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      Prevalence of Ureaplasma urealyticum, Chlamydia trachomatis, and Neisseria gonorrhoeae in gynecological outpatients, Taizhou, China

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          Abstract

          Objectives

          Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) are highly prevalent worldwide and may lead to some genital diseases. The objective of this large‐scale study was to estimate the prevalence characteristics of UU, CT, and NG among women in Taizhou, Zhejiang Province, China.

          Methods

          A total of 13 303 women who visited the gynecologic outpatient service of Taizhou First People's Hospital in Taizhou from 2013 to 2018 were analyzed. The testing of UU, CT, and NG was performed on the collected vaginal swabs using real‐time fluorescence quantitative polymerase chain reaction (RT‐PCR) method.

          Results

          The overall infection rates of UU, CT, and NG were 62.04%, 10.20%, and 4.09% in the Taizhou‐based population, respectively. The age‐specific prevalence showed that younger women (age <25 years) were the preferred period for the positive detection of UU or CT, while elder women (age ≥40 years) had the highest prevalence of NG. In addition, the UU‐CT co‐infection pattern (7.32%) predominated in the study population, and CT was significantly associated with UU and NG.

          Conclusions

          Our novel data demonstrated that UU, CT, and NG infection are prevalent among women in Taizhou, and comprehensive UU, CT, and NG screening guidelines and treatment policies for this population are warranted.

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          Antiviral Resistance and Correlates of Virologic Failure in the first Cohort of HIV-Infected Children Gaining Access to Structured Antiretroviral Therapy in Lima, Peru: A Cross-Sectional Analysis

          Barbara A. Rath, Max von Kleist, María Castillo Díaz … (2013)
          Background The impact of extended use of ART in developing countries has been enormous. A thorough understanding of all factors contributing to the success of antiretroviral therapy is required. The current study aims to investigate the value of cross-sectional drug resistance monitoring using DNA and RNA oligonucleotide ligation assays (OLA) in treatment cohorts in low-resource settings. The study was conducted in the first cohort of children gaining access to structured ART in Peru. Methods Between 2002–5, 46 eligible children started the standard regimen of AZT, 3TC and NFV Patients had a median age of 5.6 years (range: 0.7-14y), a median viral load of 1.7·105 RNA/ml (range: 2.1·103 – 1.2·106), and a median CD4-count of 232 cells/μL (range: 1–1591). Of these, 20 patients were classified as CDC clinical category C and 31/46 as CDC immune category 3. At the time of cross-sectional analysis in 2005, adherence questionnaires were administered. DNA OLAs and RNA OLAs were performed from frozen PBMC and plasma, RNA genotyping from dried blood spots. Results During the first year of ART, 44% of children experienced virologic failure, with an additional 9% failing by the end of the second year. Virologic failure was significantly associated with the number of resistance mutations detected by DNA-OLA (p < 0.001) during cross-sectional analysis, but also with low immunologic CDC-scores at baseline (p < 0.001). Children who had been exposed to unsupervised short-term antiretrovirals before starting structured ART showed significantly higher numbers of resistance mutations by DNA-OLA (p = 0.01). Detection of M184V (3TC resistance) by RNA-OLA and DNA-OLA demonstrated a sensitivity of 0.93 and 0.86 and specificity of 0.67 and 0.7, respectively, for the identification of virologic failure. The RT mutations N88D and L90M (NFV resistance) detected by DNA-OLA correlated with virologic failure, whereas mutations at RT position 215 (AZT resistance) were not associated with virologic failure. Conclusions Advanced immunosuppression at baseline and previous exposures to unsupervised brief cycles of ART significantly impaired treatment outcomes at a time when structured ART was finally introduced in his cohort. Brief maternal exposures to with AZT +/− NVP for the prevention of mother-to-child transmission did not affect treatment outcomes in this group of children. DNA-OLA from frozen PBMC provided a highly specific tool to detect archived drug resistance. RNA consensus genotyping from dried blood spots and RNA-OLA from plasma consistently detected drug resistance mutations, but merely in association with virologic failure.
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            Azithromycin Resistance through Interspecific Acquisition of an Epistasis-Dependent Efflux Pump Component and Transcriptional Regulator in Neisseria gonorrhoeae

            Crista Wadsworth, Brian J. Arnold, Mohamad R. Abdul Sater … (2018)
            ABSTRACT Mosaic interspecifically acquired alleles of the multiple transferable resistance (mtr) efflux pump operon correlate with increased resistance to azithromycin in Neisseria gonorrhoeae in epidemiological studies. However, whether and how these alleles cause resistance is unclear. Here, we use population genomics, transformations, and transcriptional analyses to dissect the relationship between variant mtr alleles and azithromycin resistance. We find that the locus encompassing the mtrR transcriptional repressor and the mtrCDE pump is a hot spot of interspecific recombination introducing alleles from Neisseria meningitidis and Neisseria lactamica into N. gonorrhoeae, with multiple rare haplotypes in linkage disequilibrium at mtrD and the mtr promoter region. Transformations demonstrate that resistance to azithromycin, as well as to other antimicrobial compounds such as polymyxin B and crystal violet, is mediated through epistasis between these two loci and that the full-length mosaic mtrD allele is required. Gene expression profiling reveals the mechanism of resistance in mosaics couples novel mtrD alleles with promoter mutations that increase expression of the pump. Overall, our results demonstrate that epistatic interactions at mtr gained from multiple neisserial species has contributed to increased gonococcal resistance to diverse antimicrobial agents.
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              Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes.

