Ciele: Cieľom pilotného projektu bolo zvýšiť testovanie ako aj prepojenie so zdravotnou starostlivosťou o novodiagnostikované osoby s infekciou HIV/HCV/syfilisu a tiež zlepšiť zber a prenos údajov pomocou štandardných nástrojov zberu údajov z komunitných centier poskytujúcich dobrovoľné poradenstvo a testovanie (CBVCT) do národného epidemiologického a monitorovacieho systému. Metódy: Integrované dobrovoľné anonymné testovanie z krvi na HIV, HCV a syfilis bolo realizované pomocou rýchlych testov v období 6 mesiacov (03/2019 až 8/2019). Účastníkom s reaktívnymi výsledkami sa odporučilo, aby navštívili špecialistu za účelom potvrdenia diagnózy a nasadenia terapie. Výsledky: Otestovaných bolo 675 klientov na HIV, 410 na HCV a 457 na syfilis. Medián veku účastníkov sa pohyboval od 24 do 35,6 (IQR:24), 75,3 % z nich bolo mužov, 23,7 % žien a 0,6 % transrodových ľudí. Z hľadiska rizika akvírovania testovaných infekcii 48,9 % zo 675 klientov boli muži majúci styk s mužmi (MSM), 0,3 % osoby pracujúce v sex-biznise (SW), 9,0 % injekční užívatelia drog (PWID), 2,4 % migranti (Mi) a 8,3 % klientov uvádzalo kombináciu týchto rizík. Pilotný projekt odhalil infekciu HIV u 0,4 %, HCV u 2,4 % a T. pallidum u 1,8 % klientov. Len 2 klienti, s potvrdenou HIV infekciou boli prepojení s následnou zdravotnou starostlivosťou. Najvyššia prevalencia HIV bola zistená u MSM/Mi (4,2 %), HCV u PWID (30,8 %) a syfilisu u SW/PWID (7,1 %). Bezkondómový styk so SW, PWID, MSM a HIV pozitívnymi za posledných 12 mesiacov uviedlo 5/92, 41/82, 3/78 a 0/88 odpovedajúcich klientov. Výsledky štúdie boli zahrnuté do ročnej národnej epidemiologickej správy. Záver: Pilotný projekt odhalil potrebu podpory integrovaného testovania v CBVCT, prekonania prekážok pri potvrdzujúcom testovaní a prepojení so zdravotnou starostlivosťou ako aj potrebu integrácie základných údajov v rámci monitorovania a hodnotenia (M&E) testovania v CBVCT do národných systémov surveillance na Slovensku.

Aim: Aim of the pilot was to increase HIV/HCV/syphilis testing and linkage to care of newly diagnosed persons, improve data collection and transfer using standard data collection tools in CBVCT services. Methods: Integrated anonymous voluntary testing from blood for HIV, HCV and syphilis was realised using rapid tests in the period of 6 months (03/2019–08/2019). Participants with reactive results were advised to see a specialist for confirmatory testing and/or treatment. Results: A total of 675 clients were tested for HIV, 410 for HCV, and 457 for syphilis. Participants’ median age ranged from 24 to 35.6 (IQR: 24), 75.3% of them were men, 23.7% were women, and 0.6% identified as transgender. In terms of groups at risk 48.9 % of 675 clients were men who have sex with men (MSM), 0.3 % sex workers (SW), 9.0 % people who inject drugs (PWID), 2.4 % migrants (Mi) and the rest of clients (8.3 %) belonged to groups at combined risk. Pilot revealed HIV, HCV and T. pallidum infections in 0.4 %, 2.4 % and 1.8 % of clients, respectively. Just 2 clients, confirmed HIV-positive, were linked to care. The highest prevalence of HIV (4.2 %), HCV (30.8 %) and syphilis (7.1 %) was found among MSM/Mi, PWID and SW/PWID, respectively. Condomless intercourse with SW, PWID, MSM and HIV-positive person in the last 12 months was reported by 5/92, 41/82, 3/78 and 0/88 of responding clients, respectively. Core indicators were included in the yearly national epidemiological report. Conclusions: Pilot revealed the need to support integrated CBVCT to overcome barriers in confirmatory testing and linkage to care and to integrate core data of monitoring and evaluation (M&E) testing framework at CBVCT services into a national surveillance and M&E systems in Slovakia.

