1
|
Moussa M, Issa H, Al Hassan J, Ghazal K. Diagnostic and treatment patterns in urinary and genital tract infections: insights from a referral clinic in Beirut, Lebanon. World J Urol 2024; 42:68. [PMID: 38308683 DOI: 10.1007/s00345-024-04770-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Urinary Tract Infections (UTIs) and Genital Tract Infections (GTIs) are common yet serious health concerns. Precise diagnosis is crucial due to the potential severe consequences of misdiagnosis. This study aims to distinguish between UTIs and GTIs, highlighting the importance of accurate differentiation. MATERIALS AND METHODS The study encompassed 294 patients, categorized into 4 groups: Group GNI (no infection, N = 57), Group GUI (urinary infection, N = 52), Group GGI (genital infection, N = 139), and Group GGUI (both infections, N = 46). Methods included patient interviews, clinical examinations, and laboratory tests such as urine and vaginal swab cultures. RESULTS The investigation revealed no significant differences in age, BMI, residency, or nationality across groups. However, socioeconomic status varied, with Group GNI having the lowest proportion of low socioeconomic status. In obstetrical characteristics, non-pregnancy rates were higher in Groups GUI and GGUI, with GGUI showing a notably higher abortion rate. Symptom analysis indicated lower symptom prevalence in Group GNI, with pain, itching, pruritus, and vaginal discharge being less frequent, suggesting a link between infection presence and symptom severity. Treatment patterns showed higher usage of ciprofloxacin, antifungals, and vaginal tablets in Groups GUI and GGUI. Laboratory findings highlighted significant Leucocyte Esterase presence and variations in WBC and RBC counts, particularly in Group GGUI. CONCLUSION The study emphasizes the need for advanced diagnostic techniques, especially those focusing on individual microbial patterns, to enhance UGTI diagnosis. Variations in symptom presentation and treatment across groups underline the necessity for personalized diagnostic and treatment strategies.
Collapse
Affiliation(s)
- Mohamad Moussa
- Urology Department, Faculty of Medicine, Lebanese University, Al Zahraa Hospital, Beirut, Lebanon
| | - Hussein Issa
- Urology Department, Lebanese University, Beirut, Lebanon
| | - Jihad Al Hassan
- Obstetrics and Gynecology Department, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Kariman Ghazal
- Obstetrics and Gynaecology Department, Lebanese University, Beirut, Lebanon.
- Obstetrics and Gynaecology Department, Al Zahraa Hospital University Medical Centre, Beirut, Lebanon.
- Obstetrics and Gynecology Department, Rafik Hariri Hospital University Medical Center, Beirut, Lebanon.
| |
Collapse
|
2
|
Al Karmi J, Alshrouf MA, Haddad TA, Alhanbali AE, Raiq NA, Ghanem H, Ibrahim OB, Khamis T, Muhaidat N. Urinary and reproductive tract infection symptoms and menstrual hygiene practices in refugee camps in Jordan: A cross-sectional study. Womens Health (Lond) 2024; 20:17455057241240920. [PMID: 38576125 PMCID: PMC10996361 DOI: 10.1177/17455057241240920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/20/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Urinary tract infections and reproductive tract infections pose significant health risks, particularly among women living in challenging conditions. Unhygienic menstrual practices can exacerbate these risks, impacting physical and psychological well-being. OBJECTIVES This study assessed the association between unhygienic menstrual care and self-reported urinary tract infection/reproductive tract infection symptoms among refugee women. In addition, it explored the association between these symptoms and mental health, specifically depressive symptoms. DESIGN This study adopted a cross-sectional observational design. METHODS This study was conducted between January and March 2023, involving 387 reproductive-age refugee women. Data collected included sociodemographic information and urinary tract infection/reproductive tract infection symptoms. In addition, we used the Menstrual Practice Needs Scale to evaluate menstrual hygiene practices and the Patient Health Questionnaire-9 for depressive symptoms. Statistical analysis was performed using Python version 3.9.12. RESULTS Of 387 refugee women, 92.25% reported having urinary or reproductive tract infection symptoms in the previous 3 months. Factors like older age (odds ratio = 1.764, 95% confidence interval = 1.083-2.873, p-value = 0.023), lower family income (odds ratio = 0.327, 95% confidence interval = 0.138-0.775, p-value = 0.011), lower educational level (odds ratio = 0.222, 95% confidence interval = 0.068-0.718, p-value = 0.012), and being married (odds ratio = 0.328, 95% confidence interval = 0.188-0.574, p-value < 0.001) were significantly associated with urinary or reproductive tract infection risk. Difficulties obtaining menstrual products and thus reusing them increased the odds of urinary or reproductive tract infection diagnosis (odds ratio = 2.452, 95% confidence interval = 1.497-4.015, p-value < 0.001). Women with urinary or reproductive tract infection symptoms exhibited higher Patient Health Questionnaire-9 scores than those without (12.14 ± 5.87 vs 9.99 ± 5.86, p-value < 0.001, respectively). CONCLUSION This study highlights a high prevalence of urinary or reproductive tract infection symptoms among refugee women residing in camps in Jordan, which was associated with poor menstrual hygiene practices and depressive symptoms. To reduce the urinary tract infection/reproductive tract infection burden in marginalized communities, public health initiatives should enhance healthcare accessibility, provide reproductive education, and promote holistic well-being practices for refugee women.
