Gene/Protein Disease Symptom Drug Enzyme Compound
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This study determined the prevalence of antimicrobial resistance by Neisseria gonorrhoeae, including penicillinase-producing gonorrhea (PPNG) strains, and monitored the trends. It further compared the results of antimicrobial sensitivity by disc diffusion and minimum inhibitory concentration (MIC). A total of 211 confirmed gonorrhea strains were subjected to antimicrobial sensitivity testing by disc diffusion using penicillin, tetracycline, ciprofloxacin, and ceftriaxone from 1995 to June 1999. PPNG strains were detected by lodometric method, and an E test method of 55 strains isolated in 1997-98 determined MIC. Statistical analysis of the results indicates that a low level of penicillin resistance and PPNG detected in 1996 was maintained over the years. In addition, a significant increasing trend of tetracycline and ciprofloxacin resistance with high MIC was found. Ceftriaxone, being 100% sensitive, was found to be the drug of choice. Moreover, comparison of resistance pattern by the two tests showed satisfactory agreement. Findings indicate the need for increased awareness, prudent use of antimicrobials, and evaluation of new antimicrobials for the treatment of gonorrhea.
Int J STD AIDS 2000 Feb
PMID:Trend of antimicrobial resistance in Neisseria gonorrhoeae at New Delhi, India. 1067 80

Gonorrhea has been declining since its 1975 peak. Risk factors include age 15 to 19 years, multiple or casual sexual contacts, sexual activity related to drug use, and low socioeconomic status. Infection is usually mild but may be asymptomatic. While no physical signs are specific to the gonococcus, pelvic inflammatory disease is a common complication and cause of infertility and should be treated if it is suspected. Diagnosis of gonorrhea is typically by culture. Newer, more accurate tests are available but are more expensive. For treatment, the CDC recommends only highly effective regimens. Patients need to refer recent sexual partners for treatment and abstain from sexual intercourse until completion of therapy and resolution of symptoms. The incidence of syphilis appears to be declining in the United States, but it should be considered if an ulcer is found in the genital region. If untreated, the disease progresses through primary, secondary, latent, and tertiary phases, and systemic symptoms can mimic other conditions. Positive standard screening tests should be confirmed by fluorescent treponemal antibody absorption testing. Darkfield microscopy is appropriate for diagnosis of an ulcer. The treatment of choice for all phases of syphilis is a single dose of intramuscular benzathine penicillin. Other components of therapy include partner notification and patient follow-up. The spread of HIV is closely linked to STD transmission. Therefore, testing for HIV is strongly encouraged when another STD has been diagnosed.
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PMID:Sexually transmitted diseases in women. Gonorrhea and syphilis. 1068 16

In Japan, male genital herpes is the third popular male STD, the most popular one being gonococcal infection and the second chlamydial infection. As specific clinical findings, superficial ulcer lesions with pain are formed in the genital area, especially in the prepuce. After HSV infection in genital mucocutaneous sites, viral particles are transported to the neurons. The state of subsequent HSV infection from external genitalia to the neurons is known as latent infection. 76% of our cases of the first episode of genital herpes infection were caused by HSV-2, and most of the recurrent episodes was caused by HSV-2. Oral acyclovir administration for five to ten days has shortened the treatment period, although about 20 days were required without any treatment. The remaining problems are, asymptomatic HSV shedding, severe infections in immunocompromised patients, transmission of HSV to sex partners and vertical infection to neonates.
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PMID:[Alpha-herpes virus infections--male genital herpes]. 1077 9

