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Immunology and Microbiology › Microbiology

Reproductive tract infections research

Works Count: 75460

Description

This cluster of papers explores the vaginal microbiome, its association with sexually transmitted infections, including bacterial vaginosis, Chlamydia trachomatis, and Neisseria gonorrhoeae. It also investigates the impact on women's reproductive health, including preterm delivery and HIV transmission.

Keywords

Vaginal Microbiome; Sexually Transmitted Infections; Bacterial Vaginosis; Chlamydia trachomatis; Neisseria gonorrhoeae; Preterm Delivery; HIV Transmission; Lactobacillus; Metronidazole Therapy; Women's Reproductive Health

Nonspecific vaginitis

1983-01-01
R Amsel , Patricia A. Totten , Carol A. Spiegel +3 more

<i>NEISSERIA GONORRHOEAE</i> I

1963-06-01
Douglas S. Kellogg , William L. Peacock , W. E. Deacon +2 more
Kellogg, Douglas S., Jr. (Communicable Disease Center, Atlanta, Ga.), William L. Peacock, Jr., W. E. Deacon, L. Brown, and Carl I. Pirkle . Neisseria gonorrhoeae . I. Virulence genetically linked … Kellogg, Douglas S., Jr. (Communicable Disease Center, Atlanta, Ga.), William L. Peacock, Jr., W. E. Deacon, L. Brown, and Carl I. Pirkle . Neisseria gonorrhoeae . I. Virulence genetically linked to clonal variation. J. Bacteriol. 85: 1274–1279. 1963.—One type, obtained from the purulent exudate of acute gonorrhea was maintained by 69 selective in vitro passages, at which point the organisms produced infections in human volunteers. A predominance of clonal types found in laboratory strains and a lack of ability to infect human volunteers resulted from 69 nonselective in vitro passages. Physiological and serological characteristics of the clonal types are compared. We are now in a position to study Neisseria gonorrhoeae organisms in their virulent form.

Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis

1989-02-01
David A. Eschenbach , Pamela Davick , Brent L. Williams +4 more
A predominance of Lactobacillus species in the vaginal flora is considered normal. In women with bacterial vaginosis, the prevalence and concentrations of intravaginal Gardnerella vaginalis and anaerobes are increased, whereas … A predominance of Lactobacillus species in the vaginal flora is considered normal. In women with bacterial vaginosis, the prevalence and concentrations of intravaginal Gardnerella vaginalis and anaerobes are increased, whereas the prevalence of intravaginal Lactobacillus species is decreased. Because some lactobacilli are known to produce hydrogen peroxide (H2O2), which can be toxic to organisms that produce little or no H2O2-scavenging enzymes (e.g., catalase), we postulated that an absence of H2O2-producing Lactobacillus species could allow an overgrowth of catalase-negative organisms, such as those found among women with bacterial vaginosis. In this study, H2O2-producing facultative Lactobacillus species were found in the vaginas of 27 (96%) of 28 normal women and 4 (6%) of 67 women with bacterial vaginosis (P less than 0.001). Anaerobic Lactobacillus species (which do not produce hydrogen peroxide) were isolated from 24 (36%) of 67 women with bacterial vaginosis and 1 (4%) of 28 normal women (P less than 0.001). The production of H2O2 by Lactobacillus species may represent a nonspecific antimicrobial defense mechanism of the normal vaginal ecosystem.
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Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation

1991-02-01
Rachel Nugent , Marijane A. Krohn , Sharon L. Hillier
The purpose of the study was to examine intercenter variability in the interpretation of Gram-stained vaginal smears from pregnant women. The intercenter reliability of individual morphotypes identified on the vaginal … The purpose of the study was to examine intercenter variability in the interpretation of Gram-stained vaginal smears from pregnant women. The intercenter reliability of individual morphotypes identified on the vaginal smear was evaluated by comparing them with those obtained at a standard center. A new scoring system that uses the most reliable morphotypes from the vaginal smear was proposed for diagnosing bacterial vaginosis. This scoring system was compared with the Spiegel criteria for diagnosing bacterial vaginosis. The scoring system (0 to 10) was described as a weighted combination of the following morphotypes: lactobacilli, Gardnerella vaginalis or bacteroides (small gram-variable rods or gram-negative rods), and curved gram-variable rods. By using the Spearman rank correlation to determine intercenter variability, gram-positive cocci had poor agreement (0.23); lactobacilli (0.65), G. vaginalis (0.69), and bacteroides (0.57) had moderate agreement; and small (0.74) and curved (0.85) gram-variable rods had good agreement. The reliability of the 0 to 10 scoring system was maximized by not using gram-positive cocci, combining G. vaginalis and bacteroides morphotypes, and weighting more heavily curved gram-variable rods. For comparison with the Spiegel criteria, a score of 7 or higher was considered indicative of bacterial vaginosis. The standardized score had improved intercenter reliability (r = 0.82) compared with the Spiegel criteria (r = 0.61). The standardized score also facilitates future research concerning bacterial vaginosis because it provides gradations of the disturbance of vaginal flora which may be associated with different levels of risk for pregnancy complications.
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Interaction of chlamydiae and host cells in vitro

1991-03-01
James W. Moulder
The obligately intracellular bacteria of the genus Chlamydia, which is only remotely related to other eubacterial genera, cause many diseases of humans, nonhuman mammals, and birds. Interaction of chlamydiae with … The obligately intracellular bacteria of the genus Chlamydia, which is only remotely related to other eubacterial genera, cause many diseases of humans, nonhuman mammals, and birds. Interaction of chlamydiae with host cells in vitro has been studied as a model of infection in natural hosts and as an example of the adaptation of an organism to an unusual environment, the inside of another living cell. Among the novel adaptations made by chlamydiae have been the substitution of disulfide-bond-cross-linked polypeptides for peptidoglycans and the use of host-generated nucleotide triphosphates as sources of metabolic energy. The effect of contact between chlamydiae and host cells in culture varies from no effect at all to rapid destruction of either chlamydiae or host cells. When successful infection occurs, it is usually followed by production of large numbers of progeny and destruction of host cells. However, host cells containing chlamydiae sometimes continue to divide, with or without overt signs of infection, and chlamydiae may persist indefinitely in cell cultures. Some of the many factors that influence the outcome of chlamydia-host cell interaction are kind of chlamydiae, kind of host cells, mode of chlamydial entry, nutritional adequacy of the culture medium, presence of antimicrobial agents, and presence of immune cells and soluble immune factors. General characteristics of chlamydial multiplication in cells of their natural hosts are reproduced in established cell lines, but reproduction in vitro of the subtle differences in chlamydial behavior responsible for the individuality of the different chlamydial diseases will require better in vitro models.
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Temporal and spatial variation of the human microbiota during pregnancy

2015-08-17
Daniel B. DiGiulio , Benjamin J. Callahan , Paul J. McMurdie +7 more
Significance The human indigenous microbial communities (microbiota) play critical roles in health and may be especially important for mother and fetus during pregnancy. Using a case-control cohort of 40 women, … Significance The human indigenous microbial communities (microbiota) play critical roles in health and may be especially important for mother and fetus during pregnancy. Using a case-control cohort of 40 women, we characterized weekly variation in the vaginal, gut, and oral microbiota during and after pregnancy. Microbiota membership remained relatively stable at each body site during pregnancy. An altered vaginal microbial community was associated with preterm birth; this finding was corroborated by an analysis of samples from an additional cohort of nine women. We also discovered an abrupt change in the vaginal microbiota at delivery that persisted in some cases for at least 1 y. Our findings suggest that pregnancy outcomes might be predicted by features of the microbiota early in gestation.
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Emended description of the order Chlamydiales, proposal of Parachlamydiaceae fam. nov. and Simkaniaceae fam. nov., each containing one monotypic genus, revised taxonomy of the family Chlamydiaceae, including a new genus and five new species, and standards for the identification of organisms

1999-04-01
Karin D. E. Everett , R. Mitchell Bush , Arthur A. Andersen
The current taxonomic classification of Chlamydia is based on limited phenotypic, morphologic and genetic criteria. This classification does not take into account recent analysis of the ribosomal operon or recently … The current taxonomic classification of Chlamydia is based on limited phenotypic, morphologic and genetic criteria. This classification does not take into account recent analysis of the ribosomal operon or recently identified obligately intracellular organisms that have a chlamydia-like developmental cycle of replication. Neither does it provide a systematic rationale for identifying new strains. In this study, phylogenetic analyses of the 16S and 23S rRNA genes are presented with corroborating genetic and phenotypic information to show that the order Chlamydiales contains at least four distinct groups at the family level and that within the Chlamydiaceae are two distinct lineages which branch into nine separate clusters. In this report a reclassification of the order Chlamydiales and its current taxa is proposed. This proposal retains currently known strains with > 90% 16S rRNA identity in the family Chlamydiaceae and separates other chlamydia-like organisms that have 80-90% 16S rRNA relatedness to the Chlamydiaceae into new families. Chlamydiae that were previously described as 'Candidatus Parachlamydia acanthamoebae' Amann, Springer, Schönhuber, Ludwig, Schmid, Müller and Michel 1997, become members of Parachlamydiaceae fam. nov., Parachlamydia acanthamoebae gen. nov., sp. now. 'Simkania' strain Z becomes the founding member of Simkaniaceae fam. nov., Simkania negevensis gen. nov., sp. nov. The fourth group, which includes strain WSU 86-1044, was left unnamed. The Chlamydiaceae, which currently has only the genus Chlamydia, is divided into two genera, Chlamydia and Chlamydophila gen. nov. Two new species, Chlamydia muridarum sp. nov. and Chlamydia suis sp. nov., join Chlamydia trachomatis in the emended genus Chlamydia. Chlamydophila gen. nov. assimilates the current species, Chlamydia pecorum, Chlamydia pneumoniae and Chlamydia psittaci, to form Chlamydophila pecorum comb. nov., Chlamydophila pneumoniae comb. nov. and Chlamydophila psittaci comb. nov. Three new Chlamydophila species are derived from Chlamydia psittaci: Chlamydophila abortus gen. nov., sp. nov., Chlamydophila caviae gen. nov., sp. nov. and Chlamydophila felis gen. nov., sp. nov. Emended descriptions for the order Chlamydiales and for the family Chlamydiaceae are provided. These families, genera and species are readily distinguished by analysis of signature sequences in the 16S and 23S ribosomal genes.

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

2014-06-30
Magnus Unemo , William M. Shafer
SUMMARY Neisseria gonorrhoeae is evolving into a superbug with resistance to previously and currently recommended antimicrobials for treatment of gonorrhea, which is a major public health concern globally. Given the … SUMMARY Neisseria gonorrhoeae is evolving into a superbug with resistance to previously and currently recommended antimicrobials for treatment of gonorrhea, which is a major public health concern globally. Given the global nature of gonorrhea, the high rate of usage of antimicrobials, suboptimal control and monitoring of antimicrobial resistance (AMR) and treatment failures, slow update of treatment guidelines in most geographical settings, and the extraordinary capacity of the gonococci to develop and retain AMR, it is likely that the global problem of gonococcal AMR will worsen in the foreseeable future and that the severe complications of gonorrhea will emerge as a silent epidemic. By understanding the evolution, emergence, and spread of AMR in N. gonorrhoeae , including its molecular and phenotypic mechanisms, resistance to antimicrobials used clinically can be anticipated, future methods for genetic testing for AMR might permit region-specific and tailor-made antimicrobial therapy, and the design of novel antimicrobials to circumvent the resistance problems can be undertaken more rationally. This review focuses on the history and evolution of gonorrhea treatment regimens and emerging resistance to them, on genetic and phenotypic determinants of gonococcal resistance to previously and currently recommended antimicrobials, including biological costs or benefits; and on crucial actions and future advances necessary to detect and treat resistant gonococcal strains and, ultimately, retain gonorrhea as a treatable infection.
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Sexually Transmitted Infections Among US Women and Men

2013-02-12
Catherine L. Satterwhite , Elizabeth Torrone , Elissa Meites +6 more
In Brief Background Most sexually active people will be infected with a sexually transmitted infection (STI) at some point in their lives. The number of STIs in the United States … In Brief Background Most sexually active people will be infected with a sexually transmitted infection (STI) at some point in their lives. The number of STIs in the United States was previously estimated in 2000. We updated previous estimates to reflect the number of STIs for calendar year 2008. Methods We reviewed available data and literature and conservatively estimated incident and prevalent infections nationally for 8 common STIs: chlamydia, gonorrhea, syphilis, herpes, human papillomavirus, hepatitis B, HIV, and trichomoniasis. Where available, data from nationally representative surveys such as the National Health and Nutrition Examination Survey were used to provide national estimates of STI prevalence or incidence. The strength of each estimate was rated good, fair, or poor, according to the quality of the evidence. Results In 2008, there were an estimated 110 million prevalent STIs among women and men in the United States. Of these, more than 20% of infections (22.1 million) were among women and men aged 15 to 24 years. Approximately 19.7 million incident infections occurred in the United States in 2008; nearly 50% (9.8 million) were acquired by young women and men aged 15 to 24 years. Human papillomavirus infections, many of which are asymptomatic and do not cause disease, accounted for most of both prevalent and incident infections. Conclusions Sexually transmitted infections are common in the United States, with a disproportionate burden among young adolescents and adults. Public health efforts to address STIs should focus on prevention among at-risk populations to reduce the number and impact of STIs. In 2008, there were an estimated 110 million prevalent sexually transmitted infections among persons in the United States. Of 19.7 million incident sexually transmitted infections, 50% were acquired by persons aged 15 to 24 years.