• MeSH
• anonymní testování * MeSH
• hepatitida C diagnóza   epidemiologie   MeSH
• HIV infekce diagnóza   epidemiologie   MeSH
• integrované poskytování zdravotní péče metody   MeSH
• lidé MeSH
• ochrana veřejného zdraví metody   MeSH
• sexuálně přenosné nemoci * diagnóza   epidemiologie   MeSH
• sexuální a genderové menšiny MeSH
• služby preventivní péče metody   MeSH
• syfilis diagnóza   epidemiologie   MeSH
• uživatelé drog * MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Slovenská republika MeSH

BACKGROUND: The increase in syphilis rates worldwide necessitates development of a vaccine with global efficacy. We aimed to explore Treponema pallidum subspecies pallidum (TPA) molecular epidemiology essential for vaccine research by analysing clinical data and specimens from early syphilis patients using whole-genome sequencing (WGS) and publicly available WGS data. METHODS: In this multicentre, cross-sectional, molecular epidemiology study, we enrolled patients with primary, secondary, or early latent syphilis from clinics in China, Colombia, Malawi, and the USA between Nov 28, 2019, and May 27, 2022. Participants aged 18 years or older with laboratory confirmation of syphilis by direct detection methods or serological testing, or both, were included. Patients were excluded from enrolment if they were unwilling or unable to give informed consent, did not understand the study purpose or nature of their participation, or received antibiotics active against syphilis in the past 30 days. TPA detection and WGS were conducted on lesion swabs, skin biopsies, skin scrapings, whole blood, or rabbit-passaged isolates. We compared our WGS data to publicly available genomes and analysed TPA populations to identify mutations associated with lineage and geography. FINDINGS: We screened 2802 patients and enrolled 233 participants, of whom 77 (33%) had primary syphilis, 154 (66%) had secondary syphilis, and two (1%) had early latent syphilis. The median age of participants was 28 years (IQR 22-35); 154 (66%) participants were cisgender men, 77 (33%) were cisgender women, and two (1%) were transgender women. Of the cisgender men, 66 (43%) identified as gay, bisexual, or other sexuality. Among all participants, 56 (24%) had HIV co-infection. WGS data from 113 participants showed a predominance of SS14-lineage strains with geographical clustering. Phylogenomic analyses confirmed that Nichols-lineage strains were more genetically diverse than SS14-lineage strains and clustered into more distinct subclades. Differences in single nucleotide variants (SNVs) were evident by TPA lineage and geography. Mapping of highly differentiated SNVs to three-dimensional protein models showed population-specific substitutions, some in outer membrane proteins (OMPs) of interest. INTERPRETATION: Our study substantiates the global diversity of TPA strains. Additional analyses to explore TPA OMP variability within strains is vital for vaccine development and understanding syphilis pathogenesis on a population level. FUNDING: US National Institutes of Health National Institute for Allergy and Infectious Disease, the Bill & Melinda Gates Foundation, Connecticut Children's, and the Czech Republic National Institute of Virology and Bacteriology.

• MeSH
• bakteriální vakcíny imunologie   aplikace a dávkování   MeSH
• dospělí MeSH
• fylogeneze MeSH
• genetická variace genetika   MeSH
• genom bakteriální MeSH
• genomika MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• molekulární epidemiologie * MeSH
• průřezové studie MeSH
• sekvenování celého genomu * MeSH
• syfilis * epidemiologie   mikrobiologie   MeSH
• Treponema pallidum * genetika   imunologie   MeSH
• Treponema MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Spojené státy americké MeSH

