Mezlocillin in gonorrhoea: a pilot study

Summary

A pilot study was carried out in 50 patients with uncomplicated, untreated gonorrhoea to assess the effectiveness of mezlocillin, a new semi-synthetic penicillin. Patients received a single intravenous injection of 2 g mezlocillin and were follow ed-up for periods up to 101 days. Four patients defaulted immediately. Clinical and bacteriological findings showed that only 1 of the 46 patients followed-up had failed to respond to treatment, indicating a cure rate of 97.8%. Five (10.8%) male patients had developed post-gonococcal urethritis when seen 3 weeks or later in the follow-up period.     

Phytomedicine Versus Gonorrhoea: The Bapedi Experience

Records regarding the phytomedicine employed by the Bapedi are almost non-existent. This is the first study of herbal remedies used by Bapedi traditional healers to treat gonorrhoea, of concern as it is a danger to reproductive health. A semi-structured questionnaire, centred on sexual health, was administered to 30 traditional healers in 15 local municipalities across the three districts of Limpopo Province during 2009/10. The questionnaire focussed on the use of plants for medicine as well their application in reproductive health management. This investigation found that the Bapedi employed no less than 18 different plant species, sometimes as multiple-plant extracts, but more often as single-plant extracts. The single most used species was Catharanthus roseus, which accounted for 60% of all reported cases, followed by Aloe marlothii subsp. marlothii (13.3%). Both these species occur abundantly throughout the province and are currently not threatened. This is the first record for the use of Callilepis salicifolia, Jatropha zeyheri and Cotyledon orbiculata to treat gonorrhoea by people of any culture.     

Correlation between In vitro susceptibility and treatment outcome with azithromycin in gonorrhoea: a prospective study

PURPOSE: This prospective study was carried out to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates by disc diffusion method and minimum inhibitory concentration (MIC) by E -test with special reference to azithromycin. Also, the correlation between in vitro susceptibility and treatment outcome with single 2 g oral dose azithromycin was assessed. METHODS: The study included 75 gonococcal isolates from males with urethritis, females with endocervicitis and their sexual contacts. All isolates were subjected to susceptibility testing for penicillin, ciprofloxacin, tetracycline, ceftriaxone, spectinomycin, cefixime and azithromycin. Males with gonococcal urethritis were randomised to receive a single dose of either azithromycin or ceftriaxone. Forty-two men with urethritis received 2 g single oral dose azithromycin, while all other patients were given 250 mg parentral ceftriaxone. All patients were called for follow-up to assess clinical and microbiological cure rates. RESULTS: While all the isolates were susceptible to ceftriaxone, spectinomycin, cefixime and azithromycin; 74 (98.7%), 24 (32%) and 23 (30.7%) strains were resistant to ciprofloxacin, penicillin and tetracycline respectively, by both disc diffusion method and E -test. The MIC range, MIC50 and MIC90 of N. gonorrhoeae strains, to azithromycin were 0.016-0.25, 0.064 and 0.19 microg/mL, respectively. Follow-up attendance of the patients was 52.4 with 100% clinical and microbiological cure rates. CONCLUSIONS: Results of our study indicate that 2 g single oral dose azithromycin is safe and effective in the treatment of uncomplicated gonorrhoea.     

Surveillance and epidemiology of syphilis,gonorrhoea and chlamydia in the non-European Union countries of the World Health Organization European Region, 2015 to 2020

BackgroundEpidemics of sexually transmitted infections (STI) are a major public health challenge in the World Health Organization (WHO) European Region.AimWe aimed to provide an overview of case reporting and other surveillance data for syphilis, gonorrhoea and chlamydia for the non-European Union (EU)/European Economic Area (EEA) countries of the Centre and East part of the WHO European Region as per classification used by the WHO Regional Office for Europe (WHO/Europe) and the European Centre for Disease Prevention and Control.MethodsData were provided by the surveillance agencies of the Member States for the period 2015 to 2019 through the WHO/Europe Communicable Diseases Annual Reporting Form. We analysed reported cases, explored data reported to the WHO Gonococcal Antimicrobial Surveillance Programme (GASP) and performed a review of publications on antimicrobial resistance (AMR) in gonorrhoea in the period 2015 to 2020 using systematic methodology.ResultsFrom 2015 to 2019, in most of the countries with three or more data points, there was a pattern of decrease in reported syphilis, gonorrhoea and chlamydia cases, which is in contrast to the EU/EEA. The number of reported cases per 100,000 population was 0.4–26.5 for syphilis, 0–18.5 for gonorrhoea and 0–43.3 for chlamydia. Four countries reported recent data on AMR in gonorrhoea to GASP, and we identified further publications from Georgia, Russia and Ukraine.ConclusionWe found wide heterogeneity in reported rates of STI. There is a strong need to improve availability and quality of STI surveillance data in the non-EU/EEA countries.     

