño-León
- Microbiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M J Olivares-Durán
- Clinical Analysis Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Beatriz Espadafor
- Dermatology Service, Centro de ETS, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Juan Antonio Reguera
- Microbiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Fernando Cobo
- Microbiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Sampedro
- Microbiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - José María Navarro
- Microbiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Liu W, Yu Y, Wang Y, Yang T, Kong Y, Xie X, Zhang J. Deciphering the genetic basis of resistome and virulome diversity among multidrug-resistant Mycoplasma hominis. Drug Resist Updat 2024; 72:101029. [PMID: 38071861 DOI: 10.1016/j.drup.2023.101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/12/2023] [Accepted: 11/24/2023] [Indexed: 01/08/2024]
Abstract
Mycoplasma hominis, a commensal bacterium that commonly inhabits the genital tract, leading to infections in both the genitourinary and extragenital regions. However, the antimicrobial resistance and pathogenic mechanisms of M. hominis isolated from extra-urogenital cystic abscess is largely unknown. This study reports the genomic epidemiological characteristics of a M. hominis isolate recovered from a pelvic abscess sample in China. Genomic DNA was extracted and sequenced using Illumina HiSeq X Ten platform. De novo assembly was performed and in silico analysis was accomplished by multiple bioinformatics tools. For phylogenomic analysis, publicly available M. hominis genomes were retrieved from NCBI GenBank database. Whole genome sequencing data showed that the genome size of M. hominis MH4246 was calculated as 679,746 bp, with 558 protein-coding sequences and a G + C content of 26.9%. M. hominis MH4246 is resistant to fluoroquinolones and macrolides, harboring mutations in the quinolone resistance-determining regions (QRDRs) (GyrA S153L, ParC S91I and ParE V417I) and 23S rRNA gene (G280A, C1500T, T1548C and T2218C). Multiple virulence determinants, such as tuf, hlyA, vaa, oppA, MHO_0730 and alr genes, were identified. Phylogenetic analysis showed that the closest relative of M. hominis MH4246 was the strain MH-1 recovered from China, which differed by 3490 SNPs. Overall, this study contributes to the comprehension of genomic characteristics, antimicrobial resistance patterns, and the mechanisms underlying the pathogenicity of this pathogen.
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Affiliation(s)
- Wenwen Liu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Yawen Yu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuting Wang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Yang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Yingying Kong
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Xinyou Xie
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China.
| | - Jun Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China.
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Moodley C, Tootla H, Amien I, Engel ME. Evaluating the utility of the Allplex STI Essential Assay to determine the occurrence of urogenital sexually transmitted infections among symptomatic and asymptomatic patients in Cape Town, South Africa. PLoS One 2023; 18:e0292534. [PMID: 38019851 PMCID: PMC10686431 DOI: 10.1371/journal.pone.0292534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Sexually transmitted infections are among the most commonly occurring infections globally, with countries in sub-Saharan Africa exhibiting disproportionately higher prevalence rates. Numerous reports indicate the need for accurate detection, epidemiological characterisation, and appropriate management of these infections. This prospective observational laboratory study sought to determine the occurrence of STI, using a validated molecular assay as a diagnostic and surveillance tool in our setting. METHODS Urogenital swabs from symptomatic and asymptomatic patients, submitted to the National Health Laboratory Service, at Groote Schuur Hospital, from 04 August 2021-03 February 2022, for routine microbiological investigations, were subjected to the Allplex™ STI Essential Assay (Seegene Inc, South Korea) to determine the distribution of STI pathogens in our setting. This multiplex assay includes C. trachomatis, Mycoplasma genitalium, Mycoplasma hominis, N. gonorrhoeae, Trichomonas vaginalis, Ureaplasma parvum, and Ureaplasma urealyticum. Correlations between detected organisms and participant age and clinical indications for testing were determined using Stata® software. RESULTS A total of 148 urogenital swabs (91.2% from women) were included in the analysis, of which 56/148 (37.84%) were from symptomatic patients. Up to 83.8% of the samples tested positive for ≥1 organism, with all seven target organisms detected in at least one sample. Ureaplasma parvum was the most common organism detected, followed by N. gonorrhoeae, M. hominis, U. urealyticum, T. vaginalis, C. trachomatis, with M. genitalium being the least detected. All 25 samples submitted for routine antenatal Group B Streptococcal screening were positive for at least one STI organism, and one sample from sexual non-accidental injury tested positive for five different organisms. CONCLUSIONS STIs comprise a variety of organisms in our setting, with many patients exhibiting coinfection with multiple organisms. This suggests the need for a critical evaluation of current syndromic testing and treatment guidelines so as to stem inadvertent spread of STI organisms and the development of resistance. The use of molecular testing methods may improve detection, especially in resource limited settings, providing speedy results, and thus allowing for guided therapy in only infected patients.
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Affiliation(s)
- Clinton Moodley
- Division of Medical Microbiology, Anzio Road Observatory, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Observatory, Cape Town, South Africa
| | - Hafsah Tootla
- Division of Medical Microbiology, Anzio Road Observatory, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Observatory, Cape Town, South Africa
| | - Imaan Amien
- Division of Medical Microbiology, Anzio Road Observatory, University of Cape Town, Cape Town, South Africa
| | - Mark E. Engel
- Department of Medicine, Cape Heart Institute, University of Cape Town, Cape Town, South Africa
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Cutoiu A, Boda D. Prevalence of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis in symptomatic and asymptomatic patients. Biomed Rep 2023; 19:74. [PMID: 37746588 PMCID: PMC10511948 DOI: 10.3892/br.2023.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
The purpose of the present study was to assess the prevalence of Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis (M. hominis) and Chlamydia trachomatis (C. trachomatis) in a Romanian population considering the presence or absence of genital symptoms. Urethral and vaginal samples were collected from patients presenting at 'Ponderas' Academic Hospital (Bucharest, Romania) from January 2021 to December 2021. A total of 266 samples were obtained from two groups of patients: Symptomatic subjects with urethritis, prostatitis, vaginitis or both urethritis and prostatitis (n=59; 22%), and asymptomatic subjects (n=207; 78%). Mycoplasma and Chlamydia kits were used to assess the presence of U. urealyticum and M. hominis, and C. trachomatis, respectively. The symptomatic subjects comprised 27 patients with urethritis symptoms, of whom 4 (15%) were infected with U. urealyticum and 1 (4%) was infected with C. trachomatis. In addition, 23 (9%) of the patients had prostatitis-like symptoms, which in 3 (13%) of the patients was associated with U. urealyticum and in 1 patient (4%) was associated with C. trachomatis. None of the symptomatic patients were infected with M. hominis. By contrast, 29 (14%) of the asymptomatic patients were discovered to be infected with U. urealyticum, 13 (6%) were coinfected with both Mollicutes and 4 (2%) were infected with C. trachomatis; only 1 patient was positive for M. hominis alone. Two patients (14%) who presented with U. urealyticum and M. hominis coinfection were also infected with C. trachomatis. No patient with U. urealyticum or M. hominis alone was also positive for C. trachomatis. Therefore, the most frequently identified pathogen populating the genital tract in both males and females was U. urealyticum, followed by coinfection with U. urealyticum and M. hominis, and C. trachomatis. As these infections are asymptomatic in numerous cases, this suggests that a thorough screening should be mandatory.
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Affiliation(s)
- Ana Cutoiu
- Department of Dermatology, ‘Colentina’ Clinical Hospital, 020125 Bucharest, Romania
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniel Boda
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Ponderas’ Academic Hospital, 014142 Bucharest, Romania
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Cheng C, Chen X, Song Y, Wang S, Pan Y, Niu S, Wang R, Liu L, Liu X. Genital mycoplasma infection: a systematic review and meta-analysis. Reprod Health 2023; 20:136. [PMID: 37700294 PMCID: PMC10496402 DOI: 10.1186/s12978-023-01684-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Recent studies have suggested that genital mycoplasma infections may be associated with male infertility. However, this association remains controversial due to time lapse, sample size, and regional prevalence. OBJECTIVES This study aimed to systematically evaluate the relationship between genital mycoplasma and male infertility through a meta-analysis and to provide a basis for the clinical management of male infertility. METHODS We conducted a search on PubMed, EMBASE, the Cochrane Library, and CNKI databases, from January 2000 to June 2023 to identify case-control studies on the interrelationship between genital mycoplasma infection and male infertility. Two independent researchers performed an assessment of the methodological quality of trials according to the Newcastle-Ottawa scale and extracted data strictly based on the inclusion and exclusion criteria, and afterward, we carried out a meta-analysis using Stata 16.0. Pooled odds ratios (OR) with 95% confidence intervals (CI) were used to assess this relationship. RESULTS This meta-analysis included 21 studies from seven countries with a total of 53025 infertility cases and 6435 controls; the age range of the participating men was from 20 to 59 years old. The results obtained showed a higher prevalence of M. genitalium, M. hominis and U. urealyticum infections in infertile men than in the controls, with the opposite result for U. parvum (M. genitalium, OR, 3.438 [95% CI: 1.780, 6.643], with P = 0.000; M. hominis, OR, 1.840 [95% CI: 1.013, 3.343], with P = 0.045; U. urealyticum, OR, 3.278 [95% CI: 2.075, 5.180], with P = 0.000; U. parvum, OR, 1.671 [95% CI: 0.947, 2.950], with P = 0.077). Further, two subgroup analyses also showed that M. hominis and U. urealyticum infections were strongly associated with male infertility in China (M. hominis, P = 0.009; U. urealyticum, P = 0.000); however, M. hominis and U. urealyticum infection was not strongly associated with male infertility worldwide (M. hominis, P = 0.553; U. urealyticum, P = 0.050). CONCLUSION This meta-analysis revealed that male infertility was significantly associated with M. genitalium, M. hominis and U. urealyticum infections, while U. parvum infection was not. Further, our study showed that genital mycoplasma infection influences male infertility and provides a basis for future treatment.
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Affiliation(s)
- Chen Cheng
- Charcteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, 300162, China
| | - Xiangyu Chen
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Yuxuan Song
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Shangren Wang
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Shuai Niu
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Rui Wang
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Li Liu
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China.
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Butcher R, Jarju S, Obayemi D, Bashorun AO, Vasileva H, Bransbury-Hare H, Agboghoroma O, Drammeh L, Holland M, Harding-Esch E, Clarke E. Prevalence of five treatable sexually transmitted infections among women in Lower River region of The Gambia. BMC Infect Dis 2023; 23:471. [PMID: 37442966 DOI: 10.1186/s12879-023-08399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The prevalence of sexually transmitted infections (STIs) in sub-Saharan Africa is poorly described. We aimed to determine the prevalence of five treatable STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, Treponema pallidum) in a sample of Gambian women from the general population. METHODS Archived specimens from 420 women aged 15 - 69 years living in The Gambia enrolled in a clinical trial of human papilloma virus vaccine schedules were tested in this study. Urine samples were tested for C. trachomatis, N. gonorrhoeae, T. vaginalis and M. genitalium using a commercially available, open-platform multiplex PCR kit. A fragment of the ompA gene was amplified from C. trachomatis-positive samples and sequenced. Serum samples were tested for T. pallidum using the Chembio DPP Syphilis Screen and Confirm test. RESULTS Overall, 41/420 (9.8%) women tested positive for at least one STI. 32 (7.6%), 9 (2.1%), 1 (0.2%), 1 (0.2%) and 0 (0.0%) tested positive for T. vaginalis, C. trachomatis, N gonorrhoeae, M. genitalium and T. pallidum, respectively. ompA gene sequence was available from five C. trachomatis infections: four were genovar D,one was genovar G and one was genovar F. CONCLUSIONS STIs are endemic in The Gambia. Monitoring systems should be established.
