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MacDonald-Ottevanger MS, Boyd A, Prins M, van der Helm JJ, Zijlmans CWR, Hindori-Mohangoo AD, Harkisoen S, Hermelijn SM, Brinkman K, Codrington J, Roosblad J, Kort SAR, Dams ETM, van de Laar TJW, Vreden SGS. Differences in prevalence of hepatitis B virus infection and genotypes between ethnic populations in Suriname, South America. Virology 2021; 564:53-61. [PMID: 34656809 DOI: 10.1016/j.virol.2021.09.005] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Epidemiological data on hepatitis B virus (HBV) are needed to benchmark HBV elimination goals. We recently assessed prevalence of HBV infection and determinants in participants attending the Emergency Department in Paramaribo, Suriname, South America. Overall, 24.5% (95%CI = 22.7-26.4%) of participants had anti-Hepatitis B core antibodies, which was associated with older age (per year, adjusted Odds Ratio [aOR] = 1.03, 95%CI = 1.02-1.04), Afro-Surinamese (aOR = 1.84, 95%CI = 1.52-2.19) and Javanese ethnicity (aOR = 1.63, 95%CI = 1.28-2.07, compared to the grand mean). 3.2% of participants were Hepatitis B surface Ag-positive, which was also associated with older age (per year, aOR = 1.02, 95%CI = 1.00-1.04), Javanese (aOR = 4.3, 95%CI = 2.66-6.95) and Afro-Surinamese ethnicity (aOR = 2.36, 95%CI = 1.51-3.71). Sex, nosocomial or culturally-related HBV transmission risk-factors were not associated with infection. Phylogenetic analysis revealed strong ethnic clustering: Indonesian subgenotype HBV/B3 among Javanese and African subgenotypes HBV/A1, HBV/QS-A3 and HBV/E among Afro-Surinamese. Testing for HBV during adulthood should be considered for individuals living in Suriname, specifically with Javanese and Afro-Surinamese ancestry.
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Affiliation(s)
- M S MacDonald-Ottevanger
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname; Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands.
| | - A Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Stichting HIV Monitoring, Amsterdam, the Netherlands
| | - M Prins
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - J J van der Helm
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - C W R Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - A D Hindori-Mohangoo
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - S Harkisoen
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname
| | - S M Hermelijn
- Department of Medical Microbiology, Academic Hospital Paramaribo, Suriname
| | - K Brinkman
- Department of Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - J Codrington
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | - J Roosblad
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | | | - E Th M Dams
- Department of Internal Medicine, Diakonessenhuis, Paramaribo, Suriname
| | - T J W van de Laar
- Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Sanquin Research, Department of Donor Medicine Research, Amsterdam, the Netherlands
| | - S G S Vreden
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname; Foundation for Scientific Research Suriname, Paramaribo, Suriname
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van der Veer C, Bruisten SM, van Houdt R, Matser AA, Tachedjian G, van de Wijgert JHHM, de Vries HJC, van der Helm JJ. Effects of an over-the-counter lactic-acid containing intra-vaginal douching product on the vaginal microbiota. BMC Microbiol 2019; 19:168. [PMID: 31345159 PMCID: PMC6659218 DOI: 10.1186/s12866-019-1545-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/18/2019] [Indexed: 12/26/2022] Open
Abstract
Background Over-the-counter intra-vaginal lactic-acid containing douches are marketed as vaginal hygiene products that support optimal vaginal pH balance. We report the effect of a commercially available douche (Etos®) on the vaginal microbiota (VM) in a prospective study. Results Twenty-five healthy women were recruited through advertisements in 2015–2017 (ethical approval: METC-2014_413) and followed over three menstrual cycles. The participants had a median age of 24 years [IQR: 22–29], were mostly Dutch-Caucasian (88%), and 60% used combined oral contraceptives. All participants douched three times a week during the second cycle, starting on the first day of that cycle. Participants completed a questionnaire at baseline, kept a daily diary to report douching, menses, and sexual activity, self-collected vaginal swabs every other day during the first and third cycle and daily during the second cycle, and measured vaginal pH mid-cycle. A median of 44 vaginal swabs [inter-quartile range (IQR): 41–50] were assessed per participant by 16S rRNA gene (V3-V4 region) sequencing and a Candida albicans PCR was done at four time-points. At baseline, 21 participants (84%) had Lactobacillus-dominated VM (Lactobacillus crispatus (n = 14), L. iners (n = 6), or diverse Lactobacillus species (n = 1) and 4 participants (16%) had VM consisting of diverse anaerobes. In multinomial logistic regression models, a trend towards increased odds were observed for having diverse anaerobic VM in the second and third cycle, compared to the first cycle, after adjusting for menses [odds ratio (OR) = 1.4 (95% CI: 0.9–2.1) and OR = 1.7 (95% CI: 0.9–3.1), respectively] (p = 0.376). Douching did not affect vaginal pH. Menses increased the odds for having VM consisting of diverse anaerobes almost two-fold (OR = 1.7; 95% CI: 1.0–2.8), while douching during menses increased the odds 2.6 fold (OR = 2.6; 95% CI: 1.0–6.5), compared to not menstruating (p = 0.099). Participants were more likely to test positive for C. albicans after cycle 2, compared to cycle 1 [OR = 3.0 (95% CI: 1.2–7.2); p = 0.017]. Conclusion The Etos® douche did not significantly affect the vaginal pH or VM composition, although increased odds for having diverse anaerobic VM was observed, especially when douching during menses. Furthermore, douching may promote C. albicans infections. Electronic supplementary material The online version of this article (10.1186/s12866-019-1545-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C van der Veer
- Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands.