Vaginal microbiome of reproductive-age women

2010-06-03
Jacques Ravel , Pawel Gajer , Zaid Abdo +7 more
The means by which vaginal microbiomes help prevent urogenital diseases in women and maintain health are poorly understood. To gain insight into this, the vaginal bacterial communities of 396 asymptomatic … The means by which vaginal microbiomes help prevent urogenital diseases in women and maintain health are poorly understood. To gain insight into this, the vaginal bacterial communities of 396 asymptomatic North American women who represented four ethnic groups (white, black, Hispanic, and Asian) were sampled and the species composition characterized by pyrosequencing of barcoded 16S rRNA genes. The communities clustered into five groups: four were dominated by Lactobacillus iners, L. crispatus, L. gasseri , or L. jensenii , whereas the fifth had lower proportions of lactic acid bacteria and higher proportions of strictly anaerobic organisms, indicating that a potential key ecological function, the production of lactic acid, seems to be conserved in all communities. The proportions of each community group varied among the four ethnic groups, and these differences were statistically significant [χ 2 (10) = 36.8, P &lt; 0.0001]. Moreover, the vaginal pH of women in different ethnic groups also differed and was higher in Hispanic (pH 5.0 ± 0.59) and black (pH 4.7 ± 1.04) women as compared with Asian (pH 4.4 ± 0.59) and white (pH 4.2 ± 0.3) women. Phylotypes with correlated relative abundances were found in all communities, and these patterns were associated with either high or low Nugent scores, which are used as a factor for the diagnosis of bacterial vaginosis. The inherent differences within and between women in different ethnic groups strongly argues for a more refined definition of the kinds of bacterial communities normally found in healthy women and the need to appreciate differences between individuals so they can be taken into account in risk assessment and disease diagnosis.
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A New Respiratory Tract Pathogen: Chlamydia pneumoniae Strain TWAR

1990-04-01
J. Thomas Grayston , Lee Ann Campbell , C C Kuo +4 more
Chlamydia pneumoniae strain TWAR, the new third species of Chlamydia, is a common cause of pneumonia and other acute respiratory tract infections. About 10% of hospitalized and outpatient pneumonia cases … Chlamydia pneumoniae strain TWAR, the new third species of Chlamydia, is a common cause of pneumonia and other acute respiratory tract infections. About 10% of hospitalized and outpatient pneumonia cases have been associated with TWAR infection. TWAR is among the four or five most commonly identified causes of all pneumonia. Most TWAR infections are mild or asymptomatic, but occasionally severe pneumonia with death has been observed. Laboratory diagnosis is not generally available. Vigorous treatment with tetracycline or erythromycin is recommended. Both epidemic and endemic infections have been described in North America and the Nordic Countries. Population prevalence antibody studies suggest that TWAR infection is wide-spread throughout the world, that nearly everyone is infected and reinfected during their life-time, and that infection is common in all ages except those less than 5 years in temperate zone countries. The infection is transmitted from person to person, apparently with a long incubation period.

Inhibition of Bacterial Adherence by Secretory Immunoglobulin A: A Mechanism of Antigen Disposal

1972-08-25
Ralph C. Williams , R.J. Gibbons
Preparations of secretory iminunoglobuilin A (S-IgA) isolated from human parotid fluid specifically inhibited the adherence of Streptococcus strains to epithelial cells. Since bacterial adherence is a prerequisite for colonization of … Preparations of secretory iminunoglobuilin A (S-IgA) isolated from human parotid fluid specifically inhibited the adherence of Streptococcus strains to epithelial cells. Since bacterial adherence is a prerequisite for colonization of mucous surfaces. S-IgA-mediated inhibition of adherence would limit bacterial colonization. This mechanism can explain how secretory immunoglobulins function in the disposal of bacterial antigens.

Temporal Dynamics of the Human Vaginal Microbiota

2012-05-02
Pawel Gajer , Rebecca M. Brotman , Guoyun Bai +7 more
Elucidating the factors that impinge on the stability of bacterial communities in the vagina may help in predicting the risk of diseases that affect women's health. Here, we describe the … Elucidating the factors that impinge on the stability of bacterial communities in the vagina may help in predicting the risk of diseases that affect women's health. Here, we describe the temporal dynamics of the composition of vaginal bacterial communities in 32 reproductive-age women over a 16-week period. The analysis revealed the dynamics of five major classes of bacterial communities and showed that some communities change markedly over short time periods, whereas others are relatively stable. Modeling community stability using new quantitative measures indicates that deviation from stability correlates with time in the menstrual cycle, bacterial community composition, and sexual activity. The women studied are healthy; thus, it appears that neither variation in community composition per se nor higher levels of observed diversity (co-dominance) are necessarily indicative of dysbiosis.
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From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection

1999-02-01
Douglas T. Fleming , Judith N. Wasserheit
OBJECTIVES: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and … OBJECTIVES: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and STD prevention policy and practice. METHODS: Articles were selected from a review of Medline, accessed with the OVID search engine. The search covered articles from January 1987 to September 1998 and yielded 2101 articles. Methods used to uncover articles which might have been missed included searching for related articles by author, and combing literature reviews. In addition, all abstracts under the category "sexually transmitted diseases" from the XI and XII International Conferences on AIDS (Vancouver 1996 and Geneva 1998) and other relevant scientific meetings were reviewed. Efforts were made to locate journal articles which resulted from the research reported in the identified abstracts. All original journal articles and abstracts which met one of the following criteria were included: (1) studies of the biological plausibility or mechanism of facilitation of HIV infectiousness or susceptibility by STDs, (2) prospective cohort studies (longitudinal or nested case-control) which estimate the risk of HIV infection associated with specific STDs or STD syndromes, or (3) intervention studies which quantitate the effect which STD treatment can have on HIV incidence. RESULTS: Strong evidence indicates that both ulcerative and non-ulcerative STDs promote HIV transmission by augmenting HIV infectiousness and HIV susceptibility via a variety of biological mechanisms. These effects are reflected in the risk estimates found in numerous prospective studies from four continents which range from 2.0 to 23.5, with most clustering between 2 and 5. The relative importance of ulcerative and non-ulcerative STDs appears to be complex. Owing to the greater frequency of non-ulcerative STDs in many populations, these infections may be responsible for more HIV transmission than genital ulcers. However, the limited reciprocal impact of HIV infection on non-ulcerative STDs and the evidence that non-ulcerative STDs may increase risk primarily for the receptive partner (rather than bidirectionally) may modulate the impact of these diseases. The results of two community level randomised, controlled intervention trials conducted in Africa suggest that timely provision of STD services can substantially reduce HIV incidence, but raise additional questions about the optimal way to target and implement these services to achieve the greatest effect on HIV transmission. CONCLUSIONS: Available data leave little doubt that other STDs facilitate HIV transmission through direct, biological mechanisms and that early STD treatment should be part of a high quality, comprehensive HIV prevention strategy. Policy makers, HIV prevention programme managers, and providers should focus initial implementation efforts on three key areas: (i) improving access to and quality of STD clinical services; (ii) promoting early and effective STD related healthcare behaviours; and (iii) establishing surveillance systems to monitor STD and HIV trends and their interrelations.
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Elevated <i>Chlamydia pneumoniae</i> Antibodies, Cardiovascular Events, and Azithromycin in Male Survivors of Myocardial Infarction

1997-07-15
Sandeep Gupta , Edward Leatham , D Carrington +3 more
The clinical significance of the association between elevated anti-Chlamydia pneumoniae (Cp) antibody titres and coronary heart disease (CHD) is unclear. We explored the relationship between antibodies against Cp and future … The clinical significance of the association between elevated anti-Chlamydia pneumoniae (Cp) antibody titres and coronary heart disease (CHD) is unclear. We explored the relationship between antibodies against Cp and future cardiovascular events in male survivors of myocardial infarction (MI). The effect of azithromycin antibiotic therapy was assessed in a subgroup of post-MI patients.We screened 220 consecutive male survivors of MI for anti-Cp antibodies. Of these, 213 patients were stratified into three groups: group Cp-ve (n=59), no detectable Cp antibodies; group Cp-I (n=74), intermediate titres of 1/8 to 1/32 dilution; and group Cp+ve (n=80), seropositive at > or = 1/64 dilution. Patients with persisting seropositivity of > or = 1/64 were randomized to either oral azithromycin (Cp+ve-A, 500 mg/d for 3 days [n=28] or 500 mg/d for 6 days [n=12]) or placebo (Cp+ve-P, n=20). Cp+ve-NR (n=20) represented patients not recruited into the antibiotic trial. The incidence of adverse cardiovascular events (over a mean follow-up period of 18+/-4 months) was recorded and shown to increase with increasing anti-Cp titre: Cp-ve, n=4 (7%); Cp-I, n=11 (15%); Cp+ve-NR, n=6 (30%); and Cp+ve-P, n=5 (25%). Cp+ve-NR and Cp+ve-P groups had a fourfold-increased risk for adverse cardiovascular events compared with the Cp-ve group (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.2 to 15.5; P=.03). In contrast, the OR for cardiovascular events in patients receiving azithromycin (Cp+ve-A, single or double course) was the same as in the Cp-ve group (OR, 0.9; 95% CI, 0.2 to 4.6, P=NS). Patients receiving azithromycin were more likely to experience a decrease in IgG anti-Cp titres than were those in the placebo group (P=.02).An increased anti-Cp antibody titre may be a predictor for further adverse cardiovascular events in post-MI patients. Taking a short course of azithromycin may lower this risk, possibly by acting against Cp.

The role of sexually transmitted diseases in HIV transmission

2004-01-01
Shannon Galvin , Myron S. Cohen

Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial

1995-08-01
Heiner Grosskurth , J. Todd , Ezra Mwijarubi +7 more

Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women

1993-01-01
Marie Laga , A.T. Manoka , M. Kivuvu +7 more
The heterosexual spread of HIV-1 is occurring at different rates in different parts of the world. The transmission probability of HIV-1 per sexual contact is low, but may be greatly … The heterosexual spread of HIV-1 is occurring at different rates in different parts of the world. The transmission probability of HIV-1 per sexual contact is low, but may be greatly enhanced by several cofactors. Sexually transmitted diseases (STD), especially genital ulcers, may be such factors. So far, epidemiological evidence that other STD facilitate HIV-1 transmission is weak. The objective of this study was to determine whether treatable STD enhanced sexual transmission of HIV-1 in a cohort of female prostitutes in Kinshasa, Zaire.We conducted a nested case-control study of 431 initially HIV-1-negative women followed prospectively for a mean duration of 2 years (with monthly STD check-ups and 3-monthly HIV-1 serology). Cases (seroconverters, n = 68) were compared with controls (women who remained HIV-1-negative, n = 126) for incidence of STD and sexual exposure during the presumed period of HIV-1 acquisition.The annual incidence of HIV-1 in this cohort was 9.8%. Seroconverters were younger than HIV-1-negative women (mean age, 24.6 versus 26.8 years; P = 0.04). During the period of HIV-1 acquisition, cases had a much higher incidence of gonorrhoea, chlamydial infection and trichomoniasis, and engaged in unprotected sex with clients and partners more frequently than controls. After controlling for sexual exposure by multivariate analysis, adjusted odds ratios for seroconversion were 4.8 [95% confidence interval (CI), 2.4-9.8] for gonorrhoea, 3.6 (95% CI, 1.4-9.1) for chlamydial infection and 1.9 (95% CI, 0.9-4.1) for trichomoniasis. Genital ulcers were more frequent in cases than controls, but much less common than other STD.Non-ulcerative STD were risk factors for sexual transmission of HIV-1 in women, after controlling for sexual exposure. Because of their high prevalence in some populations, non-ulcerative STD may represent a considerable population-attributable risk in the transmission of HIV-1 worldwide. The identification of treatable STD as risk factors for HIV-1 transmission offers an important additional strategy for the prevention of HIV/AIDS.There is only a small probability that HIV-1 will be transmitted via any single sexual contact. The risk of transmission, however, during such an act may be greatly increased by the presence of ulcerative genital sexually transmitted disease (STD). Little evidence is published on whether infection with non-ulcerative STD facilitates the transmission of HIV-1. The authors therefore investigated whether treatable STD enhanced the sexual transmission of HIV-1 in a cohort of female prostitutes in Kinshasa, Zaire. 431 initially HIV-1-seronegative women were followed prospectively in this nested case-control study for a mean duration of two years in monthly STD check-ups and three-monthly HIV-1 serology. The 68 women who seroconverted were compared against the 126 women who remained HIV-1-seronegative for the incidence of STD and sexual exposure during the presumed period of HIV-1 acquisition. There was a 9.8% annual incidence of HIV-1 in this cohort of subjects. Seroconverters were of mean age 24.6 years compared to 26.8 years for the HIV-seronegative women. During the period of HIV-1 acquisition, cases had a much higher incidence of gonorrhea, chlamydial infection, and trichomoniasis, and engaged in unprotected sex with clients and partners more frequently than controls. After controlling for sexual exposure by multivariate analysis, adjusted odds ratio for seroconversion were 4.8 for gonorrhea, 3.6 for chlamydial infection, and 1.9 for trichomoniasis. Genital ulcers were more frequent in cases than controls, but much less common than other STD. These findings therefore suggest that non-ulcerative STDs were risk factors for the sexual transmission of HIV-1 in these women. Such STD may be a considerable population-attributable risk in the transmission of HIV-1 worldwide given the high prevalence of non-ulcerative STDs in some populations.

Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1

1997-06-01
Myron S. Cohen , Irving Hoffman , Rachel A. Royce +7 more

Chronic <i>Chlamydia pneumoniae</i> Infection as a Risk Factor for Coronary Heart Disease in the Helsinki Heart Study

1992-02-15
Pekka Saikku , Maija Leinonen , Leena Tenkanen +6 more
To investigate in the prospective Helsinki Heart Study, whether chronic Chlamydia pneumoniae infection, indicated by elevated antibody titers against the pathogen, chlamydial lipopolysaccharide-containing immune complexes, or both, is a risk … To investigate in the prospective Helsinki Heart Study, whether chronic Chlamydia pneumoniae infection, indicated by elevated antibody titers against the pathogen, chlamydial lipopolysaccharide-containing immune complexes, or both, is a risk factor for coronary heart disease.The Helsinki Heart Study was a randomized, double-blind, 5-year clinical trial to test the efficacy of gemfibrozil in reducing the risk for coronary heart disease. Participants were randomized to receive either gemfibrozil (2046 patients) or placebo (2035 patients). Fatal and nonfatal myocardial infarction and sudden cardiac death were the main study end points. Serum samples were collected at 3-month intervals from all patients.One hundred forty cardiac events occurred during the follow-up period. Serum samples from 103 case patients obtained 3 to 6 months before a cardiac end point were matched with those from controls for time point, locality, and treatment. Samples were tested for markers of chronic chlamydial infection.Immunoglobulin A (IgA) and G (IgG) antibodies to C. pneumoniae were measured using the microimmunofluorescence method. Lipopolysaccharide-containing immune complexes were measured using two antigen-specific enzyme immunoassays, the lipopolysaccharide-capture and immunoglobulin M (IgM)-capture methods.Using a conditional logistic regression model, odds ratios for the development of coronary heart disease were 2.7 (95% CI, 1.1 to 6.5) for elevated IgA titers, 2.1 (CI, 1.1 to 3.9) for the presence of immune complexes, and 2.9 (CI, 1.5 to 5.4) for the presence of both factors. If we adjusted for other coronary heart disease risk factors such as age, hypertension, and smoking, the corresponding values would be 2.3 (CI, 0.9 to 6.2), 1.8 (CI, 0.9 to 3.6), and 2.6 (CI, 1.3 to 5.2), respectively.The results suggest that chronic C. pneumoniae infection may be a significant risk factor for the development of coronary heart disease.