Collapse
Affiliation(s)
- Joud Al Karmi
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Mohammad Ali Alshrouf
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Tala A Haddad
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Neven Amer Raiq
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Hadeel Ghanem
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Omar Bassam Ibrahim
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Tala Khamis
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Nadia Muhaidat
- Department of Obstetrics and Gynaecology, School of Medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
3
|
Omosa-Manyonyi GS, de Kam M, Tostmann A, Masido MA, Nyagah N, Obimbo MM, van der Ven AJAM, Oever JT. Evaluation and optimization of the syndromic management of female genital tract infections in Nairobi, Kenya. BMC Infect Dis 2023; 23:547. [PMID: 37608250 PMCID: PMC10463802 DOI: 10.1186/s12879-023-08442-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/04/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Genital tract infections pose a public health concern. In many low-middle-income countries, symptom-based algorithms guide treatment decisions. Advantages notwithstanding, this strategy has important limitations. We aimed to determine the infections causing lower genital tract symptoms in women, evaluated the Kenyan syndromic treatment algorithm for vaginal discharge, and proposed an improved algorithm. METHODS This cross-sectional study included symptomatic non-pregnant adult women presenting with lower genital tract symptoms at seven outpatient health facilities in Nairobi. Clinical, socio-demographic information and vaginal swabs microbiological tests were obtained. Multivariate logistic regression analyses were performed to find predictive factors for the genital infections and used to develop an alternative vaginal discharge treatment algorithm (using 60% of the dataset). The other 40% of data was used to assess the performance of each algorithm compared to laboratory diagnosis. RESULTS Of 813 women, 66% had an infection (vulvovaginal candidiasis 40%, bacterial vaginosis 17%, Neisseria gonorrhoea 14%, multiple infections 23%); 56% of women reported ≥ 3 lower genital tract symptoms episodes in the preceding 12 months. Vulvovaginal itch predicted vulvovaginal candidiasis (odds ratio (OR) 2.20, 95% CI 1.40-3.46); foul-smelling vaginal discharge predicted bacterial vaginosis (OR 3.63, 95% CI 2.17-6.07), and sexually transmitted infection (Neisseria gonorrhoea, Trichomonas vaginalis, Chlamydia trachomatis, Mycoplasma genitalium) (OR 1.64, 95% CI 1.06-2.55). Additionally, lower abdominal pain (OR 1.73, 95% CI 1.07-2.79) predicted sexually transmitted infection. Inappropriate treatment was 117% and 75% by the current and alternative algorithms respectively. Treatment specificity for bacterial vaginosis/Trichomonas vaginalis was 27% and 82% by the current and alternative algorithms, respectively. Performance by other parameters was poor to moderate and comparable between the two algorithms. CONCLUSION Single and multiple genital infections are common among women presenting with lower genital tract symptoms at outpatient clinics in Nairobi. The conventional vaginal discharge treatment algorithm performed poorly, while the alternative algorithm achieved only modest improvement. For optimal care of vaginal discharge syndrome, we recommend the inclusion of point-of-care diagnostics in the flowcharts.
Collapse
Affiliation(s)
| | - Marloes de Kam
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, NL, Netherlands
| | - Alma Tostmann
- Department of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, NL, Netherlands
| | | | | | - Moses M Obimbo
- Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Andre J A M van der Ven
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, NL, Netherlands
| | - Jaap Ten Oever
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, NL, Netherlands
| |
Collapse
|
4
|
Rivero MJ, Kulkarni N, Thirumavalavan N, Ramasamy R. Evaluation and management of male genital tract infections in the setting of male infertility: an updated review. Curr Opin Urol 2023; 33:180-186. [PMID: 36861760 PMCID: PMC10073322 DOI: 10.1097/mou.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE OF REVIEW Male infertility may be secondary to male genital tract infection (MGTI) in an estimated 15% of cases. In the absence of overt clinical signs, evaluation for MGTI beyond semen analysis is not well established. Therefore, we review the literature on the evaluation and management of MGTI in the setting of male infertility. RECENT FINDINGS A set of international guidelines recommends semen culture and PCR testing, but the significance of positive results remains unclear. Clinical trials evaluating anti-inflammatory or antibiotic treatment report improvements in sperm parameters and leukocytospermia, but data on the effect on conception rates are lacking. Human papillomavirus (HPV) and the novel coronavirus (SARS-CoV-2) have been associated with poor semen parameters and decreased conception rates. SUMMARY The finding of leukocytospermia on semen analysis prompts further evaluation for MGTI, including focused physical examination. The role of routine semen culture is controversial. Treatment options include anti-inflammatories; frequent ejaculation; and antibiotics, which should not be used in the absence of symptoms or microbiological infection. SARS-CoV-2 represents a subacute threat to fertility that should be screened for in the reproductive history along with HPV and other viruses.
Collapse
Affiliation(s)
- Marco-Jose Rivero
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Nikhil Kulkarni
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Nannan Thirumavalavan
- Case Western Reserve University School of Medicine, Cleveland, OH
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL
| |
Collapse
|
5
|
Langwenya N, Todd CS, Jones HE, Hoover DR, Hu NC, Ronan A, Myer L. Risk-based screening to identify reproductive tract infection among HIV-infected women desiring use of intrauterine contraceptives. BMJ Sex Reprod Health 2021; 47:137-143. [PMID: 32611546 PMCID: PMC8020848 DOI: 10.1136/bmjsrh-2019-200494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Reproductive tract infections (RTIs) are a major cause of morbidity and mortality, yet RTI testing remains limited in resource-constrained settings. We assessed performance of an existing RTI risk assessment screening tool among women living with HIV (WLHIV) considering intrauterine contraceptive (IUC) use. METHODS We conducted a cross-sectional analysis among WLHIV screened for participation in an IUC trial in Cape Town, South Africa (NCT01721798). RTI testing included Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and bacterial vaginosis. Tool scoring was based on five separately scored criteria: (1) age under 25 years, (2) cohabitation with a partner, (3) secondary education, (4) self-reported intermenstrual bleeding and (5) number of current sexual partners and condom use frequency (score 0-5). We assessed tool performance in detecting RTI at 0 vs 1-5, 0-1 vs 2-5 and 0-2 vs 3-5 score thresholds. RESULTS Of 303 women, 52% (n=157) reported antiretroviral therapy use and median age was 31 years. The prevalence of any RTI was 38% (gonorrhoea=7%, chlamydia=11%, trichomoniasis=12% and bacterial vaginosis=18%) and 8% of women had multiple RTIs. Overall, 4%, 27% and 69% of women had screening tool scores of 0, 1 or 2+, respectively. At a threshold of at least one scored criterion, the tool demonstrated high sensitivities (95%-97%) but low specificities (3%-4%) for detecting any RTI. Increasing the score threshold and/or inclusion of abnormal vaginal discharge marginally improved specificity. CONCLUSION The prevalence of RTIs observed in this population was high, and the screening tool had no discriminatory power to detect prevalent RTIs.