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Affiliation(s)
- Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
| | - Sheikh Jarju
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
| | - Dolapo Obayemi
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
| | | | - Hristina Vasileva
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Bransbury-Hare
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Lamin Drammeh
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
| | - Martin Holland
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Emma Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Ed Clarke
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, London, UK
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Determinants of Acquisition, Persistence, and Clearance of Oncogenic Cervical Human Papillomavirus Infection in the Philippines Using a Multi-Omics Approach: DEFEAT HPV Study Protocol. Healthcare (Basel) 2023; 11:healthcare11050658. [PMID: 36900663 PMCID: PMC10001359 DOI: 10.3390/healthcare11050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/26/2023] Open
Abstract
HPV infection is one of the most studied risk factors in cervical cancer-the second most common cancer site and cause of death due to cancer in the Philippines. However, there is a lack of population-based epidemiological data on cervical HPV infection in the Philippines. Local reports on co-infections with other lower genital tract pathogens, commonly reported globally, are also lacking, which emphasizes the need to increase efforts in targeting HPV prevalence, genotype, and distribution. Hence, we aim to determine the molecular epidemiology and natural history of HPV infection among reproductive-age Filipino women using a community-based prospective cohort design. Women from rural and urban centers will be screened until the target sample size of 110 HPV-positive women (55 from rural sites and 55 from urban sites) is reached. Cervical and vaginal swabs will be collected from all screened participants. For HPV-positive patients, HPV genotypes will be determined. One hundred ten healthy controls will be selected from previously screened volunteers. The cases and controls will comprise the multi-omics subset of participants and will be followed up after 6 and 12 months for repeat HPV screening. Metagenomic and metabolomic analyses of the vaginal swabs will also be performed at baseline, after 6 months, and after 12 months. The results of this study will update the prevalence and genotypic distribution of cervical HPV infection among Filipino women, determine whether the current vaccines used for HPV vaccination programs capture the most prevalent high-risk HPV genotypes in the country, and identify vaginal community state types and bacterial taxa associated with the natural history of cervical HPV infection. The results of this study will be used as the basis for developing a biomarker that can help predict the risk of developing persistent cervical HPV infection in Filipino women.
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Doron S, Horowitz G. Medical Appropriateness and Economics of Nucleic Acid Amplification Testing for Infectious Diseases. Clin Biochem 2022; 117:48-52. [PMID: 35489474 DOI: 10.1016/j.clinbiochem.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/04/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
It has become commonplace to assume that nucleic acid amplification tests (NAATs) represent the gold standard for all infectious disease diagnostic testing. This proposition has become increasingly entrenched recently, as these tests can now be done, in comparison to even just a few years ago, relatively inexpensively and with rapid analytic turnaround times. Many can even be performed at the Point-of-Care by individuals without technical backgrounds. But there may be a dark underside to this proposition. Could these tests be too sensitive? Are they always "fit for purpose"? Should they trump clinical judgement? Do they have untoward impacts on antimicrobial therapy? Could the profit motive - by manufacturers and by laboratories - be fueling the explosive expansion of NAATs? In this article, we will explore these questions in regard to several specific NAAT examples - Group A Streptococcus, Influenza, SARS-CoV-2, respiratory panels, and sexually transmitted disease panels.
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Affiliation(s)
- Shira Doron
- Tufts Medical Center, 800 Washington St., Box 238, Boston, MA 02111, United States; Tufts Medical Center, 800 Washington St., Box 115, Boston, MA 02111, United States.
| | - Gary Horowitz
- Tufts Medical Center, 800 Washington St., Box 238, Boston, MA 02111, United States; Tufts Medical Center, 800 Washington St., Box 115, Boston, MA 02111, United States.
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Karellis A, Naeem F, Nair S, Mallya SD, Routy JP, Gahagan J, Yansouni CP, Kim J, Pai NP. Multiplexed rapid technologies for sexually transmitted infections: a systematic review. THE LANCET MICROBE 2022; 3:e303-e315. [DOI: 10.1016/s2666-5247(21)00191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/17/2021] [Accepted: 07/12/2021] [Indexed: 10/19/2022] Open
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12
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PlexProbes enhance qPCR multiplexing by discriminating multiple targets in each fluorescent channel. PLoS One 2022; 17:e0263329. [PMID: 35263349 PMCID: PMC8906580 DOI: 10.1371/journal.pone.0263329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/14/2022] [Indexed: 11/25/2022] Open
Abstract
The probe technology described in this paper facilitates detection and discrimination of multiple targets in a single fluorescent channel during PCR. This provides a strategy for doubling the number of targets that can be analysed simultaneously on existing PCR instruments. These probes are referred to as PlexProbes and produce fluorescence that can be switched ‘on’ or ‘off’ in the presence of target by manipulating the temperature. During PCR, fluorescence can be measured at multiple temperatures allowing discrimination of specific targets at defined temperatures. In a single fluorescent channel, a model duplex assay allowed either real-time or endpoint detection of Chlamydia trachomatis (CT) at 52°C and end-point detection of Neisseria gonorrhoeae (GC) at 74°C. Using this model system, as few as 40 copies of each specific target could be detected as single infection or co-infection, regardless of the presence or absence of the other target. A PlexProbe prototype assay for sexually transmitted infections (PP-STI) which simultaneously enables detection and differentiation of six targets using only three fluorescent channels was then constructed and evaluated. The PP-STI assay detects GC (2 gene targets), CT, Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and an internal control (IC). To evaluate assay performance, a panel of archived clinical samples (n = 337) were analysed using PP-STI and results compared to those obtained with a commercially available diagnostic assay. The overall agreement between results obtained with the PP-STI assay and the reference test was greater than 99.5%. PlexProbes offer a method of detecting more targets from a single diagnostic test, empowering physicians to make evidence-based treatment decisions while conserving time, labour, sample volume and reagent costs.
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13
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Hiyama Y, Takahashi S, Yasuda M. AAUS guideline for chlamydial urethritis. J Infect Chemother 2021; 28:142-145. [PMID: 34887176 DOI: 10.1016/j.jiac.2021.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Abstract
Urogenital chlamydial infection is the most common sexually transmitted infection. Many cases of chlamydial infection are reported worldwide every year. Genital chlamydial infection in women can also cause obstetric issues, including infertility and miscarriage. For that purpose, appropriate care should be conducted with the latest knowledge. Only few guidelines come from Asian countries. The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) belonging to the Urological Association of Asia (UAA) had developed the guidelines regarding chlamydial urethritis. We have collected the feedback and updated the guidelines which is now submitted for consideration of publication. In addition to the levels of evidence, the recommendation grades were defined using the modified GRADE methodology. Herein, we present the new edition of the UAA-AAUS guidelines for chlamydial urethritis.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan; Department of Urology, Hakodate Goryoukaku Hospital, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan
| | - Mitsuru Yasuda
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan
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14
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Mtshali A, San JE, Osman F, Garrett N, Balle C, Giandhari J, Onywera H, Mngomezulu K, Mzobe G, de Oliveira T, Rompalo A, Mindel A, Abdool Karim SS, Ravel J, Passmore JAS, Abdool Karim Q, Jaspan HB, Liebenberg LJP, Ngcapu S. Temporal Changes in Vaginal Microbiota and Genital Tract Cytokines Among South African Women Treated for Bacterial Vaginosis. Front Immunol 2021; 12:730986. [PMID: 34594336 PMCID: PMC8477043 DOI: 10.3389/fimmu.2021.730986] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/30/2021] [Indexed: 01/04/2023] Open
Abstract
The standard treatment for bacterial vaginosis (BV) with oral metronidazole is often ineffective, and recurrence rates are high among African women. BV-associated anaerobes are closely associated with genital inflammation and HIV risk, which underscores the importance of understanding the interplay between vaginal microbiota and genital inflammation in response to treatment. In this cohort study, we therefore investigated the effects of metronidazole treatment on the vaginal microbiota and genital cytokines among symptomatic South African women with BV [defined as Nugent score (NS) ≥4] using 16S rRNA gene sequencing and multiplex bead arrays. Among 56 BV-positive women, we observed short-term BV clearance (NS <4) in a proportion of women six weeks after metronidazole treatment, with more than half of these experiencing recurrence by 12 weeks post-treatment. BV treatment temporarily reduced the relative abundance of BV-associated anaerobes (particularly Gardnerella vaginalis and Atopobium vaginae) and increased lactobacilli species (mainly L. iners), resulting in significantly altered mucosal immune milieu over time. In a linear mixed model, the median concentrations of pro-inflammatory cytokines and chemokines were significantly reduced in women who cleared BV compared to pre-treatment. BV persistence and recurrence were strongly associated with mucosal cytokine profiles that may increase the risk of HIV acquisition. Concentrations of these cytokines were differentially regulated by changes in the relative abundance of BVAB1 and G. vaginalis. We conclude that metronidazole for the treatment of BV induced short-term shifts in the vaginal microbiota and mucosal cytokines, while treatment failures promoted persistent elevation of pro-inflammatory cytokine concentrations in the genital tract. These data suggest the need to improve clinical management of BV to minimize BV related reproductive risk factors.
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Affiliation(s)
- Andile Mtshali
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
| | - James Emmanuel San
- KwaZulu-Natal Research Innovation and Sequencing Platform, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Farzana Osman
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Christina Balle
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Jennifer Giandhari
- KwaZulu-Natal Research Innovation and Sequencing Platform, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Harris Onywera
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Khanyisile Mngomezulu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Gugulethu Mzobe
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Tulio de Oliveira
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,KwaZulu-Natal Research Innovation and Sequencing Platform, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Anne Rompalo
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, United States
| | - Adrian Mindel
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Department of Epidemiology, Columbia University, New York City, NY, United States
| | - Jacques Ravel
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Jo-Ann S Passmore
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.,Department of Medical Virology, National Health Laboratory Service, Cape Town, South Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Department of Epidemiology, Columbia University, New York City, NY, United States
| | - Heather B Jaspan
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.,Seattle Children's Research Institute, University of Washington Department of Pediatrics and Global Health, Seattle, WA, United States
| | - Lenine J P Liebenberg
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
| | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.,Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
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15
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Goldstein E, Martinez-García L, Obermeier M, Glass A, Krügel M, Maree L, Gunson R, Onelia F, Pacenti M, Nelson KS, Joseph AM, Palm MJ, Lucic D, Marlowe N, Dhein J, Reinhardt B, Pfeifer K, Galan JC, Azzato F. Simultaneous identification of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis ‒ multicenter evaluation of the Alinity m STI assay. J LAB MED 2021. [DOI: 10.1515/labmed-2020-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
Accurate and rapid diagnosis of sexually transmitted infections (STIs) is essential for timely administration of appropriate treatment and reducing the spread of the disease. We examined the performance of the new Alinity m STI assay, a qualitative real-time multiplex PCR test for simultaneous identification of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and Trichomonas vaginalis (TV) run on the fully automated Alinity m platform.
Methods
This international, multicenter study evaluated the accuracy, reproducibility, and clinical performance of the Alinity m STI assay compared to commonly used STI assays in a large series of patient samples encountered in clinical practice.
Results
The Alinity m STI assay identified accurately and precisely single and mixed pathogens from an analytical panel of specimens. The Alinity m STI assay demonstrated high overall agreement rates with comparator STI assays (99.6% for CT [n=2,127], 99.2% for NG [n=2,160], 97.1% for MG [n=491], and 99.4% for TV [n=313]).
