Syphilis, caused by Treponema pallidum ssp. pallidum (TPA), is a persisting global health problem. Although syphilis diagnostics relies mainly on serology, serological tests have some limitations, and it is recommended that the final diagnosis be supported by additional tests. The purpose of this study was to analyze the relationship between serology and PCR in syphilis diagnostics. From the year 2004 to May 2019, a total of 941 samples were taken from 833 patients suspected of having syphilis, in Czech Republic. In all these samples, both nested PCR detection of TPA and serology testing were performed. Of the 941 samples, 126 were seronegative, 651 were seropositive, and 164 were serodiscrepant. Among seronegative samples (n = 126), 11 were PCR-positive (8.7%). Among seropositive samples (n = 651; i.e., samples positive for both non-treponemal and treponemal serology tests), 368 samples were PCR-positive (56.5%). The remaining 164 serodiscrepant samples included RPR negative and treponemal serological test-positive samples (n = 154) and a set of 10 RPR-positive samples negative in treponemal serological tests. While the first group revealed 73 PCR-positive samples (47.4%), the second revealed 5 PCR positive samples (50.0%). PCR detection rates were highest in primary syphilis, with lower rates in the secondary and undetermined syphilis stages. As shown here, the nested PCR can improve diagnostics of syphilis, especially in seronegative patients and in patients with discrepant serology.
- MeSH
- lidé MeSH
- polymerázová řetězová reakce * MeSH
- retrospektivní studie MeSH
- sérologická diagnostika syfilis metody MeSH
- syfilis krev diagnóza MeSH
- Treponema genetika imunologie izolace a purifikace fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
A recently introduced Multilocus Sequence Typing scheme for Treponema pallidum subsp. pallidum was applied to clinical samples collected from 2004 to 2017 from the two largest cities (Prague and Brno) in the Czech Republic. Altogether, a total of 675 samples were tested in this study and 281 of them were found PCR-positive for treponemal DNA and typeable. Most of the typed samples (n = 281) were swabs from primary or secondary syphilis lesions (n = 231), and only a minority were whole blood or tissue samples (n = 50). Swab samples from patients with rapid plasma regain (RPR) values of 1-1024 were more frequently PCR-positive (84.6%) compared to samples from patients with non-reactive RPR test (46.5%; p-value = 0.0001). Out of 281 typeable samples, 136 were fully-typed at all TP0136, TP0548, and TP0705 loci. Among the fully and partially typed samples, 25 different allelic profiles were identified. Altogether, eight novel allelic variants were found among fully (n = 5) and partially (n = 3) typed samples. The distribution of TPA allelic profiles identified in the Czech Republic from 2004 to 2017 revealed a dynamic character with allelic profiles disappearing and emerging over time. While the number of samples with the A2058G mutation was seen to increase (86.7% in 2016/2017), the number of samples harboring the A2059G mutation was found to have decreased over time (3.3% in 2016/2017). In addition, we found several allelic profile associations with macrolide resistance or susceptibility, the gender of patients, as well as patient residence.
- MeSH
- alely MeSH
- antibakteriální látky farmakologie MeSH
- bakteriální léková rezistence genetika MeSH
- DNA bakterií genetika MeSH
- dospělí MeSH
- genotyp MeSH
- lidé MeSH
- mladý dospělý MeSH
- multilokusová sekvenční typizace * MeSH
- RNA ribozomální 23S genetika MeSH
- syfilis genetika mikrobiologie patologie MeSH
- Treponema pallidum genetika patogenita MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: The aim of the study was to determine the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae co-infections among patients with newly diagnosed syphilis. METHODS: In patients with any stage of newly diagnosed syphilis swabs were performed from urethra, rectum, pharynx and cervix according to the gender and type of sexual intercourse. From these smears standard validated nucleic acid amplification tests (NAATs) for Chlamydia trachomatis and Neisseria gonorrhoeae infections were done. RESULTS: From 548 (488 men, 60 women) screened patients co-infection was detected in 15.9% of the cases. The majority of the co-infections (86.2%) were asymptomatic. The overall prevalence of chlamydial infection was 11.1% and 8.8% for gonococcal infections. In men who have sex with men (MSM) the prevalence of co-infections was significantly higher (20.0%) than in heterosexual men and women (4.2%) (p < 0.001). In MSM patients the presence of co-infection was significantly associated with HIV infection (p < 0.001). Among MSM 9.6% of the tests detected infection in anorectal site, while prevalence in urethral (2.8%) and pharyngeal (2.4%) localization was significantly lower. In heterosexual patients prevalence was less than 2.0% in all anatomic sites. CONCLUSIONS: The implementation of screening tests in case of sexually transmitted infections in patients with newly diagnosed syphilis is an important part in the management of this disease. These results suggest that screening of asymptomatic heterosexual patients leads to detection of minimum co-infections, but in MSM (especially HIV positive) should always be performed at least in anorectal site, where asymptomatic co-infections are common.
