Joinpoint regression was used to analyze the trend of syphilis and gonorrhea incidence rate among 10-19 year old adolescents in Liaoning Province from 2006 to 2020. The syphilis and gonorrhea data in Liaoning Province were reported in the infectious disease monitoring system of China's disease prevention and control information system. From 2006 to 2020, a total of 7 721 cases of syphilis in 10-19 year old adolescents were reported in Liaoning Province, with an incidence rate about 0.90/100 000-22.13/100 000. The incidence rate of syphilis in women was higher than that in men. Adolescents infected with stage Ⅰ and stageⅡ syphilis accounted for 72.6%. There were 2 726 patients with gonorrhea, with an incidence rate about 1.29/100 000-10.74/100 000. The incidence rate of gonorrhea in men was higher than that in women. Joinpoint regression model analysis showed that the incidence of syphilis generally took 2012 as the inflection point. From 2006 to 2012, the average annual growth rate of syphilis incidence rate among adolescents was 67.30% (P<0.001). The average annual growth rate of syphilis incidence rate in adolescents from 2012 to 2020 was -0.02% (P=0.994).The overall incidence of gonorrhea incidence rate took 2015 as the inflection point. From 2006 to 2015, the average annual growth rate of juvenile gonorrhea incidence rate was 23.95% (P<0.001). The average annual growth rate of gonorrhea incidence rate in adolescents from 2015 to 2020 was 4.06% (P=0.492). Overall, from 2006 to 2020, the incidence rate of syphilis and gonorrhea among 10-19 year old adolescents in Liaoning Province increased slowly. The primary and secondary prevention strategies were significantly effective in reducing the risk of sexually transmitted diseases.
Adolescent ; Adult ; Child ; Female ; Gonorrhea/prevention & control* ; Humans ; Incidence ; Male ; Regression Analysis ; Sexually Transmitted Diseases/epidemiology* ; Syphilis/epidemiology* ; Young Adult

PURPOSE: Neisseria meningitidis and Neisseria gonorrhoeae share between 80% and 90% of their genetic sequence. Meningococcal serogroup B vaccines based on outer membrane vesicles—such as VA-MENGOC-BC—could cross-protect against gonorrhea. The aim of this study was to analyze the incidence rates of gonorrhea and other sexually transmitted diseases with respect to the use of the VA-MENGOC-BC vaccine. MATERIALS AND METHODS: Health statistics between 1970 and 2017 were reviewed and the incidence of meningococcal disease and sexually transmitted diseases (gonorrhea, syphilis, condyloma acuminatum, hepatitis B and human immunodeficiency virus infection) were analyzed during the pre- and post-vaccination periods. Gonorrhea incidence was also analyzed by age groups. RESULTS: VA-MENGOC-BC was successfully used to control a meningococcal epidemic in Cuba. The strategy to combat the epidemic was carried out in two stages. The first one was a nationwide mass-vaccination campaign from 1989 to 1990, targeting the population at highest-risk aged 3 months to 24 years. During the second stage, begun in 1991, it was included in the Expanded Immunization Program. Gonorrhea incidence increased from 1970 to 1989. However, after the VA-MENGOC-BC massive vaccination campaign a sharp decrease of gonorrhea incidence was observed. It lasted between 1989 and 1993. A second incidence peak was detected in 1995, but it dropped again. Data clearly show a decline in the incidence of gonorrhea following massive vaccination, in contrast with other sexually transmitted diseases. Incidence rates in unvaccinated age groups also decreased, probably due to herd immunity. CONCLUSION: There is evidence that VA-MENGOC-BC could induce a moderate protection against gonorrhea.
Cuba ; Gonorrhea ; Hepatitis B ; HIV ; Humans ; Immunity, Herd ; Immunization Programs ; Incidence ; Membranes ; Neisseria gonorrhoeae ; Neisseria meningitidis ; Serogroup ; Sexually Transmitted Diseases ; Syphilis ; Vaccination ; Vaccines