Bacterial vaginosis as a risk factor for preterm delivery: A meta-analysis

2003-07-01
Harald Leitich , Barbara Bodner‐Adler , Mathias Brunbauer +3 more

Molecular Identification of Bacteria Associated with Bacterial Vaginosis

2005-11-02
David N. Fredricks , Tina L. Fiedler , Jeanne Marrazzo
Bacterial vaginosis affects millions of women and is associated with several serious health conditions. The cause of bacterial vaginosis remains poorly understood despite numerous studies based on cultures. Bacteria in … Bacterial vaginosis affects millions of women and is associated with several serious health conditions. The cause of bacterial vaginosis remains poorly understood despite numerous studies based on cultures. Bacteria in microbial communities can be identified without cultivation by characterizing their ribosomal DNA (rDNA) sequences.We identified bacteria in samples of vaginal fluid with a combination of broad-range polymerase-chain-reaction (PCR) amplification of 16S rDNA with clone analysis, bacterium-specific PCR assay of 16S rDNA, and fluorescence in situ hybridization (FISH) performed directly on vaginal fluid from 27 subjects with bacterial vaginosis and 46 without the condition. Twenty-one subjects were studied with the use of broad-range PCR of 16S rDNA, and 73 subjects were studied with the use of bacterium-specific PCR.Women without bacterial vaginosis had 1 to 6 vaginal bacterial species (phylotypes) in each sample (mean, 3.3), as detected by broad-range PCR of 16S rDNA, and lactobacillus species were the predominant bacteria noted (83 to 100 percent of clones). Women with bacterial vaginosis had greater bacterial diversity (P<0.001), with 9 to 17 phylotypes (mean, 12.6) detected per sample and newly recognized species present in 32 to 89 percent of clones per sample library (mean, 58 percent). Thirty-five unique bacterial species were detected in the women with bacterial vaginosis, including several species with no close cultivated relatives. Bacterium-specific PCR assays showed that several bacteria that had not been previously described were highly prevalent in subjects with bacterial vaginosis but rare in healthy controls. FISH confirmed that newly recognized bacteria detected by PCR corresponded to specific bacterial morphotypes visible in vaginal fluid.Women with bacterial vaginosis have complex vaginal infections with many newly recognized species, including three bacteria in the Clostridiales order that were highly specific for bacterial vaginosis.
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Demonstration of Chlamydia pneumoniae in Atherosclerotic Lesions of Coronary Arteries

1993-04-01
C C Kuo , Allan Shor , Lee Ann Campbell +3 more
Chlamydia pneumoniae is a human respiratory pathogen that causes acute respiratory disease and approximately 10% of community-acquired pneumonia. The infections are geographically widespread. Antibody prevalence studies have shown that virtually … Chlamydia pneumoniae is a human respiratory pathogen that causes acute respiratory disease and approximately 10% of community-acquired pneumonia. The infections are geographically widespread. Antibody prevalence studies have shown that virtually everyone is infected with the C. pneumoniae organisms at some time and that reinfection is common. In addition to respiratory disease, seroepidemiologic studies have shown an association of this organism with coronary artery disease. C. pneumoniae was detected in coronary artery atheromas by immunocytochemistry (15/36) and by polymerase chain reaction (PCR) (13/30) in 20 of 36 autopsy cases from Johannesburg, South Africa. Sequence analysis of the C. pneumoniae rRNA genes amplified by PCR confirmed that the amplified gene products were C. pneumoniae. Electron microscopy revealed typical pear-shaped C. pneumoniae elementary bodies in 6 of 21 atheromatous plaques. These findings support the seroepidemiologic studies and offer further evidence that C. pneumoniae may be involved in the atherosclerotic process.

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

2014-02-03
Roberto Romero , Sonia S. Hassan , Pawel Gajer +7 more
This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant … This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. A retrospective case–control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the predominant members of the microbial community in normal pregnancy. These results can serve as the basis to study the relationship between the vaginal microbiome and adverse pregnancy outcomes.
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Sexually transmitted diseases treatment guidelines

2003-08-01
Gale R. Burstein , Kimberly Workowski
Sexually transmitted diseases (STDs) are a major health problem for adolescents. Health care providers for adolescents play a critical role in preventing and treating STDs. In May 2002, the Centers … Sexually transmitted diseases (STDs) are a major health problem for adolescents. Health care providers for adolescents play a critical role in preventing and treating STDs. In May 2002, the Centers for Disease Control and Prevention published the Sexually Transmitted Diseases Treatment Guidelines 2002. These evidence-based guidelines are based on a systematic literature review focusing on information that had become available since the 1998 Guidelines for Treatment of STDs. This article reviews the new STD treatment guidelines for gonorrhea, chlamydia, bacterial vaginosis, trichomonas, vulvovaginal candidiasis, pelvic inflammatory disease, genital warts, herpes simplex virus infection, syphilis, and scabies. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed.

Control of sexually transmitted diseases for AIDS prevention in Uganda: a randomised community trial

1999-02-01
Maria J. Wawer , Nelson Sewankambo , David Serwadda +7 more
The study tested the hypothesis that community-level control of sexually transmitted disease (STD) would result in lower incidence of HIV-1 infection in comparison with control communities.This randomised, controlled, single-masked, community-based … The study tested the hypothesis that community-level control of sexually transmitted disease (STD) would result in lower incidence of HIV-1 infection in comparison with control communities.This randomised, controlled, single-masked, community-based trial of intensive STD control, via home-based mass antibiotic treatment, took place in Rakai District, Uganda. Ten community clusters were randomly assigned to intervention or control groups. All consenting residents aged 15-59 years were enrolled; visited in the home every 10 months; interviewed; asked to provide biological samples for assessment of HIV-1 infection and STDs; and were provided with mass treatment (azithromycin, ciprofloxacin, metronidazole in the intervention group, vitamins/anthelmintic drug in the control). Intention-to-treat analyses used multivariate, paired, cluster-adjusted rate ratios.The baseline prevalence of HIV-1 infection was 15.9%. 6602 HIV-1-negative individuals were enrolled in the intervention group and 6124 in the control group. 75.0% of intervention-group and 72.6% of control-group participants provided at least one follow-up sample for HIV-1 testing. At enrolment, the two treatment groups were similar in STD prevalence rates. At 20-month follow-up, the prevalences of syphilis (352/6238 [5.6%]) vs 359/5284 [6.8%]; rate ratio 0.80 [95% CI 0.71-0.89]) and trichomoniasis (182/1968 [9.3%] vs 261/1815 [14.4%]; rate ratio 0.59 [0.38-0.91]) were significantly lower in the intervention group than in the control group. The incidence of HIV-1 infection was 1.5 per 100 person-years in both groups (rate ratio 0.97 [0.81-1.16]). In pregnant women, the follow-up prevalences of trichomoniasis, bacterial vaginosis, gonorrhoea, and chlamydia infection were significantly lower in the intervention group than in the control group. No effect of the intervention on incidence of HIV-1 infection was observed in pregnant women or in stratified analyses.We observed no effect of the STD intervention on the incidence of HIV-1 infection. In the Rakai population, a substantial proportion of HIV-1 acquisition appears to occur independently of treatable STD cofactors.
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Vaginal Lactobacilli, Microbial Flora, and Risk of Human Immunodeficiency Virus Type 1 and Sexually Transmitted Disease Acquisition

1999-12-01
Harold Martin , Barbra A. Richardson , Patrick M. Nyange +7 more
A prospective cohort study was conducted to examine the relationship between vaginal colonization with lactobacilli, bacterial vaginosis (BV), and acquisition of human immunodeficiency virus type 1 (HIV-1) and sexually transmitted … A prospective cohort study was conducted to examine the relationship between vaginal colonization with lactobacilli, bacterial vaginosis (BV), and acquisition of human immunodeficiency virus type 1 (HIV-1) and sexually transmitted diseases in a population of sex workers in Mombasa, Kenya. In total, 657 HIV-1—seronegative women were enrolled and followed at monthly intervals. At baseline, only 26% of women were colonized with Lactobacillus species. During follow-up, absence of vaginal lactobacilli on culture was associated with an increased risk of acquiring HIV-1 infection (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.2–3.5) and gonorrhea (HR, 1.7; 95% CI, 1.1–2.6), after controlling for other identified risk factors in separate multivariate models. Presence of abnormal vaginal flora on Gram's stain was associated with increased risk of both HIV-1 acquisition (HR, 1.9; 95% CI, 1.1–3.1) and Trichomonas infection (HR, 1.8; 95% CI, 1.3–2.4). Treatment of BV and promotion of vaginal colonization with lactobacilli should be evaluated as potential interventions to reduce a woman's risk of acquiring HIV-1, gonorrhea, and trichomoniasis.

Genome Sequence of an Obligate Intracellular Pathogen of Humans: <i>Chlamydia trachomatis</i>

1998-10-23
Richard S. Stephens , Sue Kalman , C. J. Lammel +7 more
Analysis of the 1,042,519–base pair Chlamydia trachomatis genome revealed unexpected features related to the complex biology of chlamydiae. Although chlamydiae lack many biosynthetic capabilities, they retain functions for performing key … Analysis of the 1,042,519–base pair Chlamydia trachomatis genome revealed unexpected features related to the complex biology of chlamydiae. Although chlamydiae lack many biosynthetic capabilities, they retain functions for performing key steps and interconversions of metabolites obtained from their mammalian host cells. Numerous potential virulence-associated proteins also were characterized. Several eukaryotic chromatin-associated domain proteins were identified, suggesting a eukaryotic-like mechanism for chlamydial nucleoid condensation and decondensation. The phylogenetic mosaic of chlamydial genes, including a large number of genes with phylogenetic origins from eukaryotes, implies a complex evolution for adaptation to obligate intracellular parasitism.

1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults

1993-10-01
K. G. Castro , Jill Ward , Laurence Slutsker +4 more
CDC has revised the classification system for HIV infection to emphasize the clinical importance of the CD4+ T-lymphocyte count in the categorization of HIV-related clinical conditions. This classification system replaces … CDC has revised the classification system for HIV infection to emphasize the clinical importance of the CD4+ T-lymphocyte count in the categorization of HIV-related clinical conditions. This classification system replaces the system published by CDC in 1986 [1] and is primarily intended for use in public health practice. Consistent with the 1993 revised classification system, CDC has also expanded the AIDS surveillance case definition to include all HIV-infected persons who have <200 CD4+ T-lymphocytes/µL, or a CD4+ T-lymphocyte percentage of total lymphocytes of <14. This expansion includes the addition of three clinical conditions—pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer—and retains the 23 clinical conditions in the AIDS surveillance case definition published in 1987 [2]; it is to be used by all states for AIDS case reporting effective January 1, 1993.

Chlamydia pneumoniae (TWAR)

1995-10-01
C C Kuo , Lisa A. Jackson , Lee Ann Campbell +1 more
Chlamydia pneumoniae (TWAR) is a recently recognized third species of the genus Chlamydia that causes acute respiratory disease. It is distinct from the other two chlamydial species that infect humans, … Chlamydia pneumoniae (TWAR) is a recently recognized third species of the genus Chlamydia that causes acute respiratory disease. It is distinct from the other two chlamydial species that infect humans, C. trachomatis and C. psittaci, in elementary body morphology and shares less than 10% of the DNA homology with those species. The organism has a global distribution, with infection most common among children between the ages of 5 and 14 years. In children, TWAR infection is usually mild or asymptomatic, but it may be more severe in adults. Pneumonia and bronchitis are the most common clinical manifestations of infection, and TWAR is responsible for approximately 10% of cases of pneumonia and 5% of cases of bronchitis in the United States. The microimmunofluorescence serologic assay is specific for TWAR and can distinguish between recent and past infections. The organism can be isolated in cell culture; however, PCR techniques have recently facilitated its detection in tissues and clinical specimens.
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Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines

2007-03-03
Kimberly Workowski , Simeon M. Berman
fective clinical management of STDs represent an important combined strategy necessary to improve reproductive and sexual health and to improve HIV prevention efforts. This is especially relevant to women, adolescents, … fective clinical management of STDs represent an important combined strategy necessary to improve reproductive and sexual health and to improve HIV prevention efforts. This is especially relevant to women, adolescents, and infants, because untreated infections frequently result in severe, long-term complications, including facilitation of HIV infection, tubal infertility, adverse pregnancy outcomes, and cancer. For >20 years, the publication of national guidelines by the Centers for Disease Control and Prevention
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Genome sequences of Chlamydia trachomatis MoPn and Chlamydia pneumoniae AR39

2000-03-15
Timothy D. Read , R C Brunham , Chengquan Shen +7 more
The genome sequences of Chlamydia trachomatis mouse pneumonitis (MoPn) strain Nigg (1 069 412 nt) and Chlamydia pneumoniae strain AR39 (1 229 853 nt) were determined using a random shotgun … The genome sequences of Chlamydia trachomatis mouse pneumonitis (MoPn) strain Nigg (1 069 412 nt) and Chlamydia pneumoniae strain AR39 (1 229 853 nt) were determined using a random shotgun strategy. The MoPn genome exhibited a general conservation of gene order and content with the previously sequenced C.trachomatis serovar D. Differences between C.trachomatis strains were focused on an ~50 kb 'plasticity zone' near the termination origins. In this region MoPn contained three copies of a novel gene encoding a >3000 amino acid toxin homologous to a predicted toxin from Escherichia coli 0157:H7 but had apparently lost the tryptophan biosyntheis genes found in serovar D in this region. The C.pneumoniae AR39 chromosome was >99.9% identical to the previously sequenced C.pneumoniae CWL029 genome, however, comparative analysis identified an invertible DNA segment upstream of the uridine kinase gene which was in different orientations in the two genomes. AR39 also contained a novel 4524 nt circular single-stranded (ss)DNA bacteriophage, the first time a virus has been reported infecting C.pneumoniae. Although the chlamydial genomes were highly conserved, there were intriguing differences in key nucleotide salvage pathways: C.pneumoniae has a uridine kinase gene for dUTP production, MoPn has a uracil phosphororibosyl transferase, while C.trachomatis serovar D contains neither gene. Chromosomal comparison revealed that there had been multiple large inversion events since the species divergence of C.trachomatis and C.pneumoniae, apparently oriented around the axis of the origin of replication and the termination region. The striking synteny of the Chlamydia genomes and prevalence of tandemly duplicated genes are evidence of minimal chromosome rearrangement and foreign gene uptake, presumably owing to the ecological isolation of the obligate intracellular parasites. In the absence of genetic analysis, comparative genomics will continue to provide insight into the virulence mechanisms of these important human pathogens.
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Purification and partial characterization of the major outer membrane protein of Chlamydia trachomatis

