Search

As incidence of Neisseria gonorrhoeae infection increases worldwide (1-3), sporadic cases of the ceftriaxone-resistant multilocus sequence type (MLST) 1903 (original isolate FC428 identified in Japan) continue to be detected (4). [...]

Objectives To determine the prevalence and correlates of Mycoplasma genitalium (MG) infection among men and women, determine the prevalence of gene mutations conferring resistance and compare test performance of female specimen types. Methods A cross-sectional study was conducted on specimens collected for gonorrhoea (NG, Neisseria gonorrhoeae) and chlamydia (CT, Chlamydia trachomatis) among male and female Alberta STI clinic attendees using the M. genitalium transcription-mediated amplification-research use only test. Positive specimens were sequenced for 23SrRNA, parC and gyrA genes. Gender-stratified analysis compared test results using χ2 or Fisher's exact test, Mann-Whitney U test and logistic regression. Female endocervical and urine specimens were compared. Results A total of 2254 individuals were tested; 53.8% (n=1212) were male. Male prevalence of MG was 5.3%; CT was 5.9% and NG was 1.8%. Correlates of male infection were a non-gonococcal urethritis diagnosis and NG coinfection. MG prevalence for women was 7.2%; CT was 5.8% and NG was 1.8%. Correlates of female infection were younger age, Indigenous/Other ethnicity and CT/NG coinfection. Nearly two-thirds of eligible specimens had mutations associated with macrolide resistance and 12.2% of specimens had a parC mutation signifying possible moxifloxacin resistance. There was high concordance (98.1%) of results between urine and endocervical swabs. Conclusions The high prevalence of MG relative to CT and NG supports the incorporation of MG testing into routine sexually transmissible infection screening. The high rate of resistance to macrolides and moxifloxacin raises concerns about treatment options. The good concordance of results between urine and endocervical swabs supports the use of female urine specimens for testing. [ABSTRACT FROM AUTHOR]

Background: The incidence of sexually transmitted infections (STI) continues to increase worldwide. Patient incentives are one proposed intervention to increase STI testing and treatment., Methods: We conducted a retrospective cohort study comparing incentivized versus routine care for STI outreach test and treat services between October 2018-June 2019. Incentivized care included a $10 gift card for testing visits and an additional $10 gift card for results and/or treatment visits. Incentivized visits were offered to clients with a lack of housing, who were difficult to locate, or had a history of being lost to follow-up. All test and treatment visits included chlamydia, gonorrhea, syphilis, and HIV testing and/or treatment by Registered Nurses and outreach workers from an STI Clinic. Outreach visits were offered at subsidized housing locations, community-based organizations, and street outreach., Results: From October 2018 to June 2019, 2384 outreach clients were reached: 453 (19.0%) receivedincentives and 1931 (81.0%) received routine care. There were no significant differences in case-finding rates for chlamydia (4.8%), gonorrhea (2.9%), and HIV (0.1%); however, there was for syphilis (3.8% for incentivized vs. 1.9% for routine visits; p = 0.02). All newly diagnosed infections identified in the incentivized group received treatment compared with routine visits (chlamydia 100% vs. 79.1%, p = 0.008, gonorrhea 100% vs. 59.7%, p = 0.002, and syphilis 100% vs. 86.7%, p = 0.08)., Conclusions: Incentives were associated with increased case-finding rates of syphilis and were associated with 100% treatment rates. Incentives are a promising approach to decreasing the burden of STI among outreach populations., Competing Interests: Conflict of Interest declaration: The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.)

Background: We undertook an audit of a province-wide HIV pre-exposure prophylaxis (PrEP) program in Alberta (Canada)., Methods: A retrospective record review of individuals accessing PrEP in Alberta included demographics, PrEP indication(s), and reported non-prescription drug and alcohol use from March 2016 to June 2019. Hepatitis A, B, C, HIV and syphilis serology, serum creatinine, and nucleic acid amplification tests testing for chlamydia and gonorrhea were collected. Descriptive statistics, incidence, and prevalence were calculated., Results: A total of 511 participants were seen at STI, sexual, and reproductive health clinics and private family practitioner (FP) offices; 98.4% (503) were men, median age was 34 years (IQR 28-43 years), and 89.8% (459) were gay or bisexual men who have sex with men. Non-prescription drug use was reported by 39.3% (201) and alcohol use by 55.4% (283). 94.3% (482) reported condomless anal sex in the past 6 months. Testing rates were high (>95%) for all tests except for chlamydia and gonorrhea at the first follow-up visit 89.6%; (3-4 months). There was one HIV seroconversion. The incidence of new bacterial STIs was high: chlamydia 17 cases per 100 person-years (95% CI 13.5% to 21.4%), gonorrhea 11.14 cases per 100 person-years (95% CI 8.3% to 15.0%), and syphilis 1.94 cases per 100 person-years (95% CI 0.73% to 5.12%)., Conclusions: Following implementation of a provincial program for PrEP in Alberta, PrEP initiation and continuation was feasible in a range of settings and by both specialists and FPs., Competing Interests: AE Singh received consulting fees from Gilead; C Shukalek received grants or contracts from CIHR and the Royal College of Physicians and Surgeons, consulting fees and payment for speaking engagements from Gilead and Merck Canada, stock options from Purpose Med, and is a board member of The SHARP Foundation. The other authors have nothing to disclose., (Copyright © 2022, Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada).)