Neisseria gonorrhoeae (NG), as a pathogen of gonorrhea, is strictly limited to growth on the human host. In case of gonococcal infection, the body may recruit such inflammatory cells as neutrophils to resist the invasion of NG or initiate its adaptive immune response by antigen presentation to eliminate the pathogen. However, a series of immune escape mechanisms of NG make it difficult to clear up the infection. In the innate immune system, NG can not only secrete thermonuclease to degrade neutrophile granulocytes, inhibit respiratory burst to resist killing by neutrophils, activate NLRP3 to prompt the pyronecrosis of inflammatory cells, but also regulate the differentiation of macrophages to reduce the inflammatory response, combine with factor H to evade complement-mediated killing. NG infection can hardly give rise to effective adaptive immune response and immune memory, but can promote TGF-β production to inhibit Th1/Th2-mediated adaptive immune response, bind to CEACAM1 on the B cell surface to promote apoptosis in B cells, and combine with CEACAM1 on the T cell surface to inhibit helper T cell proliferation, which makes it difficult for B cells to produce high-affinity specific antibodies. With the increasing drug-resistance of NG, immunological studies may play a significant role in the development of novel therapies and effective vaccines against the infection.
Adaptive Immunity ; Antibodies ; immunology ; Antigens, CD ; immunology ; Cell Adhesion Molecules ; immunology ; Complement Factor H ; immunology ; Gonorrhea ; immunology ; Humans ; Immune Evasion ; immunology ; Immunity, Innate ; immunology ; Neisseria gonorrhoeae ; immunology

Objective To analyze the infection status of human papilloma virus (HPV),Ureaplasma urealyticum (UU),Chlamydia trachomatis (CT),and Neisseria gonorrhoeae (NG) in clinical patients.Methods The laboratory specimens including urine,urethral swabs,and cervical swabs from 870 patients from January 1st 2014 to December 31st 2017 were retrospectively analyzed. HPV-DNA was detected by multiplex fluorescent PCR,and the UU-RNA,CT-RNA,and NG-RNA were determined by isothermal nucleic acid amplification. The positive rate of each pathogen and the distribution of positive rate between male and female patients were calculated. The samples were further divided into HPV-positive group and HPV-negative group,and the positive rates of UU-RNA,CT-RNA,and NG-RNA in these two groups were compared.Results The highest positive rate was 53.68%(467/870) for UU-RNA,followed by HPV-DNA [32.41%(282/870) ]and NG-RNA [2.18%(19/870)]. The total positive rate of high-risk (HR)-HPV(subtypes:16,18,31,33,35,39,45,51,52,56,58,59,and 68) [31.52%(209/663)]and UU in female patients [60.93%(404/663)] was significantly higher than that in male patients [17.39%(36/207),30.34%(63/207)](both P<0.001). The male patients had significantly higher CT positive rate in HR-HPV-positive group than in HR-HPV-negative group [22.58%(7/31) vs. 4.54%(8/176)](P<0.001). The female patients had significantly higher CT positive rate in HR-HPV-positive group than in HR-HPV-negative group [10.5%(21/200) vs. 5.61%(26/463)](P=0.024). The UU-RNA positive rate of females in the low-risk (LR)-HPV (subtypes:6 and 11) positive group was significantly higher than that in LR-HPV negative group [70.83%(34/48) vs.2.11%(13/615)](P<0.001).Conclusions Women are more susceptible to HR-HPV and UU infections. HR-HPV-positive patients are more likely to experience CT infection. In contrast,co-infection with UU is more common in LR-HPV-positive females.
Chlamydia Infections ; diagnosis ; epidemiology ; Chlamydia trachomatis ; isolation & purification ; Female ; Gonorrhea ; diagnosis ; epidemiology ; Humans ; Male ; Neisseria gonorrhoeae ; isolation & purification ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; epidemiology ; Retrospective Studies ; Ureaplasma Infections ; diagnosis ; epidemiology ; Ureaplasma urealyticum ; isolation & purification

