bluuebunny/crossref_metadata_2025_split huggingface dataset:
P3-S7.08 Clinical evaluation of the APTIMA®Trichomonas vaginalisassay on the TIGRIS®DTS®system in asymptomatic and symptomatic female subjects
Authors: Schwebke J , Hobbs M , Taylor S , Chapin K , Catania M , Weinbaum B , Getman D , Gaydos C 
Published: July 2011

BackgroundThis study evaluated the clinical performance of the APTIMA®Trichomonas vaginalis(ATV, Gen-Probe Incorporated) Assay, a nucleic acid amplification test for the diagnosis ofTrichomonas vaginalis(TV) infection, in asymptomatic and symptomatic women.MethodsThis prospective, multicenter clinical trial enrolled 1025 women attending US OB-GYN, adolescent, family planning, or sexually transmitted disease clinics. Four specimen types were collected from each subject: physician-collected vaginal swab, endocervical swab, ThinPrep specimen, and first-catch urine. Of three vaginal swabs collected from each subject, one was used for wet mount microscopic examination, one for culture, and one for molecular testing for TV. The order of collection for each vaginal swab sample was rotated to minimise sampling bias. Each specimen was tested by ATV assay using the automated TIGRIS DTS system. ATV assay performance in each sample type was determined by comparing ATV assay test result to the patient infected status (positive in saline wet mount and/or culture) for each sample.ResultsOf 933 subjects included in the analysis, 59.9% were symptomatic. Compared to patient infected status, ATV assay clinical sensitivities and specificities were 100% and 99.0%, respectively, from vaginal swabs; 100% and 99.4%, respectively, from endocervical swab; 100% and 99.6%, respectively, from ThinPrep specimens; and 95.2% and 98.9%, respectively, from patient-collected urine samples. ATV assay performance was similar in asymptomatic and symptomatic patients, by age group (14–17 years and 18 years or older), and was consistent between testing sites. The ATV assay also demonstrated superior performance compared to wet mount microscopic examination and TV culture, regardless of the specimen type utilised.ConclusionsThis study provides clinical validation of the ATV assay for the intended uses of detecting TV rRNA in asymptomatic women, and/or to aid in the diagnosis of trichomoniasis in symptomatic women, in a US population. The use of highly accurate, fully-automated molecular tests such as the ATV assay for testing easily obtained vaginal swab and urine samples should facilitate large-scale screening for TV in the US.
P3-S7.10 Composition of vaginal microbiota in bacterial vaginosis patients and healthy women: basis for genetic diagnosis of bacterial vaginosis?
Authors: Unemo M , Fahlen A , Datcu R , Hallen A , Fredlund H , Jensen J , Engstrand L 
Published: July 2011

BackgroundBacterial vaginosis (BV) is the most common vaginal infection/disorder. BV is characterised by imbalance in the normal vaginal microbiota with a shift towards higher bacterial diversity and increased pH. The aim of the present study was to describe the differences in vaginal microbiota composition in women suffering from BV compared to healthy women, using massive parallel 454 pyrosequencing.Methods163 vaginal samples were collected from women diagnosed with characteristic BV (n=73), women with intermediate BV (n=11), and from healthy women on their regular check-ups (n=79). DNA from the samples was isolated and the bacterial compositions as well as the relative abundance of these bacteria were analysed using 454 pyrosequencing, with GS Titanium amplicons kit (Roche Inc.), of the hypervariable region V4 on the 16S rRNA gene. Finally, 17 different species-specific PCRs were used to verify the species of bacteria found in the 454 pyrosequencing.ResultsExtensive imbalance of the vaginal microbiota of women with BV compared to healthy controls was revealed. The dominating taxons of the 73 BV cases were Gardnerella, Atopobium, Prevotella, Lactobacillus, Megasphera and Sneathia, while most of the 79 healthy controls had a microbiota totally dominated by Lactobacillus with the BV associated taxons hardly detectable. Furthermore, the 11 patients with intermediate BV predominantly had a mix of the BV associated taxon Gardnerella as well as Lactobacillus. A few of the healthy controls seemed to have a microbiota changing towards the intermediate microflora. Gardnerella may be the first bacteria to establish in the transition from healthy vaginal flora towards a BV associated flora.ConclusionsA clear difference in the composition of the vaginal microbiota between individuals suffering from BV and healthy controls was identified. The present findings are important steps towards the determination of valid potential bacterial markers for BV, are shedding light upon why some women develop BV, as well as show how the microbiota is involved in the development of BV. Knowledge of the composition of the vaginal microbiota is crucial in the development of a BV diagnostic tool and for elucidating appropriate treatment for use in clinical practice.
P3-S7.12 Infections and interventions in pregnant women at high risk of preterm birth: a cohort study
Authors: Wilson J , Okpaluba I , Simpson N 
Published: July 2011