1981-03-01
Harlan D. Caldwell , J Kromhout , J Schachter
Elementary bodies (EB) of Chlamydia trachomatis serotypes C, E, and L2 were extrinsically radioiodinated, and whole-cell lysates of these serotypes were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Autoradiography … Elementary bodies (EB) of Chlamydia trachomatis serotypes C, E, and L2 were extrinsically radioiodinated, and whole-cell lysates of these serotypes were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Autoradiography of the polypeptide profiles identified a major surface protein with an apparent subunit molecular weight of 39,500 that was common to each C. trachomatis serotype. The abilities of nonionic (Triton X-100), dipolar ionic (Zwittergent TM-314), mild (sodium deoxycholate and sodium N-lauroyl sarcosine), and strongly anionic (SDS) detergents to extract this protein from intact EB of the L2 serotype were investigated by SDS-PAGE analysis of the soluble and insoluble fractions obtained after each detergent treatment. Only SDS readily extracted this protein from intact EB. Sarkosyl treatment selectively solubilized the majority of other EB proteins, leaving the 39,500-dalton protein associated with the Sarkosyl-insoluble fraction. Ultrastructural studies of the Sarkosyl-insoluble EB pellet showed it to consist of empty EB particles possessing an apparently intact outer membrane. No structural evidence for a peptidoglycan-like cell wall was found. Morphologically these chlamydial outer membrane complexes (COMC) resembled intact chlamydial EB outer membranes. The 39,500-dalton outer membrane protein was quantitatively extracted from COMC by treating them with 2% SDS at 60 degrees C. This protein accounted for 61% of the total COMC-associated protein, and its extraction resulted in a concomitant loss of the COMC membrane structure and morphology. The soluble extract obtained from SDS-treated COMC was adsorbed to a hydroxylapatite column and eluted with a linear sodium phosphate gradient. The 39,500-dalton protein was eluted from the column as a single peak at a phosphate concentration of approximately 0.3 M. The eluted protein was nearly homogeneous by SDS-PAGE and appeared free of contaminating carbohydrate, glycolipid, and nucleic acid. Hyperimmune mouse antiserum prepared against the 39,500-dalton protein from serotype L2 reacted with C. trachomatis serotypes Ba, E, D, K, L1, L2, and L3 by indirect immunofluorescence with EB but failed to react with serotypes A, B, C, F, G, H, I, and J, with the C. trachomatis mouse pneumonitis strain, or with the C. psittaci feline pneumonitis, guinea pig inclusion conjunctivitis, or 6BC strains. Thus, the 39,500-dalton major outer membrane protein is a serogroup antigen of C. trachomatis organisms.
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Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting

2015-12-08
Lori Newman , Jane Rowley , Stephen Vander Hoorn +7 more
Background Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and … Background Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and incidence of four curable STIs: chlamydia, gonorrhoea, trichomoniasis and syphilis. Methods and Findings WHO’s 2012 estimates were based upon literature reviews of prevalence data from 2005 through 2012 among general populations for genitourinary infection with chlamydia, gonorrhoea, and trichomoniasis, and nationally reported data on syphilis seroprevalence among antenatal care attendees. Data were standardized for laboratory test type, geography, age, and high risk subpopulations, and combined using a Bayesian meta-analytic approach. Regional incidence estimates were generated from prevalence estimates by adjusting for average duration of infection. In 2012, among women aged 15–49 years, the estimated global prevalence of chlamydia was 4.2% (95% uncertainty interval (UI): 3.7–4.7%), gonorrhoea 0.8% (0.6–1.0%), trichomoniasis 5.0% (4.0–6.4%), and syphilis 0.5% (0.4–0.6%); among men, estimated chlamydia prevalence was 2.7% (2.0–3.6%), gonorrhoea 0.6% (0.4–0.9%), trichomoniasis 0.6% (0.4–0.8%), and syphilis 0.48% (0.3–0.7%). These figures correspond to an estimated 131 million new cases of chlamydia (100–166 million), 78 million of gonorrhoea (53–110 million), 143 million of trichomoniasis (98–202 million), and 6 million of syphilis (4–8 million). Prevalence and incidence estimates varied by region and sex. Conclusions Estimates of the global prevalence and incidence of chlamydia, gonorrhoea, trichomoniasis, and syphilis in adult women and men remain high, with nearly one million new infections with curable STI each day. The estimates highlight the urgent need for the public health community to ensure that well-recognized effective interventions for STI prevention, screening, diagnosis, and treatment are made more widely available. Improved estimation methods are needed to allow use of more varied data and generation of estimates at the national level.
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Sexually transmitted diseases treatment guidelines (2015)

2015-06-05
Kimberly Workowski , Gail Bolan
Дані рекомендації щодо лікування осіб, які мають або піддаються ризику захворювань, що передаються статевим шляхом (ЗПСШ), були оновлені Центрами з контролю і профілактики захворювань США після консультації з групою фахівців … Дані рекомендації щодо лікування осіб, які мають або піддаються ризику захворювань, що передаються статевим шляхом (ЗПСШ), були оновлені Центрами з контролю і профілактики захворювань США після консультації з групою фахівців у сфері ЗПСШ, які зустрілися в Атланті навесні 2013 р. Це оновлена версія Керівництва з лікування ЗПСШ від 2010 р. В оновленій версії керівництва обговорюються: 1) альтернативні схеми лікування Neisseria gonorrhoeae; 2) застосування методів ампліфікації нуклеїнових кислот для діагностики трихомоніазу; 3) альтернативні способи лікування гострих кондилом; 4) роль Mycoplasma genitalium у розвитку уретритів/цервіцитів і наслідки, пов’язані з лікуванням; 5) оновлені рекомендації з консультування та вакцинації проти вірусу папіломи людини; 6) менеджмент пацієнтів-транссексуалів; 7) щорічне тестування на гепатит С осіб із ВІЛ-інфекцією; 8) оновлені рекомендації з діагностичної оцінки уретриту; 9) повторне тестування з метою виявлення нового інфікування. Дане керівництво можуть використовувати лікарі та інші медичні працівники для надання допомоги з профілактики та лікування ЗПСШ.

Trichomonas vaginalis Associated With Low Birth Weight and Preterm Delivery

1997-07-01
Mary Frances Cotch , Joseph G. Pastorek , Rachel Nugent +7 more
Several studies have suggested that pregnant women infected with Trichomonas vaginalis may be at increased risk of an adverse outcome.To evaluate prospectively the association between T. vaginalis and risk of … Several studies have suggested that pregnant women infected with Trichomonas vaginalis may be at increased risk of an adverse outcome.To evaluate prospectively the association between T. vaginalis and risk of adverse pregnancy outcome in a large cohort of ethnically diverse women.At University-affiliated hospitals and antepartum clinics in five United States cities, 13,816 women (5,241 black, 4,226 Hispanic, and 4,349 white women) were enrolled at mid-gestation, tested for T. vaginalis by culture, and followed up until delivery.The prevalence of T. vaginalis infection at enrollment was 12.6%. Race-specific prevalence rates were 22.8% for black, 6.6% for Hispanic, and 6.1% for white women. After multivariate analysis, vaginal infection with T. vaginalis at mid-gestation was significantly associated with low birth weight (odds ratio 1.3; 95% confidence interval 1.1 to 1.5), preterm delivery (odds ratio 1.3; 95% confidence interval 1.1 to 1.4), and preterm delivery of a low birth weight infant (odds ratio 1.4; 95% confidence interval 1.1 to 1.6). The attributable risk of T. vaginalis infection associated with low birth weight weight in blacks was 11% compared with 1.6% in Hispanics and 1.5% in whites.After considering other recognized risk factors including co-infections, pregnant women infected with T. vaginalis at mid-gestation were statistically significantly more likely to have a low birth weight infant, to deliver preterm, and to have a preterm low birth weight infant. Compared with whites and Hispanics, T. vaginalis infection accounts for a disproportionately larger share of the low birth weight rate in blacks.

Prevention of Pelvic Inflammatory Disease by Screening for Cervical Chlamydial Infection

1996-05-23
Delia Scholes , Andy Stergachis , Fred E. Heidrich +3 more
Chlamydia trachomatis is a frequent cause of pelvic inflammatory disease. However, there is little information from clinical studies about whether screening women for cervical chlamydial infection can reduce the incidence … Chlamydia trachomatis is a frequent cause of pelvic inflammatory disease. However, there is little information from clinical studies about whether screening women for cervical chlamydial infection can reduce the incidence of this serious illness.
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Association between Bacterial Vaginosis and Preterm Delivery of a Low-Birth-Weight Infant

1995-12-28
Sharon L. Hillier , Rachel Nugent , David A. Eschenbach +7 more
Bacterial vaginosis is believed to be a risk factor for preterm delivery. We undertook a study of the association between bacterial vaginosis and the preterm delivery of infants with low … Bacterial vaginosis is believed to be a risk factor for preterm delivery. We undertook a study of the association between bacterial vaginosis and the preterm delivery of infants with low birth weight after accounting for other known risk factors.
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A New<i>Chlamydia psittaci</i>Strain, TWAR, Isolated in Acute Respiratory Tract Infections

1986-07-17
J. Thomas Grayston , Cho‐Chou Kuo , San-Pin Wang +1 more
During a 2 1/2-year period, we studied 386 University of Washington students with acute respiratory disease, to determine whether a Chlamydia psittaci strain, here designated TWAR, is an important respiratory … During a 2 1/2-year period, we studied 386 University of Washington students with acute respiratory disease, to determine whether a Chlamydia psittaci strain, here designated TWAR, is an important respiratory pathogen. Serologic evidence of recent TWAR infection was found in 13 students, and the organism was isolated from 8 of these. TWAR infection occurred in 12 percent of the students who had pneumonia (9 of 76), 5 percent of those with bronchitis (3 of 63), and 1 percent of those with pharyngitis (1 of 150). The TWAR infections occurred throughout the study period. Pharyngitis, often accompanied by laryngitis, was a common first symptom. Clinically, the infections resembled those with Myco-plasma pneumoniae; therefore, the patients were given courses of erythromycin used for the treatment of M. pneumoniae infections. This therapy proved to be inadequate. The limited data available suggest that the TWAR strain is a "human" C. psittaci that is spread from human to human, without a bird or animal host.

Haemophilus vaginalis vaginitis

1955-05-01
Herman L. Gardner , Charles D. Dukes

Sexually Transmitted Diseases Treatment Guidelines 2002

2002-01-01
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The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases

2017-10-06
Chen Chen , Xiaolei Song , Weixia Wei +7 more
Reports on bacteria detected in maternal fluids during pregnancy are typically associated with adverse consequences, and whether the female reproductive tract harbours distinct microbial communities beyond the vagina has been … Reports on bacteria detected in maternal fluids during pregnancy are typically associated with adverse consequences, and whether the female reproductive tract harbours distinct microbial communities beyond the vagina has been a matter of debate. Here we systematically sample the microbiota within the female reproductive tract in 110 women of reproductive age, and examine the nature of colonisation by 16S rRNA gene amplicon sequencing and cultivation. We find distinct microbial communities in cervical canal, uterus, fallopian tubes and peritoneal fluid, differing from that of the vagina. The results reflect a microbiota continuum along the female reproductive tract, indicative of a non-sterile environment. We also identify microbial taxa and potential functions that correlate with the menstrual cycle or are over-represented in subjects with adenomyosis or infertility due to endometriosis. The study provides insight into the nature of the vagino-uterine microbiome, and suggests that surveying the vaginal or cervical microbiota might be useful for detection of common diseases in the upper reproductive tract.Whether the female reproductive tract harbours distinct microbiomes beyond the vagina has been a matter of debate. Here, the authors show a subject-specific continuity in microbial communities at six sites along the female reproductive tract, indicative of a non-sterile environment.
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Sexually Transmitted Diseases Treatment Guidelines, 2010

2011-06-25
Kimberly Workowski , Gail Bolan

1993 Sexually Transmitted Diseases Treatment Guidelines

1994-04-01
Kimberly Workowski , Stuart M. Berman
These guidelines for the treatment of persons who have sexually transmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs … These guidelines for the treatment of persons who have sexually transmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta, Georgia, during April 19-21, 2005. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2002 (MMWR 2002;51[No. RR-6]). Included in these updated guidelines are an expanded diagnostic evaluation for cervicitis and trichomoniasis; new antimicrobial recommendations for trichomoniasis; additional data on the clinical efficacy of azithromycin for chlamydial infections in pregnancy; discussion of the role of Mycoplasma genitalium and trichomoniasis in urethritis/cervicitis and treatment-related implications; emergence of lymphogranuloma venereum protocolitis among men who have sex with men (MSM); expanded discussion of the criteria for spinal fluid examination to evaluate for neurosyphilis; the emergence of azithromycin- resistant Treponema pallidum; increasing prevalence of quinolone-resistant Neisseria gonorrhoeae in MSM; revised discussion concerning the sexual transmission of hepatitis C; postexposure prophylaxis after sexual assault; and an expanded discussion of STD prevention approaches.