Conclusions
The newly developed Alinity m STI assay accurately detects the 4 sexually transmitted target pathogens in various collection devices across clinically relevant specimen types, regardless of single or mixed infection status.
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Affiliation(s)
| | - Laura Martinez-García
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER en Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | | | | | - Maria Krügel
- Lancet Laboratories , Johannesburg , South Africa
| | - Leana Maree
- Lancet Laboratories , Johannesburg , South Africa
| | - Rory Gunson
- West of Scotland Specialist Virology Centre , Glasgow , UK
| | | | | | - Kevin S. Nelson
- Abbott Molecular, Abbott Laboratories , Des Plaines , IL , USA
| | - Ajith M. Joseph
- Abbott Molecular, Abbott Laboratories , Des Plaines , IL , USA
| | - Michael J. Palm
- Abbott Molecular, Abbott Laboratories , Des Plaines , IL , USA
| | - Danijela Lucic
- Abbott Molecular, Abbott Laboratories , Des Plaines , IL , USA
| | | | | | | | | | - Juan-C. Galan
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER en Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Francesca Azzato
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity , Melbourne , VIC , Australia
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16
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Naeem F, Karellis A, Nair S, Routy JP, Yansouni CP, Kim J, Pai N. Multiplexed technologies for sexually transmitted infections: global evidence on patient-centered and clinical health outcomes. BMJ Glob Health 2021; 6:bmjgh-2021-005670. [PMID: 34301675 PMCID: PMC8311302 DOI: 10.1136/bmjgh-2021-005670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Conventional care packages around screening for sexually transmitted infections (STIs) entail multiple clinic visits and precipitate losses to follow-up. To prevent these losses, multiplexed technologies for STIs (immunochromatographic tests/devices/assays and molecular assays that can screen multiple pathogens or multiple strains of one STI) can yield same-day results in a single visit. Research evidence of patient-centred (preference, satisfaction) and clinical health outcomes (feasibility, case positivity, uptake, impact) has not been synthesised. We conducted a systematic review to fill this gap. Methods For the period 2009–2020, two independent reviewers searched PubMed and Embase, retrieved 4440 citations and abstracted data from 42 relevant studies. Results Of 42 studies, 10 (23.8%) evaluated multiplexed immunochromatographic and 32 (76.2%) molecular assays. Outcomes were reported as follows: preference (n=3), satisfaction (n=2), uptake (n=1), feasibility (n=2), case positivity (n=42) and impact (n=11). Screened populations included various at-risk groups. A majority (86.1%–92.4%) of participants preferred (60.2%–97.2%) multiplexed technologies (over conventional testing). Compared with conventional lab-based testing, test uptake improved by 99.4% (hepatitis C), 99.6% (Trichomonas vaginalis), 78.6% (hepatitis B) and 42.0% (HIV). Varying case positivities were documented depending on populations screened: HIV (1.8%–29.3%), hepatitis B (1.1%–23.9%), hepatitis C (0.5%–42.2%), Chlamydia trachomatis (2.8%–30.2%), Neisseria gonorrhoeae (0.0%–30.3%) and T. vaginalis (0.0%–32.7%). Regarding impact, 70.0%–100.0% of screened participants were linked to care, with result turnaround times ranging from 14 min (immunochromatographic assays) to 300 min (molecular assays). Conclusions Compared with conventional lab-based testing, rapid multiplexed technologies were preferred by testees and led to quicker turnaround times for many STIs yielding same-day results thereby allowing to initiate rapid linkages to care. They were further shown to be highly feasible and impactful for detection and treatment facilitation. Based on these promising results, multiplexed technologies offer potential to screen at-risk populations to reduce onward STI transmission worldwide.
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Affiliation(s)
- Faheel Naeem
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,CORE, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Angela Karellis
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,CORE, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Suma Nair
- Community Medicine, Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Jean-Pierre Routy
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
| | - Cédric Philippe Yansouni
- J D MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Infectious Diseases and Department of Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - John Kim
- National Laboratory for HIV Reference Services, Public Health Agency of Canada, Winnipeg, Quebec, Canada
| | - Nitika Pai
- Department of Medicine, McGill University, Montreal, Quebec, Canada .,CORE, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
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17
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Wada K, Hamasuna R, Sadahira T, Araki M, Yamamoto S. UAA-AAUS guideline for M. genitalium and non-chlamydial non-gonococcal urethritis. J Infect Chemother 2021; 27:1384-1388. [PMID: 34332883 DOI: 10.1016/j.jiac.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/09/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
Non-chlamydial non-gonococcal urethritis (NCNGU) is defined as urethritis with neither Neisseria gonorrhoeae nor Chlamydia trachomatis. Possible causative agents of NCNGU include Mycoplasma genitalium, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Trichomonas vaginalis, and so on. Among these microorganisms, the pathogenicity of M. genitalium and T. vaginalis to the male urethra has been confirmed so far. The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) belonging to the Urological Association of Asia (UAA) had developed the guidelines regarding NCNGU and the present guidelines were updated from previous edition. Relevant references were meticulously reviewed again and latest studies were collected. In addition to the levels of evidence, the recommendation grades were defined using the modified GRADE methodology. Herein, we present the new edition of the UAA-AAUS guidelines for M. genitalium and non-chlamydial non-gonococcal urethritis.
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Affiliation(s)
- Koichiro Wada
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa-machi, Nishinomiya, 663-8501, Japan
| | - Ryoichi Hamasuna
- Department of Urology, Federation of National Public Services and Affiliated Personnel Mutual Aid Associations, Shin-Kokura Hospital, Kanada 1-3-1, Kokurakita-ku, Kitakyusyu, 803-0816, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa-machi, Nishinomiya, 663-8501, Japan.
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa-machi, Nishinomiya, 663-8501, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-machi, Nishinomiya, 663-8501, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa-machi, Nishinomiya, 663-8501, Japan
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18
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Roy A, Dadwal R, Yadav R, Singh P, Krishnamoorthi S, Dasgupta A, Chakraborti A, Sethi S. Association of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Ureaplasma species infection and organism load with cervicitis in north Indian population. Lett Appl Microbiol 2021; 73:506-514. [PMID: 34089202 DOI: 10.1111/lam.13520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
Cervicitis is predominantly caused by Neisseria gonorrhoeae and Chlamydia trachomatis, which accounts for almost half of all the cases of cervicitis. The role of newer organisms like Mycoplasma genitalium and Ureaplasma sp. and association of bacterial load with cervicitis are also not well established. So the study aimed to determine the relative frequency of these organisms and their load in association with cervicitis cases from north India. A case-control study involving 300 women was conducted using quantitative real-time PCR from endocervical swabs for identification of organisms and quantification of bacterial load. Among 150 cervicitis cases, C. trachomatis, N. gonorrhoeae, M. genitalium and Ureaplasma parvum were detected in 5 (3·3%), 10 (6·6%), 37(24·6%) and 47 (31·3%) respectively. Old age (<0·001, chi-squared test) and irregular menstrual cycles (<0·001, chi-squared test) were significantly associated with cervicitis. M genitalium was the only organism to be associated significantly with cervicitis with regard to age (<0·031) and symptoms like discharge (P < 0·033, chi-squared test) and dysuria (P < 0·044, chi-squared test) in multivariate analysis. Our finding suggests that the bacterial load of these organisms is not significantly associated with cervicitis. However, we found significant association of M. genitalium infection with clinical characteristics of cervicitis cases.
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Affiliation(s)
- A Roy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Dadwal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Singh
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - S Krishnamoorthi
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bathinda, Punjab, India
| | - A Dasgupta
- Department of Biochemistry, Sharda University, Greater Noida, Uttar Pradesh, India
| | - A Chakraborti
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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19
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Luo L, Chen Q, Luo Q, Qin S, Liu Z, Li Q, Huang X, Xiao H, Xu N. Establishment and performance evaluation of multiplex PCR-dipstick DNA chromatography assay for simultaneous diagnosis of four sexually transmitted pathogens. J Microbiol Methods 2021; 186:106250. [PMID: 34029611 DOI: 10.1016/j.mimet.2021.106250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Rapid, sensitive, and specific diagnostic methods are indispensable for sexually transmitted infections (STIs). In this study, a multiplex PCR-dipstick DNA chromatography assay for diagnosis of four STI pathogens, namely Neisseria gonorrhoeae (N. gonorrhoeae), Mycoplasma hominis (M. hominis), Ureaplasma (U. urealyticum and U. parvum), and Chlamydia trachomatis (C. trachomatis), was established and evaluated. METHODS Based on the hybridization of probes and interaction between streptavidin and biotin, PCR products were visualized through hybridization of specific probes and enzymatic color generation. The sensitivity and specificity of all four pathogens were evaluated. Clinical performance of the test was evaluated using 295 specimens, and comparisons among results were determined via culture or colloidal gold assay. RESULTS No cross-reactions were observed, confirming the high specificity of this method. The limit of detection (LOD) of the four STI pathogens was 100 copies/μL. The sensitivity between PCR-dipstick DNA chromatography and culture or colloidal gold assay ranged from 84.6% to 100%. The specificity was between 93.5% and 96.6%, positive predictive value ranged from 53.6% to 86.7%, negative predictive value was over 98.3%, kappa value ranged from 0.676 to 0.864 (Cohen's kappa coefficient test), and the agreement rate was over 93.5%. CONCLUSION In conclusion, PCR-dipstick DNA chromatography serves as a rapid, sensitive, and specific method for simultaneous diagnosis of four STI pathogens.
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Affiliation(s)
- Li Luo
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qianming Chen
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qiang Luo
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Sheng Qin
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Zhenjie Liu
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qiong Li
- Research and Development Department, Guangzhou Biotron Technology Co. Ltd, Room 204, Zone C, Science and Technology Innovation Base, No. 80, Lanyue Road, Science City, Guangzhou 510000, China
| | - Xianzhang Huang
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
| | - Hui Xiao
- Research and Development Department, Guangzhou Biotron Technology Co. Ltd, Room 204, Zone C, Science and Technology Innovation Base, No. 80, Lanyue Road, Science City, Guangzhou 510000, China.
| | - Ning Xu
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
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20
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Fasciana T, Capra G, Di Carlo P, Calà C, Vella M, Pistone G, Colomba C, Giammanco A. Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094722. [PMID: 33925258 PMCID: PMC8125464 DOI: 10.3390/ijerph18094722] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 12/25/2022]
Abstract
Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patients were tested for chlamydia, syphilis, Mycoplasma genitalium infection, genital herpes and HPV infection. A total of 294 subjects with STIs (male/female ratio about 2:1) were screened. Of the total sample, 79.6% of patients were Italian. MSM accounted for 34.3%, MSW for 29.6%, bisexual men for 5.8% and females for 30.3%. A total of 44.5% of patients had a high education level, 42.5% reported irregular use of condoms, 20.7% reported having had 5-10 partners in the six months prior to the visit and 32.9% were HIV-positive. HPV infection and syphilis were the most prevalent STIs. Conclusions: The most common profile of patients attending our clinic was that of an adult, Italian man with a high level of education, poor use of condoms and a high number of partners. MSM had the highest sex-behavior-related risk for STIs. In addition, our results suggest that all STD teams need to implement counselling topics and recommendations to share with patients, as well as tips on how to approach sexual health education/counselling, thereby promoting patient-centered approaches and educational programs.
