Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is ...Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is predictable to be untreatable disease in near future. WHO GASP, WHO GLASS and WHO’s global action plan on AMR recommends to expand nationally and internationally to collect data to monitor AMR of gonococci for public health policies. Objective: Our aim is to detect resistance of gonococci to Cepha- losporins and determine the most effective empirical treatment for un-com- plicated gonococcal urethritis in males in Egypt. Methods: We depended in our methodology on selected gonococci from male urethral discharge specimens on Thyer Martien medium;collected 33 isolates during three years from 2017 to 2020;used antibiotics with MIC according to international standards and measuring IZD according to antimicrobial susceptibility testing reference ranges in international standards. Results: By statistical studies, resistance to cephalosporins was as follows: Cephradine 97%, Cefaclor 87.9%, Cefoxitin 97%, Ceftriaxone 90.9% and 42.4% to Cefepime, that shows hetero-genecity in resistance inside cephalosporin group;while resistance to Macrolides group represented by Azithromycin and Tetracyclins group represented by Doxycycline was as follows: Azithromycin 39.4%, Doxycycilne 27.3%;finally fluoroquinolones, the most effective group, resistance, was as: Levofloxacin 15.2%, Ciprofloxacin 15.2% and Ofloxacin 24.2%. Conclusion: The most effective empirical treatment for uncomplicated gonococcal urethritis in males in EGYPT is Fluoroquinolone;especially Levofloxacin ranks first susceptibility as 78.8% and 15.2% resistance followed by Ciprofloxacin susceptibility as 69.7% and 15.2% resistance, finally Ofloxacin susceptibility as 66.7% and 24.2% resistance;for Ceftriaxone not more recommended in EGYPT as empirical treatment for uncomplicated gonococcal urethritis, it is susceptibility as 6.1% and 90.9% resistance;in addition, we can use combination therapy of Fluoroquinolones with Azithromycin or Doxycycline, whose susceptibility is 30.3% for Azithromycin and 42.4% for Doxycycycline, while resistance is 39.4% for Azithromycin and 27.3% for Doxycycline. It is worth noting that only Cefepime in Cephalosporins group represents 42.4% susceptibility and 42.4% resistance;in addition to the Carbapenems group, it represents as 42.4% susceptibility for Imipenem and 45.5% resistance, then 42.2% susceptibility for Meropenem and 48.5% resistance, which can play role in combination therapy.展开更多
Background Certain infectious diseases are caused by specific bacterial pathogens,including syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,leprosy,and tuberculosis.These diseases signifi...Background Certain infectious diseases are caused by specific bacterial pathogens,including syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,leprosy,and tuberculosis.These diseases significantly impact global health,contributing heavily to the disease burden.The study aims to thoroughly evaluate the global burden of syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,and leprosy.Methods Leveraging the Global Burden of Disease(GBD)study 2021,age-specific and Socio-demographic Index(SDI)-specific incidence,disability-adjusted life-years(DALYs),and death for eight specific bacterial infections across 204 countries and territories from 1990 to 2021 were analyzed.Percentage changes in age-standardized incidence rate(ASIR),DALY rate,and mortality rate(ASMR)were also examined,with a focus on disease distribution across different regions,age groups,genders,and SDI.Results By 2021,among the eight diseases,gonococcal infection had the highest global ASIR[1096.58 per 100,000 population,95%uncertainty interval(UI):838.70,1385.47 per 100,000 population],and syphilis had the highest global age-standardized DALY rate(107.13 per 100,000 population,95%UI:41.77,212.12 per 100,000 population).Except for syphilis and gonococcal infection,the age-standardized DALY rate of the remaining diseases decreased by at least 55%compared to 1990,with tetanus showing the largest decrease by at least 90%.Globally,significant declines in the ASIR,age-standardized DALY rate,and ASMR for these eight bacterial infections have been observed in association with increases in the SDI.Regions with lower SDI,such as sub-Saharan Africa,experienced a relatively higher burden of these eight bacterial infections.Conclusions Although there has been an overall decline in these eight diseases,they continue to pose significant public health challenges,particularly in low SDI regions.To further reduce this burden in these areas,targeted intervention strategies are essential,including multi-sectoral collaboration,policy support,improved WASH management,and enhanced research efforts.展开更多