Haemophilus ducreyi (HD) is an important cause of cutaneous ulcers in several endemic regions, including the Western Pacific Region, especially among children. An HD sequence typing on swab samples taken from 1,081 ulcers in the Namatanai district of Papua New Guinea, during the pilot study for treatment of yaws, has been performed using the Grant typing system. Of the 363 samples that tested positive for the 16S rDNA of HD, the dsrA sequences of 270 samples were determined. Altogether they revealed 8 HD strain types circulating in Namatanai, including seven strain types of Class I (I.3, I.4, I.5, I.9, I.10, I.11, I.12) and one strain of Class II (II.3); four Class I types (I.9, I.10, I.11, I.12) were novel. The southern region of Namatanai (Matalai Rural) was identified as the region with the lowest genotype diversity and with most infections caused by HD Class II. The middle and northern subdistricts were affected mainly by HD Class I. Analysis of patient characteristics revealed that Class II HD infections were more often represented by longer-lasting ulcers than Class I HD infections. An increase in the prevalence of the I.10 strain was found after azithromycin administration compared to the untreated population at baseline likely reflecting higher infectivity of HD Class I, and more specifically strain type I.10.

• MeSH
• antibakteriální látky * terapeutické užití   farmakologie   MeSH
• azithromycin * terapeutické užití   MeSH
• dítě MeSH
• DNA bakterií genetika   MeSH
• dospělí MeSH
• frambézie mikrobiologie   epidemiologie   farmakoterapie   MeSH
• fylogeneze MeSH
• genotyp * MeSH
• Haemophilus ducreyi * genetika   izolace a purifikace   účinky léků   MeSH
• lidé středního věku MeSH
• lidé MeSH
• měkký vřed * mikrobiologie   epidemiologie   farmakoterapie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pilotní projekty MeSH
• předškolní dítě MeSH
• RNA ribozomální 16S genetika   MeSH
• sekvenční analýza DNA MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Papua Nová Guinea MeSH

The treponemes infecting lagomorphs include Treponema paraluisleporidarum ecovar Cuniculus (TPeC) and ecovar Lepus (TPeL), infecting rabbits and hares, respectively. In this study, we described the first complete genome sequence of TPeL, isolate V3603-13, from an infected mountain hare (Lepus timidus) in Sweden. In addition, we determined 99.0% of the genome sequence of isolate V246-08 (also from an infected mountain hare, Sweden) and 31.7% of the genome sequence of isolate Z27 A77/78 (from a European hare, Lepus europeaus, The Netherlands). The TPeL V3603-13 genome had considerable gene synteny with the TPeC Cuniculi A genome and with the human pathogen T. pallidum, which causes syphilis (ssp. pallidum, TPA), yaws (ssp. pertenue, TPE) and endemic syphilis (ssp. endemicum, TEN). Compared to the TPeC Cuniculi A genome, TPeL V3603-13 contained four insertions and 11 deletions longer than three nucleotides (ranging between 6 and2,932 nts). In addition, there were 25 additional indels, from one to three nucleotides long, altogether spanning 36 nts. The number of single nucleotide variants (SNVs) between TPeC Cuniculi A and TPeL V3603-13 were represented by 309 nucleotide differences. Major proteome coding differences between TPeL and TPeC were found in the tpr gene family, and (predicted) genes coding for outer membrane proteins, suggesting that these components are essential for host adaptation in lagomorph syphilis. The phylogeny revealed that the TPeL sample from the European brown hare was more distantly related to TPeC Cuniculi A than V3603-13 and V246-08.

• MeSH
• fylogeneze * MeSH
• genom bakteriální MeSH
• králíci MeSH
• syfilis * mikrobiologie   MeSH
• Treponema * genetika   izolace a purifikace   MeSH
• zajíci * mikrobiologie   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• lidé MeSH
• novorozenec MeSH
• vrozená syfilis * diagnóza   epidemiologie   patologie   terapie   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• přehledy MeSH