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Affiliation(s)
- Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
- Correspondence: ; Tel.: +39-3882422122
| | - Giuseppina Capra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Paola Di Carlo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Cinzia Calà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Marco Vella
- Department of Surgical, Oncological and Stomatological Sciences, Section of Urology, University of Palermo, 90127 Palermo, Italy;
| | - Giuseppe Pistone
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
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21
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Mitchev N, Singh R, Garrett N, Ramsuran V, Niehaus AJ, Mlisana KP. Performance of TaqMan probes for the detection of sexually transmitted infections in South African women. Afr J Lab Med 2021; 10:1124. [PMID: 33937002 PMCID: PMC8063552 DOI: 10.4102/ajlm.v10i1.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/08/2021] [Indexed: 11/29/2022] Open
Abstract
Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium are the four main aetiologies of sexually transmitted infections responsible for vaginal discharge syndrome (VDS). Commercially available multiplex polymerase chain reaction (PCR) assays are expensive and generally not customisable. We evaluated a highly customisable singleplex PCR approach by testing it in parallel with the Anyplex™ II STI-7 detection assay in a cohort of South African women that presented with VDS between May 2016 and January 2017. Our multiple singleplex PCR strategy proved to be a simple, accurate, rapid, affordable and scalable option for diagnosing VDS.
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Affiliation(s)
- Nireshni Mitchev
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Ravesh Singh
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.,Department of Medical Microbiology, National Health Laboratory Service, Durban, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.,Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Veron Ramsuran
- KwaZulu-Natal Research Innovation and Sequencing Platform, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Abraham J Niehaus
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.,Department of Medical Microbiology, National Health Laboratory Service, Durban, South Africa
| | - Koleka P Mlisana
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.,Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.,Department of Academic Affairs, Research and Quality Assurance, National Health Laboratory Service, Durban, South Africa
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22
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Barrientos-Durán A, de Salazar A, Fuentes-López A, Serrano-Conde E, Espadafor B, Chueca N, Álvarez-Estévez M, Garcia F. Comparison between Aptima® assays (Hologic) and the CoBAS® 6800 system (Roche) for the diagnosis of sexually transmitted infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium. Eur J Clin Microbiol Infect Dis 2021; 40:1337-1342. [PMID: 33492527 DOI: 10.1007/s10096-020-04143-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/21/2020] [Indexed: 11/25/2022]
Abstract
Nowadays, it is of utmost importance to use fully validated assays for molecular-based diagnosis. In the field of sexually transmitted disease (STD), Roche and Hologic provide assays for diagnosing Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and Trichomonas vaginalis (TV). A total of 212 clinical samples were tested. Aptima® Combo 2 (detecting CT and NG), Aptima® M. genitalium and the Aptima® T. vaginalis on the Panther® system were compared to CoBAS® CT/NG and CoBAS® TV/MG running on the CoBAS® 6800 system. To solve the discrepancies, Allplex™ STI Essential assay (Seegene®) and/or Sanger DNA sequencing were used. The diagnostic performance was calculated by mean of the sensitivity and specificity parameters. Aptima® (sensitivity: 98.90%, specificity: 100%), CoBAS® (sensitivity 100%, specificity: 96.67%). The CoBAS® combo (CT/NG) failed detecting NG from an anal/rectum specimen, which is not included into the validated specimens of the assay. Aptima® combo 2 produced two false positives (CT and NG), not detected by the third tests. All the assays showed an optimal diagnostic capacity, meeting the requirements for IVD DNA-based assays. All products work optimally on automatic platforms, minimizing time and risk of contamination during handling.
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Affiliation(s)
- Antonio Barrientos-Durán
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain
| | - Adolfo de Salazar
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain
| | - Ana Fuentes-López
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain
| | - Esther Serrano-Conde
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain
| | - Beatriz Espadafor
- Dermatology Unit, Centro de ETS, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Natalia Chueca
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain
| | - Marta Álvarez-Estévez
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain
| | - Federico Garcia
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio.Instituto de Investigación Ibs.Granada, Granada, Spain.
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23
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Caruso G, Giammanco A, Virruso R, Fasciana T. Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1038. [PMID: 33503917 PMCID: PMC7908473 DOI: 10.3390/ijerph18031038] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/18/2022]
Abstract
Sexually transmitted infections (STIs) continue to exert a considerable public health and social burden globally, particularly for developing countries. Due to the high prevalence of asymptomatic infections and the limitations of symptom-based (syndromic) diagnosis, confirmation of infection using laboratory tools is essential to choose the most appropriate course of treatment and to screen at-risk groups. Numerous laboratory tests and platforms have been developed for gonorrhea, chlamydia, syphilis, trichomoniasis, genital mycoplasmas, herpesviruses, and human papillomavirus. Point-of-care testing is now a possibility, and microfluidic and high-throughput omics technologies promise to revolutionize the diagnosis of STIs. The scope of this paper is to provide an updated overview of the current laboratory diagnostic tools for these infections, highlighting their advantages, limitations, and point-of-care adaptability. The diagnostic applicability of the latest molecular and biochemical approaches is also discussed.
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Affiliation(s)
- Giorgia Caruso
- U.O.C. of Microbiology and Virology, ARNAS “Civico, Di Cristina and Benfratelli”, 90127 Palermo, Italy
| | - Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.G.); (T.F.)
| | - Roberta Virruso
- U.O.C. of Microbiology, Virology and Parassitology, A.O.U.P. “Paolo Giaccone”, 90127 Palermo, Italy;
| | - Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.G.); (T.F.)
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24
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Lieberman JA, Cannon CA, Bourassa LA. Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections. J Appl Lab Med 2021; 6:264-273. [PMID: 33247907 PMCID: PMC7799034 DOI: 10.1093/jalm/jfaa163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/24/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Rates of sexually transmitted infections (STI) have risen steadily in recent years, and racial and ethnic minorities have borne the disproportionate burden of STI increases in the United States. Historical inequities and social determinants of health are significant contributors to observed disparities and affect access to diagnostic testing for STI. CONTENT Public health systems rely heavily on laboratory medicine professionals for diagnosis and reporting of STI. Therefore, it is imperative that clinicians and laboratory professionals be familiar with issues underlying disparities in STI incidence and barriers to reliable diagnostic testing. In this mini-review, we will summarize contributors to racial/ethnic disparity in STI, highlight current epidemiologic trends for gonorrhea, chlamydia, and syphilis, discuss policy issues that affect laboratory and public health funding, and identify specific analytic challenges for diagnostic laboratories. SUMMARY Racial and ethnic disparities in STI in the US are striking and are due to complex interactions of myriad social determinants of health. Budgetary cuts for laboratory and public health services and competition for resources during the COVID-19 pandemic are major challenges. Laboratory professionals must be aware of these underlying issues and work to maximize efforts to ensure equitable access to diagnostic STI testing for all persons, particularly those most disproportionately burdened by STI.
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Affiliation(s)
- Joshua A Lieberman
- Division of Microbiology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Chase A Cannon
- Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA
| | - Lori A Bourassa
- Division of Microbiology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
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25
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Bellinato F, Maurelli M, Gisondi P, Lleo Fernandez M, Girolomoni G. Clinical profile and co-infections of urethritis in males. Ital J Dermatol Venerol 2021; 156:681-685. [PMID: 33423450 DOI: 10.23736/s2784-8671.20.06773-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infectious urethritis are classified in N. gonorrhoeae (NG) urethritis and non-gonococcal urethritis, caused commonly by C. trachomatis (CT) or M. genitalium (MG) in Western Europe. The primary objective of the study is to evaluate the association between the clinical profile and the pathogens. Secondly, to assess the prevalence of co-infections. METHODS The clinical profile of urethritis in men caused by NG, CT and MG confirmed by nucleic acid amplification test (NAAT) on first void urine has been retrospectively collected. The clinical profiles comprised the assessment of dysuria and/or discharge and the clinical-dermoscopic examination of the genitalia. Serological tests for syphilis and HIV were also performed. RESULTS A total of 101 episodes of NAAT confirmed NG, CT or MG urethritis were identified. The prevalence for each pathogen was 50.60%, 33.73% and 15.66%, respectively. Co-infections were observed in few cases (four MG+CT, one NG+CT, one NG+MG), with M. hominis, U. urealitycum and U. parvum positivity found concomitantly in 7-8% cases. The median age of patients was 33 years. Dysuria was reported in 88% cases (95% NG, 79% CT, 78% MG urethritis). Urethral discharge was found in 86% of cases, including purulent discharge in 61% (98% NG, 70% MG) and transparent in 25% (64% CT). Dysuria and purulent discharge were observed in 95% NG, 54% MG and 29% CT cases, whereas dysuria and transparent discharge were observed in 50% CT, 23% MG and in none of NG cases (P<0.01). Balanitis/meatitis was observed in 24% of cases, genital warts in 12% and proctalgia in 4%. CONCLUSIONS NAAT is crucial for defining urethritis etiology. Dysuria is the most common symptom. Gonococcal urethritis present with purulent discharge, whereas transparent discharge is associated with non-gonococcal pathogens. Co-infections are rare. Clinical exam may detect other infectious diseases, in particular genital warts.
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Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy -
| | - Martina Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Maria Lleo Fernandez
- Section of Microbiology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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26
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Andersson N, Ejnestrand J, Lidgren Y, Allard A, Boman J, Nylander E. Are Swedish swingers a risk group for sexually transmitted infections? Int J STD AIDS 2021; 32:427-434. [PMID: 33427085 PMCID: PMC8008433 DOI: 10.1177/0956462420973108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate whether Swedish swingers constitute a risk group for sexually transmitted infections (STIs). Two swinger clubs were invited to participate. At swinger meetings, members were offered an STI sampling kit and a questionnaire. Samples were analyzed for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using a multiplex real-time polymerase chain reaction assay. In total, 235 swingers participated (118 women and 117 men). Urogenital C. trachomatis prevalence was 1.7%. Urogenital M. genitalium prevalence was 7.6% for women and 4.3% for men. No one tested positive for N. gonorrhoeae or T. vaginalis. For women, the mean number of unprotected temporary sex partners within the last 12 months was four men (range 0-35) and three women (range 0-50). Among men, the mean number of unprotected temporary sex partners within the last 12 months was five women (range 0-50) and 0 men (range 0-10). During vaginal sex, 46.6% women and 38.5% men always used protection with a temporary sex partner. Swedish swingers did not seem to have an increased prevalence of STIs. However, there was high-risk sexual behavior with unprotected sex and multiple sex partners, thereby making them a vulnerable group for acquiring STIs.
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Affiliation(s)
- Nirina Andersson
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
| | - Jennifer Ejnestrand
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
| | - Yvonne Lidgren
- Virology, Clinical Microbiology, 8075Umeå University, Umeå, Sweden
| | - Annika Allard
- Virology, Clinical Microbiology, 8075Umeå University, Umeå, Sweden
| | - Jens Boman
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
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27
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Hinić V, Seth-Smith HMB, Damm S, Amico P, Khanna N, Egli A, Bättig V. Unexpected Mycoplasma hominis infection in two renal transplant recipients traced back to the same donor by whole-genome sequencing. Eur J Clin Microbiol Infect Dis 2020; 40:1097-1102. [PMID: 33367958 PMCID: PMC8084823 DOI: 10.1007/s10096-020-04116-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022]
Abstract
Mycoplasma hominis is a common colonizer of the lower genitourinary tract. Although its clinical relevance for causing urogenital infections in immunocompetent individuals is controversial, this bacterium has been involved in severe invasive infections in allograft recipients. In this report, we describe two cases of M. hominis infection in two young renal transplant recipients within the first month post-transplant. Although at first no epidemiological link between the two cases had been suspected, whole-genome sequencing (WGS) analysis showed that both isolates were identical, highly suggestive of an origin with the common organ donor.
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Affiliation(s)
- V Hinić
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.
| | - H M B Seth-Smith
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - S Damm
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - P Amico
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - A Egli
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - V Bättig
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
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28
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Leos-Alvarado C, Llaca-Díaz J, Flores-Aréchiga A, Pérez-Chávez F, Casillas-Vega N. Male urethritis. A review of the ideal diagnostic method. Actas Urol Esp 2020; 44:523-528. [PMID: 32684296 DOI: 10.1016/j.acuro.2019.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/20/2019] [Accepted: 11/19/2019] [Indexed: 10/23/2022]
Abstract
Male urethritis is an inflammation of the urethra and the periurethral glands; it is widely classified as gonococcal or non-gonococcal. The most frequent microorganisms responsible are Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. In the last three decades, the diagnosis of sexually transmitted diseases depended almost exclusively on traditional methods, such as culture, enzyme immunoassay, fluorescent antibody staining, and hybridization, until the appearance of molecular techniques. Clinical syndromes such as urethritis are rarely specific for a single microorganism, so screening strategies should allow multiple agents to be considered. Multiplex PCR is the fastest and most sensitive technique for the diagnosis of gonococcal and non-gonococcal urethritis. Male urethritis without treatment is one of the main health problems related to reproductive and sexual function, constituting one of the main causes of infertility. The objective of this mini-review was to analyze the epidemiology, causes, diagnosis, and complications of male urethritis.
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29
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MYCO WELL D-ONE detection of Ureaplasma spp. and Mycoplasma hominis in sexual health patients in Wales. Eur J Clin Microbiol Infect Dis 2020; 39:2427-2440. [PMID: 32725499 PMCID: PMC7669805 DOI: 10.1007/s10096-020-03993-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/20/2020] [Indexed: 10/26/2022]
Abstract
The genital mycoplasmas are a unique group of inherently antibiotic-resistant sexually transmitted bacteria, often associated with non-gonococcal urethritis and bacterial vaginosis. The MYCO WELL D-ONE is a culture-based assay that aims to detect these organisms whilst concurrently screening them for antibiotic resistance. Urine and/or swabs from 856 informed and consented participants attending Welsh sexual health clinics were subjected to MYCO WELL D-ONE analysis, alongside qPCR and culture titration methodologies to determine sensitivity, specificity, PPV, NPV and accuracy. Resistance was confirmed by CLSI-compliant susceptibility testing and genetic mechanisms determined. The MYCO WELL D-ONE displayed a sensitivity and specificity of 91.98% and 96.44% for the detection of Ureaplasma spp., with sensitivity and specificity values of 78.23% and 98.84% for Mycoplasma hominis, compared with qPCR. Swabs harboured significantly greater bacterial loads than urine samples for both Ureaplasma spp. and M. hominis. Levofloxacin resistance rates, mediated by Ser83Leu mutation in ParC, for Ureaplasma spp. were 0.54%. Tetracycline resistance rates, mediated by tet(M), were 0.54% and 2% for Ureaplasma spp. and M. hominis, respectively; sequence analysis of tet(M)-positive Ureaplasma spp. and M. hominis strains isolated from a single individual confirmed separate resistance gene origins. The MYCO WELL D-ONE is a sensitive and specific assay for the detection of Ureaplasma spp. and M. hominis in genitourinary medicine samples, facilitating the accurate detection of these organisms within low-technology environments. While good for antibiotic resistance screening, accurate confirmation by MIC determination or molecular methods are required, and more optimally performed on urine samples.
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30
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Güralp O, Bostancı A, Özerkman Başaran E, Schild-Suhren M, Kaya B. Evaluation of the prevalence of sexually transmitted bacterial pathogens in Northern Cyprus by nucleic acid amplification tests, and investigation of the relationship between these pathogens and cervicitis. Turk J Obstet Gynecol 2020; 16:242-248. [PMID: 32231855 PMCID: PMC7090263 DOI: 10.4274/tjod.galenos.2019.80269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/12/2019] [Indexed: 01/29/2023] Open
Abstract
Objective: To evaluate the prevalence of pathogens, Chlamydia trachomatis, Neisseria gonorrhea and Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, and Ureaplasma parvum in women via multiplex-polymerase chain reaction (PCR)-deoxyribonucleic acid (DNA). Materials and Methods: Cervical swabs of 273 women in reproductive age who underwent gynecologic examination in our outpatient clinic were evaluated using the multiplex-PCR-DNA method. The presence of cervicitis, contraceptive methods, marital status, and the number of partners were evaluated. Results: One hundred six (39%) of the 273 women had at least one bacterium, 25 women (9.8%) had two bacteria, and three women (1%) had three bacteria. U. urealyticum was the most frequently encountered bacterium (13.9%), followed by M. hominis (12.8%), U. parvum (12.4%), C. trachomatis (5.4%), M. genitalium (2.9%), N. gonorrhea (2.5%), and T. vaginalis (0.3%). Bacterial infection was detected more frequently in women aged <25 years, single, who had multiple partners, and clinically diagnosed with cervicitis. The cervicitis rate was 39% in our study. M. genitalium was significantly more frequent in women with cervicitis than in women without cervicitis (5.6 vs. 1.2%, p=0.005). C. trachomatis and N. gonorrhea, which are often associated with cervicitis, were comparable in women with and without cervicitis. Conclusion: Women with clinically diagnosed cervicitis or even with a normal-appearing cervix should be tested using multiplex-real-time PCR-nucleic-acidamplification tests on suspicion of such an infection. M. genitalium is an emerging bacterial agent for cervicitis along with C. trachomatis and N. gonorrhea.
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Affiliation(s)
- Onur Güralp
- Carl von Ossietzky Oldenburg University Faculty of Medicine, Obstetrics and Gynecology, Klinikum AöR, Oldenburg, Germany
| | - Ayşegül Bostancı
- Near East University Faculty of Medicine, Department of Molecular Biology and Genetics, Lefkosa-TRNC, Turkey
| | - Esra Özerkman Başaran
- Near East University Faculty of Medicine, Department of Molecular Biology and Genetics, Lefkosa-TRNC, Turkey
| | - Meike Schild-Suhren
- Carl von Ossietzky Oldenburg University Faculty of Medicine, Obstetrics and Gynecology, Klinikum AöR, Oldenburg, Germany
| | - Barış Kaya
- Near East University Faculty of Medicine, Department of Obstetrics and Gynecology, Nicosia, Northern Cyprus
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31
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Meyer T, Buder S. The Laboratory Diagnosis of Neisseria gonorrhoeae: Current Testing and Future Demands. Pathogens 2020; 9:E91. [PMID: 32024032 PMCID: PMC7169389 DOI: 10.3390/pathogens9020091] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 02/05/2023] Open
Abstract
The ideal laboratory test to detect Neisseria gonorrhoeae (Ng) should be sensitive, specific, easy to use, rapid, and affordable and should provide information about susceptibility to antimicrobial drugs. Currently, such a test is not available and presumably will not be in the near future. Thus, diagnosis of gonococcal infections presently includes application of different techniques to address these requirements. Microscopy may produce rapid results but lacks sensitivity in many cases (except symptomatic urogenital infections in males). Highest sensitivity to detect Ng was shown for nucleic acid amplification technologies (NAATs), which, however, are less specific than culture. In addition, comprehensive analysis of antibiotic resistance is accomplished only by in vitro antimicrobial susceptibility testing of cultured isolates. As a light at the end of the tunnel, new developments of molecular techniques and microfluidic systems represent promising opportunities to design point-of-care tests for rapid detection of Ng with high sensitivity and specificity, and there is reason to hope that such tests may also provide antimicrobial resistance data in the future.
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Affiliation(s)
- Thomas Meyer
- Department of Dermatology, Venerology and Allergology, St. Josef Hospital, Ruhr-University, 44791 Bochum, Germany
| | - Susanne Buder
- German Consiliary Laboratory for Gonococci, Department of Dermatology and Venerology, Vivantes Hospital Berlin, 12351 Berlin, Germany;
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32
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Van Der Pol B. A profile of the cobas® TV/ MG test for the detection of Trichomonas vaginalis and Mycoplasma genitalium. Expert Rev Mol Diagn 2020; 20:381-386. [PMID: 31917618 DOI: 10.1080/14737159.2020.1714440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Trichomonas vaginalis and Mycoplasma genitalium are highly prevalent sexually transmitted pathogens that may be asymptomatic or may cause cervicitis and pelvic inflammatory disease in women and urethritis in men. Our limited understanding of the epidemiology of these infections has been hampered by a lack of diagnostic capacity, but the new cobas® TV/MG assay runs on the cobas® 6800/8800 platform offers a solution to this gap in our current diagnostic capacity.Areas covered: This article will describe what we know about the epidemiology and impact of untreated infections with these organisms as well as current recommendations for testing. The features and performance of the cobas 6800/8800 and the TV/MG assay will be described based on the emerging data related to this assay.Expert commentary: Molecular diagnostics for trichomonas and mycoplasma that can be performed on a high-throughput system with the flexibility to order only those tests required are needed in order to reduce the burden of disease and of consequences of undiagnosed infections caused by these pathogens. As a result of the complexities in the needs for testing in different populations, sample-specific flexibility in test ordering is an absolute need in the molecular laboratory.
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Affiliation(s)
- Barbara Van Der Pol
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Barrientos-Durán A, de Salazar A, Alvarez-Estévez M, Fuentes-López A, Espadafor B, Garcia F. Detection of sexually transmitted disease-causing pathogens from direct clinical specimens with the multiplex PCR-based STD Direct Flow Chip Kit. Eur J Clin Microbiol Infect Dis 2020; 39:235-241. [PMID: 31902016 DOI: 10.1007/s10096-019-03686-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 08/26/2019] [Indexed: 10/25/2022]
Abstract
Pathogens causing sexually transmitted diseases (STDs) include viruses, bacteria, and parasites. The ability to rapidly and efficiently detect these pathogens in a single reaction still remains a health challenge. The aim of this study was to evaluate the clinical reliability and accuracy of the STD Direct Flow Chip Kit (Vitro, IVD-EC approved), which can simultaneously detect up to 9 different species of STD pathogens at once. This kit enables direct analysis-direct-PCR-of clinical specimens (urine, semen, endocervical, urethral, nasopharyngeal, and perianal swabs) without DNA purification for the following pathogens: Chlamydia trachomatis (serovars A-K and L1-L3), Haemophilus ducreyi, Herpes Simplex Virus (Types I and II), Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and Ureaplasma. The Anyplex™ II STI-7 Detection Kit (Seegene, IVD-EC) was used as the reference's method. Existing discordances were resolved using either a third molecular assay or DNA sequencing. Clinical performance was evaluated at two different stages: (i) from purified DNA of three hundred and fifty-eight clinical specimens with a diagnostic sensitivity (SE) and specificity (SP) of 99.4% and 100%, respectively, and an agreement of 99% (kappa index, κ = 0.97) with the reference's method and; (ii) by direct-PCR from six hundred and thirty-three specimens rendering SE, SP, and agreement values of 98.4%, 99.9%, and 98.0% (κ = 0.95), respectively. The STD Direct Flow Chip Kit constitutes a promising alternative to routine procedures in diagnostic, allowing direct analysis of specimens and enabling the detection of a broad panel of pathogens.