Collapse
Affiliation(s)
- Nontokozo Langwenya
- Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Catherine S Todd
- Global Health, Population, and Nutrition Department, FHI 360, Durham, North Carolina, USA
| | - Heidi E Jones
- Department of Epidemiology & Biostatistics, City University of New York, New York, New York, USA
| | - Donald R Hoover
- Department of Statistics and Biostatistics, Rutgers University, New Brunswick, New Jersey, USA
| | - Nai-Chung Hu
- Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Agnes Ronan
- Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa
| |
Collapse
|
6
|
Kalra B, Punyani H, Malhotra N, Kalra S. Pre-conception management. J PAK MED ASSOC 2020; 70:762-763. [PMID: 32296232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This communication shares two frameworks which help conceptualize the vast spectrum of pre-conception care. A 3x3 rubric classifies pre-conception assessment and interventions into gynaeco-obstetric, biomedical and psychosocial. Yet another creative checklist uses the letters A through I to present 9 aspects of pre-conception management. The aim of this article is to simplify the vast field of pre-conception care for primary care physicians and other health care professionals.
Collapse
Affiliation(s)
- Bharti Kalra
- Department of Obstetrics, , Bharti Hospital, Karnal, India
| | - Hitesh Punyani
- Department of Medicine, Chaitanya Cardio Diabetes Centre, New Delhi, India
| | | | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| |
Collapse
|
7
|
Abstract
In the context of refugee migrations infectious diseases are being more frequently diagnosed, which the responsible physicians as well as urologists have never seen before. This is due to the poorer health and hygiene conditions in the country of origin, during the flight and in the refugee camps. In Europe increasing incidences of tuberculosis, schistosomiasis and scabies have recently been observed. Tuberculosis and schistosomiasis are often accompanied by unspecific symptoms or can resemble normally encountered urological diseases. Due to the highly contagious nature of scabies, a screening of new arrivals is recommended. A timely differential diagnostic inclusion of these disease patterns is enormously important. Despite the reduction in the numbers of asylum applications in Germany, a higher number of unregistered migrants is generally assumed, who also elude the healthcare system and can therefore contribute to the spread of these rare infectious diseases.
Collapse
Affiliation(s)
- K Bausch
- Department Urologie, Universitätsspital Basel, Basel, Schweiz
- Universität Basel, Basel, Schweiz
| | - E Kulchavenya
- Urogenital Department, Novosibirsk Research TB Institution, Novosibirsk, Russland
| | - F Wagenlehner
- Klinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Giessen, Giessen, Deutschland
| | - G Bonkat
- Universität Basel, Basel, Schweiz.
- Merian Iselin Klinik, Centre of Biomechanics & Calorimetry, Alta Uro AG, Centralbahnplatz 6, 4051, Basel, Schweiz.
| |
Collapse
|
8
|
Xiao L, Wang Y, Kang R, Wu X, Lin H, Ye Y, Yu J, Ye J, Xie J, Cao Y, Wei Y, Liao D, Pan M, Lin Y, Dai Z, Li X. Development and application of a novel Bio-Plex suspension array system for high-throughput multiplexed nucleic acid detection of seven respiratory and reproductive pathogens in swine. J Virol Methods 2018; 261:104-111. [PMID: 30145179 DOI: 10.1016/j.jviromet.2018.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/17/2018] [Accepted: 08/22/2018] [Indexed: 02/08/2023]
Abstract
The aim of this study was to develop a multiple PCR assay based on the suspension array system for the simultaneous detection of respiratory and reproductive pathogens in swine. Pseudorabies virus (PRV), Japanese encephalitis virus (JEV), classic swine fever virus (CFSV), African swine fever virus (ASFV), porcine circovirus type 2 (PCV-2), porcine reproductive and respiratory syndrome virus (PRRSV) and porcine parvovirus (PPV) are the major respiratory and reproductive viral pathogens in pig farms. Seven pairs of specific primers and probes were designed, and the multiple PCR was performed, with the PCR products hybridized to beads coupled to probes, which were then detected by Bio-Plex suspension array system. The limit of detection, specificity and repeatability of this method was determined. The assay was further tested using 137 clinical samples, and the results were compared with conventional PCR to evaluate the ability of the method to diagnose porcine viruses. The results showed that the assay had a high degree of specificity and repeatability, and the simultaneous detection limit for the seven viruses reached 103 copies/μL. Forty-nine of the clinical samples tested positive for at least one of the viruses, the principal viral infections in the clinical samples were PCV-2 and PRRSV. The suspension method represented a rapid, specific and high-throughput tool for single or mixed detection of the seven porcine viruses simultaneously, and has great significance for the development of liquid chip techniques for the diagnosis of diseases in animals.
Collapse
Affiliation(s)
- Lu Xiao
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Yin Wang
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, 611130, China.