The current study is carried out to find the in-vitro susceptibility of N. gonorrhoeae to Ciprofloxacin, Norfloxacin, Gentamycin etc. in 110 isolates obtained from acute gonococcal urethritis confirmed by smear examination. The isolates obtained are from the patients attending the Skin and STD Clinic of a teaching hospital, clinically diagnosed as suffering from acute gonococcal urethritis. Antibiotic susceptibility test was done by Kirby Bauer disc diffusion technique. Four to five similar well isolated colonies of the gonococcal strains were picked up with a wire loop and transferred to 5 cc of sterile trypticase soya broth (TSB). Tubes were incubated at 36 degrees C. GC agar base plates were inoculated with suspensions using a sterile cotton swab. Antibiotic discs were placed on these plates. The plates were incubated at 35 degrees C for 18-24 hours in a candle jar with 5-10% CO2. The plates were then observed to note the zones of inhibition around the discs. 87.27% of isolated strains were inhibited by norfloxacin at an MIC of 0.06 mu gm/ml; 89.08% of the strains were inhibited by ciprofloxacin at an MIC of 0.025 mu gm/ml. All the strains (110) were inhibited by ciprofloxacin at a concentration of 0.2 mu gm/ml. Gentamycin sensitivity was 86.36%. Out of 110 patients, 85 were treated with norfloxacin of which 81 (95.29%) were cured. Twenty five were treated with ciprofloxacin of which 24 (96%) were cured. This study shows high sensitivity of N. gonorrhoeae to norfloxacin and ciprofloxacin.
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PMID:Antibiotics sensitivity pattern of N. gonorrhoeae with special emphasis on norfloxacin and ciprofloxacin. 1077 25

The aim of this study was to screen healthy rural and urban Tanzanian men for chlamydial infection and gonorrhoea, and determine the prevalence and the predictive value of urethral symptoms, signs and pyuria. In 2 cross-sectional surveys, 796 men were interviewed regarding symptoms and examined for signs of urethritis. Gonorrhoea was detected by culture/gram-stained smears, Chlamydia trachomatis by antigen immunoassay, and pyuria by leukocyte esterase dipstick test. The prevalence of chlamydial infection, gonorrhoea and pyuria among rural men was 9.6%, 0.4%, and 12.7%, and among urban bar workers 7.4%, 8.1% and 6.3% respectively. Among all, 0.6% had urethral discharge confirmed by examination, while 2.6% reported urethral discharge and 7.4% dysuria. Among chlamydia-infected men, 59 (89%) of the 66 cases did not have urethritis symptoms or signs. Similarly, 24 (88%) of 28 men with gonorrhoea were asymptomatic. Treatment based on the urethral discharge sign, would have detected only one out of 92 cases with gonorrhoea and/or chlamydia in these populations.
Int J STD AIDS 2000 Oct
PMID:Asymptomatic gonorrhoea and chlamydial infection in a population-based and work-site based sample of men in Kilimanjaro, Tanzania. 1105 38

Our objectives were to determine the prevalence of Neisseria gonorrhoeae not fully sensitive to ciprofloxacin from a sexually transmitted infection (STI) clinic in London and where the isolates were acquired from. Data of antibiotic sensitivities of N. gonorrhoeae from 292 patients were reviewed over a 6-month period at St Mary's Genitourinary Medicine (GUM) Clinic, London. Isolates which exhibited reduced susceptibility (minimum inhibitory concentration [MIC] 0.03-0.12 mg/l) and high level resistance (MIC>0.12 mg/l) to ciprofloxacin represented 10% and 1.3% of the total respectively. All patients infected with a high level resistant isolate to ciprofloxacin had had a recent sexual partner from abroad but 18 of the 28 patients infected with a reduced susceptibility isolate denied recent travel. None of the 20 patients with a non-sensitive isolate who re-attended for post treatment cultures had persistant gonococcal infection. From this study we concluded that although N. gonorrhoeae resistant to ciprofloxacin was rare and probably always acquired abroad, isolates exhibiting reduced susceptibility were more common and were mainly as a result of infection from the UK. A stat dose of ciprofloxacin 500 mg and doxycycline 100 mg twice a day for one week was effective treatment.
Int J STD AIDS 2000 Dec
PMID:Neisseria gonorrhoeae in a London sexually transmitted infection clinic not fully sensitive to quinolones: are isolates imported and how effective is ciprofloxacin as a first-line therapy? 1113 10