Sexually Transmitted Diseases 7982 Treatment Guidelines

1982-12-01
Kimberly Workowski , Stuart M. Berman

Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016

2019-06-06
Jane Rowley , Stephen Vander Hoorn , Eline L. Korenromp +7 more
To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016.For chlamydia, gonorrhoea and … To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016.For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI.For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases.Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.Produire des estimations de la prévalence et de l'incidence mondiales des infections urogénitales dues à la chlamydiose, à la gonorrhée, à la trichomonase et à la syphilis chez les femmes et les hommes de 15 à 49 ans, en 2016.Pour la chlamydiose, la gonorrhée et la trichomonase, nous avons systématiquement recherché les études menées entre 2009 et 2016 qui s’intéressaient à la prévalence. Nous avons également consulté des experts régionaux. Pour produire des estimations, nous avons eu recours à une méta-analyse bayésienne. Pour la syphilis, nous avons regroupé les estimations nationales obtenues à l'aide de Spectrum-STI.Pour la chlamydiose, la gonorrhée et/ou la trichomonase, 130 études étaient éligibles. Pour la syphilis, la base de données de Spectrum-STI contenait 978 points de données pour la période considérée. Les estimations de la prévalence mondiale en 2016 chez les femmes étaient les suivantes: chlamydiose 3,8% (intervalle d'incertitude de 95%, II: 3,3–4,5); gonorrhée 0,9% (II 95%: 0,7–1,1); trichomonase 5,3% (II 95%: 4,0–7,2); et syphilis 0,5% (II 95%: 0,4–0,6). Chez les hommes, les estimations de la prévalence étaient les suivantes: chlamydiose 2,7% (II 95%: 1,9-3,7); gonorrhée 0,7% (II 95%: 0,5-1,1); trichomonase 0,6% (II 95%: 0,4-0,9); et syphilis 0,5% (II 95%: 0,4–0,6). L'incidence totale estimée était de 376,4 millions de cas: 127,2 millions (II 95%: 95,1–165,9 millions) de cas de chlamydiose; 86,9 millions (II 95%: 58,6-123,4 millions) de cas de gonorrhée; 156,0 millions (II 95%: 103,4-231,2 millions) de cas de trichomonase; et 6,3 millions (II 95%: 5,5–7,1 millions) de cas de syphilis.Les estimations mondiales de la prévalence et de l'incidence de ces quatre infections sexuellement transmissibles guérissables restent élevées. Cette étude souligne la nécessité d'amplifier les efforts de collecte de données au niveau des pays et offre un point de référence pour suivre la progression de la Stratégie mondiale du secteur de la santé contre les IST 2016–2021 de l'Organisation mondiale de la Santé.Generar estimaciones de la prevalencia y la incidencia mundiales de la infección urogenital por clamidia, gonorrea, tricomoniasis y sífilis en mujeres y hombres de 15 a 49 años de edad en 2016.Para la clamidia, la gonorrea y la tricomoniasis, se realizaron búsquedas sistemáticas de estudios realizados entre 2009 y 2016 que registrasen la prevalencia. También se consultó a expertos regionales. Para generar estimaciones, se utilizó el metanálisis bayesiano. Para la sífilis, se añadieron las estimaciones nacionales generadas por el uso de Spectrum-STI.Para la clamidia, la gonorrea y/o la tricomoniasis, hubo 130 estudios que cumplían los criterios. Para la sífilis, la base de datos Spectrum-STI contenía 978 puntos de datos para el mismo periodo. Las estimaciones de prevalencia mundial en mujeres en 2016 fueron: clamidia 3,8 % (intervalo de incertidumbre, II, del 95 %: 3,3-4,5); gonorrea 0,9 % (II del 95 %: 0,7-1,1); tricomoniasis 5,3 % (II del 95 %: 4,0-7,2); y sífilis 0,5 % (II del 95 %: 0,4-0,6). Las estimaciones de prevalencia en hombres fueron: clamidia 2,7 % (intervalo de incertidumbre, II, del 95 %: 1,9-3,7); gonorrea 0,7 % (II del 95 %: 0,5-1,1); tricomoniasis 0,6 % (II del 95 %: 0,4-0,9); y sífilis 0,5 % (II del 95 %: 0,4-0,6). El total estimado de casos incidentes fue de 376,4 millones: 127,2 millones (II del 95 %: 95,1-165,9 millones) de casos de clamidia; 86,9 millones (II del 95 %: 58,6-123,4 millones) de casos de gonorrea; 156,0 millones (II del 95 %: 103,4-231,2 millones) de casos de tricomoniasis; y 6,3 millones (II del 95 %: 5,5-7,1 millones) de casos de sífilis.Las estimaciones mundiales de la prevalencia y la incidencia de estas cuatro enfermedades de transmisión sexual curables siguen siendo elevadas. El estudio destaca la necesidad de ampliar los esfuerzos de recopilación de datos a nivel nacional y proporciona una base inicial para el seguimiento de los progresos de la Estrategia Mundial del Sector de la Salud de la Organización Mundial de la Salud sobre las ETS entre 2016 y 2021.وضع تقديرات للانتشار والإصابة العالمية لعدوى الجهاز البولي التناسلي، وأمراض الكلاميديا، والسيلان، وداء المشعرات، والزهري لدى النساء والرجال، الذين تتراوح أعمارهم بين 15 و49 سنة، في عام 2016.بالنسبة للكلاميديا، والسيلان، وداء المشعرات، فقد قمنا بالبحث بشكل منهجي عن الدراسات التي تمت خلال الفترة من 2009 إلى 2016 والتي توضح مدى الانتشار. كما قمنا باستشارة خبراء إقليميين. ولوضع التقديرات، قمنا باستخدام التحليل التلوي Bayesian. بالنسبة لمرض الزهري، قمنا بتجميع التقديرات الوطنية الناتجة عن استخدام Spectrum-STI.بالنسبة لأمراض الكلاميديا، والسيلان، وداء المشعرات، كانت هناك 130 دراسة مؤهلة. وبالنسبة لمرض الزهري، احتوت قادة بيانات Spectrum-STI على 978 نقطة بيانات لنفس الفترة. كانت تقديرات الانتشار العالمي في عام 2016 في النساء: الكلاميديا 3.8% (فاصل عدم الثقة 95%: 3.3 إلى 4.5)، والسيلان 0.9% (فاصل عدم الثقة 95%: 0.7 إلى 1.1)، وداء المشعرات 5.3% (فاصل عدم الثقة 95%: 4.0 إلى 7.2)؛ والزهري 0.5% (فاصل عدم الثقة 95%: 0.4 إلى 0.6). كانت تقديرات الانتشار في عام 2016 في الرجال: الكلاميديا 2.7% (فاصل عدم الثقة 95%: 1.9 إلى 3.7)، والسيلان 0.7% (فاصل عدم الثقة 95%: 0.5 إلى 1.1)، وداء المشعرات 0.6% (فاصل عدم الثقة 95%: 0.4 إلى 0.9)، والزهري 0.5% (فاصل عدم الثقة 95%: 0.4–0.6). بلغ مجموع حالات الإصابة التقديري 376.4 مليون حالة: 127.2 مليون (فاصل عدم الثقة 95%: 95.1 إلى 165.9 مليون) حالات الكلاميديا؛ 86.9 مليون (فاصل عدم الثقة 95%: 58.6 إلى 123.4 مليون) حالات السيلان؛ 156.0 مليون (فاصل عدم الثقة 95%: 103.4 إلى 231.2 مليون) حالات داء المشعرات؛ 6.3 مليون (فاصل عدم الثقة 95%: 5.5 إلى 7.1 مليون) حالات الزهري.لا تزال التقديرات العالمية عالية لانتشار والإصابة بهذه الأمراض الأربعة المنقولة جنسياً والعلاج منها. تسلط الدراسة الضوء على الحاجة إلى توسيع جهود جمع البيانات على مستوى الدول، وتوفر خط أساس أولي لمراقبة التقدم المحرز في إستراتيجية قطاع الصحة العالمية التابع لمنظمة الصحة العالمية بشأن الأمراض المنقولة جنسياً خلال الفترة من 2016 إلى 2021.旨在估计 2016 年 15-49 岁男女泌尿生殖系统感染衣原体病、淋病、滴虫病和梅毒的全球患病率和发病率。.对于衣原体病、淋病和滴虫病,我们系统搜索了 2009 年至 2016 年间的患病率报告研究。我们还咨询了区域专家。为了生成估计值,我们使用了贝叶斯荟萃分析。对于梅毒,我们汇总分析了使用 Spectrum-STI 生成的全国估计值。.对于衣原体病、淋病和/或滴虫病,符合要求的有 130 项研究。对于梅毒, Spectrum-STI 数据库包含了同一时期的 978 个数据点。2016 年,全球女性患病率估计值为:衣原体病 3.8%(95% 不确定区间,UI:3.3-4.5);淋病 0.9%(95% UI:0.7–1.1);滴虫病 5.3%(95% UI:4.0–7.2)和梅毒 0.5%(95% UI:0.4-0.6)。全球男性患病率估计值为:衣原体病 2.7%(95% UI:1.9-3.7);淋病 0.7%(95% UI:0.5-1.1);滴虫病 0.6%(95% UI:0.4-0.9);梅毒 0.5%(95% UI:0.4-0.6)。预计病例总数为 3.764 亿:1.272 亿(95% UI:9510-16590 万)衣原体病病例;8690 万(95% UI:5860-12340 万)淋病病例;15600 万(95% UI:10340-23120 万)滴虫病病例;630 万(95% UI:550-710 万)梅毒病例。.对这四种可治愈的性传播疾病的患病率和发病率的全球估计值仍然很高。该研究强调了扩大国家级数据收集工作的必要性,并为监测 2016 至 2021 年世卫组织全球卫生部门性传播疾病战略的进展提供了初始基线。.Оценить распространенность в мировом масштабе и частоту урогенитальных инфекций, вызываемых хламидией, а также гонореи, трихомониаза и сифилиса у мужчин и женщин в возрасте от 15 до 49 лет по состоянию на 2016 год.Для хламидиоза, гонореи и трихомониаза авторы провели систематический поиск исследований, выполненных в период с 2009 по 2016 год, в которых приводились данные по распространенности заболеваний. Авторы также консультировались с международными специалистами. Для оценки использовался байесовский метаанализ. Для исследования сифилиса нами были объединены национальные оценки, созданные с использованием методики Spectrum-STI.Было обнаружено 130 исследований на тему хламидийной инфекции, гонореи и (или) трихомониаза. Что касается сифилиса, база данных Spectrum-STI за тот же период содержала 978 источников данных. По состоянию на 2016 год распространенность изучаемых заболеваний в мире среди женщин составляла: хламидиоз 3,8% (95%-й интервал неопределенности, ИН: 3,3–4,5), гонорея 0,9% (95%-й ИН: 0,7–1,1), трихомониаз 5,3% (95%-й ИН: 4,0–7,2) и сифилис 0,5% (95%-й ИН: 0,4–0,6). У мужчин распространенность хламидиоза составила 2,7% (95%-й ИН: 1,9–3,7), гонореи 0,7% (95%-й ИН: 0,5–1,1), трихомониаза 0,6% (95%-й ИН: 0,4–0,9) и сифилиса 0,5% (95%-й ИН: 0,4–0,6). Общее приблизительное количество случаев заболевания составило 376,4 млн человек: 127,2 млн (95 %-й ИН: 95,1–165,9 млн) случаев хламидийной инфекции, 86,9 млн (95%-й ИН: 58,6–123,4 млн) случаев гонореи, 156,0 млн (95%-й ИН: 103,4–231,2 млн) случаев трихомониаза и 6,3 млн (95%-й ИН: 5,5–7,1 млн) случаев сифилиса.Оценки мировой распространенности и частоты этих четырех излечимых инфекций, передаваемых половым путем (ИППП), остаются высокими. Исследование показывает необходимость предпринимать дальнейшие усилия по сбору данных на уровне каждой страны и может служить источником базовых значений для мониторинга прогресса в исполнении глобальных стратегий ВОЗ в секторе здравоохранения относительно ИППП на период 2016–2021 гг.
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Sexually Transmitted Infections Treatment Guidelines, 2021

2021-07-22
Kimberly Workowski , Laura H. Bachmann , Philip A. Chan +6 more
These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field … These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs.
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Vulvovaginal candidosis

2007-06-01
Jack D. Sobel

Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates, 2000

2004-01-01
Hillard Weinstock , Stuart M. Berman , Willard Cates
CONTEXT In the United States, young people aged 15–24 represent 25% of the sexually experienced population. However, the incidence and prevalence of sexually transmitted diseases (STDs) among this age‐group are … CONTEXT In the United States, young people aged 15–24 represent 25% of the sexually experienced population. However, the incidence and prevalence of sexually transmitted diseases (STDs) among this age‐group are unknown. METHODS Data from a variety of sources were used to estimate the incidence and prevalence of STDs among 15–24‐year‐olds in the United States in 2000. The quality and reliability of the estimates were categorized as good, fair or poor, depending on the quality of the data source. RESULTS Approximately 18.9 million new cases of STD occurred in 2000, of which 9.1 million (48%) were among persons aged 15–24. Three STDs (human papillomavirus, trichomoniasis and chlamydia) accounted for 88% of all new cases of STD among 15–24‐year‐olds. CONCLUSIONS These estimates emphasize the toll that STDs have on American youth. More representative data are needed to help monitor efforts at lowering the burden of these infections.
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Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates, 2000

2004-01-01
Hillard Weinstock , Stuart M. Berman , Willard Cates

Validation of Rapid Point-of-Care Diagnostic Tests for Sexually Transmitted Infection Self-Testing Among Adolescent Girls and Young Women

2025-06-25
Krishnaveni Reddy , Jiaying Hao , Nompumelelo Sigcu +7 more | Diagnostics
Background/Objectives: High rates of sexually transmitted infections (STIs) increase HIV transmission risk among adolescent girls and young women (AGYW) in South Africa. AGYW prefer discreet self-testing options for HIV and … Background/Objectives: High rates of sexually transmitted infections (STIs) increase HIV transmission risk among adolescent girls and young women (AGYW) in South Africa. AGYW prefer discreet self-testing options for HIV and pregnancy; however, other STI self-testing options are currently unavailable in this region. Methods: Seven Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Trichomonas vaginalis (TV) assays were validated for AGYW self-test use (using self-collected vaginal samples) in a cross-sectional study (PROVE). Paired GeneXpert® NG/CT (Cepheid®, Sunnyvale, CA, USA) and OSOM® Trichomonas test (Sekisui Diagnostics, Burlington, MA, USA) results from nurse-collected samples served as reference results to calculate sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV). One test, the polymerase chain reaction (PCR)-based Visby Medical™ Sexual Health Test device (Visby Medical™, San Jose, CA, USA), was validated for accuracy of positive test results using self-collected samples and home-based testing in a longitudinal follow-up study enrolling AGYW aged 16–18 years. Paired GeneXpert® NG/CT and TV results from nurse-collected vaginal samples served as reference tests. Results: In PROVE, 146 AGYW contributed 558 paired samples. The Visby Medical™ Sexual Health Test exhibited moderate to high sensitivity (66.7–100%), specificity (80–100%), NPV (66.7–100%), and PPV (66.7–100%) for NG, CT, and TV. The remaining tests’ performances were markedly lower. In the longitudinal study, 28 AGYW contributed 84 paired samples, and the Visby Medical™ Sexual Health Test demonstrated 100% accuracy of positive results for CT, NG, and TV. Conclusions: The Visby Medical™ Sexual Health Test demonstrated high reliability as a potential option for AGYW to discreetly self-test for multiple STIs concurrently. Testing of its acceptability, utility, and feasibility in a larger sample of AGYW is in progress.

In adults with uncomplicated vulvovaginal candidiasis, is oral antifungal therapy more effective than intravaginal antifungal?

