Objective To investigate the type distribution of urogenital Chlamydia trachomatis(Ct)among STD clinic outpatients in Guangxi Zhuang Autonomous Region, and to estimate the prevalence of Ct infection among the patients during posttreatment follow?up. Methods Urethral and cervical swabs were collected from male and female outpatients with confirmed urogenital Ct infection, respectively, in Institute of Dermatology of Guangxi Zhuang Autonomous Region. The patients with positive results in preliminary screening tests were followed up after treatment, and specimens were collected at follow?up visits. General and clinical information was also obtained from these patients. DNA was extracted from these samples by using the QIAxtractor instrument. Nested PCR was performed to amplify the major outer membrane protein A(ompA)gene for ompA typing, and to amplify CT046(hctB), CT058, CT144, CT172 and CT682 (pbpB) genes for high?resolution multilocus sequence typing (hr?MLST). Then, PCR products were sequenced, and ompA and MLST types of Ct were determined by sequence alignment and MLST analysis, respectively. The obtained MLST sequence types (STs) were compared with those from an Italian population by using the BioNumerics7 software, and a minimum spanning tree(MST)was generated. Results Totally, 44 and 6 Ct?positive specimens were collected at first visits and follow?up visits respectively. Among the 50 specimens, 42 underwent successful ompA typing and hr?MLST, and 7 ompA genotypes and 15 hr?MLST STs were identified, including 3 first reported STs. The distribution of STs of Ct isolates from Guangxi Zhuang Autonomous Region was significantly different from that from the Italian population. Among the 6 followed patients with posttreatment Ct infection, 3 were confirmed to be reinfected with Ct, and the other 3 failed to be diagnosed because of unsuccessful genotyping. Conclusion The genotypes of Ct strains isolated from STD clinic outpatients in Guangxi Autonomous Region were characteristic, and Ct reinfection occurred in some patients during follow?up.

ObjectiveTo investigate the prevalence of syphilis among outpatients in sexually transmitted disease (STD) clinics in Guangxi Zhnang Autonomous Region,and to assess the socioeconomic and behavioral factors associated with the infection.MethodsThe outpatients to 14 STD clinics in 8 cities of Guangxi Zhnang Autonomous Region were investigated with questionnaires by their doctors at the first visit.Venous blood samples were obtained from these outpatients and subjected to toludine red unheated serum test (TRUST) to screen for syphilis.Treponema pollidum particle agglutination (TPPA) was performed for TRUSTpositive samples.The epidemiological data were collected by using EpiData software,statistically analyzed by using SPSS13.0 software package.ResultsA total of 10 930 STD outpatients were recruited in the study,and 1297 samples were confirmed to be both TRUST and TPPA positive.The prevalence of syphilis was 11.9％ in all of the outpatients,14.3％ in female outpatients and 10.3％ in male outpatients,13.3％ in the outpatients of Zhuang nationality,and 11.4％ in those of Han nationalily.Multivariate analysis showed that syphilis was independently related to female sex[odds ratio(OR) 2.23,95％ confidence interval(CI) 1.69 - 3.00,P＜0.01 ],low educaiion level (middle school:OR 1.70,95％ CI 1.11 - 2.62,P ＜ 0.05; primary school or illiteracy,OR 1.98,95％ CI 1.13 - 3.46,P＜0.05),annual income of more than 30000 Yuan (OR 1.91,95％ CI 1.18 -3.10,P ＜ 0.01 ),commercial sex workers or having multiple sexual partners(OR 1.54,95％ CI 1.16 - 2.06,P ＜0.01 ).ConclusionsSyphilis serology should be the routine test in STD clinical settings in Guangxi region,and the intervention should be enhanced to control the prevalence of syphilis in high-risk populations.

Objective To estimate the prevalence of hepatitis C virus (HCV) infection among sexually transmitted disease (STD) clinic attendees infected with human immunodeficiency virus type 1 (HIV-1) in Guangxi Zhuang Autonomous Region.Methods Totally,11 553 blood plasma samples were collected from STD clinic attendees in Guangxi Zhuang Autonomous Region,and subjected to HIV-1 antibody screening and confirmatory testing.Enzyme linked immunosorbent assay (ELISA) was performed to detect anti-HCV antibodies in 140 anti-HIV-1 antibody-positive samples and 282 anti-HIV-1 antibody-negative samples from age-and marital status-matched attendees.Chi-square test was performed to assess the differences in the prevalence rate of HCV infection between anti-HIV-1-negative and-positive samples,and Logistic regression analysis to evaluate the risk factors for HCV and HIV co-infection.Results The positivity rate of anti-HCV antibodies was 33.57％ (47/140)among anti-HIV-1-positive samples,significantly higher than that in anti-HIV-1-negative samples (1.06％ (3/282),x2 =94.66,P ＜ 0.05).Logistic regression analysis showed a statistical increase in the prevalence of HCV/HIV co-infection in individuals reporting more than one sexual partners compared with those reporting only one sexual partner (OR =2.4,95％ CI (1.0-5.6),P =0.05),and in intravenous drug users compared with non-intravenous drug users (OR =20.8,95％ CI(5.7-76.5),P ＜ 0.05).Conclusions HCV infection appears to be associated with HIV-1 infection,and comprehensive intervention on HIV-1-infected patients may slow down HCV transmission.