Introduction Urethritis, a common presentation of several sexually transmitted infections, results from infectious and noninfectious conditions. Urethritis accounts for a significant burden of disease in young individ...Introduction Urethritis, a common presentation of several sexually transmitted infections, results from infectious and noninfectious conditions. Urethritis accounts for a significant burden of disease in young individuals over 2.8 million cases in the United States each year[1], and is associated with complications including acute epididymitis, orchitic, and prostatitis. Symptoms of urethritis include discharge of mucopurulent or purulent material, dysuria, or urethral frequency, pruritus. The most common infectious etiologies of urethritis are gonorrhea and chlamydia[2].展开更多
Purpose: A 40-year-old male with a severe corneal melting, peripheral infiltration and nasal perforation in the right eye after a not affiliated case of urethritis is reported. Methods: Retrospective case report. Resu...Purpose: A 40-year-old male with a severe corneal melting, peripheral infiltration and nasal perforation in the right eye after a not affiliated case of urethritis is reported. Methods: Retrospective case report. Results: A sample of conjunctival discharge was sent to culture, in where Gram-diplococci grew and therefore a systemic antibiotic treatment was initiated. Given the severity of the clinic, a penetrating keratoplasty is conducted two days after admission and the corneal button was sent to microbiology, which polymerase chain reaction was positive for Neisseria gonorrhoeae. Conclusion: Despite it being a rare process in an adult, keratitis caused by Neisseria gonorrhoeae should be suspected in all sexually active patients with conjunctivitis and with a clinic genitourinary medical history. The systemic therapy showed a superior effectiveness in combination with topical therapy than the last one on its own.展开更多
Objective: Monitoring the spread of antimicrobial-resistant Neisseria gonorrhoeae (N. gonorrhoeae) is a major priority for national surveillance programs in the Russian Federation. From 2021 to 2022, there has been a ...Objective: Monitoring the spread of antimicrobial-resistant Neisseria gonorrhoeae (N. gonorrhoeae) is a major priority for national surveillance programs in the Russian Federation. From 2021 to 2022, there has been a trend in which the previously increased sensitivity of N. gonorrhoeae to penicillins, tetracyclines, fluoroquinolones, and macrolides was replaced by an increase in the number of strains resistant to these drugs, including multi-resistant strains. The aim of this study was to analyze the genetic characteristics of the contemporary Russian population of N. gonorrhoeae based on whole-genome sequencing (WGS) data. Methods: A total 19 strains isolated in the Russian Federation in 2022 were sequenced and included in the present study together with the data on the reference strain FA19 and 169 N. gonorrhoeae strains from various countries taken from the NCBI GenBank and PubMLST databases. We used the Parsnp 1.6 to perform phylogenetic analysis of the studied samples. For single nucleotide polymorphisms calling, reads were mapped to the reference genome using Bowtie2. Single nucleotide polymorphisms calling was performed using GATK protocol. The data were shown as number and percentage. Results: In the present study, molecular typing of N. gonorrhoeae strains revealed changes in the genetic structure of the N. gonorrhoeae population, which was long considered to be very conservative;in particular, there was a detection of a significant number of genotypes that have rarely or never been detected before in the Russian population. WGS data showed the formation of a separate cluster consisting of N. gonorrhoeae strains within the MLST10314, MLST9363 and MLST8134 genogroups. Furthermore, a large number of single nucleotide polymorphisms in the genes of the mtrCDE and mtrR efflux system were revealed. Conclusion: The present results indicate the need to enhance measures to control the spread of antibiotic-resistant N. gonorrhoeae strains and to continue WGS of the Russian N. gonorrhoeae population to identify strains with genetic determinants of antimicrobial resistance.展开更多
Fitz-Hugh-Curtis syndrome （FHCS） was reported by Curtis after he found a fibrous adhesion between the surface of the liver and peritoneum in patients with gonococcal pelvic inflammation during laparoscopy in 1930, a...Fitz-Hugh-Curtis syndrome （FHCS） was reported by Curtis after he found a fibrous adhesion between the surface of the liver and peritoneum in patients with gonococcal pelvic inflammation during laparoscopy in 1930, and the first report by Fitz-Hugh as acute gonococcal peritonitis in the right upper quadrant abdomen was published in 1934, The so-called FHCS is believed to originate from an inflammation in the pelvis which may ascend toward the diaphragmatic surface of the liver along the right paracolic gutters to cause the inflammation of the liver capsule with right upper abdominal pain. Previously, FHCS was only seen in females at the age of 20 and 30 years and was often misdiagnosed as acute cholecystitis, cholelithiasis, gastrointestinal diseases, pleuritis, etc., because of involvement of the liver capsule and peritoneum with right upper abdominal pain as the major clinical symptom, which was related to the respiratory movement. We retrospectively reviewed 21 patients with FHCS to evaluate the clinical manifestations and CT and MRI findings of this disease.展开更多
