Inflammatory Disease In Women Research Articles

Estimates of the Lifetime Productivity Costs of Chlamydia, Gonorrhea, and Syphilis in the United States.

Productivity costs of STIs reflect the value of lost time due to STI morbidity and mortality, including time spent travelling to, waiting for, and receiving STI treatment. The purpose of this study was to provide updated estimates of the average lifetime productivity cost for chlamydia, gonorrhea, and syphilis, per incident infection. We adapted published decision tree models from recent studies of the lifetime medical costs of chlamydia, gonorrhea, and syphilis in the United States. For each possible outcome of infection, we applied productivity costs that we obtained based on published health economic studies. Productivity costs included the value of patient time spent to receive treatment for STIs and for related sequelae such as pelvic inflammatory disease in women. We used a human capital approach and included losses in market (paid) and non-market (unpaid) productivity. We conducted one-way sensitivity analyses and probabilistic sensitivity analyses. The average lifetime productivity cost per infection was $28 for chlamydia in men, $205 for chlamydia in women, $37 for gonorrhea in men, $212 for gonorrhea in women, and $411 for syphilis regardless of sex, in 2023 US dollars. The estimated lifetime productivity costs of these STIs acquired in the United States in 2018 was $795 million. These estimates of the lifetime productivity costs can help in quantifying the overall economic burden of STIs in the United States beyond just the medical cost burden and can inform cost-effectiveness analyses of STI prevention activities.

563. Mycoplasma genitalium with Fluoroquinolone Resistance: Design and Development of a Multiplex Real-Time PCR Assay for Detection and Differentiation

Abstract Background Mycoplasma genitalium is a sexually transmitted bacterium causing urethritis in men and associated with cervicitis and pelvic inflammatory disease in women. Only a few antimicrobial classes have activity against mycoplasmas. The first-line treatment for M. genitalium infections is doxycycline followed by azithromycin. Due to overuse of azithromycin to treat infections, resistance to azithromycin has been rapidly increasing. The moxifloxacin of fluoroquinolones family of antibiotics was 100% effective against M. genitalium, but recently the resistance markers for fluoroquinolone treatment have also emerged. Multiple studies attribute fluoroquinolone treatment failure to single nucleotide polymorphisms (SNPs) in parC and gyrA genes. We aim to demonstrate proof of principle for a Real-Time PCR assay that simultaneously detects M. genitalium and fluoroquinolone resistance. Methods The MGB Alert M. genitalium with fluoroquinolone resistance RUO Detection Reagent is a multiplex of real-time PCR reagents that simultaneously detect M. genitalium DNA and distinguish fluoroquinolone resistance-associated mutations and wild type in M. genitalium. The assay targets parC and gyrA genes and includes a set of two primers and two probes specific to M. genitalium. The DSQ probe identifies the species DNA. The Pleiades hybridization probes serve to identify and distinguish a wild type genotype and several known resistance-conferring point mutations by melt curve analysis. Results Analytical Study: Analytical sensitivity was determined and verified at 1.42 copy of bacterial genome per reaction. A linear range was established from 1e7 to 10 genome copies per reaction. Test results showed no cross-reactivity with organisms that might be present in normal vaginal swabs and urine specimens. Conclusion Preliminary analytical evaluation of the MGB Alert M. genitalium with fluoroquinolone resistance RUO Detection Reagent indicates potential as a valuable tool in the diagnosis of M. genitalium and resistance guided treatment. Disclosures Boris Alabyev, PhD, ELITechGroup MDx LLC: Salary Irina Ankoudinova, MS, ELITechGroup MDx LLC: Salary Noah Scarr, BS, ELITechGroup MDx LLC: Salary Becca Decker, BS, ELITechGroup MDx LLC: Salary Eugene Lukhtanov, PhD, ELITechGroup MDx LLC: Salary

Assessment of Factors Associated with Increased Number of Sexually Transmitted Infection Cases among the Youth in Serenje Urban District, Zambia