- MeSH
- Chlamydia trachomatis izolace a purifikace MeSH
- chlamydiové infekce epidemiologie MeSH
- gonorea epidemiologie MeSH
- HIV infekce epidemiologie MeSH
- homosexualita mužská statistika a číselné údaje MeSH
- koinfekce MeSH
- lidé MeSH
- Neisseria gonorrhoeae izolace a purifikace MeSH
- prevalence MeSH
- průřezové studie MeSH
- syfilis diagnóza MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Since the notification of the first case of lymphogranuloma venereum (LGV) in the Czech Republic in 2010, the numbers of LGV cases have steadily increased in the country. In 2015, 40 LGV cases were diagnosed, bringing the total for 2010-2015, to 88 cases. The profile of the most affected group, HIV-positive men who have sex with men with a previous sexually transmitted infection, matches that of those described in LGV outbreaks in western Europe.
- MeSH
- anální kanál mikrobiologie MeSH
- Chlamydia trachomatis genetika izolace a purifikace MeSH
- dospělí MeSH
- epidemický výskyt choroby * MeSH
- homosexualita mužská * MeSH
- inguinální kanál mikrobiologie MeSH
- koinfekce epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymphogranuloma venereum diagnóza epidemiologie mikrobiologie patologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- polymerázová řetězová reakce MeSH
- rektum mikrobiologie MeSH
- sexuálně přenosné nemoci bakteriální diagnóza epidemiologie mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- bakteriální léková rezistence MeSH
- diferenciální diagnóza MeSH
- faryngitida etiologie farmakoterapie MeSH
- gonorea * diagnóza epidemiologie farmakoterapie patofyziologie MeSH
- incidence MeSH
- kombinovaná farmakoterapie MeSH
- konjunktivitida etiologie farmakoterapie MeSH
- lidé MeSH
- Neisseria gonorrhoeae izolace a purifikace patogenita MeSH
- proktitida etiologie farmakoterapie MeSH
- rezistence k cefalosporinům MeSH
- uretritida etiologie farmakoterapie MeSH
- zánět děložního hrdla etiologie farmakoterapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- MeSH
- antibakteriální látky aplikace a dávkování škodlivé účinky MeSH
- diferenciální diagnóza MeSH
- HIV infekce komplikace krev MeSH
- hlášení nemocí normy zákonodárství a právo MeSH
- infekční komplikace v těhotenství diagnóza epidemiologie mikrobiologie MeSH
- lidé MeSH
- nežádoucí účinky léčiv MeSH
- plošný screening MeSH
- povinné vyšetření MeSH
- prediktivní hodnota testů MeSH
- sérologická diagnostika syfilis MeSH
- syfilis * diagnóza epidemiologie farmakoterapie klasifikace MeSH
- treponematocidní látky aplikace a dávkování škodlivé účinky MeSH
- vrozená syfilis diagnóza farmakoterapie komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- MeSH
- adjuvancia imunologická terapeutické užití MeSH
- aminochinoliny * terapeutické užití MeSH
- aplikace lokální MeSH
- čajovník čínský chemie MeSH
- dospělí MeSH
- katechin terapeutické užití MeSH
- kondylomata akuminata * diagnóza farmakoterapie MeSH
- lidé MeSH
- masti MeSH
- rostlinné extrakty terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Jessenius
176 s. : il., tab. ; 18 cm
- MeSH
- diferenciální diagnóza MeSH
- komplikace těhotenství MeSH
- sexuálně přenosné nemoci diagnóza klasifikace terapie MeSH
- Publikační typ
- příručky MeSH
- učebnice MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- dermatovenerologie