              Romina Capoccia, Gilbert Greub, David Baud (2013)
              Mycoplasma hominis and Ureaplasma urealyticum may colonize the human genital tract and have been associated with adverse pregnancy outcomes. Chorioamnionitis, spontaneous preterm labour and preterm premature rupture of membranes are significant contributors to neonatal morbidity and mortality. However, as these bacteria can reside in the normal vaginal flora, there are controversies regarding their true role during pregnancy and thus the need to treat these organisms. We review here the recent data on the epidemiology of mycoplasmas and their clinical role during pregnancy. The association of these organisms with preterm labour has been suggested by many observational studies, but proof of causality remains limited. PCR is an excellent alternative to culture to detect the presence of these organisms, but culture allows antibiotic susceptibility testing. Whether antimicrobial treatment of mycoplasma-colonized pregnant patients can effectively reduce the incidence of adverse pregnancy outcomes warrants further investigations. The role of Mycoplasma spp. and U. urealyticum in adverse pregnancy outcomes is increasingly accepted. However, sole presence of these microorganisms in the vaginal flora might be insufficient to cause pathological issues, but their combination with other factors such as bacterial vaginosis or cervical incompetence may be additionally needed to induce preterm birth.
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                Author and article information

                Contributors
                Zaixing Yang:
                ORCID: https://orcid.org/0000-0002-7545-642X
                yangzaixingdiyi@163.com
                Jinyan Zou: wyzoujinyan@163.com
                Journal
                Journal ID (nlm-ta): J Clin Lab Anal
                Journal ID (iso-abbrev): J. Clin. Lab. Anal
                Journal ID (doi): 10.1002/(ISSN)1098-2825
                Journal ID (publisher-id): JCLA
                Title: Journal of Clinical Laboratory Analysis
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0887-8013
                ISSN (Electronic): 1098-2825
                Publication date (Electronic): 01 November 2019
                Publication date Collection: February 2020
                Volume: 34
                Issue: 2 ( doiID: 10.1002/jcla.v34.2 )
                Electronic Location Identifier: e23072
                Affiliations
                [ 1 ] Department of Laboratory Medicine Taizhou First People’s Hospital Huangyan Hospital of Wenzhou Medical University Zhejiang China
                [ 2 ] Outpatient Department Taizhou First People’s Hospital Huangyan Hospital of Wenzhou Medical University Zhejiang China
                [ 3 ] Department of Gastroenterology Taizhou First People’s Hospital Huangyan Hospital of Wenzhou Medical University Zhejiang China
                Author notes
                [*] [* ] Correspondence

                Zaixing Yang, Department of Laboratory Medicine, Taizhou First People’s Hospital, 218 Hengjie Road, Taizhou, Zhejiang 318020, China.

                Email: yangzaixingdiyi@ 123456163.com

                Jinyan Zou, Department of Gastroenterology, Taizhou First People’s Hospital, 218 Hengjie Road, Taizhou, Zhejiang 318020, China.

                Email: wyzoujinyan@ 123456163.com

                Author information
                https://orcid.org/0000-0001-8860-4084
                https://orcid.org/0000-0002-7545-642X
                Article
                Publisher ID: JCLA23072
                DOI: 10.1002/jcla.23072
                PMC ID: 7031556
                PubMed ID: 31675147
                SO-VID: 9c696d4f-6d99-4ab1-944b-0b5ee0487f4a
                Copyright © © 2019 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals, Inc.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                Date received : 05 January 2019
                Date revision received : 05 September 2019
                Date accepted : 29 September 2019
                Page count
                Figures: 3, Tables: 1, Pages: 5, Words: 3679
                Categories
                Subject: Research Article
                Subject: Research Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date February 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.5 mode:remove_FC converted:20.02.2020

                ScienceOpen disciplines: Clinical chemistry
                Keywords: chlamydia trachomatis,neisseria gonorrhoeae,prevalence,ureaplasma urealyticum
                Data availability:
                ScienceOpen disciplines: Clinical chemistry
                Keywords: chlamydia trachomatis, neisseria gonorrhoeae, prevalence, ureaplasma urealyticum

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