The objectives of this paper were to examine changes in AIDS/STD knowledge and behaviour from 1992-1998, current levels of STD infection and psychosocial and demographic determinants of condom use and STD infection among female sex workers. Data for the study were drawn from cross-sectional surveys of female sex workers conducted in 1992, 1994 and 1997-8. For each survey, women participated in a face-to-face interview in the brothel complexes. Survey questions included information on AIDS/STD knowledge, demographics, sexual history and psychosocial factors related to condom use. After the last survey, women were offered a vaginal exam for STD diagnosis and treatment. Sera were tested for HIV infection (anonymous, Elisa/Western blot) and syphilis (TYPHA, RPR). Cervical mucous was tested for chlamydia (LcX), gonorrhea (LCx), herpes (pcr) and HPV (pcr). Knowledge of AIDS and awareness of STDs has increased tremendously in this population since 1992. Reported condom use has also increased substantially (69.9%). Perceived susceptibility toward HIV infection remains low. Ineffective preventive strategies such as medication use continue to be common. HIV infection remains very low in this population (0.2%), although the prevalence of other STDs such as gonorrhea (60.5%), chlamydia (41.3%) and HPV (37.7%) were very high. STD knowledge and self-efficacy were significantly related to condom use as were the sex workers' perceived susceptibility to STD and HIV infection. Women with a larger number of partners were more likely to be infected with gonorrhea, chlamydia and HIV. Women who had come to Bali recently were more likely to be infected with HIV and gonorrhea.
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PMID:AIDS and STD knowledge, condom use and HIV/STD infection among female sex workers in Bali, Indonesia. 1121 39

Seven research centers have been established by the National Institute of Allergy and Infectious Diseases (NIAID) to support collaborative multi-disciplinary studies of serious infections. The Sexually Transmitted Diseases Cooperative Research Centers (STD-CRCs) will focus on the objectives of the NIAID STD program, which include prevention of four serious consequences of STDs: infertility, adverse outcomes of pregnancy, cancer of the cervix and other anogenital sites, and HIV infection. Investigators will work together to bridge biomedical, clinical, behavioral, and epidemiological research, promote productive collaborations, and facilitate the development of intervention-oriented research. Studies will focus on: preventing reproductive tract infections, evaluating the microbial etiology of non-gonococcal ureteritis, determining new approaches to primary and secondary STD prevention, answering biomedical and behavioral questions associated with chlamydia and gonococcus, and creating prevention strategies.
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PMID:NIAID funds STD research centers. National Institute of Allergy and Infectious Diseases. 1136 49

Epidemiological surveillance systems are an integral part of programmes geared towards disease control and therapy especially programmes for infectious diseases. In particular, the collection, analysis, and interpretation of data on the spread of sexually transmitted diseases provide the foundation for prevention and control programmes. During the last decade, the lack of data about the diffusion of the emerging STD, such as genital herpes, genital warts and non gonococcal genital infections, has conducted in Italy to set up a STD Surveillance System based on the reporting of cases from selected clinical sites. This report reviews the general principles and methods to be used in setting up of Italian STD Surveillance Project.
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PMID:[Survival in sexually transmitted diseases and HIV infection. Methodology and data flow]. 1136 16

Recent research reported that bacterial vaginosis (BV) might enhance the acquisition and transmission of HIV. BV is also associated with an increased risk of pelvic inflammatory disease, a disease also associated with intrauterine device (IUD) insertion. To measure the magnitude of this problem, we conducted a prevalence survey of BV and sexually transmitted diseases (STDs; defined as current infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and/or Trichomonas vaginalis) among all patients attending a family planning clinic in Manado from May to July 1999. BV was diagnosed by Gram stain using Nugent's criteria and vaginal trichomoniasis by wet mount or culture. Cervical infections with C. trachomatis and N. gonorrhoeae were diagnosed by DNA probe. Of 357 patients, 116 (32.5%) had BV, 83 (23.3%) had trichomoniasis, 9 (2.5%) had chlamydia, and 8 (2.2%) had gonorrhea. The prevalence of STD was similar among users of all types of contraception. However, BV was more common among IUD users (47.2%) than among non-IUD users (29.9%). This association persisted after controlling for age, education, ever had douching, and any STD (odds ratio 2.0, 95% CI 1.1-3.8). BV was also associated with STD (41.3% in women with STD vs. 29.4% in women without). This association remained significant after adjusting for age, education, ever had douching, and IUD use (odds ratio 1.7, 95% CI 1.1-2.9). Because we found that BV was associated with IUDs and that other studies reported that both BV and IUDs were associated with pelvic inflammatory disease, a Gram stain evaluation of BV may be considered prior to IUD insertion
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PMID:High rate of bacterial vaginosis among women with intrauterine devices in Manado, Indonesia. 1170 96


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