PURPOSE: The detection of high-level tetracycline-resistant strains of Neisseria gonorrhoeae (TRNG) can make important epidemiological contributions that are relevant to controlling infections from this pathogen. In this study, we aimed to determine the incidence of TRNG isolates over time and also to investigate the characteristics and genetic epidemiology of these TRNG isolates in Korea. MATERIALS AND METHODS: The antimicrobial susceptibilities of 601 isolates of N. gonorrhoeae from 2004 to 2011 were tested by standard Clinical and Laboratory Standards Institute methods. To determine the molecular epidemiological relatedness, N. gonorrhoeae multi-antigen sequence typing was performed. RESULTS: The incidence of TRNG increased from 2% in 2004 to 21% in 2011. The minimum inhibitory concentration distributions of ceftriaxone and susceptibility of ciprofloxacin in TRNG were different from non-TRNG and varied according to the year of isolation. Most of the TRNG isolates collected from 2004 to 2007 exhibited genetic relatedness, with sequence type (ST) 1798 being the most common. From 2008 to 2011, the STs of the isolates became more variable and introduction of genetically unrelated TRNG were noted. CONCLUSION: The increased incidence of TRNG strains until 2007 appears to be due, at least in part, to clonal spread. However, we propose that the emergence of various STs since 2008 could be associated with foreign import.
Anti-Bacterial Agents/*pharmacology ; Ceftriaxone/pharmacology ; Ciprofloxacin/pharmacology ; DNA, Bacterial/analysis ; Drug Resistance, Multiple, Bacterial/*genetics ; Gonorrhea/drug therapy/epidemiology/microbiology ; Humans ; Incidence ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Neisseria gonorrhoeae/*drug effects/*genetics/isolation & purification ; Republic of Korea/epidemiology ; Sequence Analysis, DNA ; Tetracycline/pharmacology ; Tetracyclines/*pharmacology

BACKGROUND: Neisseria gonorrhoeae infection remains prevalent, and the emergence of antimicrobial resistance has made the treatment and control of gonorrhea more difficult. Therefore, it is important to compare isolation methods and transport media to overcome gonorrhea via epidemiologic understanding and to determine co-infection rates with other sexually transmitted diseases among primary-care hospitals. In this study, we determine the recovery rate of transferred specimens according to type of transport media and co-infection rate using PCR. METHODS: Genital specimens were collected at three primary-care hospitals from January 2010 to November 2012 using transgrow media and commercial BD transport media. Culture and multiplex PCR were conducted to isolate N. gonorrhoeae. RESULTS: Among 162 specimens, 57 (35.2%) isolates were recovered, and 146 (90.1%) specimens were positive for multiplex PCR. The recovery rate was 29.9% (78/261) using transgrow media and 19.2% (50/261) using BD transport media. The most common co-infected bacteria with N. gonorrhoeae was Chlamydia trachomatis (15.8%), followed by Mycoplasma hominis (6.2%) and M. genitalium (3.4%). CONCLUSION: Under general transport conditions, the rate of recovery of N. gonorrhoeae was as low as 19.2-29.9% depending on the type of transport media, suggesting that molecular diagnostic methods are required to detect the remaining 70% of gonorrhea-infected patients. Co-infection with other sexually transmitted diseases was not rare, and other tests for accurate additional antimicrobial regimens should also be considered.
Bacteria ; Chlamydia trachomatis ; Coinfection* ; Gonorrhea ; Humans ; Multiplex Polymerase Chain Reaction ; Mycoplasma hominis ; Neisseria gonorrhoeae* ; Pathology, Molecular ; Polymerase Chain Reaction ; Prevalence* ; Sexually Transmitted Diseases

Chlamydia trachomatis ; genetics ; Chlamydiaceae Infections ; diagnosis ; genetics ; Genes, Bacterial ; genetics ; Genes, Viral ; genetics ; Gonorrhea ; diagnosis ; genetics ; Herpes Simplex ; diagnosis ; genetics ; Herpesvirus 2, Human ; genetics ; Humans ; Multiplex Polymerase Chain Reaction ; Neisseria gonorrhoeae ; genetics ; Ureaplasma Infections ; diagnosis ; genetics ; Ureaplasma urealyticum ; genetics

OBJECTIVETo investigate the genotype and characteristics of Neisseria gonorrhoeae (N.gonorrhoeae) isolates with reduced susceptibility to ceftriaxone in Shenzhen from 2009 to 2011.

METHODSA total of 296 N.gonorrhoeae isolates were collected in Shenzhen from 2009 to 2011.ceftriaxone strains (minimum inhibitory concentration between 0.06 and 0.50 µg/ml) were determined by agar dilution method.Logistic regression was used to analyze the associated factors of ceftriaxone N.gonorrhoeae infection.Neighbor-joining (NJ) phylogenetic tree analysis and N.gonorrhoeae multi antigen sequence typing (NG-MAST) were performed on all ceftriaxone isolates and susceptible control isolates randomly selected in accordance with the principle of 1: 1 sampling.

RESULTSNo isolates displayed resistance to ceftriaxone, whereas 53(17.9%) showed reduced susceptibility to ceftriaxone among 296 isolates.Only antibiotic use in recent two months was associated with ceftriaxone isolates infection (OR = 3.080, 95%CI: 1.376-6.894) . Among the ceftriaxone isolates, 48 different ST were identified including 5 STs (ST1768, ST3927, ST641, ST7076 and ST7078) containing 2 isolates and 43 single STs. There were 26 STs previously reported from HongKong in China.Low sensitive strains clustering was not observed by NJ phylogenetic tree.