| | - Runmin Kang
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Xulong Wu
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, 611130, China
| | - Hua Lin
- Sichuan Entry-Exit Inspection and Quarantine Bureau, Chengdu, Sichuan, 610041, China
| | - Yonggang Ye
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Jifeng Yu
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Jianqiang Ye
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Jing Xie
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Ye Cao
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Yong Wei
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Dangjin Liao
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Meng Pan
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Yi Lin
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Zhuojian Dai
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| | - Xingyu Li
- Sichuan Animal Science Academy, Chengdu, 610066, China; Key Laboratory of Animal Genetics and Breeding of Sichuan Province, Chengdu, 611130, China
| |
Collapse
|
9
|
Randjelovic I, Moghaddam A, Freiesleben de Blasio B, Moi H. The Role of Polymorphonuclear Leukocyte Counts from Urethra, Cervix, and Vaginal Wet Mount in Diagnosis of Nongonococcal Lower Genital Tract Infection. Infect Dis Obstet Gynecol 2018; 2018:8236575. [PMID: 30147292 PMCID: PMC6083538 DOI: 10.1155/2018/8236575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/04/2018] [Indexed: 11/26/2022] Open
Abstract
Objective The aim of this study was to evaluate whether the polymorphonuclear leukocyte (PMNL) inflammatory response in women with nongonococcal lower genital tract infection (LGTI) can be used to optimize criteria for syndromic treatment. Methods A cross-sectional study of 375 women attending the STI clinic in Oslo. Urethral, cervical, and vaginal specimens underwent microscopy for PMNLs. Chlamydia trachomatis (Ct) and other STIs were detected in the cervical/vaginal swabs and urine, using nucleic acid amplification test (NAAT). After excluding vulvovaginal candidiasis, genital herpes, and trichomoniasis, we correlated clinical and microscopic signs of inflammation with positive NAAT for Ct, mycoplasma genitalium (Mg), and Ureaplasma urealyticum (Uu) in a subgroup of 293 women. Results To predict a positive Ct, the combination of high cut-off urethritis (≥10 PMNLs/HPF) and microscopic cervicitis had a high specificity of 0.93, a PPV of 0.37, and a sensitivity of 0.35. LGTI criteria had low predicting values for Mg and Uu. Conclusion Including microscopic criteria for the diagnosis of LGTI gives better indication for presumptive antibiotic treatment than anamnestic and clinical diagnosis alone.
Collapse
Affiliation(s)
- Ivana Randjelovic
- Oslo University Hospital, Department of Venereology, The Olafia Clinic, Norwegian National Advisory Unit on Sexually Transmitted Infections, Oslo, Norway
| | | | - Birgitte Freiesleben de Blasio
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Harald Moi
- Oslo University Hospital, Department of Venereology, The Olafia Clinic, Norwegian National Advisory Unit on Sexually Transmitted Infections, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
10
|
Shrivastav S, Adhikari RC. Tungiasis: A Rare Parasitic Infestation in Genitals of a Native Male from Kathmandu. J Nepal Health Res Counc 2018; 15:295-297. [PMID: 29353907 DOI: 10.3126/jnhrc.v15i3.18860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 06/07/2023]
Abstract
Tungiasis is a common parasitic infection inmany parts of the world, including South and Central America and parts of Africa. It is rare in other places, such as in India and Pakistan and imported cases have been reported in Taiwan, Italy, the United States of America, etc. Our diagnosis was made based on histopathologiocal features of the parasite, which corresponds too ther reports and description of tungiasis.1-3 It was treated by surgical excision alone. The fact that the disease has never been reported in Nepal makes it difficult to diagnose clinically, but should be considered in the future. Histopathology can aid in diagnosingthis rare condition.
Collapse
Affiliation(s)
- Shreya Shrivastav
- Institute of Medicine, Trbhuvan University Teaching Hospital Maharajgunj Kathmandu, Nepal
| | - Ram Chandra Adhikari
- Institute of Medicine, Trbhuvan University Teaching Hospital Maharajgunj Kathmandu, Nepal
| |
Collapse
|
11
|
Kalra S, Chawla A. Diabetes and balanoposthitis. J PAK MED ASSOC 2016; 66:1039-1041. [PMID: 27524547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This review describes the association of balanoposthitis with diabetes. It reviews the multifaceted relationship of both conditions, and summarizes the etiology, clinical features and treatment options for this condition. The commonest etiology of balanoposthitis in males with diabetes is Candida, and the mainstay of treatment is maintenance of hygiene, euglycaemia, and eradication of infection. The review sensitizes diabetes care providers to take a history and perform a physical examination in persons with penile symptoms, and also encourages dermatology care providers to screen for diabetes in such persons.
Collapse
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, New Delhi, India
| | - Aastha Chawla
- Department of Diabetology, North Delhi Diabetes Centre, New Delhi, India
| |
Collapse
|
12
|
Handisurya A, Lázár S, Papay P, Primas C, Haitel A, Horvat R, Tanew A, Vogelsang H, Kirnbauer R. Anogenital Human Papillomavirus Prevalence is Unaffected by Therapeutic Tumour Necrosis Factor-alpha Inhibition. Acta Derm Venereol 2016; 96:494-8. [PMID: 26581127 DOI: 10.2340/00015555-2298] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Patients receiving tumour necrosis factor alpha (TNF-α) inhibitors are at increased risk of exacerbation of (myco-)bacterial and some viral infections. However, information on anogenital human papillomavirus (HPV) infection in these patients is sparse or conflicting. In this study 222 patients with psoriasis or inflammatory bowel disease (IBD), who received either anti-TNF-α inhibitors or alternatives (purine-, folic acid analogues, phototherapy, fumaric ester, mesalazine) continuously for at least 6 months, were evaluated for the presence of anogenital HPV-induced lesions, mucosal HPV DNA, and serological status of mucosal low-risk HPV6 and high-risk HPV16/HPV18. Hallmarks of anogenital HPV infection were more frequently detected in patients with psoriasis than in those with IBD. HPV-induced lesions, viral DNA, and seroprevalence were not elevated in participants with psoriasis or IBD, who received TNF-α inhibitors for a mean duration of 31.4 months (range 6-96 months) compared with recipients of alternative or no treatment. TNF-α blockade for a mean period of 31.4 months does not increase detectable anogenital HPV infection or disease.
Collapse
|
13
|
Abstract
Endometriosis results from the ectopic invasion of endometrial glands and stroma in the peritoneal cavity. The exact etiology of endometriosis is still unknown. It has, however, been shown that there are higher numbers of Escherichia coli in menstrual blood, and higher endotoxin levels in menstrual fluid, as well as, in the peritoneal fluid of patients with endometriosis. In this study, we aimed to determine whether lower genital tract infections could increase the risk of endometriosis.We used the Taiwan National Health Insurance database to conduct a population-based cohort study. We included patients diagnosed with inflammatory diseases of the cervix, vagina, and vulva, and a control group comprising patients matched by age, sex, and comorbidities but without inflammatory diseases of the cervix, vagina, or vulva.A total of 79,512 patients were included in the inflammatory disease group and an equal number of control individuals were selected. The incidence of endometriosis (hazard ratio, 2.01; 95% confidence interval, 1.91-2.12; P < 0.001) was higher among patients than controls. Cox proportional hazards models showed that irrespective of comorbidities, lower genital tract infection was an independent risk factor for endometriosis.Patients with lower genital tract infections exhibit a substantially higher risk for developing endometriosis.