2025-06-25
Whitney Keiffer-Sharp , L. Gray Davis | Evidence-Based Practice

<i>Trichomonas vaginalis</i> extracellular vesicles suppress IFNε-mediated responses driven by its intracellular bacterial symbiont <i>Mycoplasma hominis</i>

2025-06-25
Joshua A. Kochanowsky , Emma L. Betts , Gabriel Encinas +2 more | Proceedings of the National Academy of Sciences
Trichomonas vaginalis is a common, extracellular, sexually transmitted parasite which is often found in symbiosis with the intracellular bacterium Mycoplasma hominis (Mh), an opportunistic pathogen of the female reproductive tract. … Trichomonas vaginalis is a common, extracellular, sexually transmitted parasite which is often found in symbiosis with the intracellular bacterium Mycoplasma hominis (Mh), an opportunistic pathogen of the female reproductive tract. How this symbiosis affects infection outcomes and the host cell innate immune response is poorly understood. Here, we show that infection with T. vaginalis in symbiosis with M. hominis or M. hominis alone triggers a noncanonical type I interferon, interferon-epsilon (IFNε), but infection with T. vaginalis alone does not. We also demonstrate that extracellular vesicles (TvEVs) produced by the parasite downregulate host cell IFNε, counteracting this symbiont-driven response and elevating infection. We further demonstrate that IFNε, a hormonally regulated cytokine produced in the human reproductive system, is protective against T. vaginalis cytoadherence and cytolysis of host cells. These studies provide insight into how a parasite and its bacterial symbiont work in concert to regulate host cell innate immune responses to drive infection.

Extensively Drug-Resistant <i>Neisseria gonorrhoeae</i> Strain, Canada

2025-06-24
Brigitte Lefebvre , Irene Martín , Robyn Thorington +4 more | Emerging infectious diseases
We identified a case of extensively drug-resistant (ceftriaxone- and cefixime-resistant and high-level azithromycin-resistant) Neisseria gonorrhoeae in Canada. The strain harbors the penA 60.001 allele, which includes the A311V and 23S … We identified a case of extensively drug-resistant (ceftriaxone- and cefixime-resistant and high-level azithromycin-resistant) Neisseria gonorrhoeae in Canada. The strain harbors the penA 60.001 allele, which includes the A311V and 23S rRNA A2059G single-nucleotide polymorphisms associated with high-level azithromycin resistance. The infection was likely acquired during travel in Cambodia.

High Prevalence of Vaginal Candidiasis and Absence of Trichomonas vaginalis Among Female Patients in Da Nang, Vietnam

2025-06-24
Vinh Xuan Le , Kieu Thi-Thuy Nguyen , Minh Van Nguyen +5 more | Deleted Journal
Vaginitis is a major health concern among women, with inadequate treatment potentially leading to reproductive complications. This study aimed to assess vaginitis prevalence, identify predominant pathogens, and evaluate associated risk … Vaginitis is a major health concern among women, with inadequate treatment potentially leading to reproductive complications. This study aimed to assess vaginitis prevalence, identify predominant pathogens, and evaluate associated risk factors among female patients at Da Nang Dermato-Venereology Hospital. A prospective study of 796 female patients undergoing physical examinations was conducted, with demographic, clinical, and microbiological data collected. Vaginitis was diagnosed in 180 (22.6%) of 796 female patients, predominantly caused by Candida spp. (66.1%) and bacterial pathogens (31.7%), with no Trichomonas vaginalis detected, and was most prevalent in women aged 20–30 years. Poor hygiene practices, including infrequent sanitary pad changes (OR = 5.01, p &lt; 0.001) and routine vaginal douching (OR = 6.77, p &lt; 0.001), were significantly associated with vaginitis. The Amsel criteria showed high specificity (99.1%) for bacterial vaginosis diagnosis. The absence of T. vaginalis suggests a potential shift in the epidemiology of vaginal infections. The Amsel criteria are a practical diagnostic tool in resource-limited settings. Our findings highlight the need for targeted hygiene education to reduce vaginitis prevalence in Vietnam.

Association of Dysbiotic Vaginal Flora with Oncogenic Human Papillomavirus Infection, Bacterial Vaginosis and Pap Smear Abnormalities: Indian Context

2025-06-23
Kavita Anand , Sharmila Pimple , Gauravi Mishra +1 more | Indian Journal of Gynecologic Oncology
Abstract Purpose Bacterial vaginosis (BV) is reported to be the most common cause of dysbiotic vaginal flora with frequent relapses among women. It increases the susceptibility to other genital infections … Abstract Purpose Bacterial vaginosis (BV) is reported to be the most common cause of dysbiotic vaginal flora with frequent relapses among women. It increases the susceptibility to other genital infections resulting in cervicitis. Cervicitis can potentially modulate the progression of the oncogenic Human Papilloma virus infection. The current study addresses the gaps in literature regarding the prevalence and association of HPV, co-burden of HPV with BV infection among women with cervicitis in Indian context. Methods Totally, 508 eligible women, 254 with cervicitis (case arm) and 254 asymptomatic women with healthy cervix (control arm), attending a tertiary cancer hospital for cervical cancer screening were enrolled in the study. All enrolled women, irrespective of the study arm underwent Gram-stained smears for diagnosing Bacterial Vaginosis (BV), Hybrid Capture-2 test to diagnose oncogenic Human Papilloma Virus infection (HPV) and Pap smears to demonstrate epithelial cell abnormalities (ECA). Results The odds ratio of having BV infection (OR 18, 95% CI 9.62–36.99), ECA (OR 4.1, 95% CI 2.21–8.29) and HPV infection (OR 2.8, 95% CI 2.71–3.14) among women in case arm were significantly higher as compared to the control arm. Women in the case arm were also at significantly increased risk of co-infections of HPV with BV (OR 1.6, 95% CI 1.42–1.52). Conclusion Strong association of BV and HPV infection with increased ECA demonstrated in our study warrants prompt and effective treatment of BV. Genital infections are known modulators of persistent HPV infection. More longitudinal studies may lend better understanding of vaginal microbiome and its interplay between BV and HPV infections.

Modeling Chlamydia transmission with caputo fractional derivatives: exploring memory effects and control strategies

2025-06-23
Nkuba Nyerere , Stephen Edward | Modeling Earth Systems and Environment

Sexually Transmitted Infections in Prostate Cancer: A Prospective Multicenter Analysis

2025-06-21
Teresa Pina‐Vaz , Alberto Costa Silva , Gabriel Brito Costa +7 more | Urologia Internationalis
Objective: Chronic inflammation and infections have been implicated in prostate cancer (PCa) pathogenesis. The association between sexually transmitted infections (STIs) and PCa remains inconclusive. The objective was to evaluate the … Objective: Chronic inflammation and infections have been implicated in prostate cancer (PCa) pathogenesis. The association between sexually transmitted infections (STIs) and PCa remains inconclusive. The objective was to evaluate the presence of STI-related pathogens in patients with PCa compared to a control group. Methods: A prospective multicenter study involving 239 male patients with a clinical suspicion of PCa was conducted. Among the participants, 176 had histologically confirmed PCa, while 63 served as controls with benign histology. Urine, glans swabs, and prostate biopsy specimens were collected from each participant and analyzed using polymerase chain reaction (PCR) to detect a broad panel of STI-causing pathogens, including Candida spp., Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus types 1 and 2, and human papillomavirus. Results: A total of 717 samples were processed. The detection frequency of STI-related pathogens was relatively low across all sample types. Mycoplasma genitalium was the most frequently detected pathogen, particularly in prostate biopsy samples. No statistically significant association was found between the presence of these pathogens and the incidence of PCa. Neisseria gonorrhoeae and Candida spp. were not detected in any of the samples. Conclusion: This study did not find a statistically significant association between the presence of STIs and PCa. The low prevalence of STI pathogens despite the use of highly sensitive PCR methods suggests that these infections may play a limited role in prostate carcinogenesis. Future research should consider focusing on the role of the urinary and prostatic microbiome in chronic prostatic inflammation.

Dynamic changes of vaginal microbiota in healthy Chinese women from pre‐pregnancy to the postpartum period

2025-06-21
Dan Li , Chuqi Yang , Huawei Yang +2 more | International Journal of Gynecology & Obstetrics

Modeling gonorrhea vaccination to find optimal targeting strategies that balance impact with cost-effectiveness

2025-06-21
Trystan Leng , Lilith K. Whittles , Dariya Nikitin +1 more | npj Vaccines
Abstract Vaccination for UK men who have sex with men (MSM) at increased gonorrhea risk has been advised, but not yet implemented. Effective targeting is essential for cost-effectiveness, but previously-examined … Abstract Vaccination for UK men who have sex with men (MSM) at increased gonorrhea risk has been advised, but not yet implemented. Effective targeting is essential for cost-effectiveness, but previously-examined approaches have disadvantages: Vaccination-on-Diagnosis has low coverage (limiting impact), and Vaccination-according-to-Risk requires asking about sexual behavior to identify at-risk individuals, which is not always feasible. We developed a transmission-dynamic model to evaluate novel strategies offering vaccination based on information readily available to clinicians (diagnostic/vaccination history, if the patient is seeking care due to partner notification). Offering vaccination to MSM who are notified partners of gonorrhea cases or were diagnosed themselves in the past 2 years averts 1.6x more cases and is more cost-effective than Vaccination-on-Diagnosis. If vaccination provides 20% protection for 1.5 years after primary vaccination and 3 years after revaccination then at £18/dose administered, all considered strategies have ≥50 and ≥90% probabilities of positive net monetary benefit compared with no vaccination with a quality-adjusted life year valued at £20,000 and £30,000 respectively, thus meeting the UK criteria for cost-effectiveness. All novel strategies considered achieve greater impact than Vaccination-on-Diagnosis without the feasibility issues of Vaccination-according-to-Risk.

Rapid Identification of &lt;em&gt;Neisseria gonorrhoeae&lt;/em&gt;, &lt;em&gt;Chlamydia trachomatis&lt;/em&gt;, and &lt;em&gt;Ureaplasma urealyticum&lt;/em&gt; by RNA Amplification Lateral Flow Assay

2025-06-20
Rui Deng , Zhixiang Tan , D.C. Wang +4 more | Journal of Visualized Experiments

Where we stand on doxyPEP depends on where we sit: a viewpoint

2025-06-20
Thibaut Vanbaelen , Fabian Kong , Izumo Kanesaka +2 more | Frontiers in Microbiology
There is a striking variation in national doxycycline post exposure prophylaxis (doxyPEP) guidelines for sexually transmitted infections (STIs). Whilst some countries advocate doxyPEP for all men who have sex with … There is a striking variation in national doxycycline post exposure prophylaxis (doxyPEP) guidelines for sexually transmitted infections (STIs). Whilst some countries advocate doxyPEP for all men who have sex with men (MSM) and transgender women (TGW) with certain risks, others restrict the use to research settings. In this viewpoint, we argue that part of the explanation for this divergence can be attributed to different underlying conceptual frameworks. For individuals and organizations dominated by biomedical individualist frameworks, the primary goal of STI services is reducing the incidence of STIs. We have good evidence that doxyPEP does this and therefore, particularly in the setting of increasing STI incidence, this framework regards it as logical to roll out doxyPEP as fast as possible. By way of contrast, if organizations and their members operate within an ecosocial framework then their primary goal is the optimization of the sexual and overall health of individuals and populations and not just reducing STI rates. This framework sees the prevalence of STIs as being driven by the connectivity of local sexual networks. Recent increases in STI prevalence are seen as being due to increased network connectivity. The intensive use of antimicrobials such as doxycycline to reduce this prevalence is seen as introducing a selection pressure for the emergence of resistance to tetracyclines and other antimicrobials in N. gonorrhoeae and other species. This plus the other risks of doxyPEP, leads those animated by this framework to tend toward the precautionary principle and restrict the use of doxyPEP to research settings. The differences in these two frameworks thus leads different individuals and organizations with access to the same evidence-base to very different conclusions as to the net risk-benefit of doxyPEP.

Functional and Compositional Analysis of the Fecal and Vaginal Microbiota in Vestibulodynia: An Explorative Case–Control Study

2025-06-20
Elisa Viciani , Barbara Santacroce , Antonella Padella +7 more | Women
Vestibulodynia is vulvodynia localized to the vulvar vestibule and is a chronic disease defined as vulvar pain of at least three months’ duration, without a defined cause, that severely affects … Vestibulodynia is vulvodynia localized to the vulvar vestibule and is a chronic disease defined as vulvar pain of at least three months’ duration, without a defined cause, that severely affects women’s health and quality of life with limited treatment options. We collected stool and vaginal samples from 30 women affected by vestibulodynia and 27 healthy women. Bacterial gut and vaginal microbiomes were characterized by amplicon sequencing, and compositional and functional differences between the control and the patient groups were assessed. No differences in vaginal or fecal alpha and beta diversity were found, but vaginal microbiota of patients was found to be associated with Lactobacillus iners. Moreover, the relative abundance of L. iners negatively correlated with the relative abundance of L. crispatus, and positive correlations between commensals and pathobionts were found in the vestibulodynia vaginal microbiota but not in the healthy controls. The bacterial functions and contributors were defined in the study groups for the fecal and vaginal microbiota. Our results portrayed the vaginal microbiome of patients with vestibulodynia as potentially not as efficient at living in an anaerobic environment as the healthy microbiome is and too inclined to acidify this environment, exposing it to the risk of developing other ailments.

Sexually transmitted infection test positivity and associated factors in individuals tested at anonymous clinics in North Rhine-Westphalia state, Germany, 2021

2025-06-20
Siling Katja , Pia Grotegut , Emma M. Harding‐Esch +1 more | medRxiv (Cold Spring Harbor Laboratory)
Sexually transmitted infections (STIs) are increasing globally. To improve understanding of the epidemiology of STIs in key populations, we analysed sentinel surveillance data on STI test positivity among individuals tested … Sexually transmitted infections (STIs) are increasing globally. To improve understanding of the epidemiology of STIs in key populations, we analysed sentinel surveillance data on STI test positivity among individuals tested using subsidised tests at anonymous walk-in clinics in North Rhine-Westphalia (NRW), Germany. This was a cross-sectional analysis of sentinel surveillance data from all 53 local health authority anonymous walk-in clinics in NRW during 2021. Test positivity for HIV, syphilis, chlamydia, and gonorrhoea was analysed by key population group. We used univariable and multivariable logistic regression to examine factors associated with each infection. Among 11,560 consultations, overall STI test positivity was 6.6%. Chlamydia was the most frequently detected (6.4%), followed by gonorrhoea (2.7%), syphilis (0.9%), and HIV (0.6%). We observed disparities in STI test positivity among key population groups. Men-who-have-sex-with-men (MSM) (aOR 1.93; 95%CI 1.38-2.68), sex work (aOR 2.77; 95%CI 1.9-3.96), and having an STI-positive partner (aOR 1.71; 95%CI 1.30-2.22) were associated with increased STI risk. Coinfections were rare (0.4%) and predominantly occurred among MSM. Anonymous walk-in clinics reach diverse high-risk populations with substantial STI burdens. Findings support targeted prevention strategies for key populations and highlight the importance of comprehensive STI screening in anonymous settings for surveillance and case detection.