淋球菌、支原体和沙眼衣原体在急性尿道炎中的感染分布及耐药性分析

目的了解淋球菌、支原体和沙眼衣原体在急性尿道炎中的感染分布和耐药情况。方法用培养法对淋球菌和支原体进行分离鉴定和药敏试验，用头孢硝噻吩法对淋球菌进行口一内酰胺酶检测，用单克隆抗体胶体金标法测定沙眼衣原体。支原体药敏试验用支原体药敏试剂盒检测，淋球菌药敏试验采用中K—B法。结果在389份尿道口分泌物标本中，阳性分离率为94．6％。淋球菌β-内酰胺酶的产生率为29．0％，对青霉素的敏感率为2．9％，对氧氟沙星和环丙沙星的敏感率为6．8％和7．2％，对壮观霉素、头孢菌素和头孢西丁的敏感性均较高。支原体对乙酰螺旋霉素、红霉素、环丙沙星、左氧氟沙星和司巴沙星以及壮观霉素的敏感率均不超过50．0％，而对四环素、强力霉素、罗红霉素、美满霉素、交沙霉素和阿奇霉素的敏感率均超过70．0％。结论急性尿道炎患者主要以淋球菌感染为主，支原体和沙眼衣原体可引起混合感染。监测淋球菌和支原体的耐药性对指导临床合理使用抗生素有重要意义。     

诺氟沙星泡腾栓治疗女性淋病的临床疗效观察

应用诺氟沙星泡腾栓和青霉素对女性淋病进行疗效对比观察。结果表明诺氟沙星泡腾栓治愈率为100％,而青霉素为71％。使用诺氟沙星泡腾栓后形成的大量泡沫,能增加药物的吸收表面积,克服普通栓剂在阴道给药时充盈不好的缺点。     

Disseminated gonorrhoea from a pharyngeal infection in a prepubertal child

A young boy with disseminated gonorrhoea from the pharynx is presented. The clinical setting in which this may be seen is also discussed.     

The use of aztreonam in the treatment of uncomplicated gonorrhoea

Summary

A total of 57 men and 26 women with uncomplicated gonorrhoea was treated with 1?g aztreonam intramuscularly. The cure rate was 96% and included successful treatment of 4 infections due to beta-lactamase producing organisms and 8 patients with pharyngeal involvement. The minimum inhibitory concentrations of aztreonam in vitro were lower than those of penicillin and similar to cefuroxime, and side-effects were minimal. It is concluded that aztreonam is effective against Neisseria gonorrhoeae in vivo and in vitro.     

Infections at the bottom end of the gastrointestinal tract

This article concentrates on specific infections of the distal gastrointestinal (GI) tract, particularly those that are transmitted sexually, by anal intercourse. Syphilis, gonorrhoea and lymphogranuloma venereum (LGV) are age old and well known diseases, but the features may be unfamiliar to GI histopathologists. Every histopathology trainee will have seen Herpes simplex virus (HSV) infection of squamous epithelium (e.g. oesophagus, vulva and anus), but the HSV pseudotumour of the anus/perineum can present a pitfall to those who have not previously encountered this entity. Another, more recently described, entity that has a predilection for the ano-rectal region is Epstein–Barr Virus (EBV) positive mucocutaneous ulcer, and this also presents a diagnostic trap to the unwary.     

Sexual networks: the integration of social and genetic data

New methods for studying sexual networks are presented, drawing upon routine procedures followed in genitourinary medicine clinics in the UK for tracing partners and identifying strains of infection. The routine social procedures were developed to incorporate a structured interview. The routine microbiological diagnosis of gonorrhoea was augmented by phenotyping and the development of new genetic techniques for the fine discrimination of gonococcal strains (opa-typing). Selected results from a study in Sheffield, UK show that each method has limitations, when conducted separately, but these are minimised when the methods are combined. Moreover, the use of simple and routine methods of data collection resolve issues of scale and sample that have beset other network studies, as they provide a means of covering a larger and defined population. Popular concepts about these methods are discussed in the conclusion. The integrated approach employed in our research raises questions both about social methods, 'of people who lie, particularly when they talk about sex', and about microbiological methods, 'of genes that tell the truth' and bypass what people say and think altogether. We argue that these stereotypes are misleading insofar as they suggest that genetic techniques can substitute for the social, and we suggest that even the finest discrimination of organisms at the genetic level will never obviate the need for their interpretation in the light of social data.