Objective To study the antibiotic resistance of Neisseria gonorrhoeae and the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) and high-level tetracycline resistant Neisseria gonorrhoeae (TRNG) in Nanning. Methods Minimum inhibitory concentrations (MIC) were determined by agar dilution method and ?-lactamase production was comfirmed by acidometric method.Results Among 458 strains, 33 strains(7.20%) were found to be PPNG and 231 strains(50.44%) were TRNG. The resistance rate to ciprofloxacin, ceftriaxone and spectinomycin were 87.33%, 1.31% and 0.22% respectively. Conclusion The situation of resistance to ciprofloxacin was very serious, and it was also found that a few of gonococcal isolates were resistant to ceftriaxone and spectinomycin. The study showed that it is important to successively survey the antibiotic resistance of Neisseria gonorrhoeae.

Objective To determine the prevalence and genotype profiles of urogenital Chlamydia trachomatis and their related factors in patients attending sexually transmitted diseases (STD) clinics in Guangxi Zhuang Autonomous Region. Methods C. trachomatis was screened by a plasmid PCR in 598 patients attending STD clinics. Then, positive specimens underwent nested-PCR to amplify the major outer membrane protein 1 (ompl) gene. The amplicons of ompl gene were digested by restriction endonucleases Alu I plus Hinf I and Cfol . C. trachomatis was differentiated according to the restriction fragment length polymorphism (RFLP) patterns. Results Out of the 598 samples, 83 were positive for plasmid-PCR. The prevalence of chlamydial infection was 13.9% with no significant difference between male and female patients. Nested-PCR based RFLP analysis showed that genotype E amounted to 27.7% (23/83), F 20.5% (17/83), D 13.2%(11/83), G 12.0%(10/83), K 7.2%(6/83), H 4.8%(4/83), I 3.6% (3/83), J 3.6%(3/83)and uncertain types 7.2% (6/83). Visible symptoms were observed less frequently in infections with C. trachomatis genotypes E and F compared with the other genotypes, while low abdominal pain occurred in 80% of infections with type G. Conclusions A certain proportion of out-patients attending STD clinic are infected with various types of C. trachomatis in Guangxi Zhuang Autonomous Region. The polymorphism of ompl gene may serve as a useful tool in molecular epidemiological studies of C. trachomatis.

Objective To investigate genotyps of Treponema pallidum (Tp) in several cities in Guangxi province. Methods A total of 300 patients with suspected early syphilis were enrolled from STD clinics in Guangxi between January 2012 and July 2016, and tissue fluid samples were collected from skin lesions. Silver staining was performed to detect Tp, and PCR to amplify the Tp polA gene for the diagnosis of early syphilis. Positive samples were subjected to PCR amplification of a 60-bp tandem repeat region within the arp gene, restriction fragment length polymorphism(RFLP)analysis of the tpr Ⅱgene after digestion with Mse Ⅰ enzyme and tp0548 genotyping. Results Finally, 215 patients were diagnosed with early syphilis, including 210(97.7%)patients positive for PCR and 105(48.8%)patients positive for silver staining, and the positive rate significantly differed between the two methods (χ2 = 103.01, P < 0.05). Among the PCR-positive samples, 190 could be genotyped by analysis of three target genes, and 17 genotypes were identified. The genotype 14d/f was predominant (45.3%, 86/190), followed by 15d/f (13.7%, 26/190), 16d/f(11.6%, 22/190), 17d/f(7.4%, 14/190), 13d/f(6.8%, 13/190), 10d/f(4.2%, 8/190), 18d/f(1.6%, 3/190), 16a/f(1.6%, 3/190), 5d/f(1.1%, 2/190), 7d/f(1.1%, 2/190), 12d/f(1.1%, 2/190), 16d/e(1.1%, 2/190), 14a/f(1.1%, 2/190), 9h/c(1.1%, 2/190), 15l/f(0.5%, 1/190), 25a/e(0.5%, 1/190), 15i/f(0.5%, 1/190). Conclusion Tp genotypes are diversified in patients with early syphilis in Guangxi, and the genotype 14 d/f is predominant.