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Affiliation(s)
- Antonio Barrientos-Durán
- Servicio de Microbiología. Instituto de Investigación ibs.GRANADA, Hospital Universitario Clínico San Cecilio, Avenida de la Ilustración S/N, 18016, Granada, Spain
| | - Adolfo de Salazar
- Servicio de Microbiología. Instituto de Investigación ibs.GRANADA, Hospital Universitario Clínico San Cecilio, Avenida de la Ilustración S/N, 18016, Granada, Spain
| | - Marta Alvarez-Estévez
- Servicio de Microbiología. Instituto de Investigación ibs.GRANADA, Hospital Universitario Clínico San Cecilio, Avenida de la Ilustración S/N, 18016, Granada, Spain
| | - Ana Fuentes-López
- Servicio de Microbiología. Instituto de Investigación ibs.GRANADA, Hospital Universitario Clínico San Cecilio, Avenida de la Ilustración S/N, 18016, Granada, Spain
| | - Beatriz Espadafor
- Servicio de Dermatología. Centro de ETS., Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Federico Garcia
- Servicio de Microbiología. Instituto de Investigación ibs.GRANADA, Hospital Universitario Clínico San Cecilio, Avenida de la Ilustración S/N, 18016, Granada, Spain.
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Molecular Diagnosis of Sexually Transmitted Infections (STI) in Symptomatic Women of Puducherry by a Commercial Real Time Multiplex PCR, FTD Urethritis Plus - A Preliminary Report. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.3.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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de Salazar A, Espadafor B, Fuentes-López A, Barrientos-Durán A, Salvador L, Álvarez M, García F. Comparison between Aptima Assays (Hologic) and the Allplex STI Essential Assay (Seegene) for the diagnosis of Sexually transmitted infections. PLoS One 2019; 14:e0222439. [PMID: 31513653 PMCID: PMC6742210 DOI: 10.1371/journal.pone.0222439] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/29/2019] [Indexed: 11/26/2022] Open
Abstract
Sexually transmitted infections (STIs) remain a worldwide problem and a severe threat to public health. The purpose of this study was to compare Aptima® Assays (Hologic®) and the Allplex™ STI Essential Assay (Seegene®) for the simultaneous detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium in clinical practice. The Aptima® assays (Hologic®) are based on a transcription-mediated amplification (TMA) method. The Allplex™ STI Essential assay (Seegene®) is based on a multiplex Real-Time PCR (RT-PCR) method. A total of 622 clinical samples from different anatomical sites were tested using both methods. A total of 88 (14.1%) and 66 (10.6%) positive samples were found for any of the TMA assays used and for the RT-PCR assay, respectively. Aptima® assays showed a slightly higher rate of positive results for all pathogens except for T. vaginalis, the results of which were similar to those obtained with Allplex™. The most commonly detected pathogen was C. trachomatis (37 samples; 5.9% using TMA assays) and the anatomical site with the highest prevalence of microorganisms was a non-urogenital site, the pharynx (27 positive samples; 4.3%). Using the Aptima® assays as reference method, the comparison showed that the average specificity of multiplex RT-PCR was 100.0% for the four pathogens. However an average sensitivity of 74.5% was observed, showing 95.2% (CI95%; 93.6–96.9) of overall concordance (κ = 0.80). In conclusion, the Aptima® assays show a higher sensitivity on a wide range of sample types compared to the Allplex™ assay.
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Affiliation(s)
- Adolfo de Salazar
- Hospital Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación Ibs, Granada, Spain
| | - Beatriz Espadafor
- Hospital Universitario Virgen de las Nieves, Servicio de Dermatología, Centro de ETS, Granada, Spain
| | - Ana Fuentes-López
- Hospital Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación Ibs, Granada, Spain
| | - Antonio Barrientos-Durán
- Hospital Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación Ibs, Granada, Spain
| | - Luis Salvador
- Hospital Universitario Virgen de las Nieves, Servicio de Dermatología, Centro de ETS, Granada, Spain
| | - Marta Álvarez
- Hospital Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación Ibs, Granada, Spain
| | - Federico García
- Hospital Universitario San Cecilio, Servicio de Microbiología, Instituto de Investigación Ibs, Granada, Spain
- * E-mail:
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Compain F, Nodjikouambaye ZA, Sadjoli D, Moussa AM, Adawaye C, Bouassa RSM, Koyalta D, Tonen-Wolyec S, Péré H, Podglajen I, Bélec L. Low Prevalence of Common Sexually Transmitted Infections Contrasting with High Prevalence of Mycoplasma Asymptomatic Genital Carriage: A Community-Based Cross-Sectional Survey in Adult Women Living in N’Djamena, Chad. Open Microbiol J 2019. [DOI: 10.2174/1874285801913010222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
We herein report a cross-sectional study which consecutively enrolled adult women from the community living in N'Djamena, Chad. The aim of the study was to estimate the burden of asymptomatic genital carriage of common curable sexually transmitted infections (STIs) (including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis) and genital Mycoplasma spp., as well as to assess their possible associated risk factors.
Methods:
A total of 251 women were consecutively included and screened for common curable STIs as well as for genital mycoplasma carriage by multiplex real-time PCR.
Results:
Only seven (2.8%) women were found to be infected with at least one common STI by multiplex real-time PCR: C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis were recovered from 3 (1.2%), 1 (0.4%), 4 (1.6%) and 1 (0.4%) women, respectively. No sociodemographic and behavioral characteristics could be associated in multivariate analysis with the genital carriage of the four detected common curable STIs. In contrast, the prevalence of genital mycoplasmas was much higher (54.2%) with a predominance of Ureaplasma parvum (42.6% of the total population).
Conclusion:
Our study shows a low prevalence of common STIs in contrast with a high prevalence of mycoplasmas among asymptomatic adult women recruited on a community basis in Chad. These observations highlight the need for etiologic management of STIs relying on PCR-based techniques rather than a syndromic approach in resource-limited countries.
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Xiu L, Zhang C, Li Y, Wang F, Peng J. Simultaneous detection of eleven sexually transmitted agents using multiplexed PCR coupled with MALDI-TOF analysis. Infect Drug Resist 2019; 12:2671-2682. [PMID: 31695443 PMCID: PMC6717854 DOI: 10.2147/idr.s219580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/10/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose Sexually transmitted infections (STIs), representing a major global health problem, are caused by different microbes, including bacteria, viruses, and protozoa. Unfortunately, infections of different sexually transmitted pathogens often present similar clinical symptoms, so it is almost impossible to distinguish them clinically. Therefore, the aim of the current study was to develop a sensitive, multitarget, and high-throughput method that can detect various agents responsible for STIs. Methods We developed and tested a 23-plex PCR coupled with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) assay (sexually transmitted infection-mass spectrometry, STI-MS) that simultaneously targets 11 different agents, including 8 most common clinical pathogens related to STIs (HSV-1, HSV-2, Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Trichomonas vaginalis, Mycoplasma genitalium, and Haemophilus ducreyi) and 3 controversial microorganisms as pathogens (Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum). Results The results showed that the STI-MS approach can accurately detect the expected agents, without cross-reaction with other organisms. The limit of detection of each STI-MS assay was ranged from 1.739 to 10.009 copies/reaction, using probit analyses. The verification rate for each target organism of the STI-MS ranged from a minimum of 89.3% to a maximum of 100%, using conventional assays and ultrasensitive digital PCR to confirm the STI-MS-positive results. To further evaluate the clinical performance of this assay, 241 clinical specimens (124 urethral/cervical swabs and 117 urine) were tested in parallel using the STI-MS assay and monoplex real-time PCR for each agent. The overall validation parameters of STI-MS were extremely high including sensitivity (from 85.7% to 100%), specificity (from 92.3% to 100%), PPV (from 50% to 100%), and NPV (from 99.1% to 100%) for each target. Conclusion STI-MS is a useful high-throughput screening tool for detecting mixed infections of STIs and has great potential for application in large-scale epidemiological programs for specific microorganisms of STI.
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Affiliation(s)
- Leshan Xiu
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Chi Zhang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yamei Li
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Feng Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Junping Peng
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
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Nodjikouambaye ZA, Compain F, Sadjoli D, Mboumba Bouassa RS, Péré H, Veyer D, Robin L, Adawaye C, Tonen-Wolyec S, Moussa AM, Koyalta D, Belec L. Accuracy of Curable Sexually Transmitted Infections and Genital Mycoplasmas Screening by Multiplex Real-Time PCR Using a Self-Collected Veil among Adult Women in Sub-Saharan Africa. Infect Dis Obstet Gynecol 2019; 2019:8639510. [PMID: 31379424 PMCID: PMC6662439 DOI: 10.1155/2019/8639510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/15/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa. Genital self-sampling may facilitate the screening of STIs in hard-to-reach remote populations far from large health care centers and may increase screening rates. The cross-sectional GYNAUTO-STI study was carried out to assess the performance of a novel genital veil (V-Veil-Up Gyn Collection Device, V-Veil-Up Pharma, Ltd., Nicosia, Cyprus) as a genital self-sampling device to collect genital secretions to diagnose STIs by molecular biology as compared to reference clinician-collected genital specimens, in adult African women. Methods Adult women living in N'Djamena, the capital city of Chad, were recruited from the community and referred to the clinic for women's sexual health "La Renaissance Plus". A clinician obtained an endocervical specimen using flocked swab. Genital secretions were also obtained by self-collection using veil. Both clinician- and self-collected specimens were tested for common curable STIs (including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis) and genital Mycoplasma spp. by multiplex real-time PCR (Allplex™ STI Essential Assay, Seegene, Seoul, South Korea). Test positivities for both collection methods were compared by assessing methods agreement, sensitivity, and specificity. Results A total of 251 women (mean age, 35.1 years) were prospectively enrolled. Only seven (2.8%) women were found to be infected with at least one common STIs [C. trachomatis: 3 (1.2%), N. gonorrhoeae: 1 (0.4%), M. genitalium: 4 (1.6%) and T. vaginalis: 1 (0.4%)], while the prevalence of genital mycoplasmas was much higher (54.2%) with a predominance of Ureaplasma parvum (42.6%). Self-collection by veil was non-inferior to clinician-based collection for genital microorganisms DNA molecular testing, with "almost perfect" agreement between both methods, high sensitivity (97.0%; 95%CI: 92.5-99.2%), and specificity (88.0%; 95%CI: 80.7-93.3%). Remarkably, the mean total number of genital microorganisms detected per woman was 1.14-fold higher in self-collected specimens compared to that in clinician-collected specimens. Conclusions Veil-based self-collection of female genital secretions constitutes a convenient tool to collect in gentle way cervicovaginal secretions for accurate molecular detection of genital bacteria. Such sampling procedure could be easily implemented in STIs clinics in sub-Saharan Africa.