Infekce humánními papilomaviry je nejčastější virovou sexuálně přenosnou infekcí, postihuje hlavně mladší sexuálně aktivní populaci. Condylomata acuminata jsou jedním z nejčastějších projevů této infekce. Přestože nejde o život ohrožující onemocnění, je hlavním problémem jeho obtížná léčba a časté recidivy, které mohou pacienta traumatizovat a ovlivňovat nejen jeho sexuální život. V současné době existuje velké množství léčebných postupů, ale žádný není 100% účinný. Vzhledem k širokému spektru charakteru projevů a jejich různé lokalizaci je nutno přistupovat ke každému pacientovi individuálně. Proto i v současnosti je hlavní zbraní proti tomuto onemocnění prevence, tedy bezpečné sexuální chování a nověi vakcinace.
Infection with human papillomavirus is the most common viral sexually transmitted infection that mainly affects younger sexually active population. Genital warts are one of the most common manifestations of this infection. Although not a life-threatening disease, it is difficult to treat and frequent recurrence can traumatize the patient and influence not only his sexual life. Currently there are many treatment possibilities, but none is 100% efficient. Because of the wide range of character manifestation and their different localization is necessary to approach each patient individually. Therefore, there is a major weapon against this disease prevention, a safe sexual behavior and a new vaccination.
- MeSH
- Alphapapillomavirus MeSH
- infekce papilomavirem prevence a kontrola přenos MeSH
- kondylomata akuminata * diagnóza patofyziologie prevence a kontrola terapie MeSH
- lidé MeSH
- recidiva MeSH
- vakcinace MeSH
- vakcíny proti papilomavirům terapeutické užití MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
One hundred twenty-four patients-53 with neuroborreliosis, 48 with erythema migrans, and 23 with Lyme arthritis-were tested in a prospective study for the presence of the DNA of Borrelia burgdorferi sensu lato in plasma, cerebrospinal fluid (CSF), urine, and synovial fluid by nested polymerase chain reaction (PCR). Specific DNA was detected using five amplification systems simultaneously: three targeted chromosomal genes encoding 16S rDNA, flagellin, and p66; and two plasmid sequences of OspA and OspC. Patients were examined clinically and by PCR before and after treatment and again after 3 and 6 months. Before treatment, the specific DNA was detected in 78 patients (62.9 %). Forty-one neuroborreliosis patients were DNA-positive (77.4 %), with CSF positivity in 26 patients, urine in 25, and plasma in 16. Twenty-six erythema migrans patients were DNA-positive (54.2 %), with plasma positivity in 18 cases and urine in 14. Eleven Lyme arthritis cases (47.8 %) were DNA positive (six in urine, five in plasma, and four in synovial fluid). The frequency of PCR positives was comparable in CSF and urine, and it was lower by approximately 50 % in plasma. Specific DNA was also found in a significant number of patients in later testing periods: 48 patients after treatment, 29 patients after 3 months, and 6 patients after 6 months. The prolonged PCR positivity was not explainable by persistent infection according to the clinical manifestations of the disease. Possible explanations of the problem are discussed.
- MeSH
- Borrelia burgdorferi komplex genetika MeSH
- časové faktory MeSH
- DNA bakterií izolace a purifikace MeSH
- lidé MeSH
- lymeská nemoc farmakoterapie mikrobiologie MeSH
- polymerázová řetězová reakce MeSH
- tělesné tekutiny mikrobiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