Introduction: Sexually transmitted infections among the youth are of paramount concern to all people who work on improving the health status of populations worldwide as the highest reported rates of sexually transmitted infections are found among the people between 15-24 years of age which predispose them to infertility, general ill-health, pelvic inflammatory diseases in women, three-fold HIV transmission with mother-to-child sexually transmitted infections resulting in still births, neonatal deaths, prematurity, sepsis, pneumonia, congenital deformities and other morbidities. Therefore the study aimed to assess the factors associated with increased number of sexually transmitted cases in the youth of Serenje Urban District, Zambia. Methodology: A cross-sectional study was conducted on 138 youth of Serenje urban district selected using simple random sampling technique. The data were collected using a structured, pre-tested interviewer-administered questionnaire. Chi square and multivariate logistical regression analyses were employed through SPSS version 22 to assess and identify factors associated with increased sexually transmitted cases in the youth of Serenje urban district. Odds Ratio with a 95% confidence interval was computed to determine the level of association. In the multivariate analysis, variables with p-value less than 5% were considered as statistically associated, association between covariates and sexually transmitted infections. Results: The prevalence of sexually transmitted infections among the youth of Serenje Urban District was found to be 55%. About 47.8% of the respondents had high knowledge levels on STIs, 60% had multiple sexual partners, 34.8% used condom during the last intercourse, 27.5% experienced sexual coercion and 24.5% utilized youth friendly services. Most (43.5%) respondents in this study had poor practices towards STI prevention. Service related such as lack of consumable for STI treatment (92%) and erratic supply ........

PFKFB3 promotes endometriosis cell proliferation via enhancing the protein stability of β-catenin

Endometriosis is a common inflammatory disease in women of reproductive age and is highly associated with infertility. However, the molecular mechanism of endometriosis remains unclear. 6-Phosphofructose-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) is a key enzyme in glycolysis and plays an important regulatory role in the development of cancer. Here we found that PFKFB3 is highly expressed in endometriotic tissues. PFKFB3 promotes the proliferation and growth of endometriosis cells. Meanwhile, PFKFB3 promotes glycolysis in endometriosis cells. Furthermore, PFKFB3 promotes migration and invasion of endometriosis cells. On this basis, we found that PFKFB3 promotes epithelial-mesenchymal transition (EMT) in endometriosis cells. PFKFB3 interacts with the essential factor of EMT, β-catenin, and promotes the protein stability of β-catenin. In addition, the PFKFB3 inhibitor PFK-015 inhibites the growth of endometriosis cells and the development of endometrial tissue. In conclusion, our study shows that PFKFB3 plays an important role in the development of endometriosis and provides new ideas for the clinical diagnosis or treatment of endometriosis.

Antimullerian Hormone, a Marker of Ovarian Reserve, Is Protective Against Presence and Severity of NASH in Premenopausal Women

Antimüllerian hormone (AMH) is a marker of ovarian reserve with emerging data linking lower levels to some metabolic and inflammatory diseases in women. Whether AMH levels influence nonalcoholic fatty liver disease (NAFLD) is unknown. Leveraging the NASH Clinical Research Network we determined the association of AMH levels within 6 months of liver biopsy with presence and severity of histologic measures of NAFLD in premenopausal women. Outcomes included presence of nonalcoholic steatohepatitis (NASH), presence and severity of fibrosis, and NAFLD Activity Score and its components. Logistic and ordinal logistic regression models were adjusted for age, race/ethnicity, homeostatic model assessment for insulin resistance, body mass index, dyslipidemia, polycystic ovary syndrome, estrogen-progestin use, and menstrual cyclicity. Median cohort age was 35 years; 73% were white and 24% Hispanic. Thirty-three percent had diabetes, 81% had obesity, and 95% had dyslipidemia. On biopsy 71% had NASH, 68% had any fibrosis, and 15% had advanced fibrosis. On adjusted analysis (n= 205), higher AMH quartiles were inversely associated with NAFLD histology including prevalent NASH (adjusted odds ratio [AOR], 0.64; 95% confidence interval [CI], 0.41-1.00), NAFLD Activity Score ≥5 (AOR, 0.52; 95% CI, 0.35-0.77), Mallory hyaline (AOR, 0.54; 95% CI, 0.35-0.82), and higher fibrosis stage (AOR, 0.70; 95% CI, 0.51-0.98). The protective effects of AMH were more pronounced among women without polycystic ovary syndrome (n= 164), including lower odds of NASH (AOR, 0.53; 95% CI, 0.32-0.90) and any NASH fibrosis (AOR, 0.54; 95% CI, 0.32-0.93). AMH may reflect a unique biomarker of NASH in premenopausal women and findings suggest a novel link between reproductive aging and histologic severity of NAFLD in women.