Collapse
Affiliation(s)
- Wu-Chou Lin
- From the Department of Obstetrics and Gynecology (W-CL, CY-YC, LW); School of Chinese Medicine (W-CL, Y-AH, LW); School of Medicine, China Medical University, Taichung (CY-YC); Institute of Molecular Medicine, National Tsing Hua University, Hsinchu (Y-AH); Management Office for Health Data, China Medical University Hospital (J-HC); Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University (J-HC) and Department of Biotechnology, Asia University (LW), Taichung, Taiwan
| | | | | | | | | |
Collapse
|
14
|
Francis SC, Hou Y, Baisley K, van de Wijgert J, Watson-Jones D, Ao TT, Herrera C, Maganja K, Andreasen A, Kapiga S, Coulton GR, Hayes RJ, Shattock RJ. Immune Activation in the Female Genital Tract: Expression Profiles of Soluble Proteins in Women at High Risk for HIV Infection. PLoS One 2016; 11:e0143109. [PMID: 26814891 PMCID: PMC4729472 DOI: 10.1371/journal.pone.0143109] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/30/2015] [Indexed: 01/20/2023] Open
Abstract
Soluble cervicovaginal biomarkers of inflammation, immune activation and risk of HIV acquisition are needed to reliably assess the safety of new biomedical prevention strategies including vaccines and microbicides. However, a fuller understanding of expression profiles in women at high risk for HIV infection is crucial to the effective use of these potential biomarkers in Phase 3 trial settings. We have measured 45 soluble proteins and peptides in cervicovaginal lavage samples from 100 HIV negative women at high risk for HIV infection. Women were followed over one menstrual cycle to investigate modulation by hormonal contraception, menstrual cycle phase, recent sexual exposure and intravaginal practices. Women using injectable DMPA had increased concentration of several soluble proteins of the innate and adaptive immune system, including IL-1α, IL-1β, IL-2, MIP-1β, IP-10, IL-8, TGF-β, HBD4, IgA, IgG1, and IgG2. Women using combined oral contraceptives had a similar signature. There were differences in concentrations among samples from post-ovulation compared to pre-ovulation, notably increased immunoglobulins. Increased prostate-specific antigen, indicative of recent sexual exposure, was correlated with increased IL-6, MCP-1, and SLPI, and decreased GM-CSF and HBD3. The identified signature profiles may prove critical in evaluating the potential safety and impact on risk of HIV acquisition of different biomedical intervention strategies.
Collapse
Affiliation(s)
- Suzanna C. Francis
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- * E-mail:
| | - Yanwen Hou
- Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom
| | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Janneke van de Wijgert
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Trong T. Ao
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Carolina Herrera
- Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom
| | - Kaballa Maganja
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Aura Andreasen
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saidi Kapiga
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Gary R. Coulton
- Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom
| | - Richard J. Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robin J. Shattock
- Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom
| |
Collapse
|
15
|
Marty E, Simon P. [Common genital infections]. Rev Med Brux 2016; 37:274-277. [PMID: 28525226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Vulvo-vaginal infections are frequently encountered by gynecologists and general practitioners. The diagnosis and the recurrence of these affections must lead to a discussion about sexually transmitted disease, notably when trichomonas vaginalis and herpetic infections are found. Even if they do not correspond to classical sexually transmitted diseases, their prevalence is increased by sexual intercourses reports and the number of partners which should also be treated. It is necessary to document the responsible germs, even in case of recurrence as more and more resistance to usual treatments are found together with the appearance of new germs like Candida glabrata.
Collapse
Affiliation(s)
- E Marty
- Service de Gynécologie-Obstétrique, Hôpital Erasme, ULB, Route de Lennik 808, Bruxelles, Belgium
| | - P Simon
- Service de Gynécologie-Obstétrique, Hôpital Erasme, ULB, Route de Lennik 808, Bruxelles, Belgium
| |
Collapse
|
16
|
Geraets DT, Struijk L, Kleter B, Molijn A, van Doorn LJ, Quint WGV, Colau B. The original SPF10 LiPA25 algorithm is more sensitive and suitable for epidemiologic HPV research than the SPF10 INNO-LiPA Extra. J Virol Methods 2015; 215-216:22-9. [PMID: 25698462 DOI: 10.1016/j.jviromet.2015.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Two commercial HPV tests target the same 65 bp fragment of the human papillomavirus genome (designated SPF10): the original HPV SPF10 PCR-DEIA-LiPA25 system, version 1, (LiPA25) and the INNO-LiPA HPV Genotyping Extra (INNO-LiPA). The original SPF10 LiPA25 system was designed to have high analytical sensitivity and applied in HPV vaccine and epidemiology studies worldwide. But due to apparent similarities, this test can be easily confused with INNO-LiPA, a more recent assay of which the intended use, i.e., epidemiological or clinical, is currently unclear. The aim was to compare the analytical sensitivity of SPF10 LiPA25 to that of INNO-LiPA on the level of general HPV detection and genotyping. HPV testing by both assays was performed on the same DNA isolated from cervical swab (n = 365) and biopsy (n = 42) specimens. In cervical swabs, SPF10 LiPA25 and INNO-LiPA identified 35.3% and 29.3% multiple infections, 52.6% and 51.5% single infections, and no HPV type in 12.1% and 19.2%, respectively. Genotyping results were 64.7% identical, 26.0% compatible and 9.3% discordant between both methods. SPF10 LiPA25 detected significantly more genotypes (p < 0.001). The higher analytical sensitivity of SPF10 LiPA25 was confirmed by the MPTS123 genotyping assay. HPV positivity by the general probes in SPF10 DEIA was significantly higher (87.9%) than by those on INNO-LiPA (77.0%) (kappa = 0.592, p < 0.001). In cervical biopsies, SPF10 LiPA25 and INNO-LiPA identified 21.4% and 9.5% multiple types, 76.2% and 81.0% single types, and no type in 2.4% and 9.5%, respectively. Between both tests, the identification of genotypes was 76.3% identical, 14.3% compatible and 9.5% discordant. Overall, significantly more genotypes were detected by SPF10 LiPA25 (kappa = 0.853, p = 0.022). HPV positivity was higher by the SPF10 DEIA (97.6%) than by the INNO-LiPA strip (92.9%). These results demonstrate that SPF10 LiPA25 is more suitable for HPV genotyping in epidemiologic and vaccine-related studies, due to its higher analytical sensitivity.