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Affiliation(s)
- Zita Aleyo Nodjikouambaye
- Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l'Enfant, N'Djamena, Chad
- Ecole Doctorale Régionale en Infectiologie Tropicale de Franceville, Franceville, Gabon
| | - Fabrice Compain
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMRS 1138, UPMC Université (Paris VI), Université Paris Descartes (Paris V) and Université Paris Diderot (Paris VII), Centre de Recherche Biomédicale des Cordeliers, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Damtheou Sadjoli
- Cabinet Médical de Gynécologie-Obstétrique “La Renaissance Plus”, N'Djamena, Chad
| | - Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale en Infectiologie Tropicale de Franceville, Franceville, Gabon
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Hélène Péré
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMRS 1138, UPMC Université (Paris VI), Université Paris Descartes (Paris V) and Université Paris Diderot (Paris VII), Centre de Recherche Biomédicale des Cordeliers, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - David Veyer
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Leman Robin
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Chatté Adawaye
- Institut National Supérieur des Sciences et Techniques d'Abéché, Abéché, Chad
| | - Serge Tonen-Wolyec
- Ecole Doctorale Régionale en Infectiologie Tropicale de Franceville, Franceville, Gabon
- Faculté de Médecine, Université de Bunia, Bunia, Democratic Republic of the Congo
- Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, Democratic Republic of the Congo
| | - Ali Mahamat Moussa
- Faculté de Médecine, N'Djamena, Chad
- Service de Gastro-Entérologie, Hôpital Général de Référence Nationale, N'Djamena, Chad
| | | | - Laurent Belec
- Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMRS 1138, UPMC Université (Paris VI), Université Paris Descartes (Paris V) and Université Paris Diderot (Paris VII), Centre de Recherche Biomédicale des Cordeliers, Paris, France
- Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
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López-Corbeto E, González V, Lugo R, Rivaya B, Casabona J, Matas L. Pooling of urine samples for molecular detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium as a screening strategy among young adults in Catalonia. Enferm Infecc Microbiol Clin 2019; 38:65-71. [PMID: 31288994 DOI: 10.1016/j.eimc.2019.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/06/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Bacterial sexually transmitted infections (STIs) have an important impact on reproductive health, highlighting the increase in Chlamydia trachomatis infection rates among young people. To reduce the costs of STI detection, the pooling strategy is beneficial for high-throughput tests in low-prevalence populations using non-invasive samples. OBJECTIVES (1) To describe the performance of a 7-STI PCR assay using the pooling of three urine samples to detect C. trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium; (2) to estimate the cost saving of the pooling strategy; (3) to describe the prevalence, risk factors and coinfections of C. trachomatis, N. gonorrhoeae and M. genitalium in young people ≤25 years in Catalonia. METHODS cross-sectional prevalence study conducted in 2016 among young people ≤25 years of age seen in sexual and reproductive health centres throughout Catalonia from pools of three urine samples. A standardized questionnaire was used to collect clinical-epidemiological and behavioural variables. RESULTS 1032 young people were tested. The prevalence of C. trachomatis, N. gonorrhoeae and M. genitalium was 8.5%, 0.6% and 3.5%, respectively. The pooling strategy provided a 33% savings in reagent costs. CONCLUSIONS The pooling strategy implemented for epidemiological studies in our context provides a savings that has an impact on the viability of STI detection programmes. In the same way, this study shows that C. trachomatis prevalence continues to increase in this population and, for the first time in Catalonia, the prevalence of M. genitalium in young people is shown.
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Affiliation(s)
- Evelin López-Corbeto
- Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Generalitat de Catalunya, Badalona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona 08916, Spain.
| | - Victoria González
- Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Generalitat de Catalunya, Badalona, Spain; Microbiology Service, North Metropolitan Area Clinical Laboratory, Germans Trias i Pujol University Hospital, Badalona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona 08916, Spain
| | - Rossie Lugo
- Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Generalitat de Catalunya, Badalona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona 08916, Spain
| | - Belen Rivaya
- Microbiology Service, North Metropolitan Area Clinical Laboratory, Germans Trias i Pujol University Hospital, Badalona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Casabona
- Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Generalitat de Catalunya, Badalona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Department of Paediatrics, Obstetrics and Gynaecology, Preventive Medicine, and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona 08916, Spain
| | - Lurdes Matas
- Microbiology Service, North Metropolitan Area Clinical Laboratory, Germans Trias i Pujol University Hospital, Badalona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
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Manage DP, Lauzon J, McMullen LM, Pilarski LM. Application of lab-on-a-chip multiplex cassette PCR for the detection of enterohemorrhagic Escherichia coli. BMC Microbiol 2019; 19:93. [PMID: 31088365 PMCID: PMC6515682 DOI: 10.1186/s12866-019-1463-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 04/23/2019] [Indexed: 11/20/2022] Open
Abstract
Background Fast molecular detection methods benefit from ready-to-run lab-on-a-chip molecular assays with minimum preparation time. Detection efficiency of such methods can improve if multiple targets are detected simultaneously per given reaction. Detection of food pathogens, i.e. Escherichia coli (E. coli), is generally performed in two stages with the detection of multiple targets in each stage.With simultaneous testing, screening for pathogens is fast and efficient. Results In this study, we show the application of multiplex PCR performed on a ready-made cassette to detect 10 targets each for eight samples known to harbor E. coli. In cassette PCR, the aluminum cassette (38.6 mm × 31.4 mm) contains 10 trenches having a total of 50 capillaries with microliter volumes of desiccated acrylamide gels holding all reagents required for the PCR including internal positive and negative controls. The gel contains LCGreen dye to detect double stranded DNA. Fluorescence monitoring allows the detection of the amplified products by melt curve analysis. In this application, each of the five capillaries in a given trench contains two of the primer sets for the detection of 10 targets in pathogenic E. coli, namely, O157, Eae, Stx1, Stx2 and six O-antigen genes. Primer specificity was confirmed. Each trench tests one sample. Eight minimally processed enriched beef carcass swab samples were analyzed for parallel detection of 10 targets within 1 h and 15 min. Samples were delivered to the capillaries by capillary forces thereby hydrating the gels. Multiplex cassette PCR results were confirmed with conventional multiplex PCRs performed in a commercial real-time PCR system. Conclusions Cassette PCR technology is ideally suited to multi-target detection of pathogens in food products. The cassette performs multiple PCR reactions in parallel, with multiplex detection of targets within each reaction unit. Cassette PCR/ melt curve analysis results for the simultaneous detection of 10 targets of pathogenic E.coli in beef carcass swab samples were confirmed with a conventional real-time PCR/ melt curve analysis as well as with agarose gel electrophoresis. Although designed for the detection of E. coli, this multiplex cassette PCR technique can be applied to any other assay where the fast detection of multiple targets is required.
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Affiliation(s)
- Dammika P Manage
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2P5, Canada.
| | - Jana Lauzon
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2P5, Canada
| | - Lynn M McMullen
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2P5, Canada
| | - Linda M Pilarski
- Department of Oncology, University of Alberta and Cross Cancer Institute, 11560 University Ave, Edmonton, AB, T6G 1Z2, Canada
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Taylor J, Sampene Ossei PP, Pradhan K, Adjah J, Agyeman-Duah E, Afranie BO, Donkor S, Ayibor W. Detecting Ureaplasma urealyticum among HIV-infected women with or without human papillomavirus using real-time PCR with the ANYPLEX™ II STI-7 assay system. J Taibah Univ Med Sci 2019; 14:295-299. [PMID: 31435420 PMCID: PMC6695007 DOI: 10.1016/j.jtumed.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives Human immunodeficiency virus (HIV) infections increase the chances of women contracting human papillomavirus (HPV), the prime causative agent of cervical cancer. Additionally, Ureaplasma urealyticum is the most frequent pathogen prevailing in sexually transmitted diseases in HIV-infected women. The aim of this study was to determine the presence of U. urealyticum among HIV-infected women with or without HPV in Ghana. Methods DNA samples were extracted from cervico-vaginal swabs obtained from 96 HIV-infected women attending the Kumasi South Hospital. U. urealyticum in the DNA samples was detected by real-time PCR with the Anyplex™ II STI-7 detection assay. Microsoft Excel was used to analyze the data, and the Chi-square test was used to determine associations and dependence among the variables. Results Among the study population, 93.75% (90/96) were positive for at least one pathogen.In total, 36.5% (35/96) of the women were infected by U. urealyticum, with 30.21% (29/96) being co-infected with HPV. There was no significant association (95% CI, p > 0.05) between U. urealyticum and HPV status among the HIV-infected women. Conclusion U. urealyticum and HPV are highly pathogenic, and their prevalence in this study reiterates the need for their routine screening in HIV-infected patients.
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Affiliation(s)
- John Taylor
- Department of Molecular Biology and Biotechnology, Tezpur University, Assam, India
- Corresponding address: Department of Molecular Biology and Biotechnology, Tezpur University, Assam, India.
| | - Paul P. Sampene Ossei
- Department of Pathology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Krishna Pradhan
- Department of Molecular Biology and Biotechnology, Tezpur University, Assam, India
| | - Joshua Adjah
- West Africa Center for Cell Biology of Infectious Pathogens (WACCBIP), Legon, Ghana
| | - Eric Agyeman-Duah
- Department of Molecular Medicine, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Bright O. Afranie
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sampson Donkor
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - William Ayibor
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Favalli C, Favaro M, Santi F, Piperno M, D'Agostini C, Ciotti M. Performance Evaluation of a New Culture Colorimetric Detection Assay. Eurasian J Med 2019; 51:5-7. [PMID: 30911247 DOI: 10.5152/eurasianjmed.2018.17364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 06/27/2018] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the performance of the culture colorimetric detection assay MYCO WELL D-ONE® (MWD-ONE), designed to detect sexually transmitted infections using real-time polymerase chain reaction (PCR) as a reference method. Materials and Methods One hundred and ten urogenital samples were screened for Gardnerella vaginalis (GV), Trichomonas vaginalis (TV), Mycoplasma hominis (MH), Mycoplasma spp., and Ureaplasma urealyticum (UU)/Ureaplasma parvum (UP) using the MWD-ONE and real-time PCR assays Gardnerella vaginalis/Lactobacillus species Real-TM Quant and Anyplex II STI-7 Detection, respectively. Results GV was detected in 33 samples by both the MWD-ONE and real-time PCR, while 6 samples gave discordant results. TV was detected by both MWD-ONE and Anyplex II STI-7 Detection kits in 3 samples, while 107 were negative. MH was detected by both methods in 5 cases, 4 samples gave discordant results, and 101 were negative. Mycoplasma genitalium (MG) was detected by Anyplex II STI-7 in 2 cases, 1 of which was detected as Mycoplasma spp. by MWD-ONE. Ten samples were positive by MWD-ONE, and 98 were negative with both assays. With regard to UU/UP, 24 cases were detected by MWD-ONE and Anyplex PCR, 25 by PCR only, 4 by MWD-ONE, and 57 tested negative with both methods.The positive predictive values (PPV) and negative predictive values (NPV) of the MWD-ONE assay for the pathogens tested were as following: GV, PPV 94.3%, NPV 94.7%; TV, PPV and NPV 100%; MH, PPV 71.4%, NPV 98.1%; Mycoplasma spp., PPV 9.1%, NPV 98.9%; and Ureaplasma spp., PPV 85.7 %, NPV 69.5 %. The agreement between the MWD-ONE and PCR was strong for GV and MH (k=0.8 and 0.7, respectively); perfect for TV (k=1); and moderate for UU/UP (k=0.4). Conclusion MWD-ONE assay appears to be suitable for routine testing of sexually transmitted infections.