Obstetrical and perinatal consequences of birth in women depending on the term of gestation

The objecticve: to analyze peculiarities of pregnancy course, childbirth and the condition of newborns in women, depending on the gestation period on the basis of clinical and statistical analysis.Materials and methods. An analysis of pregnancy course, childbirth and perinatal outcomes has been carried out in 137 pregnant women. Patients were divided into 2 groups depending on the gestational age: 41 patients (I group) delivered in 37–40 weeks of gestation and 96 patients (II group) – in 41-42 weeks of pregnancy. Functional assessment of the fetal condition was performed using a cardiotocographic examination with cardiomonitors «Oxford Team 8000» and Hewlett Packard according to the generally accepted method, ultrasound examination – by ultrasound machine «Biomedica Au-530» with a linear sensor of 3.5 MHz frequency. Variational and statistical processing of the results has been carried out using licensed standard packages of multivariate statistical analysis application programs «STATISTICA 13».Results. An evaluation of anamnestic data allowed to establish that the majority of patients in the II group (53.13 %) had extragenital pathology that was in 2 times more than in the I group (24.39 %). The frequency of chronic salpingo-oophoritis was also significantly higher in the II group compared to the I one (12.50 % and 2.44 %, respectively), and such pathology as uterine leiomyoma (7.29 %) and cervical dysplasia (4.17 %) were diagnosed only among the women in the II group.A higher rate of pregnancy loss, anemia during pregnancy and disorders of uteroplacental bloodflow in patients in the II group was determined. The frequency of obstetric complications in the II group was in 4 times higher compared to the I group. This had a direct impact on the increase in the rate of cesarean section and vacuum extraction of fetus. Thus, fetal distress during childbirth was diagnosed in 13.54 % of women in the II group and in 7.32 % in the I group, and the weakness of labor activity (8,3 %) and clinically contracted pelvis (5.21 %) were determined only in the II group. Trauma of the birth canal was found in 37.5 % of women in the II group, which was almost 4 times higher than in the group I (9.76 %). The frequency of postpartum bleeding was also higher in the group II (15.6 %) and exceeded the indicator in the I group (4.88 %) in 3 times.The signs of prolonged pregnancy were found in 7.32 % newborns in the I group and 13.54 % – in the II group. It should be noted that the clinical features of early adaptation, which are characterized by a low Apgar score at birth, as well as higher morbidity, including high frequency of damage to the nervous system were determined in the newborns in the II group.Conclusions. Results of the study indicate the importance of constitutional and age characteristics, as well as concomitant somatic pathology and genital inflammatory diseases in women with a delivery date of 41–42 weeks of pregnancy, which can increase the probability of postterm pregnancy in these women. According to the results of the comparative analysis in the research groups, depending on the date of delivery, the predominance of obstetric and perinatal complications was established in women who delivered at 41–42 weeks of pregnancy compared to women who had labor at 37–40 weeks. A high rate of obstetric complications (anomalies of uterine activity in labor, fetal distress, clinically contracted pelvis) had a direct impact on the increase in a percentage of operative delivery (vacuum extraction of a fetus and caesarean sections). Babies born at 41–42 weeks had clinical features of early adaptation, characterized by a low Apgar score, higher morbidity and frequent damage of the nervous system compared to newborns with gestation period of 37–40 weeks.