Collapse
Affiliation(s)
- Daan T Geraets
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands.
| | - Linda Struijk
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Bernhard Kleter
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Anco Molijn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Leen-Jan van Doorn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Brigitte Colau
- GSK Vaccines, Rue de l'Institut 89, B-1330 Rixensart, Belgium
| |
Collapse
|
17
|
Song T, Ye A, Xie X, Huang J, Ruan Z, Kong Y, Song J, Wang Y, Chen J, Zhang J. Epidemiological investigation and antimicrobial susceptibility analysis of ureaplasma species and Mycoplasma hominis in outpatients with genital manifestations. J Clin Pathol 2014; 67:817-20. [PMID: 24982440 DOI: 10.1136/jclinpath-2014-202248] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS The aim of this study was to assess the prevalence and drug resistance of Ureaplasma species and Mycoplasma hominis in outpatients with genital manifestation from 2005 to 2013 in Hangzhou, China. METHODS A total of 2689 female and 2336 male patients with various genital symptoms were included in this study. Species identification and antimicrobial susceptibility test were performed by using the mycoplasma IST-2 kit. RESULTS The prevalence rate of Ureaplasma species was 39.9%, M hominis was 1.2% in female patients, and the coinfection rate was 13.4%; while in males, the prevalence rate of Ureaplasma species was 18.8%, M hominis was 0.4%, and the coinfection rate was 2.9%. Moreover, significantly high positive rates for mycoplasmas (Ureaplasma species M hominis) and were found in 16–20-year-old females (65.2%) and males (27.3%). Ureaplasma species and M hominis displayed relatively lower resistance rates (<5.0%) to doxycycline, josamycin, tetracycline and pristinamycin, and the resistance rates did not change during the study period, while the resistance rates of Ureaplasma species to quinolones (ofloxacin and ciprofloxacin) were much higher (>50%) and increased significantly from 2005 to 2013. CONCLUSIONS Our study indicates that high positive rates of Ureaplasma species and M hominis were found in young outpatients with genital symptoms, and monitoring the local drug resistance is critical for prevention of the occurrence of resistant strains.
Collapse
|
18
|
Adams EJ, Ehrlich A, Turner KME, Shah K, Macleod J, Goldenberg S, Meray RK, Pearce V, Horner P. Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK. BMJ Open 2014; 4:e005322. [PMID: 25056977 PMCID: PMC4120370 DOI: 10.1136/bmjopen-2014-005322] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 07/02/2014] [Accepted: 07/03/2014] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES We aimed to explore patient pathways using a chlamydia/gonorrhoea point-of-care (POC) nucleic acid amplification test (NAAT), and estimate and compare the costs of the proposed POC pathways with the current pathways using standard laboratory-based NAAT testing. DESIGN/PARTICIPANTS Workshops were conducted with healthcare professionals at four sexual health clinics representing diverse models of care in the UK. They mapped out current pathways that used chlamydia/gonorrhoea tests, and constructed new pathways using a POC NAAT. Healthcare professionals' time was assessed in each pathway. OUTCOME MEASURE The proposed POC pathways were then priced using a model built in Microsoft Excel, and compared to previously published costs for pathways using standard NAAT-based testing in an off-site laboratory. RESULTS Pathways using a POC NAAT for asymptomatic and symptomatic patients and chlamydia/gonorrhoea-only tests were shorter and less expensive than most of the current pathways. Notably, we estimate that POC testing as part of a sexual health screen for symptomatic patients, or as stand-alone chlamydia/gonorrhoea testing, could reduce costs per patient by as much as £16 or £6, respectively. In both cases, healthcare professionals' time would be reduced by approximately 10 min per patient. CONCLUSIONS POC testing for chlamydia/gonorrhoea in a clinical setting may reduce costs and clinician time, and may lead to more appropriate and quicker care for patients. Further study is warranted on how to best implement POC testing in clinics, and on the broader clinical and cost implications of this technology.
Collapse
Affiliation(s)
- Elisabeth J Adams
- Aquarius Population Health Limited, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | - Kunj Shah
- Aquarius Population Health Limited, Bristol, UK
| | - John Macleod
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Simon Goldenberg
- Centre for Clinical Infection & Diagnostics Research, Guy's & St Thomas’ NHS Foundation Trust and King's College, London, UK
| | | | | | - Patrick Horner
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Department of Genitourinary Medicine, NHS Bristol, Bristol, UK
| |
Collapse
|
19
|
Wang DN, Wang H. [Improved sample collection methods and bacteriologic localization patterns for male genital tract infection]. Zhonghua Nan Ke Xue 2014; 20:423-429. [PMID: 24908733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To improve the sample collection methods and bacteriologic localization patterns in male genital tract infection, and to investigate the influence of specimen collection and pathogen isolation on the diagnosis and treatment of prostatitis. METHODS We collected the samples of the initial urinary stream, the third portion of the urinary stream, expressed prostatic secretion (ESP), and semen from 200 adult males with chronic prostatitis-like symptoms, inoculated them quantitatively in culture media for isolation of microorganisms, and evaluated their laboratory diagnostic significance according to the count of colonies and distribution of the isolates. RESULTS A total of 468 strains of microorganisms were isolated from the samples, including 414 strains of bacteria spp (88.5%), 12 strains of fungi spp (2.6%), 40 strains of mycoplasma spp (8.5%), and 2 strains of chlamydia spp (0.4%). Pathogens were isolated from the ESP in 66 cases (33.0%), from the semen in 34 cases (17.0%), and from both the ESP and semen in 100 cases (50.0%). Only 1 species of pathogen was found in the ESP samples of 36 cases (18.0%), in the semen samples of 20 cases (10%), and in both the ESP and semen samples of 39 cases (19.5%); 2 species in the ESP samples of 30 cases (15.0%), in the semen samples of 14 cases (7.0%), and in both the ESP and semen samples of 60 cases (30.0%); and 3 species in both the ESP and semen samples of 1 case (0.5%). CONCLUSION Multiple microbial infection (MMI), multi-organ infection (MOI) and drug-resistance strains infection are common in patients with prostatitis-like symptoms, frequently leading to missed diagnosis and misdiagnosis in clinic and laboratory, and affecting the effect of antimicrobial therapy. MMI and MOI can be diagnosed and differentially diagnosed with the improved sample collection methods and bacteriologic localization patterns.