Syphilis is a multistage sexually transmitted disease caused by Treponema pallidum ssp. pallidum. In the Czech Republic, there are around 700-800 new syphilis cases annually, continuously increasing since 2012. This study analyzed a total of 1228 samples from 2004 to 2022. Of the PCR-positive typeable samples (n = 415), 68.7% were fully-typed (FT), and 31.3% were partially-typed. Most of the identified isolates belonged to the SS14-clade and only 6.3% were the Nichols-like cluster. While in the beginning of sample collection isolates have been macrolide-susceptible, recent isolates are completely resistant to macrolides. Among the FT samples, 34 different allelic profiles (APs) were found. Most of the profiles (n = 27) appeared just once in the Czech population, while seven profiles were detected more than twice. The most frequent APs belonged to two separate groups of SS14-like isolates, including group of 1.3.1 (ST 1) and 1.26.1 (ST 25) profiles, and the second group containing 1.1.8 (ST 3), 1.1.1 (ST 2), and 1.1.3 (ST 11) (representing 57.5%, and 25.3% of all detected APs, respectively). Both groups consistently differed in 6 nucleotide positions in five genes (TP0150, TP0324, TP0515, TP0548, and TP0691) coding amino-acid replacements suggesting that one or more of these differences could be involved in the higher success of the first group.

• MeSH
• alely * MeSH
• dospělí MeSH
• genotyp MeSH
• lidé středního věku MeSH
• lidé MeSH
• makrolidy farmakologie   MeSH
• multilokusová sekvenční typizace * MeSH
• syfilis * mikrobiologie   epidemiologie   genetika   MeSH
• Treponema pallidum * genetika   izolace a purifikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Pohlavně přenosné nemoci (STD) jsou infekce šířící se pohlavním stykem. Rizikovou skupinou jsou dospívající, kteří předčasně začínají se sexuálním životem, experimentují v sexuální oblasti a nedbají na ochranu svého zdraví. Výskyt těchto nemocí se poslední roky v České republice zvyšuje. Některé z těchto nemocí podléhají povinnému hlášení. Od roku 2011 dochází k postupnému nárůstu gonokokové infekce, která v posledních letech převyšuje i počty nakažených syfilis. U dospívajících se v letech 2020 až 2022 nejčastěji vyskytovala právě gonokoková infekce, na druhém místě byla syfilis. V článku jsou přiblíženy zejména pohlavně přenosné nemoci podléhající povinnému hlášení.

Sexually transmitted diseases (STDs) are infections spread by sexual intercourse. Adolescents who initiate their sexual life early, experiment in sexual activities, and do not care about protecting their health are a risk group. The incidence of STDs has been increasing in the Czech Republic in recent years. Some of these diseases are compulsorily notifiable. Since 2011, there has been a gradual increase in the rates of gonococcal infection that have recently even exceeded those of syphilis infection. Between 2020 and 2022, it was gonococcal infection that had the highest rates in adolescents, followed by syphilis. The article particularly deals with STDs that are compulsorily notifiable.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• cefalosporiny třetí generace terapeutické užití   MeSH
• chlamydiové infekce farmakoterapie   MeSH
• gonorea diagnóza   farmakoterapie   MeSH
• HIV MeSH
• lidé MeSH
• měkký vřed farmakoterapie   MeSH
• mladiství * MeSH
• peniciliny terapeutické užití   MeSH
• sexuálně přenosné nemoci * diagnóza   farmakoterapie   MeSH
• svrab farmakoterapie   MeSH
• syfilis diagnóza   farmakoterapie   MeSH
• tetracykliny farmakologie   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• mladiství * MeSH

The etiological agent of yaws is the spirochete Treponema pallidum (TP) subsp. pertenue (TPE) and infects the children of Papua New Guinea, causing ulcerative skin lesions that impairs normal growth and development. Closely related strains of Treponema pallidum subsp. pertenue, JE11, and TE13 were detected in an ulcer biospecimen derived from a 5-year-old yaws patient. Cloning experiments validated the presence of two distinct but similar genotypes, namely TE13 and JE11, co-occurring within a single host. While coinfection with highly related TPE strains has only limited epidemiological and clinical relevance, this is the first documented coinfection with genetically distinct TP strains in a single patient. Similar coinfections in the past were explained by the existence of over a dozen recombinant loci present in the TP genomes as a result of inter-strain or inter-subspecies recombination events following an anticipated scenario of TP coinfection, i.e., uptake of foreign DNA and DNA recombination.