BackgroundPreterm birth (PTB) accounts for 65% neonatal deaths and 50% neurological disability in children. Prior spontaneous PTB is the highest risk factor for subsequent PTB and is usually associated with sub-clinical infection, possibly due to genetic polymorphisms of proinflammatory cytokines. Bacterial vaginosis (BV) has been implicated in PTB and early treatment may reduce it but less attention has been paid to other infections. We assessed the infective and obstetric complications in a group of pregnant women at high risk of PTB and the interventions to reduce PTB.MethodsStudy group: Pregnant women at high risk of PTB Interventions: Microbiological screening for infections from beginning of second trimester then 4-weekly until 28 weeks gestation with treatment of infections found; 2-weekly ultrasound assessment of cervical length during second trimester with cerclage and progesterone injections if needed. Outcome: Gestational age at delivery.ResultsWe have managed 104 pregnancies in 95 multiparous women who had at least one previous mid-trimester miscarriage (MTM), PTB or stillbirth due to chorioamnionitis. 21% had two previous MTM and/or PTB; 5% had three; 4% had four and 1% had five MTM/PTB. 75% were of white ethnicity, 7% asian, 18% black. One or more infection was identified in 51 (49%) of the pregnancies; Group B streptococcal infection (GBS) in 21%, BV in 16%,S aureusin 3%, heavy growth vaginal or urinary coliforms in 16%. Prevalence of infections was more frequent in black (68%), than white (48%), than asian (14%) women. Pregnancy outcome: Exact gestational age unknown in 4 due to transfer to different hospital when >28/40 gestation so outcomes for 100 pregnancies. Four resulted in MTM leaving 96 viable pregnancies. Gestational age at delivery: 24–27/40 in 3%; 28–31/40 in 3%; 32–37/40 in 13%, term in 81%. There was no association with treated infection and pregnancy outcome, infections had been identified and treated in 39% of PTBs and 50% of term births.ConclusionsIn this group of women with high risk pregnancies, 49% had infections known to be associated with PTB which were treated in the second trimester. The overall PTB rate was 19% with 6% extremely or very preterm. There was no association between treated infection in pregnancy and PTB. Although the PTB rates are higher than the normal obstetric population they are significantly lower than would be predicted for such high risk pregnancies.
P3-S7.14 The association ofUreaplasma urealyticumwith male non-gonococcal urethritis
Authors: Frølund M , Lidbrink P , Cullberg M , Wikström A , Ahrens P , Jensen J S 
Published: July 2011

BackgroundThe aetiology of non-gonococcal urethritis (NGU) is unexplained in 30–50% of cases. The role of ureaplasmas is not clear. We detectedUreaplasma urealyticum(Uu) andU parvum(Up) by quantitative PCR in the urine of men with and without NGU to show a possible association with urethritis.MethodsUrine samples from 158 male STD-clinic attendees with symptomatic NGU (>5 PMNL/hpf) and 77 asymptomatic men without NGU (<5 PMNL/hpf) were collected. The patient's age and number of partners within the previous 6 months were recorded. All samples were tested forNeisseria gonorrhoeae(Ng),Chlamydia trachomatis(Ct),Mycoplasma genitalium(Mg), Uu, Up,Trichomonas vaginalis(Tv), herpes simplex virus (HSV) 1 and 2, and adenovirus by real-time PCR.ResultsCt and Mg were found in 22 and 30% of NGU, respectively, and were associated with NGU (p<0.0001 both). Three had dual Ct and Mg infection. Uu was detected in 13% of NGU cases and 12% of controls (p>0.99). The median Uu bacterial DNA load was higher in men with NGU than in men without (223 genome equivalents (geq) and 10 geq, respectively; p=0.002). Using ROC-curve analysis to determine the optimal cut-off, patients with >53 geq were more likely to have urethritis (p=0.02). In men with NGU of unknown aetiology, there was no difference in the rate of Uu detection when compared to controls (p=0.26). The corresponding median Uu bacterial DNA load were significantly higher in this group than in controls (p=0.01), and using a cut-off of >53 geq, men with NGU of unknown aetiology were more likely to harbour Uu (14%) than were men from the control group (1%), (p=0.005). Up was detected in 14% of NGU cases and 19% of controls (p=0.34). There was no difference in the detection rate of Up or in the median Up bacterial load in any of the groups. HSV-1 was detected in 3% of cases and 1% of controls. HSV-2 was found in 2% of NGU cases. All urine samples were negative for adenovirus. Cases and controls had similar median number of partners within 6 months (2 partners) and age (28 and 29 years, respectively).ConclusionThe bacterial load ofU urealyticumin men with NGU and in men with NGU of unknown aetiology was higher than in men without NGU, and the presence of >53 geq of Uu was associated with urethritis in both groups. In accordance with other studies,U parvumwas not associated with urethritis. (Preliminary results were presented at the ASM general meeting, San Diego 2010).
P3-S7.16 Lactobacillus crispatuscolonisation reduces risk of Bacterial Vaginosis (BV) acquisition
Authors: Antonio M , Petrina M , Meyn L , Hillier S 
Published: July 2011