CONCLUSIONThe proportion of ceftriaxone strains among the 296 N.gonorrhoeae isolates collected from 2009 to 2011 in Shenzhen is high. The STs of ceftriaxone strains may have unique epidemic features in Shenzhen.

Adult ; Anti-Bacterial Agents ; pharmacology ; Ceftriaxone ; pharmacology ; China ; epidemiology ; Drug Resistance, Bacterial ; genetics ; Female ; Gonorrhea ; epidemiology ; microbiology ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; Neisseria gonorrhoeae ; classification ; drug effects ; genetics ; isolation & purification ; Young Adult

OBJECTIVETo detect the genes of Neisseria spp. isolated from patients with male genitourinary tract infections, and to study the pathogenicity of non-gonococcal strains of Neisseria and the laboratory diagnosis for the infections caused by Neisseria spp.

METHODSUsing polymerase chain reaction and nucleotide sequencing, we amplified and sequenced 4 genes of Neisseria spp. isolated from patients with male genitourinary tract infections, including 16S rRNA, orfl, cppB and nspA.

RESULTSFourteen Neisseria strains were identified through analysis of the 16S rRNA gene, including 3 N. mucosa strains, 3 N. cinerea strains, 2 N. gonorrhoea strains, 2 N. sicca strains, 2 N. subflava strains, 1 N. lactamica strain, and 1 N. polysaccharea strain. Among them, 9 showed positive results in gonococcal fluorescence-labeled multiplex-PCR detection, 1 in cppB gene reaction, 5 in orfl gene reaction, and 3 in nspA gene reaction. The consistency rate was 85.7% between the above results from our gene detection and those from the routine bacteriological methods.

CONCLUSIONThe cppB gene is absent in the non-gonococcal strains of Neisseria spp. that can cause male genitourinary tract infection. Most of the strains not only lack virulence-associated orfl and nspA genes, but also show positive results in gonococcal fluorescence-labeled multiplex-PCR detection, which is one of the important reasons for the misdiagnosis and missed diagnosis of gonorrhea infection. The combination of routine bacteriological methods and gene detection in laboratory examinations may help improve the accuracy rates of Neisseria species identification and clinical diagnosis of the infections caused by Neisseria spp.

Genes, Bacterial ; Gonorrhea ; diagnosis ; microbiology ; Humans ; Male ; Neisseria gonorrhoeae ; classification ; genetics ; Polymerase Chain Reaction ; Urinary Tract Infections ; microbiology

BACKGROUNDPrevious studies have shown evidence of health-related risk behaviors among women who have sex with women (WSW), such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections (RTI)/sexually transmitted infections (STI).

METHODSParticipants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests.

RESULTSWe recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% (206/224) of women reported sexual relations with women. The RTI rates were: gonorrhea (15.8%), chlamydia (3.5%), syphilis (0.5%), bacterial vaginosis (14.4%), hepatitis B virus (HBV) (0.9%), hepatitis C virus (HCV) (0.5%), and candidiasis (6.9%). No HIV or herpes simplex virus (HSV) positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency (odds ratio (OR) = 2.1, 95% confidence interval (CI): 1.2 - 3.8) and genital-genital contact (OR = 3.1, 95%CI: 1.3 - 7.2); factors associated with curable STI (excluding bacterial vaginosis, candidiasis, HBV and HCV) were non-Beijing local residency (OR = 1.9; 95%CI: 1.2 - 3.0) and bleeding during or after sex (OR = 18.1; 95%CI: 5.2 - 62.6); and the factor associated with RTI (including all the infections tested) was bleeding during or after sex (OR = 37.8, 95%CI: 11.2 - 127.4).

CONCLUSIONSBehaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planning corresponding prevention and interventions.

Adult ; Candidiasis ; epidemiology ; China ; Female ; Gonorrhea ; epidemiology ; Hepatitis B ; epidemiology ; Hepatitis C ; epidemiology ; Homosexuality, Female ; statistics & numerical data ; Humans ; Risk Factors ; Sexually Transmitted Diseases ; epidemiology ; Syphilis ; epidemiology ; Vaginosis, Bacterial ; epidemiology ; Young Adult