Seroepidemiological study of Chlamydia abortus in domestic and wild ruminants in Spanish Mediterranean ecosystems

2025-06-20
Débora Jiménez‐Martín , Ignacio García‐Bocanegra , Saúl Jiménez‐Ruiz +5 more | Preventive Veterinary Medicine

<i>Chlamydia trachomatis</i> infections among men who have sex with men and transgender women attending four community-based clinics in Thailand, 2019–2021

2025-06-19
Jutatip Sillabutra , Sarika Pattanasin , Wachiraporn Wanichnopparat +5 more | International Journal of STD & AIDS
Background Chlamydia trachomatis (CT) infections are prevalent and often asymptomatic. Point-of-Care (PoC) tests offer a diagnostic option. We described the incidence and predictors of CT infection using secondary data collected … Background Chlamydia trachomatis (CT) infections are prevalent and often asymptomatic. Point-of-Care (PoC) tests offer a diagnostic option. We described the incidence and predictors of CT infection using secondary data collected from men who have sex with men (MSM) and transgender women (TGW) attending Community-Based Organizations (CBOs) clinics in Thailand. Methods MSM and TGW aged ≥18 and had HIV risks were enrolled and followed for 12 months with visits every 3 months. Behavioral risks and Sexually Transmitted Infection testing were assessed at every visits. Specimens were collected via pharyngeal swab, urine sample, rectal swab, and neovaginal swab for TGW. These specimens were tested for CT using PoC test. The incidence was calculated using survival analysis, and the Cox regression model for multiple failures. Results From 2019–2021, 1886 participants were enrolled. Of these, 89.7% were MSM; 10.3% were TGW: 20.7% were lost to follow-up. Of the remaining participants, 18.2% had CT at baseline, with 36.4% experiencing repeat infections. The incidence rate of CT was 42.9 infections per 100 person-years. Predictors of CT infections included enrollment year, age 18–24 years, HIV status, pre-exposure prophylaxis and condom use. Conclusion Repeat CT infections were common. CBOs should incorporate POC STI testing into services, and the provision of STI prevention strategies.

The Clinically Significant Changes in the Composition and Functional Diversity of the Vaginal Microbiome in Women with Type 2 Diabetes Mellitus

2025-06-19
Min Jeong Kim , Jaeeun Yoo , Soon Jib Yoo +3 more | Microorganisms
Type 2 diabetes mellitus (T2DM) significantly influences the composition and diversity of the vaginal microbiome, with implications for mucosal immunity, infection risk, and genitourinary health. This study aimed to investigate … Type 2 diabetes mellitus (T2DM) significantly influences the composition and diversity of the vaginal microbiome, with implications for mucosal immunity, infection risk, and genitourinary health. This study aimed to investigate the vaginal microbiome profiles in women with T2DM, with a focus on differences according to menopausal status and associations with Candida colonization and the use of sodium–glucose cotransporter 2 (SGLT2) inhibitors. Compared to healthy controls, women with T2DM exhibited a decreased abundance of Lactobacillus species and increased microbial diversity. Community state of type (CST) IV, characterized by low Lactobacillus abundance and dominance of anaerobic taxa, was prevalent in the T2DM group. Among Candida-positive patients, Lactobacillus iners-dominant CST III was frequently observed, along with elevated levels of total and L-lactic acid. SGLT2 inhibitor users exhibited a different CST distribution pattern and slightly lower microbial richness and diversity, although these differences were not statistically significant. These findings underscore the impact of T2DM and its treatment on vaginal microbial composition and highlight the importance of considering vaginal health as part of comprehensive diabetes management in women.

Bacterial vaginosis

2025-06-19
Catriona S. Bradshaw , Erica L. Plummer , Christina A. Muzny +4 more | Nature Reviews Disease Primers

Bacterial vaginosis

2025-06-19
| Nature Reviews Disease Primers

Advances in the interrelated nature of vaginal microecology, HPV infection, and cervical lesions

2025-06-19
Mingyu Cui , Yishi Wu , Zhongyi Liu +2 more | Frontiers in Cellular and Infection Microbiology
Vaginal microecology serves as a crucial defense mechanism in women’s reproductive health. It encompasses vaginal anatomy, microbial flora, endocrine regulation, and immune responses. Lactobacillus species dominate this ecosystem, maintaining a … Vaginal microecology serves as a crucial defense mechanism in women’s reproductive health. It encompasses vaginal anatomy, microbial flora, endocrine regulation, and immune responses. Lactobacillus species dominate this ecosystem, maintaining a dynamic balance essential for vaginal health. Studies have highlighted a strong association between vaginal microecology, human papillomavirus (HPV) infection, and cervical lesions. A well-balanced vaginal microenvironment enhances mucosal barriers and immune function, aiding in HPV prevention and clearance. Conversely, disruptions in vaginal microecology compromise these defenses, increasing susceptibility to HPV infection. Persistent high-risk HPV (HR-HPV) infections are key contributors to cervical lesions and may further destabilize the vaginal microbiota(VMB). Additionally, cervical lesion progression is influenced by local immune responses, with HPV infection potentially accelerating disease development by suppressing cervical immunity. This review explores the intricate association between vaginal microecology, HPV infection, and cervical lesions, offering insights into early diagnosis, prevention, and treatment strategies.

Chlamydia and Perihepatitis (Fitz-Hugh-Curtis Syndrome) in an 18-Year-Old Male: A Case Report

2025-06-18
Anup H Kotadia , Kenneth Raney | Cureus
Perihepatitis, a complication of pelvic inflammatory disease, is most commonly observed in women. This condition results from inflammation of the liver capsule, leading to scarring and adhesions in the abdominal … Perihepatitis, a complication of pelvic inflammatory disease, is most commonly observed in women. This condition results from inflammation of the liver capsule, leading to scarring and adhesions in the abdominal cavity with associated complications. We present the case of an 18-year-old male with three months of abdominal pain. Upon admission, he was diagnosed with peritonitis, and imaging revealed extraluminal air in the liver vasculature. He was found to be positive for Chlamydia trachomatis, leading to a diagnosis of chlamydia and perihepatitis. Recognizing pelvic inflammatory disease-like intraabdominal infections in male patients is crucial, given it has the potential to cause lifelong intraabdominal complications.

Self-treatment options for gynecological issues

2025-06-18
Nina Netíková , Táňa Ryantová | Česká a slovenská farmacie

Assessment and Treatment of Vaginitis: Correction

2025-06-18
Caroline M. Mitchell | Obstetrics and Gynecology

The management of vulvovaginal candidiasis: the results of survey in Lviv, Ukraine

2025-06-18
Oksana Horodnycha , Tetiana Ryvak , Oksana Nepyivoda | Česká a slovenská farmacie

OnkoCampus

2025-06-17
| Kompass Onkologie

Changes in clinic-level STI burden after doxycycline post-exposure prophylaxis implementation in an urban sexual health clinic

2025-06-17
Jana Jarolimova , Ingrid V. Bassett , Laura Platt +3 more | Sexually Transmitted Diseases
Abstract In an urban sexual health clinic, a substantial portion of the clinic population initiated doxycycline post-exposure prophylaxis (doxyPEP) for bacterial STIs in the first 12 months, and implementation of … Abstract In an urban sexual health clinic, a substantial portion of the clinic population initiated doxycycline post-exposure prophylaxis (doxyPEP) for bacterial STIs in the first 12 months, and implementation of doxyPEP was associated with a subsequent decrease in clinic-level chlamydia and syphilis positivity, but no change in overall gonorrhea positivity.

MICROBIOTA VAGINAL E DISBIOSE RELACIONADA À DOENÇAS GINECOLÓGICAS

2025-06-17
BÁRBARA SCHWERZ GALBINSKI , EDUARDA AGOSTINETTO MACHADO , Elizabeth Teixeira +7 more | Editora Pasteur eBooks

Leitliniengerechte Infektionsdiagnostik und -therapie bei habituellen Aborten

2025-06-16
Nina Rogenhofer , Michael K. Bohlmann | Gynäkologische Endokrinologie

Sexually Transmitted Infections in Adolescents: Age-specific Issues

2025-06-16
Judit Jimenez-Betancort , Claudia Broto , María Espiau +1 more | The Pediatric Infectious Disease Journal

Testing Pooled Specimens With the Abbott Alinity m STI Assay: Four Years’ Experience

2025-06-16
M. Ángeles Argudín , Ahalieyah Anantharajah , Antoine Mairesse +5 more | Cureus

Screening for gonorrhoea and chlamydia: identifying key target populations and intensity—a modelling study of MSM in Belgium

2025-06-15
Achilleas Tsoumanis , Thibaut Vanbaelen , Christophe Van Dijck +2 more | Sexually Transmitted Infections
Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are two of the most common bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM). Screening for CT … Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are two of the most common bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM). Screening for CT and NG has been promoted as an intervention to reduce the prevalence of these STIs. We aimed to evaluate the effect of different screening intensities on the prevalence of CT, NG and the emergence of azithromycin-resistant NG (AR-NG) in an MSM population. Methods We developed a network-based model for CT and NG transmission among MSM in Belgium to estimate the prevalence of CT, NG and AR-NG in the population. The model simulates transmission of CT/NG among three anatomical sites in a population of 10 000 MSM, divided into high-activity and low-activity groups, over 10 years. The effect of different screening frequencies and coverage was evaluated in terms of CT, NG and AR-NG prevalence. Results Gonorrhoea prevalence ranged between 12% and 16% in scenarios screening 0–80% of the population. Screening among the low-activity MSM (LA-MSM) group had little effect on NG prevalence but increased the risk of AR-NG. Infrequent screening (less than every 180 days) with high coverage (over 40%) resulted in the highest risk for the spread of AR-NG in the population. Screening up to 40% of low-activity (HA-MSM) every 90 days and up to 20% of LA-MSM reduced NG prevalence to 14% without selecting for AMR. Screening coverage and frequency had little impact on CT prevalence in all scenarios. Conclusions Our model suggests that NG/CT screening has a modest effect in controlling the prevalence of these infections in the MSM population in Belgium. Screening efforts should move away from LA-MSM. Screening alone would not be sufficient to control the CT/NG epidemic, and future models should incorporate the impact of additional interventions such as vaccination and doxycycline post-exposure prophylaxis.

Sexually Transmitted Diseases: An Overview of Common Diseases, Diagnosis and Treatment

2025-06-15
Prafull S. Dhoke , Prashant G. Shelke , Pooja R. Hatwar +1 more | Journal of Drug Delivery and Therapeutics
Sexually transmitted diseases (STDs) are a significant global health concern, affecting millions of people worldwide. These diseases can lead to serious health complications, including infertility, cancer, and pregnancy problems. The … Sexually transmitted diseases (STDs) are a significant global health concern, affecting millions of people worldwide. These diseases can lead to serious health complications, including infertility, cancer, and pregnancy problems. The most common STDs include gonorrhea, syphilis, chlamydia, trichomoniasis, and HIV. This review highlights the current state of STDs, their symptoms, diagnosis, treatment options, and prevention strategies. This article explores the causes, transmission, and effects of each disease, as well as the importance of early diagnosis and treatment. The review also explores the challenges in treating STDs, including antibiotic resistance and the need for effective prevention strategies. Understanding STDs is crucial for developing effective prevention and treatment programs, and this review aims to provide a comprehensive overview of the current state of STDs. Keywords: gonorrhea, syphilis, trichomoniasis, chlymadia, HIV.

Pathogenesis and Clinical Management of Vulvovaginal Candidiasis in Mexican Diabetic Patients: A Literature Review

2025-06-14
Erick Alexánderson‐Rosas , José Emiliano González Flores , Ana D Zamudio Carías +7 more | Cureus

Factors associated with Nugent-bacterial vaginosis in pregnancy and postpartum among women in rural northwestern Bangladesh

2025-06-13
Lena Kan , Susan Tuddenham , Parul Christian +7 more | PLOS Global Public Health
Community-based longitudinal data on factors linked to bacterial vaginosis (BV) during and after pregnancy in Bangladesh are limited. Using data from a rural randomized trial of vitamin A and β-carotene … Community-based longitudinal data on factors linked to bacterial vaginosis (BV) during and after pregnancy in Bangladesh are limited. Using data from a rural randomized trial of vitamin A and β-carotene supplementation, we examined factors associated with Nugent-score–assessed BV. Self-collected vaginal swabs from 1,812 participants were obtained in early pregnancy, late pregnancy, and 3 months postpartum for Nugent scoring. We analyzed associations between participant factors and Nugent-BV (scores 7–10 vs. 0–6; 4–10 vs. 0–3) at each time point. Bivariate associations were tested using chi-square and t-tests, and multivariable log-binomial regression was used to estimate adjusted prevalence ratios with 95% confidence intervals. In early pregnancy, consistent soap use during bathing (vs. never/sometimes) was associated with a decreased risk of Nugent-BV 7–10 (adjusted prevalence ratio (aPR): 0.64, 95% CI: 0.43, 0.96). In late pregnancy, Hindu religion (vs. Muslim) (aPR: 2.68, 95% CI: 1.52, 4.72) and higher gestational age (aPR: 1.18, 95% CI: 1.04, 1.35) were associated with increased risk of Nugent-BV 7–10 and 4–10. Furthermore, maternal underweight (BMI &lt; 18.5 kg/m² vs. ≥ 18.5) (aPR: 0.62, 95% CI: 0.44, 0.87) and having ≥1 antenatal care visit (vs. none) (aPR: 0.59, 95% CI: 0.38, 0.91) were associated with reduced risk of Nugent-BV 4–10. Among multiparous individuals, a longer pregnancy interval of ≥18 months (vs. &lt; 18 months) was protective against Nugent-BV 7–10 (aPR: 0.34, 95% CI: 0.14, 0.81). At 3-months postpartum, vitamin A supplementation (vs. placebo) was associated with a decreased risk of Nugent-BV 7–10, consistent with prior trial findings. Our findings indicate that Nugent-BV during pregnancy and postpartum is linked to modifiable factors, including hygiene, nutrition, birth spacing, and healthcare access. Rigorous randomized trials are needed to evaluate their ability to reduce BV, promote long-term vaginal health, and lower the risk of adverse pregnancy outcomes.