BackgroundLongitudinal studies have found that vaginal colonisation by hydrogen peroxide-producing strains of lactobacilli is associated with a reduced risk of BV acquisition. SeveralLactobacillus spp.includingL crispatus,L jensenii, andL gasserican produce hydrogen peroxide, but no longitudinal studies to date have assessed whether all hydrogen peroxide producing species are equally protective. The objective of this study was to determine which species of Lactobacillus were associated with a reduced risk of BV acquisition.MethodsIn this secondary analysis of women enrolled in a vaccine trial, 112 women aged 18–40 who had Gram stain Nugent scores <6 at study entry were followed bimonthly for up to 18 months for acquisition of BV. Vaginal and rectal swabs were collected at each visit for culture identification of lactobacilli. Species identification was performed by repetitive sequence PCR, and if necessary, 16S rRNA gene RFLP or sequencing. Cox proportional hazards models were used to assess the association between Lactobacillus colonisation at the prior visit and BV acquisition.ResultsThere were 40 BV acquisitions detected during 486 follow-up visits over 65.3 woman-years for an incidence of 61 per 100 woman-years. As shown in Abstract P3-S7.16 table 1, women colonised byL crispatuswere 53% less likely to acquire BV at a subsequent visit (p=0.023).Abstract P3-S7.16 Table 1Association betweenLactobacilluscolonisation in the vagina and acquisition of bacterial vaginosis (BV)Lactobacillusspp.# BV acquisitions per woman-yearsRate Per 100 woman-yearsUnadjusted HR (95% CI)p ValueL crispatus Present14/35.5390.47 (0.24 to 0.90)0.023 Absent26/29.887L jensenii Present18/22.6801.42 (0.76 to 2.66)0.270 Absent22/42.752L gasseri Present11/16.1681.08 (0.54 to 2.17)0.820 Absent29/49.359L iners Present13/20.2641.13 (0.60 to 2.13)0.695 Absent27/45.160ConclusionsL crispatuswas the only species protective against BV acquisition. Since neitherL jenseniinorL gasserireduced the risk of BV despite their capacity to produce hydrogen peroxide, other characteristics ofL crispatusmay be more critical then peroxide production in protecting from BV acquisition.
P1-S1.05 The detection rate ofChlamydia trachomatisandMycoplasma genitaliuminfections in STD clinics in Novosibirsk, Russian Federation
Authors: Khryanin A , Reshetnikov O 
Published: July 2011