| | - S M Bruisten
- Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands.,Amsterdam Infection & Immunity Institute Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - R van Houdt
- Department of Medical Microbiology and Infection prevention, VU University Medical Center, Amsterdam, the Netherlands
| | - A A Matser
- Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands
| | - G Tachedjian
- Disease Elimination Program Life Sciences Discipline, Burnet Institute, Melbourne, Victoria, Australia.,Department of Microbiology, Monash University, Clayton, Victoria, Australia.,Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - J H H M van de Wijgert
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - H J C de Vries
- Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands.,Amsterdam Infection & Immunity Institute Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.,Academic Medical Centers, Department of Dermatology, Amsterdam, the Netherlands
| | - J J van der Helm
- Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands
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van der Veer C, Bruisten SM, van der Helm JJ, de Vries HJC, van Houdt R. A33 The cervico-vaginale microbiota in chlamydia trachomtais notified women: a case–control study at the sexually transmitted infection outpatient clinic in Amsterdam. Virus Evol 2017; 3:vew036.032. [PMID: 28845275 PMCID: PMC5565987 DOI: 10.1093/ve/vew036.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - S M Bruisten
- Public Health Laboratory, Public health Service Amsterdam, Amsterdam, The Netherlands
| | - J J van der Helm
- Public Health Service Amsterdam, Sexually transmitted infections outpatient clinic, Amsterdam, The Netherlands
| | - H J C de Vries
- Public Health Service Amsterdam, Sexually transmitted infections outpatient clinic, Amsterdam, The Netherlands
| | - R van Houdt
- Department of Medical Microbiology and Infection Prevention, VU University Medical Centre, Amsterdam, The Netherlands
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Achterbergh R, van der Helm JJ, van den Boom W, Heijman T, Stolte IG, van Rooijen MS, de Vries H. Is rectal douching and sharing douching equipment associated with anorectal chlamydia and gonorrhoea? A cross-sectional study among men who have sex with men. Sex Transm Infect 2017; 93:431-437. [PMID: 28108702 DOI: 10.1136/sextrans-2016-052777] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 12/21/2016] [Accepted: 01/04/2017] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Men who have sex with men (MSM) are at high risk for anorectal chlamydia and gonorrhoea infections. Many MSM use rectal douches in preparation for sex, which might break down the mucosal barrier function and facilitate the acquisition of STI. We determined whether rectal douching or sharing douching equipment was associated with anorectal chlamydia and gonorrhoea. METHODS In a cross-sectional study among 994 MSM attending the STI outpatient clinic of Amsterdam between February and April 2011, data were collected on rectal douching, sexual behaviour and STI. We used multivariable logistic regression analysis to determine the association between rectal douching, including sharing of douching equipment, and anorectal chlamydia and gonorrhoea for those reporting receptive anal sex. We adjusted for other risk behaviour, that is, condom use, number of partners and HIV status. RESULTS Of 994 MSM, 46% (n=460) practised rectal douching, of whom 25% (n=117) shared douching equipment. Median age was 39 years (IQR 30-47), median number of sex partners in the 6 months prior to consult was five (IQR 3-10) and 289 (29.0%) participants were HIV positive. The prevalence of anorectal chlamydia and/or gonorrhoea for those reporting receptive anal sex was 9.6% (n=96). In multivariable analysis, HIV positivity (aOR=2.2, 95% CI 1.3 to 3.6), younger age (aOR=2.5, CI 1.4 to 4.5 for those aged <35 years compared with those aged ≥45 years), and more sexual partners (aOR=1.2, 95% CI 1.0 to 1.5 for 1 log increase) were significantly associated with anorectal STI. However, rectal douching or sharing douching equipment were not significantly associated with anorectal chlamydia and/or gonorrhoea (p=0.647). CONCLUSIONS Almost half of MSM used rectal douching and a quarter of these shared douching equipment. Though using douching equipment does not appear to contribute to anorectal chlamydia and gonorrhoea in this study, STI prevalence remains high and prevention strategies like early testing and treatment remain of utmost importance.