Collapse
|
20
|
Afanasyeva GA, Simonova AN. [Features of coagulative blood potential disorder in acute constitutional inflammatory response of septic tubo-ovarian formations]. Vestn Ross Akad Med Nauk 2014:5-10. [PMID: 25971120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND There are no any systemized studies of relationship between the coagulative haemostasis' disorders and metabolic and cytokine status in patients with septic tuboovarial formations. OBJECTIVE The aim of the present work was to study the mechanisms of blood coagulation disorders and their relationships with changes of cytokine status and acute phase of inflammatory response in septic tubo-ovarian formations in women. METHODS 32 patients with purulent tubovarial formations and 30 healthy women were examined. RESULTS Shortening of activated partial thromboplastin, prothrombin and thrombin clotting time, increasing the duration of XIIa-kallikrehin-dependent fibrinolysis, as well as the elevation of paracoagulation products in blood plasma were observed. IL-1β (p =0.000023), TNF-α (p <0.001), C-reactive protein (p <0.001), haptoglobin (p <0.001) and fibrinogen (p <0.001) levels were higher in peripheral blood of patients in comparison with healthy women. Accumulation of lipid hydroperoxides (p <0. 001) and malonic dialdehyde (p <0.001) occurred in the blood plasma of patients. Serum albumin (p <0.001) and transferring (p <0.001) levels were lesser in patients with purulent tubo ovarial formations in comparison with healthy women. CONCLUSION The obtained results showing an initiating role of cytokine and oxidative metabolic status changes in blood coagulation potential's and fibrinolysis activity's disorders developing. This biochemical signs may be used as objective criteria which may serve to determine the risk of thrombosis in case of acute inflammatory response in women with purulent inflammation.
Collapse
|
21
|
Kløvstad H, Natås O, Tverdal A, Aavitsland P. Systematic screening with information and home sampling for genital Chlamydia trachomatis infections in young men and women in Norway: a randomized controlled trial. BMC Infect Dis 2013; 13:30. [PMID: 23343391 PMCID: PMC3558461 DOI: 10.1186/1471-2334-13-30] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 01/18/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND As most genital Chlamydia trachomatis infections are asymptomatic, many patients do not seek health care for testing. Infections remain undiagnosed and untreated. We studied whether screening with information and home sampling resulted in more young people getting tested, diagnosed and treated for chlamydia in the three months following the intervention compared to the current strategy of testing in the health care system. METHOD We conducted a population based randomized controlled trial among all persons aged 18-25 years in one Norwegian county (41 519 persons). 10 000 persons (intervention) received an invitation by mail with chlamydia information and a mail-back urine sampling kit. 31 519 persons received no intervention and continued with usual care (control). All samples from both groups were analysed in the same laboratory. Information on treatment was obtained from the Norwegian Prescription Database (NorPD). We estimated risk ratios and risk differences of being tested, diagnosed and treated in the intervention group compared to the control group. RESULTS In the intervention group 16.5% got tested and in the control group 3.4%, risk ratio 4.9 (95% CI 4.5-5.2). The intervention led to 2.6 (95% CI 2.0-3.4) times as many individuals being diagnosed and 2.5 (95% CI 1.9-3.4) times as many individuals receiving treatment for chlamydia compared to no intervention in the three months following the intervention. CONCLUSION In Norway, systematic screening with information and home sampling results in more young people being tested, diagnosed and treated for chlamydia in the three months following the intervention than the current strategy of testing in the health care system. However, the study has not established that the intervention will reduce the chlamydia prevalence or the risk of complications from chlamydia.
Collapse
Affiliation(s)
- Hilde Kløvstad
- Norwegian Institute of Public Health, PO box 4404, Nydalen, Oslo, 0403, Norway
| | - Olav Natås
- Stavanger University Hospital, PO box. 8100, Forus, Stavanger, 4068, Norway
| | - Aage Tverdal
- Norwegian Institute of Public Health, PO box 4404, Nydalen, Oslo, 0403, Norway
| | - Preben Aavitsland
- Norwegian Institute of Public Health, PO box 4404, Nydalen, Oslo, 0403, Norway
- Current adress: Epidemi, Lasarettet, Kristiansand, 4610, Norway
| |
Collapse
|
22
|
|
23
|
Mahmud NU, Hossain MA, Nahar K, Ahmed GS, Mahmud C, Paul SK, Khan SI, Amin SR, Nasreen SA, Ahmed S, Kabir MR, Hoque N. Non-culture diagnosis of Chlamydia trachomatis genital infection in sexually active women. Mymensingh Med J 2012; 21:8-12. [PMID: 22314447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Infections caused by Chlamydia trachomatis (CT) are one of the most prevalent of all sexually transmitted diseases (STD). This cross sectional study was carried out to diagnose genital CT infection on 108 (59 pregnant and 49 non-pregnant) women attending at Department of Gynaecology and Obstetrics, Mymensingh Medical College Hospital (MMCH) during the period from January 2009 to December 2009. This non- culture technique was based on detection of CT major outer membrane protein (MOMP) by Direct Fluorescence Antibody Test (DFAT) from endocervical swab. Chlamydial inclusion bodies (IB) were looked for using Iodine stain. CT antigens were detected in 45.3% (49/108) cases by DFAT; IBs were detected in 5.5% cases (06/108) by Iodine staining technique. Majority of CT positive cases (65%) were found in the younger age group (15 to 25 years). The CT infection was found 47.2 % (35/74) in symptomatic cases, 41.1% (14/34) in asymptomatic cases and 47.4% in pregnant group, 42.8% in non-pregnant group. Although high incidence of genital chlamydia infection is common both in pregnant, non-pregnant, symptomatic and asymptomatic women in Bangladesh an early and reliable diagnostic method for genital chlamydia infection in Bangladesh should be further explored.
Collapse
Affiliation(s)
- N U Mahmud
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Roynet D. [Gynecological infections in general practice]. Rev Med Brux 2011; 32:247-251. [PMID: 22034753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
It's really frequent that general practitioners have to handel with genito-urinary complaints. Most of those pathologies are not sexually transmissible, but even so, being "annoying", "shamefull", "guilt-provoking", those recurrent illness make women's live a misery. A good understanding of vaginal ecosystem, an acurate anamnesis, and a good clinical examination are the keys of an efficient treatment.
Collapse
Affiliation(s)
- D Roynet
- D.M.G.-ULB et Planning familial Rochefort, Jemelle.
| |
Collapse
|
25
|
|
26
|
Khanam M, Perveen S, Mirza S. Reproductive and sexual health issues: knowledge, opinion and attitude of medical graduates from Karachi. J PAK MED ASSOC 2011; 61:648-652. [PMID: 22204238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To asses the knowledge, opinion and attitude of medical graduates regarding selected reproductive tract infections, diagnosis of sexual dysfunction, identification of sexual abuse and other sexual health issues in Fatima Baqai Hospital Gadap Town. METHODS A cross sectional study conducted from January 2009 to July 2009 in Fatima Baqai Hospital Karachi. An anonymous, self administrated structured questionnaire was completed by medical graduates. Formal/informal interviews were also arranged. The questionnaire and interviews addressed socio-demographic features, reproductive problems knowledge, attitudes and experience of those medical graduates. Descriptive statistics were analyzed by SPSS version 11. RESULT A total of 50 medical graduates participate in the study. Of the total nearly half scored less than 50% in the knowledge section. Attitude and practices assessment suggested a tendency to be judgmental, gender/rights discriminatory and with little provision for enabling clients to make their own decision, so essential for quality sexual health provision. CONCLUSION The level of reproductive and sexual health knowledge among the participant medical graduates were lower than expected. Attitudes and opinions indicate judgmental approach and indicating lack of experience of training in dealing with sexuality issues.
Collapse
|
27
|
Mahmood MA, Saniotis A. Use of syndromic management algorithm for sexually transmitted infections and reproductive tract infections management in community settings in Karachi. J PAK MED ASSOC 2011; 61:453-457. [PMID: 22204178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Syndromic management is promoted as a measure to manage and control STIs in resource poor settings. This research was conducted to assess the diagnosis and prescription patterns using syndromic management algorithms as part of a community-based reproductive health programme. METHODS The research was conducted in four squatter settlements of Karachi. Health care providers working for a reproductive health programme in these settlements received similar training on the use of algorithms. The people in these settlements had comparable socioeconomic and cultural backgrounds and access to health services. The medical records of 400 women who attended the centres for RTI/STIs were randomly selected. These records were reviewed for diagnosis and prescription patterns. RESULTS The diagnoses by and prescription practices of the health care providers differed greatly across the four clinics. As often there are more than one etiologic agents for most of the STI/RTI syndromes, algorithms allow multiple antibiotics use. However, this research pointed that despite diagnosing many patients as suffering from one particular infection, a large number of patients were prescribed more than one antibiotic. CONCLUSION It appeared that the health care providers had difficulties in using the algorithms, pointing to the need for ongoing support and training. The difficulty in correctly diagnosing STIs/RTIs could be the reason for over prescription. There is likelihood that the use of algorithms without sufficient support might contribute to the problems of drug resistance and prescription of drugs when they are contraindicated. Effective use of syndromic management algorithms requires training for effective communication, understanding about the locally prevalent STIs & RTIs, and periodic assessments of the quality of services.
Collapse
Affiliation(s)
- Mohammad Afzal Mahmood
- Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Australia
| | | |
Collapse
|
28
|
Singh S, Chaturvedi S, Kumar A, Kannan AT. Impact of health education and condom distribution on incidence of RTI/STI among the newly married urban poor women in Delhi. J Commun Dis 2010; 42:53-61. [PMID: 22468552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study was carried out to find out the impact of a specially designed preventive intervention on menstrual and sexual hygiene practices and incidence of RTI/STI among the newly married women. A community based intervention study with controls was conducted in two resettlement colonies of Delhi. Total 74 subjects in intervention group and 71 subjects in the control group were studied. Each subject was followed up for 9 months every three monthly. The intervention package included education about menstrual and sexual hygiene, RTI/STIs and contraceptive usage, and packets of condoms. RTI/STI was diagnosed using syndromic approach. Only 2 and 8 subjects in the intervention and control group respectively used condoms (p>0.05 after adjustment). Practice of washing genitals improved in the intervention group (p<0.05 both with and without adjustment). 19 (25.68%) women in intervention and 22 (30.99%) in the control group (p=0.478) reported RTI/STI symptoms during study period; after adjusting for other variables OR=0.37 (p=0.007). 57.89% of RTI/STI patients consulted doctor in intervention group as compared to 18.18% in control group (p<0.05). Increasing awareness and providing intervention at the very beginning of sexual life of newly married women can modify some of the high risk behaviors and thus reduce the risk of acquiring RTI/STIs.
Collapse
Affiliation(s)
- Samiksha Singh
- Department of Community Medicine, University College of Medical Sciences, Delhi, India.
| | | | | | | |
Collapse
|