BackgroundCurrently, in Russia, the incidence of syphilis, gonorrhoea, chlamydia, trichomoniasis, urogenital herpes, and anogenital warts are officially registered. However, statistical records and reporting forms do not include mycoplasma infections (eg,Mycoplasma genitalium).MethodsThe aim of the present study was to evaluate the detection rates ofChlamydia trachomatisandM genitaliuminfections in patients who had attended to STD clinics in Novosibirsk in 2009–2010. A total of 9208 and 13 006 patients were examined forM genitaliumandC trachomatis, respectively, in different settings (antenatal clinics, hospitals, health centers, STI clinics). Both infections were tested in urethral and/or cervical swabs with nucleic acid amplification techniques (“Litex” and “DNA technology”, Russia).ResultsThe detection rates ofM genitaliumandC trachomatishad not changed over 2009 and 2010, accounting to 12.6–12.6%, and 12.9–13.0%, respectively. Coinfection was observed in only 0.55% of examinies. However, seasonal variations showed different patterns for these two infections (Abstract P1-S1.05 figure 1). Statistical analysis by month revealed that the highest rates ofM genitaliumwere reported in February and March, and the lowest ones—in July. Monthly analysis found even distribution of infection withC trachomatisalong a year, while the lowest incidence was found in July.Abstract P1-S1.05 Figure 1Detection rates ofMycoplasma genitaliumandChlamydia trachomatisaccording to the attendance data (by month in %).ConclusionsThe incidence rates ofC trachomatisandM genitaliumare approximately the same and account for 12–13% among men and women, equally. The combination of these infections is rare (0.55%). During 2009–2010, there are parallel trends in the detection of these two infections, but in September the reciprocal event was shown. This discrepancy may be due to the peculiarities of various microorganisms, and the clinical signs of the infection—chlamydia can cause non-gonococcal urethritis, which is the reason for examination, and mycoplasma infection is mainly symptomless. Nevertheless, a hypothesis of various patterns of infections prevalence around a year in northern countries (ie, Canada, Alaska, Scandinavia, Russia) needs further clarification. The post-holiday period (September–October) may be a crucial point in the activity of the infectious process.
P1-S1.50 A decade of early syphilis in East and inner city London
Authors: Anderson H , Williams A , Zirngibl M , Fatima J , Symonds M , Goh B 
Published: July 2011

BackgroundFollowing a rise in cases of early syphilis in the UK, a programme of national enhanced surveillance (ES) was commenced in 2001 by the Health Protection Agency with the aims of establishing case distribution and trends in behaviour groups. Local analysis of data acquired via the ES has led to changes to our services in targeting specific high risk groups through increased outreach and community based screening and improvement in health promotion interventions. These include screening for syphilis in all patients attending STI/HIV clinics, dedicated MSM and CSW clinics and outreach work to gay saunas and CSW. The purpose of this study is to look at the epidemiology of infectious syphilis in East and Inner City London over the past decade to provide data on the burden of infection and to further inform local strategy as a measure of outbreak control.MethodsData were obtained from patients with infectious syphilis attending the Royal London and St Bartholomew's Hospitals in the City and East London from 2001 to 2010. The data were collated and analysed from the ES form.ResultsOf 778 patients, 39% had primary syphilis, 37% secondary syphilis and 24% had early latent syphilis; 94% were male, 6% female, 51% white British and 12% were Afro-Caribbean. Of the male, 85% were MSM. Three cases were age <16, 27% 17–30 years and 34% were >40 years of age. 257 (32%) were HIV positive. The main reasons for attendance at clinic were for routine screen (24%), symptom management (46%), consequent of partner notification (6%). 18% had one partner, 58 % had 2–9 partners, 19% had 10–99 partner, and 2% had ≥100 partners past 3 months. 82% acquired their syphilis in London, 4% acquired elsewhere in UK, and 8% in Europe. 4% were female sex workers and 6% acquired their infection through sex workers. 10% acquired their infection in gay saunas, 21% acquired through clubs and 14% via the internet. There were 21 cases in 2001, 115 in 2006 and 44 cases in 2010.Conclusions(1) The syphilis outbreak peaked in 2006 and has decreased by 62% in 2010 indicating that intervention strategy which is still in place, is having an effect. (2) More preventive work need to be done in clubs and on internet dating. (3) HIV coinfection is common and is a cause for concern as syphilitic ulcers enhanced transmission of HIV and HIV coinfection can lead to more severe syphilis manifestation. (4) 21% had 10 partners past 3 months, mainly untraceable, and sex abroad will continue to fuel the outbreak.
P4-S1.01 Role ofChlamydia trachomatisheat shock proteins 60 and 10 in induction of apoptosis in endocervical epithelial cells
Authors: Mittal A S N , Jha R , Salhan S 
Published: July 2011