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Affiliation(s)
- Rca Achterbergh
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - J J van der Helm
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - W van den Boom
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - T Heijman
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - I G Stolte
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - M S van Rooijen
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Hjc de Vries
- STI outpatient clinic, department of infectious diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.,Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Helm JJVD, Koekenbier RH, Rooijen MSV, Vries HJCD. P5.014 What is the Optimal Time to Rescreen STI Clinic Visitors with a Urogenital Chlamydia Infection? Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Helm JJVD, Geraets D, Grunberg A, Quint K, Sabajo L, Vries HD. P3.050 High-Risk Urogenital HPV Infections in Paramaribo, Suriname: Prevalence and Risk Factors Among Ethnic Diverse Women. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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de Vries HJC, van der Helm JJ, Schim van der Loeff MF, van Dam AP. Multidrug-resistant Neisseria gonorrhoeae with reduced cefotaxime susceptibility is increasingly common in men who have sex with men, Amsterdam, the Netherlands. ACTA ACUST UNITED AC 2009; 14. [PMID: 19761737 DOI: 10.2807/ese.14.37.19330-en] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antimicrobial resistance is an increasing problem in Neisseria gonorrhoeae (NG) treatment. Presently, third-generation parenteral cephalosporins, like ceftriaxone and cefotaxime, are the first option. Resistance to oral, but not to parenteral, third-generation cephalosporins has been reported previously. We analysed the microbial susceptibility (as minimum inhibitory concentration - MIC) of NG cultures obtained from high-risk visitors of the largest Dutch outpatient clinic for sexually transmitted infections (STI) in Amsterdam, the Netherlands. Among 1,596 visitors, we identified 102 patients with at least one NG isolate with reduced susceptibility to cefotaxime (0.125 microg/ml < MIC < or = 0.5 microg/ml). The percentage of NG isolates with reduced susceptibility to cefotaxime rose from 4.8% in 2006 to 12.1% in 2008 (chi2 17.5, p<0.001). With multivariate logistic regression, being a man who has sex with men (MSM) was significantly associated with reduced susceptibility to cefotaxime (p<0.001). Compared to susceptible NG isolates, those with decreased susceptiblity to cefotaxime were more often resistant also to penicillin (16.5% vs. 43.3%), tetracycline (21.5% vs. 68.9%) and ciprofloxacin (44.4% vs. 90.0%, all p<0.001). The increased prevalence of NG strains with reduced susceptibility to cefotaxime among MSM may herald resistance to third-generation parenteral cephalosporins. A considerable proportion of these strains show resistance to multiple antibiotics which could limit future NG treatment options.
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Affiliation(s)
- H J C de Vries
- STI outpatient clinic, Cluster Infectious Diseases, Municipal Health Service Amsterdam, Amsterdam, The Netherlands.
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Heymans R, Kolader ME, van der Helm JJ, Coutinho RA, Bruisten SM. TprK gene regions are not suitable for epidemiological syphilis typing. Eur J Clin Microbiol Infect Dis 2009; 28:875-8. [PMID: 19229562 DOI: 10.1007/s10096-009-0717-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 02/04/2009] [Indexed: 10/21/2022]
Abstract
Given reports of increasing syphilis incidence in Western countries, we used molecular typing and epidemiological data to elucidate Treponema pallidum transmission networks. Samples and data were collected, dating from 2002 to 2005, from a well-defined population of patients with an ulcus and a diagnosis of infectious syphilis. Molecular typing using the tprK gene (V3-V5 region) was performed on 211 isolates from 205 Amsterdam STI clinic patients. We revealed 32 T. pallidum clusters and recognized ten large clusters, consisting predominantly of homosexual men (89%). Yet, no common patient characteristics were found to link the patients in these clusters. We therefore conclude that the highly variable tprK region (V3-V5) is not suitable for elucidating T. pallidum transmission networks in a high risk population.
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Affiliation(s)
- R Heymans
- GGD, Public Health Laboratory, Cluster of Infectious Diseases, Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
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de Vries HJC, Catsburg A, van der Helm JJ, Beukelaar EC, Morré SA, Fennema JSA, Thiesbrummel H. No indication of Swedish Chlamydia trachomatis variant among STI clinic visitors in Amsterdam. ACTA ACUST UNITED AC 2007; 12:E070208.3. [PMID: 17370951 DOI: 10.2807/esw.12.06.03134-en] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/20/2022]
Abstract
A Chlamydia trachomatis variant has recently been reported from Sweden, characterised by a 377 base pair deletion in open reading frame 1 in the Chlamydia trachomatis plasmid (located outside the chromosome).
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Affiliation(s)
- H J C de Vries
- STI outpatient clinic, Infectious diseases cluster, Health Service Amsterdam, Amsterdam, The Netherlands.
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van der Helm JJ. [Specialists and assistant physicians; disciplinary division of responsibilities]. Ned Tijdschr Geneeskd 2001; 145:1416-9. [PMID: 11494693] [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: 02/21/2023]
Abstract
In every day hospital practice, the division of responsibility between specialists and assistant physicians plays an important role. This division of responsibility has repercussions in disciplinary judgements concerning the conduct of the supervisor and the assistant physician. The problem with this is that disciplinary law assumes individual liability. If a patient chooses to lodge a claim solely against the assistant physician then whether the assistant physician can appeal to shortcomings in the supervision is dependent upon the situation concerned. The supervisor is obliged to ensure that the necessary supervision is given or if the assistant physician indicates that a given task is beyond his own abilities then the supervisor should carry this out or find someone else to carry it out on his behalf. Within jurisprudence the value of protocols is becoming increasingly important.
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