文摘Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is predictable to be untreatable disease in near future. WHO GASP, WHO GLASS and WHO’s global action plan on AMR recommends to expand nationally and internationally to collect data to monitor AMR of gonococci for public health policies. Objective: Our aim is to detect resistance of gonococci to Cepha- losporins and determine the most effective empirical treatment for un-com- plicated gonococcal urethritis in males in Egypt. Methods: We depended in our methodology on selected gonococci from male urethral discharge specimens on Thyer Martien medium;collected 33 isolates during three years from 2017 to 2020;used antibiotics with MIC according to international standards and measuring IZD according to antimicrobial susceptibility testing reference ranges in international standards. Results: By statistical studies, resistance to cephalosporins was as follows: Cephradine 97%, Cefaclor 87.9%, Cefoxitin 97%, Ceftriaxone 90.9% and 42.4% to Cefepime, that shows hetero-genecity in resistance inside cephalosporin group;while resistance to Macrolides group represented by Azithromycin and Tetracyclins group represented by Doxycycline was as follows: Azithromycin 39.4%, Doxycycilne 27.3%;finally fluoroquinolones, the most effective group, resistance, was as: Levofloxacin 15.2%, Ciprofloxacin 15.2% and Ofloxacin 24.2%. Conclusion: The most effective empirical treatment for uncomplicated gonococcal urethritis in males in EGYPT is Fluoroquinolone;especially Levofloxacin ranks first susceptibility as 78.8% and 15.2% resistance followed by Ciprofloxacin susceptibility as 69.7% and 15.2% resistance, finally Ofloxacin susceptibility as 66.7% and 24.2% resistance;for Ceftriaxone not more recommended in EGYPT as empirical treatment for uncomplicated gonococcal urethritis, it is susceptibility as 6.1% and 90.9% resistance;in addition, we can use combination therapy of Fluoroquinolones with Azithromycin or Doxycycline, whose susceptibility is 30.3% for Azithromycin and 42.4% for Doxycycycline, while resistance is 39.4% for Azithromycin and 27.3% for Doxycycline. It is worth noting that only Cefepime in Cephalosporins group represents 42.4% susceptibility and 42.4% resistance;in addition to the Carbapenems group, it represents as 42.4% susceptibility for Imipenem and 45.5% resistance, then 42.2% susceptibility for Meropenem and 48.5% resistance, which can play role in combination therapy.
文摘Background Certain infectious diseases are caused by specific bacterial pathogens,including syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,leprosy,and tuberculosis.These diseases significantly impact global health,contributing heavily to the disease burden.The study aims to thoroughly evaluate the global burden of syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,and leprosy.Methods Leveraging the Global Burden of Disease(GBD)study 2021,age-specific and Socio-demographic Index(SDI)-specific incidence,disability-adjusted life-years(DALYs),and death for eight specific bacterial infections across 204 countries and territories from 1990 to 2021 were analyzed.Percentage changes in age-standardized incidence rate(ASIR),DALY rate,and mortality rate(ASMR)were also examined,with a focus on disease distribution across different regions,age groups,genders,and SDI.Results By 2021,among the eight diseases,gonococcal infection had the highest global ASIR[1096.58 per 100,000 population,95%uncertainty interval(UI):838.70,1385.47 per 100,000 population],and syphilis had the highest global age-standardized DALY rate(107.13 per 100,000 population,95%UI:41.77,212.12 per 100,000 population).Except for syphilis and gonococcal infection,the age-standardized DALY rate of the remaining diseases decreased by at least 55%compared to 1990,with tetanus showing the largest decrease by at least 90%.Globally,significant declines in the ASIR,age-standardized DALY rate,and ASMR for these eight bacterial infections have been observed in association with increases in the SDI.Regions with lower SDI,such as sub-Saharan Africa,experienced a relatively higher burden of these eight bacterial infections.Conclusions Although there has been an overall decline in these eight diseases,they continue to pose significant public health challenges,particularly in low SDI regions.To further reduce this burden in these areas,targeted intervention strategies are essential,including multi-sectoral collaboration,policy support,improved WASH management,and enhanced research efforts.