BackgroundChlamydiae are known to modulate host cell to escape from immune response and prolong their persistence to cause fallopian tube damage, ectopic pregnancy and infertility. In addition, Chlamydiae have been reported to elicit both the induction of host cell death, or apoptosis, under some circumstances and actively inhibit apoptosis under others. Chlamydial heat shock proteins (cHSPs) have been known to be responsible for proinflammatory pathologic manifestations of human chlamydial disease in the reproductive tract. Moreover, cHSP60 has been shown to induce apoptosis, in vitro, in primary human trophoblasts, placental fibroblasts, and the JEG3 trophoblast cell line. However, no study has been dedicated to their potential role in apoptosis of primary cervical epithelial cells that are privilege target for chlamydial infection. In the present study, we investigated the ability of cHSP60 and cHSP10 to induce apoptosis in primary cervical epithelial cells.MethodsPrimary cervical epithelial cells were stimulated with cHSP60 and cHSP10 for 4 h. Quantitative measurements of apoptosis have been performed by cytofluorometry and apoptosis-related genes were analysed by microarray, real-time PCR and western blotting. Further, levels ofd proinflammatory cytokines (IL-18 and IL-1ß) were determined by semi-quantitative RT-PCR.ResultsTreatment with cHSP60 significantly increased the mean percentage of apoptotic cells (57.4±5.9 % vs 9.3±1.2 % in control cells, p <0.05). Similarly, treatment with cHSP10 significantly increased the mean percentage of apoptotic cells (47.8±4.8 % vs 9.3±1.2 % in control cells, p <0.05). A cDNA microarray study showed significant (p <0.05) upregulation of interleukin (IL)-1 ß-convertase, caspase-3, -8 and -9 genes were confirmed in real-time RT-PCR in cHSP60 and cHSP10 stimulated than in control cells. The transcript levels of IL-1ß and IL-18 in cells treated with cHSP60 and cHSP10 was found to be significantly (p <0.05) higher in stimulated than in control cells.ConclusionsIn women with persistent chlamydial infection, the release of extracellular cHSPs may lead to cell apoptosis and to an inflammatory response involved in fibrosis and scarring of female genital tract that may contribute severe tubal pathologies including infertility.
P4-S1.05 Polymerase chain reaction-based typing of penA genes exhibiting elevated MIC values to cephalosporins in Isolates of Neisseria gonorrhoeae
Authors: Trees D , Burroughs M , Harris S , Johnson S 
Published: July 2011

ObjectiveDevelop a PCR based assays for rapid analysis of isolates that exhibit elevated MIC values to penicillin and cephalosporins (MICs of 0.015–0.06 ug/ml to ceftriaxone). These primers were designed to detect mosaic and nonmosaic sequences in the penA gene.MethodsTwo sets of primer pairs were generated that allowed the detection of mosaic-type and nonmosaic-type penA gene sequences in isolates ofN gonorrhoeaethat exhibited elevated MIC values to three cephalosporins. Additional primer sets were generated that detected the presence of an inserted aspartic acid residue in nonmosaic penA genes involved in resistance and to detect base substitutions to distinguish between two different mosaic penA genes. DNA sequences were determined as necessary by standard sequencing or pyrosequencing.ResultsPCR analysis of 28 isolates, exhibiting elevated MIC values to cephalosporins and from different geographic areas, that used these primer sets in combination allowed for the detection of mosaic penA genes in 12 isolates. The remaining isolates possessed nonmosaic genes. Not all of the 12 isolates contained complete mosaic-type sequences with five of the isolates indicating mosaic sequences present in the 5′ region of the penA gene with wild type DNA sequence replacing the last 120 bp of the gene. Another isolate contained nonmosaic penA sequences with an aspartic acid insertion (after aa 345) in the 5′ region of the gene but mosaic sequences in the 3′ end. Finally, mosaic-related sequences were detected by PCR and confirmed by DNA sequencing in the last 106 base pairs of the penA gene of a penicillin sensitive strain isolated prior to 1976.ConclusionPCR can be used to easily detect the presence of mosaic penA genes in isolates ofN gonorrhoeae. This study has shown the 3′ region of the gene may contain mosaic, partial mosaic and nonmosaic-type sequences and that mosaic-type sequence has been encountered in the 3′ region of penA in a sensitive strain. We have also observed isolates with increased MICs to cephalosporins that do not contain mosaic sequences. Finally, isolates that possess mosaic penA genes have been detected in dispersed geographic regions in the US, which is of concern due to the evidence mosaic-type penA alleles are involved in the process of increasing gonococcal MICs to cephalosporins.