Objective To determine the prevalence of penicillinase-producing Neisseria gonorrhoeae(PPNG) and the distribution of blaTEM-135 gene variants in PPNG at several gonococcal antimicrobial surveillance sites in China, to compare N. gonorrhoeae multi-antigen sequence typing(NG-MAST)types of PPNG and its blaTEM-135 gene variants, and to assess the difference and association in NG-MAST types of blaTEM-135 gene variants among different regions. Methods A total of 572 N. gonorrhoeae isolates were collected at 6 gonococcal antimicrobial surveillance sites from Jiangsu, Shanghai, Zhejiang, Tianjin, Guangdong and Guangxi in 2012. After isolation, purification, and identification, cefalotin paper discs were used for detection of PPNG. DNA was extracted by QIAxtractor DX kits after cultivation of the PPNG strains. Then, mismatch amplification mutation assay (MAMA) PCR was performed to identify blaTEM-135 variants, and NG-MAST analysis to determine N. gonorrhoeae genotypes. Results Among the 572 N. gonorrhoeae strains, 38.1%(218/572) were identified as PPNG, and of the PPNG strains, 52.3% (114/218) were blaTEM-135 variants. The detection rate of PPNG at these surveillance sites from high to low was as follows: 51.7% (45/87, Zhejiang), 45.6%(36/79, Shanghai), 38.0% (78/205, Guangdong), 37.5% (12/32, Guangxi), 31.2% (24/77, Jiangsu) and 25.0%(23/92, Tianjin), and that of blaTEM-135 variants was as follows: 68.9%(31/45, Zhejiang), 58.3%(14/24, Jiangsu), 50.0%(39/78, Guangdong), 47.2%(17/36, Shanghai), 39.1%(9/23, Tianjin)and 33.3%(4/12, Guangxi). NG-MAST analysis showed that the ST2318, ST1768, ST1866, ST1053 and ST8726 types predominated among these bla TEM-135 variants, and a strong correlation was found between blaTEM-135 variants and some NG-MAST types, such as ST1768, ST1053 and ST8726 types. The distribution of NG-MAST types was significantly different between the surveillance site in Tianjin (in the Northern part of China) and the other sites (in the Southern part of China), but highly similar among the surveillance sites in Jiangsu, Zhejiang and Shanghai regions. Conclusions There is a high prevalence of PPNG and its blaTEM-135 variants at several gonococcal antimicrobial surveillance sites in China, with significant differences in NG-MAST genotype distribution of PPNG and its blaTEM-135 variants among different regions.

Objective:To assess the susceptibility of gonococcal clinical isolates to gentamicin in Guangxi region, China, and to analyze the correlation between the minimum inhibitory concentration (MIC) of gentamicin and MICs of 7 other antibiotics.Methods:From December 2020 to December 2021, 584 gonococcal clinical isolates were collected from 37 medical institutions in 14 prefecture-level cities in Guangxi region. The susceptibility of gonococcal clinical isolates to ceftriaxone, cefixime, azithromycin, spectinomycin, penicillin, tetracycline, ciprofloxacin and gentamicin was determined by using an agar dilution method. The MIC values of antibiotics were logarithmically transformed with base 2, and Spearman correlation analysis was carried out to evaluate the correlation between the MIC of gentamicin and MICs of the other 7 antibiotics.Results:The MIC of gentamicin ranged from 1 to 16 mg/L, and the MIC50 and MIC90 values were 4 and 8 mg/L, respectively; 361 strains (61.8%) were fully sensitive to gentamicin with the MIC ≤ 4 mg/L, 223 strains (38.2%) moderately sensitive with the MIC ranging from 8 to 16 mg/L, and no gentamicin-resistant strains were found. The number of strains resistant to azithromycin, penicillin, tetracycline and ciprofloxacin was 136 (23.3%), 415 (71.1%), 339 (58.0%) and 574 (98.3%) respectively, the number of lowly sensitive strains to ceftriaxone and cefixime was 17 (2.9%) and 6 (1.0%) respectively, and no spectinomycin-resistant strains were found. Spearman correlation analysis showed that the MIC of gentamicin was weakly correlated with the MICs of azithromycin, spectinomycin, penicillin, tetracycline, and ciprofloxacin (all P < 0.05), but was uncorrelated with the MICs of ceftriaxone and cefixime (both P > 0.05) . Conclusion:All gonococcal clinical isolates tested in this study showed a certain degree of susceptibility to gentamicin, and cross-resistance between gentamicin and other antibiotics was less likely to occur.