文摘Introduction Urethritis, a common presentation of several sexually transmitted infections, results from infectious and noninfectious conditions. Urethritis accounts for a significant burden of disease in young individuals over 2.8 million cases in the United States each year[1], and is associated with complications including acute epididymitis, orchitic, and prostatitis. Symptoms of urethritis include discharge of mucopurulent or purulent material, dysuria, or urethral frequency, pruritus. The most common infectious etiologies of urethritis are gonorrhea and chlamydia[2].
文摘Purpose: A 40-year-old male with a severe corneal melting, peripheral infiltration and nasal perforation in the right eye after a not affiliated case of urethritis is reported. Methods: Retrospective case report. Results: A sample of conjunctival discharge was sent to culture, in where Gram-diplococci grew and therefore a systemic antibiotic treatment was initiated. Given the severity of the clinic, a penetrating keratoplasty is conducted two days after admission and the corneal button was sent to microbiology, which polymerase chain reaction was positive for Neisseria gonorrhoeae. Conclusion: Despite it being a rare process in an adult, keratitis caused by Neisseria gonorrhoeae should be suspected in all sexually active patients with conjunctivitis and with a clinic genitourinary medical history. The systemic therapy showed a superior effectiveness in combination with topical therapy than the last one on its own.
基金funded by the Ministry of Health of Russian Federation,government assignment No.056-00003-24-02.
文摘Objective: Monitoring the spread of antimicrobial-resistant Neisseria gonorrhoeae (N. gonorrhoeae) is a major priority for national surveillance programs in the Russian Federation. From 2021 to 2022, there has been a trend in which the previously increased sensitivity of N. gonorrhoeae to penicillins, tetracyclines, fluoroquinolones, and macrolides was replaced by an increase in the number of strains resistant to these drugs, including multi-resistant strains. The aim of this study was to analyze the genetic characteristics of the contemporary Russian population of N. gonorrhoeae based on whole-genome sequencing (WGS) data. Methods: A total 19 strains isolated in the Russian Federation in 2022 were sequenced and included in the present study together with the data on the reference strain FA19 and 169 N. gonorrhoeae strains from various countries taken from the NCBI GenBank and PubMLST databases. We used the Parsnp 1.6 to perform phylogenetic analysis of the studied samples. For single nucleotide polymorphisms calling, reads were mapped to the reference genome using Bowtie2. Single nucleotide polymorphisms calling was performed using GATK protocol. The data were shown as number and percentage. Results: In the present study, molecular typing of N. gonorrhoeae strains revealed changes in the genetic structure of the N. gonorrhoeae population, which was long considered to be very conservative;in particular, there was a detection of a significant number of genotypes that have rarely or never been detected before in the Russian population. WGS data showed the formation of a separate cluster consisting of N. gonorrhoeae strains within the MLST10314, MLST9363 and MLST8134 genogroups. Furthermore, a large number of single nucleotide polymorphisms in the genes of the mtrCDE and mtrR efflux system were revealed. Conclusion: The present results indicate the need to enhance measures to control the spread of antibiotic-resistant N. gonorrhoeae strains and to continue WGS of the Russian N. gonorrhoeae population to identify strains with genetic determinants of antimicrobial resistance.
文摘Fitz-Hugh-Curtis syndrome （FHCS） was reported by Curtis after he found a fibrous adhesion between the surface of the liver and peritoneum in patients with gonococcal pelvic inflammation during laparoscopy in 1930, and the first report by Fitz-Hugh as acute gonococcal peritonitis in the right upper quadrant abdomen was published in 1934, The so-called FHCS is believed to originate from an inflammation in the pelvis which may ascend toward the diaphragmatic surface of the liver along the right paracolic gutters to cause the inflammation of the liver capsule with right upper abdominal pain. Previously, FHCS was only seen in females at the age of 20 and 30 years and was often misdiagnosed as acute cholecystitis, cholelithiasis, gastrointestinal diseases, pleuritis, etc., because of involvement of the liver capsule and peritoneum with right upper abdominal pain as the major clinical symptom, which was related to the respiratory movement. We retrospectively reviewed 21 patients with FHCS to evaluate the clinical manifestations and CT and MRI findings of this disease.