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Affiliation(s)
- Cartesio Favalli
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy.,Department of Biochemical Sciences, Catholic University "Our Lady of Good Counsel", Tirana, Albania.,Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Favaro
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Flavia Santi
- Department of Statistical Sciences, "La Sapienza" University of Rome, Rome, Italy
| | - Micol Piperno
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Cartesio D'Agostini
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Ciotti
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
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Park H, Lee G. Roles of Ureaplasma Species in Idiopathic Chronic Prostatitis: A Case-Control Study. World J Mens Health 2019; 37:355-363. [PMID: 30799562 PMCID: PMC6704302 DOI: 10.5534/wjmh.180081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/17/2018] [Accepted: 12/30/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose Because of the inconsistent symptoms associated with Ureaplasma infections, their clinical significances in genitourinary tracts are under debate. Therefore, we evaluated the presence of Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in urine samples and examined their associations with chronic prostatitis (CP) through a case and control study. Materials and Methods We included 696 nonchlamydial nongonococcal (NCNG) urine samples from men; 350 were categorized into non-inflammatory CP, 88 in inflammatory CP, and 258 in non-CP group. We amplified a region in the Ureaplasma urease areas from these samples and determined their biovars using the Sanger method. Results Among the NCNG population, the rates of UU, UP, and non-UU/UP were 3.88%, 6.46%, and 89.66%, respectively. The overall infection rates of non-CP, inflammatory CP, and non-inflammatory CP groups were 4.15%, 6.10%, and 3.65% in UU (p=0.612) and 6.85%, 7.22%, and 6.50% in UP (p=0.968), respectively. UU infection increased the risk of white blood cell (WBC) counts (≥5) in urine (p=0.005). In contrast, UP infections did not increase the risks of urethritis. Re-analysis from the 633 men who were excluded from urethritis effects did not reveal the associations between UU infection and the clinical characteristics of CP. Furthermore, the profiles from the National Institutes of Health-Chronic Prostatitis Symptom Index questionnaire and WBC counts in expressed prostatic secretion were similar among the non-CP and the two CP groups in each Ureaplasma infection. Conclusions We found that UU may induce male urethritis. However, Ureapalsma species in urine were not definitively associated with the occurrence of CP.
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Affiliation(s)
- Heeyoon Park
- Department of Urology, Dankook University College of Medicine, Cheonan, Korea
| | - Gilho Lee
- Department of Urology, Dankook University College of Medicine, Cheonan, Korea.
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Wendt N, Tittelbach J, Grimm MO, Scheungraber C, Löffler B, Baier M, Karrasch M. Prospective evaluation study on the benefit of the simultaneous detection of seven sexually transmitted pathogens for the clinical management of patients suffering from sexually transmitted diseases. J LAB MED 2019. [DOI: 10.1515/labmed-2018-0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Sexually transmitted infections (STIs) represent a growing relevant public health problem. Early and accurate STI diagnosis is capable of preventing the spread and severe complications of curable STIs through pathogen adapted antibiotic treatment regimens. Limitations of current STI diagnostic tools are the lack of simultaneous pathogen detection and result quantification.
Methods
A prospective analysis of clinical specimens (n=100, from 82 symptomatic patients) from different sites of infections was performed. All samples were processed with multiplex real-time polymerase chain reaction (PCR) assay Anyplex™ II STI-7, using thermal cycler CFX96™. The Anyplex™ II STI-7 detection assay covers Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma parvum (UP), Ureaplasma urealyticum (UU) and Trichomonas vaginalis (TV). STI-7 results were compared to standard methods and transferred to the attending physician for treatment adjustment.
Results
Compared to performed standard method results the assay achieved sensitivities ranging from 90.9% to 100%, respectively, and specificities of 100%, with negative predictive values (NPV) ranging from 98.5% to 100%, respectively, and positive predictive values (PPV) of 100%. The Anyplex™ II STI-7 detection assay measured a Cohen’s kappa of 1.00 for UU/UP, MH, and MG and a Cohen’s κ agreement of 0.95 and 0.96 for NG and CT, respectively.
Conclusions
The Anyplex™ II STI-7 assay can easily be introduced into the microbiological laboratory work flow due to its short hands-on-time and PCR mutiplexity. The simultaneous detection of seven STI pathogens provides a comprehensive profile for each patient, enabling clinicians to decide on best treatment options, decreasing antibiotic misuse and infection spreading risk. The semi-quantitative results enables clinicians to gain a complete package of diagnostic information including disease diagnosis, disease degree severity and treatment monitoring, although. Further clinical studies on this topic are needed.
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Huh HJ, Ki CS, Yun SA, Lee J, Oh GY, Lee NS, Yoon YH, Lee NY. Comparison between DiaPlexQ™ STI6 and GeneFinder™ STD I/STD II multiplex Real-time PCR Kits in the detection of six sexually transmitted disease pathogens. J Clin Lab Anal 2018; 33:e22703. [PMID: 30390337 DOI: 10.1002/jcla.22703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/24/2018] [Accepted: 10/01/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The DiaPlexQ™ STI6 Detection Kit (DiaPlexQ; Solgent Co., Ltd., Daejeon, South Korea) is a multiplex real-time PCR assay for the detection of the following sexually transmitted disease (STD) pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Trichomonas vaginalis, Ureaplasma urealyticum, and Mycoplasma genitalium. We compared the performance of the DiaPlexQ assay with the GeneFinder™ STD I (CT/NG/UU) and STD II (MG/MH/TV) Multiplex Real-time PCR Kits (GeneFinder; Infopia Co., Ltd., Anyang, South Korea). METHODS We evaluated the performance of the DiaPlexQ assay in comparison to that of GeneFinder using 1106 clinical specimens (542 genital swabs and 564 urine samples). The analytical performance of the DiaPlexQ assay, including the limit of detection (LOD) and analytical specificity, was evaluated using reference strains. RESULTS The positive percent agreement, negative percent agreement, and kappa value between the two assays were 96.6%-99.4%, 98.2%-99.8%, and 0.93%-0.99%, respectively. No cross-reactivity was observed in a collection of 41 different microorganisms and the LOD of the DiaPlexQ assay ranged from 1 to 10 copies/reaction for each microorganism. CONCLUSION The DiaPlexQ assay showed comparable performance to that of the GeneFinder assay so that it can be used for the screening and diagnosis of non-viral curable STD pathogens.
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Affiliation(s)
- Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Sun Ae Yun
- Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | | | | | | | | | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Van Der Pol B. We have the technology, but should we build the test? Expert Rev Mol Diagn 2018; 18:917-919. [PMID: 30307788 DOI: 10.1080/14737159.2018.1535905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Barbara Van Der Pol
- a University of Alabama at Birmingham , School of Medicine , Birmingham , AL , USA
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Cabello A, Górgolas M. Anorectal sexually transmitted infections. An infradiagnosticated epidemic. Med Clin (Barc) 2018; 152:102-103. [PMID: 30146356 DOI: 10.1016/j.medcli.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Alfonso Cabello
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España.
| | - Miguel Górgolas
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
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Latino MA, Botta G, Badino C, Maria DD, Petrozziello A, Sensini A, Leli C. Association between genital mycoplasmas, acute chorioamnionitis and fetal pneumonia in spontaneous abortions. J Perinat Med 2018; 46:503-508. [PMID: 28599391 DOI: 10.1515/jpm-2016-0305] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 02/09/2017] [Indexed: 01/04/2023]
Abstract
AIM Ureaplasma parvum, Ureaplasma urealyticum and Mycoplasma hominis are also known as genital mycoplasmas. Acute chorioamnionitis is an inflammation of the placenta associated with miscarriage. We retrospectively evaluated a possible association between genital mycoplasmas detection, acute chorioamnionitis and fetal pneumonia from second and third trimester spontaneous abortions. METHODS One hundred and thirty placenta and fetal lung samples were evaluated for histological examination. The placenta samples, along with corresponding fetal tracheo-bronchial aspirates, also underwent bacterial and fungal culture and real-time polymerase chain reaction (PCR) assay for the detection of genital mycoplasmas. RESULTS Acute chorioamnionitis and pneumonia were diagnosed in 80/130 (61.5%) and 22/130 (16.9%) samples, respectively. Among samples positive for acute chorioamnionitis, the proportion of samples positive by real-time PCR and/or culture, was significantly higher than that of negative controls [54/80 (67.5%) vs. 26/80 (32.5%); P<0.001]. Ureaplasma parvum detection was significantly associated with acute chorioamnionitis compared to controls [9/11 (81.8%) vs. 2/11 (18.2%); P=0.019], as well as U. urealyticum [6/7 (85.7%) vs. 1/7 (14.3%); P=0.039]. Among tracheo-bronchial aspirates from abortions with pneumonia, the proportion of real-time PCR and/or culture positive samples was significantly higher than that of controls [13/22 (59.1%) vs. 9/22 (40.9%); P=0.029]. CONCLUSIONS A strong association was found between acute histologic chorioamnionitis and microbial invasion with U. parvum and/or U. urealyticum.
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Affiliation(s)
- Maria Agnese Latino
- Department of Laboratory Medicine, Unit of Bacteriology, Città della Salute e della Scienza, Turin, Italy
| | - Giovanni Botta
- Fetal and Maternal Pathology, Department of Pathology, OIRM/Sant' Anna, Città della Salute e della Scienza, Turin, Italy
| | - Claudia Badino
- Fetal and Maternal Pathology, Department of Pathology, OIRM/Sant' Anna, Città della Salute e della Scienza, Turin, Italy
| | - Daniela De Maria
- Department of Laboratory Medicine, Unit of Bacteriology, Città della Salute e della Scienza, Turin, Italy
| | - Annalisa Petrozziello
- Department of Laboratory Medicine, Unit of Bacteriology, Città della Salute e della Scienza, Turin, Italy
| | | | - Christian Leli
- Unit of Microbiology and Virology, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy
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Momčilović S, Cantacessi C, Arsić-Arsenijević V, Otranto D, Tasić-Otašević S. Rapid diagnosis of parasitic diseases: current scenario and future needs. Clin Microbiol Infect 2018; 25:290-309. [PMID: 29730224 DOI: 10.1016/j.cmi.2018.04.028] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Parasitic diseases are one of the world's most devastating and prevalent infections, causing millions of morbidities and mortalities annually. In the past, many of these infections have been linked predominantly to tropical or subtropical areas. Nowadays, however, climatic and vector ecology changes, a significant increase in international travel, armed conflicts, and migration of humans and animals have influenced the transmission of some parasitic diseases from 'book pages' to reality in developed countries. It has also been noted that many patients who have never travelled to endemic areas suffer from blood-borne infections caused by protozoa. In the light of existing knowledge, this new trend can be explained by the fact that in the process of migration a large number of asymptomatic carriers become a part of the blood bank donor and transplant donor populations. Accurate and rapid diagnosis represents the crucial weapon in the fight against parasitic infections. AIMS To review old and new approaches for rapid diagnosis of parasitic infections. SOURCES Data for this review were obtained through searches of PubMed using combinations of the following terms: parasitological diagnostics, microscopy, lateral flow assays, immunochromatographic assays, multiplex-PCR, and transplantation. CONTENT In this review, we provide a brief account of the advantages and limitations of rapid methods for diagnosis of parasitic diseases and focus our attention on current and future research in this area. The approximate costs associated with the use of different techniques and their applicability in endemic and non-endemic areas are also discussed. IMPLICATIONS Microscopy remains the cornerstone of parasitological diagnostics, especially in the field and low-resource settings, and provides epidemiological assessment of parasite burden. However, increased use and availability of point-of-care tests and molecular assays in modern era allow more rapid and accurate diagnoses and increased sensitivity in the identification of parasitic infections.
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Affiliation(s)
- S Momčilović
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Serbia.
| | - C Cantacessi
- Department of Veterinary Medicine, University of Cambridge, UK
| | - V Arsić-Arsenijević
- Department for Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Serbia
| | - D Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari, Italy
| | - S Tasić-Otašević
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Serbia; Center of Microbiology and Parasitology, Public Health Institute Niš, Serbia
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Prevalence of cervical colonization by Ureaplasma parvum, Ureaplasma urealyticum , Mycoplasma hominis and Mycoplasma genitalium in childbearing age women by a commercially available multiplex real-time PCR: An Italian observational multicentre study. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 51:220-225. [DOI: 10.1016/j.jmii.2017.05.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 11/13/2016] [Accepted: 05/07/2017] [Indexed: 11/15/2022]
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