Pharmacological effects and mechanisms of <i>Mahonia Fortunei</i> in treating aerobic vaginitis through regulation of vaginal microbiota

2025-06-13
Jie Mo , Huiyu Liu , Quan Chen +2 more | QJM
Abstract Background Aerobic vaginitis (AV) caused by abnormal aerobic bacterial infections, is characterized by inflammation, and dysbiosis of vaginal microbiota. The traditional herbal medicine, Mahonia Fortunei, has shown potential anti-inflammatory … Abstract Background Aerobic vaginitis (AV) caused by abnormal aerobic bacterial infections, is characterized by inflammation, and dysbiosis of vaginal microbiota. The traditional herbal medicine, Mahonia Fortunei, has shown potential anti-inflammatory and antimicrobial properties, which could be beneficial for treating AV. Methods In this study, both low-dose and high-dose Mahonia Fortunei treatments were administered to AV model rats induced by Staphylococcus aureus infection. Vaginal pH levels, bacterial infection, and neutrophil infiltration were measured. Network pharmacology analysis was conducted to identify bioactive ingredients, and 16S rDNA analysis was used to study the vaginal microbiota composition and explain the mechanisms of inflammatory action. Results The results indicated that Mahonia Fortunei significantly reduced vaginal pH, alleviated bacterial infections, and decreased neutrophil infiltration in AV rats. Bioactive compounds such as berberine, coptisine, and palmatine were selected for network pharmacological analysis. KEGG analysis showed that Mahonia Fortunei downregulated inflammatory pathways such as JAK-STAT and NF-κB, thereby reducing pro-inflammatory cytokines IL-1. Additionally, Mahonia Fortunei restored vaginal microbiota diversity, particularly increasing Gammaproteobacteria, a crucial biomarker for vaginal dysbiosis, and downregulating oxidative phosphorylation and stress-related pathways, reducing oxidative stress and inflammation. Conclusion Mahonia Fortunei exhibited significant therapeutic potential in treating AV by regulating vaginal microbiota, reducing inflammation, and restoring vaginal health.

Late gene regulation by the alternative sigma factors of <i>Chlamydia trachomatis</i>

2025-06-12
Syed Meraj Azhar Rizvi , Asha Densi , Owais R. Hakiem +2 more | mSystems
ABSTRACT The pathogenic bacterium Chlamydia reproduces via two specialized forms inside a eukaryotic host cell. The dividing form called the reticulate body (RB) must convert at late times into the … ABSTRACT The pathogenic bacterium Chlamydia reproduces via two specialized forms inside a eukaryotic host cell. The dividing form called the reticulate body (RB) must convert at late times into the infectious elementary body (EB) for spread to new host cells. Late genes are a temporal class of chlamydial genes believed to be responsible for RB-to-EB conversion, but late gene regulation is incompletely understood. In this study, we used chromatin immunoprecipitation (ChIP) to investigate two alternative sigma factors, σ 28 and σ 54 , that alter the promoter specificity of Chlamydia trachomatis RNA polymerase. σ 28 ChIP-seq identified hctB and tsp as the only promoters bound by σ 28 , and binding only occurred late, around the time of RB-to-EB conversion. Overexpression of σ 28 confirmed that these genes are transcribed in a σ 28 -dependent manner. σ 54 ChIP-seq showed that σ 54 only bound ctl0021 and ctl0052 and only at late times. This σ 54 regulon appears to be conserved as in silico analysis identified σ 54 promoter sequences upstream of ctl0021 and ctl0052 homologs in all Chlamydia spp. The genes encoding σ 28 and σ 54 were only transcribed at late times, but ChIP analysis with the late regulator Euo showed that Euo only controls σ 28 expression, and late transcription of σ 54 is regulated in an Euo-independent manner. Thus, multiple mechanisms regulate late genes, including Euo and different forms of RNA polymerase. The dedicated use of two alternative RNA polymerases to control a small subset of late genes suggests that these genes and the independent control of their temporal expression are important for RB-to-EB conversion. IMPORTANCE In this study, we performed chromatin immunoprecipitation-seq to identify genes transcribed by alternative forms of RNA polymerases in Chlamydia trachomatis . Under normal growth conditions, the sigma factors, σ 28 and σ 54 , bound only two genes each, and binding was only detected at late times. In addition, the late regulator Euo controls the expression of σ 28 but not σ 54 . Thus, Chlamydia utilizes multiple mechanisms to regulate late gene expression and uses alternative forms of RNA polymerases for specialized control of specific late genes that likely have important roles in reticulate body to elementary body conversion. This genome-wide binding approach can be applied to identify target genes of alternative sigma factors in other pathogenic bacteria.

Epidemiological changes in Chlamydia pneumoniae molecular detections before, during and after the COVID-19 pandemic in 27 European sites and Taiwan, 2018 to 2023

2025-06-12
Florian Tagini , Søren Anker Uldum , Carla Berengua +7 more | Eurosurveillance
Background During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as social distancing, lockdowns and enhanced hygiene led to a decrease in respiratory pathogens. However, as NPIs were relaxed, a resurgence … Background During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as social distancing, lockdowns and enhanced hygiene led to a decrease in respiratory pathogens. However, as NPIs were relaxed, a resurgence in several respiratory pathogens was observed including one local Chlamydia pneumoniae outbreak in Switzerland, prompting the need for a better understanding of C. pneumoniae epidemiology. Aim To assess temporal and geographical variations in C. pneumoniae detection before, during and after the COVID-19 pandemic. Methods Data on C. pneumoniae PCR detection ratios (number of positive tests/ total number of tests) across pre-pandemic (2018–2019), pandemic (2020–2022) and post-pandemic (2023) periods were collected via a global survey disseminated through various professional networks. Results C. pneumoniae detection ratios were analysed across 28 sites (27 in Europe, one in Taiwan) in 2023 (Dataset A, n = 172,223 tests) and 20 sites from 2018 to 2023 (Dataset B, n = 693,106 tests). Twenty-seven sites were laboratories (hospital or clinical) and one a surveillance system (Denmark). A significant decrease in detection ratios was observed during the pandemic period (from 1.05% to 0.23%, p &lt; 0.001). In 2023, detection ratios increased to 0.28% (p &lt; 0.002). Notable regional variations were found, with statistically significant increases in detection ratios at six sites located in Switzerland and Slovenia, where ratios ranged from 0.52% to 3.25%. Discussion The study highlights how NPIs influenced C. pneumoniae epidemiology, with reduced detection during the pandemic and partial resurgence afterwards. Regional variations suggest differing NPI impacts and underscore the need for continued surveillance.

Sex disparities in chlamydia and gonorrhea treatment in <scp>U.S.</scp> adult emergency departments: A systematic review and meta‐analysis

2025-06-12
Rachel E. Solnick , Rahi Patel , Ethan Chang +7 more | Academic Emergency Medicine
Empiric antibiotic treatment for gonorrhea (GC) and chlamydia (CT) is common in U.S. emergency departments (EDs) due to the delayed availability of test results. Local studies have identified sex-based disparities … Empiric antibiotic treatment for gonorrhea (GC) and chlamydia (CT) is common in U.S. emergency departments (EDs) due to the delayed availability of test results. Local studies have identified sex-based disparities in sexually transmitted infection (STI) care, with females potentially receiving less empiric treatment than males. This study evaluates how STI treatment aligns with laboratory-confirmed results to quantify potential overtreatment and undertreatment rates and investigates sex differences for these outcomes. We conducted a preregistered (PROSPERO #241429) systematic review and meta-analysis of studies published between January 2010 and January 2025 in U.S. EDs, excluding studies conducted exclusively in pediatric settings. Searches were performed in Medline, Cochrane, Embase, Scopus, Web of Science, CINAHL, and PsycINFO. Data from 19 studies encompassing 32,593 tested patients were analyzed using a random-effects model to calculate pooled estimates. Primary outcomes included GC/CT positivity, empiric treatment rates, and discordance between treatment and test results stratified by sex. Overall GC/CT positivity was 14% (95% confidence interval [CI] 12%-16%): 11% (95% CI 8%-14%) in females and 25% (95% CI 23%-26%) in males. Antibiotics were given to 46% (95% CI 38%-54%) of patients: 31% (95% CI 24%-37%) of females and 73% (95% CI 65%-80%) of males. Among patients with negative test results, 38% (95% CI 30%-47%) received antibiotics (i.e., potential overtreatment): 27% (95% CI 20%-34%) of females and 64% (95% CI 55%-73%) of males. Conversely, 39% (95% CI 31%-46%) of laboratory-positive patients did not receive antibiotics (i.e., potential undertreatment): 52% (95% CI 46%-57%) of females and 15% (95% CI 12%-17%) of males. Significant sex-based disparities exist in ED empiric antibiotic treatment for GC/CT. Females were 3.5 times more likely than males to be potentially undertreated. These findings underscore the need for targeted interventions to reduce disparities and improve treatment accuracy. Interpretation is limited by study heterogeneity and incomplete sex-specific data.

Gentamicin induction of the gonococcal hicAB toxin-antitoxin encoding system and 2 impact on gene expression influencing biofilm formation and in vivo fitness in a strain specific manner

2025-06-11
Concerta L. Holley , Vijaya Dhulipala , Adriana Le Van +4 more | bioRxiv (Cold Spring Harbor Laboratory)
Abstract The continued emergence of Neisseria gonorrhoeae (Ng) isolates resistant to first-line antibiotics has focused efforts on understanding how alternative therapies such as expanded use of gentamicin (Gen) might counteract … Abstract The continued emergence of Neisseria gonorrhoeae (Ng) isolates resistant to first-line antibiotics has focused efforts on understanding how alternative therapies such as expanded use of gentamicin (Gen) might counteract this global public health problem. Focusing on Gen as a viable alternative antibiotic for treatment of gonorrheal infections, we used RNA-Seq to determine if sub-lethal levels of Gen might impact gonococci on a transcriptional level. We found that sub-lethal Gen levels altered expression of 23 genes in Ng strain FA19. Many of the differentially regulated genes were associated with known stress responses elaborated by Ng under different harmful conditions. We found that the transcripts of the hicAB operon, which encodes a putative HicA-HicB toxin-antitoxin system that is encoded by tandem genes with the prophage Ngo φ3, were increased in response to Gen. While loss of hicAB did not impact gonococcal susceptibility to a variety of antimicrobial agents or harmful environmental conditions it did reduce biofilm formation in Ng strains F62, FA1090, WHO X and CDC200 but not that of strain FA19. Further, in strain F62, but not FA19, loss of hicAB reduced the in vivo fitness of Ng during experimental lower genital tract infection of female mice. Further, we found that expression of hicAB can influence levels of the norB transcript, which encodes the nitrate reductase shown previously to be upregulated in gonococcal biofilms. We propose that sub-lethal Gen has the capacity to influence gonococcal pathogenesis through the action of the HicAB toxin-antitoxin system. Importance During antibiotic treatment bacteria can be exposed to sub-lethal levels that could serve as a stress signal resulting in changes in gene expression. The continued emergence of multi-drug resistant strains of Ng has rekindled interest in expanded use of gentamicin (Gen) for treatment of gonorrheal infections. We report that sub-lethal levels of Gen can influence levels of Ng transcripts including that of the gonococcal hicAB -encoded toxin-antitoxin (TA) locus, which is embedded within an integrated prophage, While loss of this TA locus did not impact Ng susceptibility to Gen it reduced the biofilm forming ability of 4/5 Ng strains. Further, in an examined strain in this group we found that Ng fitness during experimental infection was negatively impacted. We propose that that levels of the hicA-hicB transcripts can be increased by sub-lethal levels of an antibiotic used in treatment of gonorrhea and that this could influence pathogenicity.

Особенности применения антибактериального препарата джозамицин в гинекологической практике

2025-06-10
А. З. Хашукоева , М. И. Агаева , З.А. Агаева +3 more | Лечащий врач
Введение. В настоящее время первое место по распространенности среди всех бактериальных заболеваний, передающихся половым путем, занимает урогенитальный хламидиоз. Наряду с хламидиями в этиологии урогенитальных заболеваний все большее внимание привлекают другие … Введение. В настоящее время первое место по распространенности среди всех бактериальных заболеваний, передающихся половым путем, занимает урогенитальный хламидиоз. Наряду с хламидиями в этиологии урогенитальных заболеваний все большее внимание привлекают другие внутриклеточные возбудители – микоплазмы и уреаплазмы. Воспалительные заболевания органов малого таза наносят существенный урон здоровью женщины, способствуют нарушению репродуктивной функции, снижению качества жизни, а также формированию угрожающих жизни состояний при тяжелом течении. Вопросы своевременной диагностики воспалительных заболеваний органов репродуктивной системы представляют множество сложностей, связанных со стертостью клинической симптоматики, многообразием возбудителей, а также различным течением воспалительного процесса. Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis являются ведущими этиологическими факторами воспалительных заболеваний органов малого таза, до 60% случаев воспалительных заболеваний женских половых органов являются следствием микробных ассоциаций Chlamydia trachomatis и Mycoplasma genitalium. Наибольшую опасность данные инфекции представляют во время беременности. Сложности диагностики приводят к запоздалому лечению, что способствует увеличению числа хронических форм заболеваний и неблагоприятных исходов, связанных с осложненным течением болезней. Терапия воспалительных заболеваний половых органов требует комплексного подхода и вызывает множество дискуссий, основным звеном лечения является рациональный подбор антибактериальной терапии. Результаты. В настоящем обзоре продемонстрированы современные данные о высокой эффективности и безопасности применения джозамицина в терапии данных нозологий. Применение отечественного препарата с действующим веществом джозамицин в терапии воспалительных заболеваний органов малого таза, урогенитального хламидиоза и микоплазмоза, в особенности в период беременности, является эффективным и безопасным, позволит сократить частоту неблагоприятных исходов беременности и инфекционно-воспалительных осложнений. Background. Currently, urogenital chlamydia occupies the first place in terms of prevalence among all bacterial sexually transmitted diseases. Along with chlamydia, other intracellular pathogens, mycoplasmas and ureaplasmas, are attracting increasing attention in the etiology of urogenital diseases. Inflammatory diseases of the pelvic organs cause significant damage to the health of women, contribute to the violation of reproductive function, reduce the quality of life, as well as the formation of life-threatening conditions in severe course. The issues of timely diagnosis of inflammatory diseases of the reproductive system present many difficulties, justified by the vagueness of clinical symptoms, the variety of causative agents, as well as the different course of the inflammatory process. Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis are the leading etiologic factors of inflammatory diseases of pelvic organs, up to 60% of cases of inflammatory diseases of female genital organs are the result of microbial associations of Chlamydia trachomatis, Mycoplasma genitalium. These infections are most dangerous during pregnancy. Difficulties in diagnosis lead to delayed treatment, which contributes to an increase in the number of chronic forms of diseases and unfavorable outcomes associated with a complicated course of diseases. Therapy of inflammatory diseases of the genitals requires a comprehensive approach and causes a lot of discussion, the main link of treatment is the rational selection of antibacterial therapy. Results. This review demonstrates current data on the high efficacy and safety of the use of josamycin in the treatment of these diseases.The use of the domestic drug with active substance josamycin in the treatment of inflammatory diseases of the pelvic organs, urogenital chlamydia and mycoplasmosis, especially during pregnancy, is effective and safe, and will reduce the frequency of adverse pregnancy outcomes and infectious and inflammatory complications.