• MeSH
• DNA bakterií genetika   MeSH
• frambézie * mikrobiologie   MeSH
• fylogeneze MeSH
• genotyp * MeSH
• koinfekce * mikrobiologie   MeSH
• lidé MeSH
• předškolní dítě MeSH
• sekvenční analýza DNA MeSH
• Treponema pallidum * genetika   izolace a purifikace   klasifikace   MeSH
• Treponema MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Papua Nová Guinea MeSH

Yaws is an endemic disease caused by Treponema pallidum subsp. pertenue (TPE) that primarily affects children in rural regions of the tropics. The endemic character of yaws infections and the expected exclusive reservoir of TPE in humans opened a new opportunity to start a yaws eradication campaign. We have developed a multi-locus sequence typing (MLST) scheme for TPE isolates combining the previously published (TP0548, TP0488) and new (TP0858) chromosomal loci, and we compared this typing scheme to the two previously published MLST schemes. We applied this scheme to TPE-containing clinical isolates obtained during a mass drug administration study performed in the Namatanai District of Papua New Guinea between June 2018 and December 2019. Of 1081 samples collected, 302 (28.5%) tested positive for TPE DNA, from which 255 (84.4%) were fully typed. The TPE PCR-positivity in swab samples was higher in younger patients, patients with single ulcers, first ulcer episodes, and with ulcer duration less than six months. Non-treponemal serological test positivity correlated better with PCR positivity compared to treponema-specific serological tests. The MLST revealed a low level of genetic diversity among infecting TPE isolates, represented by just three distinct genotypes (JE11, SE22, and TE13). Two previously used typing schemes revealed similar typing resolutions. Two new alleles (one in TP0858 and one in TP0136) were shown to arise by intragenomic recombination/deletion events. Compared to samples genotyped as JE11, the minor genotypes (TE13 and SE22) were more frequently detected in samples from patients with two or more ulcers and patients with higher values of specific TP serological tests. Moreover, the A2058G mutation in the 23S rRNA genes of three JE11 isolates was found, resulting in azithromycin resistance.

• MeSH
• dítě MeSH
• frambézie * epidemiologie   MeSH
• genotyp MeSH
• lidé MeSH
• multilokusová sekvenční typizace MeSH
• mutace MeSH
• Treponema pallidum * genetika   MeSH
• Treponema genetika   MeSH
• vřed MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Papua Nová Guinea MeSH

AIMS: To analyse the hallmarks of ocular manifestations of and therapeutic modalities for syphilis in the last two decades. The clinical features of syphilitic uveitis, and association with the human immunodeficiency virus (HIV) coinfection are described. METHODS: Retrospective study of 16 patients diagnosed with ocular syphilis confirmed by serological tests in the General University Hospital in Prague between the years 2004 and 2021. General characteristics of ocular and systemic manifestations and visual functions were analysed. RESULTS: An increasing incidence of syphilitic uveitis correlates with a general rise in syphilis cases. In our study, the ocular manifestation of syphilis was panuveitis (44%), posterior uveitis (31%) and anterior uveitis (25%). Posterior uveitis was found in 3 patients (19%) associated with preretinal infiltrates, that are often present in syphilitic uveitis. The worst visual outcomes were among patients with human immunodeficiency virus (HIV) coinfection and/or neurosyphilis, however the data were not significant. Optic disc edema was present in 56%, macular involvement in 37% of patients. Overall, 31% of patients in our cohort had persistent visual field defects due to impairment of their optic nerve or macula despite the final median Snellen visual acuity of 1.0. Two out of sixteen patients were treated with corticosteroids in addition to antibiotics. CONCLUSION: Posterior uveitis with preretinal infiltrates and optic disc edema should arouse suspicion of ocular syphilis. Recent data show the advantages of adjacent systemic corticosteroid treatment for severe forms of syphilitic uveitis and/or neuritis. Our observation supports this finding.

• MeSH
• HIV infekce * komplikace   diagnóza   farmakoterapie   MeSH
• koinfekce * komplikace   MeSH
• lidé MeSH
• městnavá papila * komplikace   MeSH
• oční infekce bakteriální * farmakoterapie   diagnóza   epidemiologie   MeSH
• retrospektivní studie MeSH
• syfilis * komplikace   farmakoterapie   diagnóza   MeSH
• uveitida * farmakoterapie   etiologie   diagnóza   MeSH
• zadní uveitida * komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH