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Query: EC:2.7.10.2 (
focal adhesion kinase
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44,029
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A pre-treatment and a 3-week post-treatment isolate of Neisseria gonorrhoeae from a 13-year-old boy treated with azithromycin in a single 1 g oral dose were characterized microbiologically. Both isolates were of the same serovar/auxotype (1B6/non-requiring) and had similar antibiograms apart from erythromycin and azithromycin: the pre- and post-treatment MICs (minimum inhibitory concentrations) were: 1 mg/L and 32 mg/L to erythromycin and 0.125 mg/L and 3 mg/L to azithromycin. The finding that both isolates were 1B6/NR, had similar antibiograms (other than azithromycin and erythromycin), and no other 1B6/NR isolates were resistant to erythromycin supports the view that macrolide resistance developed following treatment. A high overall level of azithromycin susceptibility was confirmed by testing 67 clinical isolates: MIC90 0.5 mg/L (range 0.023-0.75 mg/L). We conclude that the long half-life of azithromycin which is beneficial in treating chlamydial infection may result in increased selective pressure for resistance in gonococci. This report also highlights the importance of antibiotic susceptibility surveillance of gonococci and stresses the need for appropriate treatment of
gonococcal
infection, particularly when it is prescribed outwith departments of genitourinary medicine.
Int J
STD
AIDS 1997 May
PMID:Azithromycin and erythromycin resistant Neisseria gonorrhoeae following treatment with azithromycin. 917 50
Of 22,274 patients > or = 12 years old attending a Nairobi primary health care (PHC) clinic, 1076 (4.8%) had
STD
-related complaints, of whom 980 underwent assessment of risk factors for human immunodeficiency virus (HIV) infection and infrequent condom use.
Gonorrhoea
, chancroid, syphilis seroactivity, trichomoniasis, or objective signs of
STD
were found in 78%, and HIV seropositivity in 15% of men and 19% of women. Most women were married, living with a spouse; while most men were single, or married, but living separated from a spouse. Among married men, last sex was with a female sex worker (FSW) or casual partner for 60% not living with a spouse and 26% living with a spouse (P<0.005). Two or more partners during the past year were reported by 82% of men and 25% of women (P <0.001), and 55% of men and 11% of women reported the last partner was high risk. HIV seropositivity among both genders was associated with numbers of partners, and among women, with being widowed or divorced. Only 3% reported use of a condom with the last partner. Among men whose last sex was with a FSW, 74% said the reason for not using a condom was not having one. Thus, infrequent condom use, low condom availability, and gender differences in behaviour necessitate modifying development policies that separate families; and better coordination between family planning, PHC, and AIDS/
STD
programmes, with improved supply, social marketing and community-based distribution of condoms in high-risk settings for
STD
/HIV prevention.
Int J
STD
AIDS 1997 Aug
PMID:High HIV prevalence, low condom use and gender differences in sexual behaviour among patients with STD-related complaints at a Nairobi primary health care clinic. 925 99
A total of 17,824 sera were screened for the presence of HIV 1 + 2 antibodies by Enzyme Immuno Assay (EIA) to determine (i) seroprevalence of HIV infection in hospital high risk groups (ii) time trend of HIV seroprevalence in
STD
clinic attendees (both
STD
patients and non
STD
patients), over a period of six years, (iii) relationship of the
STD
's with HIV seropositivity (iv) clinical profile and epidemiological characteristics of the AIDS cases. A progressive increase in the HIV seropositive
STD
patients showing a five fold rise over six years was seen. Most gave history of multipartner sex especially with female CSW's. The most common
STD
associated with HIV seropositivity was Syphilis followed by Chancroid and
Gonorrhoea
. All had HIV-1 infection. The AIDS cases (20) presented mainly with tuberculosis, both pulmonary and extrapulmonary. The mode of infection, both in the HIV seropositive and AIDS cases, was mainly heterosexual relationship followed by blood transfusion. In a few cases, infection was perinatally transmitted. In the limited number of HIV positive contacts studied, seven were confirmed as Western Blot positive. HIV infection, although a later introduction in Delhi compared to the coastal cities, has shown a clear increasing trend in the
STD
patients.
...
PMID:Sero surveillance of HIV infection in high risk groups and in suspected AIDS cases in a New Delhi hospital. 946 34
We evaluated Cobas Amplicor, a highly automated polymerase chain reaction (PCR) system, to test first-void urine (FVU) and urethral swab specimens for Chlamydia trachomatis and Neisseria gonorrhoeae in men attending a sexually transmitted infection (STI) clinic. Results were compared against an in-house radioimmune dot blot (DB) test for C. trachomatis and selective culture for N. gonorrhoeae. Three hundred and ninety sets of specimens were obtained from 378 consecutive new and returned-new patients.
Gonorrhoea
prevalence was 9.49%, with no significant difference in sensitivity or specificity between culture and PCR. Chlamydia prevalence was 15.4%, with sensitivities of: DB 55%, PCR of FVU 86.7%, urethral swab PCR 90%. The specificity of PCR on FVU and urethral swabs was 100%. We have shown that Cobas Amplicor PCR is highly sensitive and specific in the diagnosis of chlamydia and gonorrhoea in men attending an STI clinic. Further economic and scientific studies are needed to determine the cost-effectiveness of this technique for screening in primary care settings.
Int J
STD
AIDS 1998 Jan
PMID:Detection of male genital infection with Chlamydia trachomatis and Neisseria gonorrhoeae using an automated multiplex PCR system (Cobas Amplicor). 951 10
While the incidence of new HIV infections or HIV prevalence appears to be declining in North America, Australasia, and Western Europe, and beginning to either plateau or decline in sub-Saharan Africa, levels of HIV infection are rapidly increasing in southeast Asia. Bangladesh is surrounded by Myanmar and India, two countries experiencing major HIV epidemics. Findings are presented from a study conducted to assess the prevalence of HIV antibody and selected STDs in a resident population of 593 brothel-based female prostitutes in a business town 100 km from Dhaka. Endocervical and blood samples from 296 of the women were tested for the presence of genital chlamydia,
gonorrhea
, HIV, and syphilis, while consecutive blood samples were taken from another 170 of the subjects for HIV testing. No HIV antibody was found in any of the 466 blood samples. 169 (57.1%) women, however, had evidence of either past or present infection with syphilis as measured by Treponema pallidum hemagglutination (TPHA) testing, 20 (6.8%) women were Venereal Disease Research Laboratory (VDRL)-positive at a more than 1:8 dilution, and 82 (28%) women were infected with either
gonorrhea
or chlamydia. The high prevalence of
gonorrhea
or chlamydia and TPHA detected in this study suggest that HIV infection would spread rap[idly if introduced in this population, and later expand into the general population.
Int J
STD
AIDS 1998 Jan
PMID:Low HIV and high STD among commercial sex workers in a brothel in Bangladesh: scope for prevention of larger epidemic. 951 15
The epidemiology of
gonorrhea
is characterized by geographically defined hyperendemic areas, or "cores." Geographic information system (GIS) technology offers new opportunities to evaluate these patterns. The authors developed a GIS system linked to the disease surveillance database at the Baltimore Health Department and used this system to evaluate the geographic epidemiology of
gonorrhea
in Baltimore, Maryland, during 1994. There were 7,330 reported cases, of which 87.4% were in persons aged 15-39 years; 56.6% were of the cases were in males; and 60.5% of the cases were reported from the nonsexually transmitted disease (
STD
) clinic sector. Valid residential addresses were available for 6,831 (93.5%) of cases. In the GIS system,
gonorrhea
cases were geocoded by reported address using digitized maps, and assigned to census tract. Census tract-specific rates for persons aged 15-39 years were calculated using 1990 census data.
Gonorrhea
was reported from 196/202 (97%) of census tracts, of which 90 census tracts had >30 cases. For these 90 census tracts, rates were ranked. The core was considered as the top rate quartile, consisting of 13 geographically contiguous census tracts with rates 4,370-6,370 per 100,000; adjacent areas were 19 census tracts in the second quartile (rates: 3,730-4,370 per 100,000). As radial distance from the core areas increased, incidence rates decreased and male/female ratio increased, which is consistent with previous definitions of the core theory of
STD
transmission. Mapping of cases by provider showed that cases reported from
STD
clinics had similar geographic distribution to those from the non-
STD
clinic sector. From an operational perspective, GIS can be effectively integrated with clinical data systems to provide epidemiologic analysis.
...
PMID:Geographic epidemiology of gonorrhea in Baltimore, Maryland, using a geographic information system. 955 11
Ciprofloxacin-resistant strains of Neisseria gonorrhoeae have been on the increase over the past few years in Singapore and worldwide. The aim of this study is to correlate treatment failures with in vitro ciprofloxacin resistance of N. gonorrhoeae. A total of 694 patients attending the Department of
STD
Control (DSC) clinic in 1996 who were diagnosed to have
gonococcal
infection confirmed by culture were analysed. Treatment failure rates for ciprofloxacin were determined and the minimum inhibitory concentration (MIC) of ciprofloxacin were traced for all cases of treatment failure. The case notes of all patients who had strains with MICs of ciprofloxacin in the resistant (> or = 1 microg/ml) and less sensitive (0.125-0.5 microg/ml) range were also reviewed to determine the clinical outcome. Ciprofloxacin treatment failure rate was 1.7% (8/461) which was lower than the percentage of ciprofloxacin-resistant strains isolated in the laboratory. Of these 8 cases, 6 were resistant and 2 were less sensitive to ciprofloxacin. Cure rates with ciprofloxacin for resistant and less sensitive strains were 40% and 92% respectively. In conclusion, in vitro resistance to ciprofloxacin may not translate into clinical treatment failure. Clinical treatment failures, on the other hand, are also seen in less sensitive strains.
Int J
STD
AIDS 1998 Jun
PMID:Gonorrhoea treatment failure and ciprofloxacin resistance. 967 Dec 44
Gonorrhoea
in the UK is now a highly focal problem that is localized to certain inner city areas where it presents a significant public health concern. However, the majority of men and a proportion of women infested with Neisseria gonorrhoeae do not experience symptoms of sufficient intensity to prompt them to seek medical advice and the current strategy of treating symptomatic individuals in specialist clinics with subsequent tracing of sexual partners is therefore failing to control the spread of infection in these areas. One method for addressing this problem would be the extension of effective diagnostic services into the clinical environments most likely to be accessed by these high-risk individuals. This paper reviews the scientific literature examining the various methodologies available for the identification of N. gonorrhoeae and assesses their suitability for the diagnosis of gonorrhoea in these alternative clinical settings.
Int J
STD
AIDS 1998 Aug
PMID:The role of effective diagnosis for the control of gonorrhoea in high prevalence populations. 970 90
Findings are reported from a study conducted to assess the prevalence of sexually transmitted infections, including HIV, among female prostitutes working at truckstops in the KwaZulu-Natal midlands of South Africa. The 145 participating prostitutes were recruited from 5 truckstops along the major national road between Durban and Johannesburg from August 1996 to March 1997. Their mean age was 25 years and they had been prostitutes for an average of 3 years. A gynecologic examination was performed upon each woman, including a speculum examination, and investigations were also conducted to identify
gonorrhea
, syphilis, chlamydia, candidiasis, trichomoniasis, bacterial vaginosis, and HIV infection. The examinations found that 50.3% of the women were HIV seropositive, 41.3% were infected with Trichomonas vaginalis, 40.6% had Candida albicans, 14.3% had Neisseria gonorrheae, 16.4% had Chlamydia trachomatis, 71% had bacterial vaginosis, and 42.1% had active syphilis. These findings point to the need for HIV/
STD
prevention interventions among both the prostitutes and their clients.
...
PMID:Sexually transmitted infections among sex workers in KwaZulu-Natal, South Africa. 971 13
This study determined the prevalence of HIV and other sexually transmitted infections (STIs) in a rural South African community. A population-based survey of adults in 110 homesteads was conducted in 1995. A questionnaire on demographics, sexual practices and histories of STIs was administered. Neisseria
gonorrhea
and Chlamydia trachomatis infections were detected using ligase chain reaction assay of urine. The seroprevalence of syphilis rapid plasma reagin and Treponema pallidum hemagglutination assay and HIV infection (ELISA) was determined. Among 259 subjects, the prevalence of HIV was 10.5%; N.
gonorrhea
, 4.5%; C. trachomatis, 6.1%; active syphilis, 8.8%. All infections were asymptomatic. About 40% of sexually active men had more than one concurrent sexual partner. Only 14% of subjects had ever used condoms. In general, these findings indicate that high levels of asymptomatic infections, high partner concurrence, and low condom use are promoting the STI epidemic in this community.
Int J
STD
AIDS 1998 Sep
PMID:HIV infection and asymptomatic sexually transmitted infections in a rural South African community. 976 41
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