Effect of 6 weeks of aerobic training with nanocurcumin consumption on IL1β, nitric oxide, and depression in women with metabolic syndrome

Backgrounds and ObjectivesThe use of anti-inflammatory supplements is important in improving the executive function of obese people. This research aims to investigate the effect of 6 weeks of aerobic exercise with moderate intensity as well as the consumption of nanocurcumin on IL1β, nitric oxide (NO), and depression in women aged 60–65 with metabolic syndrome.Materials and MethodsFourty-four women with metabolic syndrome were randomly selected and divided into four groups of 10 based on their use of nanocurcumin supplement. The treatment included the training (T), nanocurcumin (N), training + nanocurcumin (TN), and the control groups. The groups exposed to training performed aerobic exercise for 6 weeks (three sessions per week). Blood samples were obtained before and after the training period for antioxidant indicators and lipid degradation measurement. Also, the Beck anxiety questionnaire was used for evaluating levels of anxiety. T-test and one-way analysis of variance (ANOVA) tests were used for the assessment of within-group and between-group differences, respectively.ResultsThere was a significant difference in IL1β, NO, and depression before and after exercise in all three experimental groups (p ≤ 0.05). Also, the results showed a significant difference in the level of NO and depression in the experimental groups. The highest decrease in these variables was observed in the T and TN groups (p ≤ 0.05).ConclusionThese findings indicated that 6-week nanocurcumin supplementation with aerobic training is a suitable method for reducing IL1β, NO, and depression, preventing metabolic, cardiovascular, and inflammatory diseases in women with metabolic syndrome.Name of the registry: IR.SEMUMS.REC.1396.107Trial registration number: IRCT2017082335857N1

Potential therapeutic targets for combating Mycoplasma genitalium.

Mycoplasma genitalium (M. genitalium) has emerged as a sexually transmitted infection (STI) all over the world in the last three decades. It has been identified as a cause of male urethritis, and there is now evidence that it also causes cervicitis and pelvic inflammatory disease in women. However, the precise role of M. genitalium in diseases such as pelvic inflammatory disease, and infertility is unknown, and more research is required. It is a slow-growing organism, and with the advent of the nucleic acid amplification test (NAAT), more studies are being conducted and knowledge about the pathogenicity of this organism is being elucidated. The accumulation of data has improved our understanding of the pathogen and its role in disease transmission. Despite the widespread use of single-dose azithromycin in the sexual health field, M. genitalium is known to rapidly develop antibiotic resistance. As a result, the media frequently refer to this pathogen as the "new STI superbug." Despite their rarity, antibiotics available today have serious side effects. As the cure rates for first-line antimicrobials have decreased, it is now a challenge to determine the effective antimicrobial therapy. In this review, we summarise recent M. genitalium research and investigate potential therapeutic targets for combating this pathogen.

Chlamydia trachomatis Coinfection Does Not Influence Mycoplasma genitalium Bacterial Load in Urogenital Samples.

Mycoplasma genitalium (MG) is associated with urethritis in men and weakly associated with pelvic inflammatory disease in women. Mycoplasma genitalium coinfections with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are commonly reported; however, little is known about their interaction. One study suggested that MG/NG coinfections might increase the bacterial load of NG, which has been shown to have a higher transmission potential. As even less is known about the impact of a simultaneous MG/CT infection, we assessed whether patients with urogenital MG/CT coinfections have a higher bacterial load than patients with a single infection. There were 1673 urogenital samples from patients from a population-based chlamydia study, and our sexually transmitted infection clinic tested for both CT and MG. When positive, the load was quantified. Nonparametric tests compared the CT and MG load, and linear regression analyses tested the association of the CT and MG load within a patient. In 60 MG-positive patients, MG load ranged from 1.7 to 6.0 log10 copies/ml, similar to the CT load distribution. Only 6 patients were MG-positive and CT-negative, but the MG load distribution was similar to that of CT-positive patients (n.s.). The MG and CT load was unrelated in coinfected persons (n.s.). We found no correlation between the CT and MG load in urogenital samples, and the MG load distribution was similar in CT-positive and CT-negative patients. These results could have implications for the transmission risk of these infections.

Huayu Jiedu Fang Protects Ovarian Function in Mouse with Endometriosis Iron Overload by Inhibiting Ferroptosis.

Endometriosis (EM) is a common chronic inflammatory disease in women. Sampson's retrograde menstruation theory is the most widely accepted theory of EM pathogenesis. The periodic bleeding of ectopic lesions is an important pathological feature of this disease, and the occurrence and progression of EM are closely associated with the iron overload caused by ectopic lesions. However, animal models that simulate menstrual-blood reflux and hemorrhage from EM lesions are lacking. In this study, we performed intraperitoneal injection of endometrial fragments and periodic intraperitoneal blood injection to simulate the real cause and disease state of EM and successfully constructed a mouse model of EM iron overload. Our research found that the number, size, and degree of adhesion of EM lesions in the iron-overload model mouse were significantly higher than those in the model mouse. Moreover, the iron concentration in the abdominal fluid and ovary significantly increased, and the level of malondialdehyde (MDA) in the ovary increased. Conversely, GPX4, GSH, and other anti-ferroptosis-related proteins were downregulated, proving the occurrence of ferroptosis. Huayu Jiedu Fang (HYJDF) is an empirical prescription for EM treatment. This study combined animal experiments, UHPLC-QE-MS analysis, and network pharmacology to analyze whether HYJDF can inhibit ferroptosis to slow down the progression of EM and protect ovarian function. Based on the constructed iron-overload model, HYJDF can reduce the volume of EM lesions and the degree of adhesion, downregulate the total iron concentration in the peritoneal fluid and ovary, upregulate GPX4 expression and GSSG in the ovary, downregulate the level of MDA in the ovary, and promote the development of follicles. We further confirmed that HYJDF can inhibit the progression of EM disease and improve the ovarian function of the model mouse by inhibiting ferroptosis. Finally, through UHPLC-QE-MS and network pharmacology analysis, the natural compounds in HYJDF were identified and verified and the regulatory effect of HYJDF on the EM ferroptosis pathway through the IL-6/hepcidin pathway was preliminarily elucidated.

Frequency of Pelvic Inflammatory Disease in Infertile Patients

Aim: Frequency of pelvic inflammatory disease in women presenting with infertility Study design: Cross sectional research Setting: Obstetrics/Gynaecology Deptt., Services Hospital, Lahore from 20-10-2017 to 20-04-2018. Methods: One hundred married females with Infertility (Primary/Secondary) were included in the study. Patients with H/o intrauterine contraceptive devices usage, diabetes, male factor Infertility and H/O pelvic surgery were excluded. All women were taken complete history and detailed physical and gynecological examination and HVS was sent to laboratory for culture. Results: Age was from 20 to 35 years with mean ± SD 29.41±2.35 yrs, mean±SD of weight 70.09±12.66kg, mean±SD height 1.54±0.09 meters, mean ± SD of BMI 29.67±5.09 Kg/m2 and mean±SD duration of Infertility was 2.5±0.97 years. Majority of the patients were from 0-2 parity (92%). Primary infertility was found in 64% women while secondary infertility was 36%. Pelvic Inflammatory Disease was found in 27% patients. Conclusion: Tubal damage before and during the index episode of PID is correlated with infertility. Keywords: Infertility, Pelvic inflammatory disease, Frequency

Mycoplasma genitalium: A new superbug.

Mycoplasma genitalium (MG) is an emerging sexually transmitted pathogen. It is an important cause of nongonococcal urethritis in men and is associated with cervicitis and pelvic inflammatory disease in women, putting them at risk of infertility. Multiple factors that aid pathogenesis of MG include its ability of adhesion, gliding motility, and intracellular invasion by means of the tip organelle. Through intracellular localization and antigenic variation, MG could result in treatment-resistant chronic infection. There are limited data on the prevalence of MG in Indian patients with urogenital syndromes. Recently, a high prevalence of extra genital infection with MG has been reported. Molecular assays are the major diagnostic techniques of MG infection. Antimicrobial agents such as macrolides, along with fluoroquinolones, are the treatment of choice for MG infections. The issue of drug resistance to azithromycin and fluoroquinolones in MG is rising globally. As molecular tests are becoming available for MG, both for the diagnosis and the detection of antimicrobial resistance, any patient with MG infection should then be tested for antimicrobial resistance. Consideration of MG as a cause of sexually transmitted disease in the Indian population is crucial in diagnostic algorithms and treatment strategies. The purpose of this review is to understand the prevalence of MG in different clinical scenarios, molecular mechanisms of pathogenesis, current status of antimicrobial resistance, and its impact on MG treatment.

Immunoassay to categorize chlamydial inflammatory disease in women to develop biomarker from peptide derived stimulant and its response to cytokine

Chlamydia trachomatis infection in women can result in serious sequelae such as pelvic inflammatory disease and infertility. Previous research has suggested that peptide epitopes from HtrA and HSP60 are potential biomarkers for immune cell reactions. Thus, in this study we tested the hypothesis that these peptides could be used for future development of an immunoassay to detect at-risk women of pathology by a profile of the cytokine response. Our findings indicate that some chlamydial peptide antigens stimulated cervical mononuclear cell production of IL-6 and IFN-y resulting from cervical cell proliferation from women with pelvic inflammatory disease (PID) and/or cervicitis to a greater extent than that observed in negative control cohorts. Proliferative response of cervical cells induced by peptide antigens strongly reduces IL-10 concentration. We evaluated the suitability of different pairs of peptide antigens for the predictive value of chlamydial infection based on the cytokine induction. Whilst the cytokine response was not statistically significant, the data suggests that an immunoassay may be possible to develop in future for early detection of serious chlamydial infection sequelae.

Azithromycin and Doxycycline Resistance Profiles of U.S. Mycoplasma genitalium Strains and Their Association with Treatment Outcomes.

ABSTRACTMycoplasma genitalium is a sexually transmitted bacterium associated with nongonococcal urethritis (NGU) in men and cervicitis, endometritis, and pelvic inflammatory disease in women. Effective treatment is challenging due to the inherent, and increasingly acquired, antibiotic resistance in this pathogen. In our treatment trial conducted from 2007 to 2011 in Seattle, WA, we demonstrated poor efficacy of azithromycin (AZM) and doxycycline (DOX) against M. genitalium among men with NGU. In the present study, we cultured M. genitalium from 74 of 80 (92.5%) PCR-positive men at enrollment (V-1) and defined the MICs of AZM (N = 56 isolates) of DOX (N = 62 isolates). Susceptibility to AZM was bimodal; MICs were >8 μg/ml (44.6%) and <0.004 μg/ml (55.4%) for these isolates. The association of MIC with treatment efficacy was determined for men initially treated with either AZM (N = 30) or DOX (N = 24). Men treated with AZM were more likely to experience microbiologic treatment failure (P < 0.001) if infected with isolates that had AZM MICs of >8 μg/ml (18/18 men) than those with isolates that had AZM MICs of <0.004 μg/ml (1/12 men). Clinical treatment failure also was more likely to occur (P = 0.002) with AZM MICs of >8 μg/ml (12/18 men) than with AZM MICs of <0.004 μg/ml (1/12 men). In contrast, DOX MICs ranged from <0.125 to 2 μg/ml and were not correlated with microbiologic (P = 0.71) or clinical treatment (P = 0.41) failure, demonstrating no relationship between DOX MICs and treatment efficacy. Given the rapid spread of AZM resistance and the emergence of quinolone resistance, the current second-line therapy, monitoring MICs and evaluating other potential treatments for M. genitalium will be critical.

Diagnosis of severity and choice of tactics for the treatment of pelvic inflammatory diseases in women

Purpose of the study: to analyze the diagnosis of severity and the choice of treatment tactics for pelvic inflammatory diseases in women.Material and methods. The analysis of clinical studies of 14 women with pelvic inflammatory diseases, including 9 women who were treated conservatively and 5 patients who underwent urgent surgical treatment in the City Clinical Hospital №1 of the city of Odesa in 2020-2021, was carried out. For the diagnosis of the severity of the disease and the choice of tactics for the treatment of pelvic inflammatory diseases, the level of procalcitonin and the data of calculations of the leukocyte index of intoxication of Kalf-Kalif were taken into account.Results. The average age of the patients participating in the study was 34.1 ± 1.2 years, the median was 33.5 years, and the mode was 32 years. The average age of patients who were operated on for pelvic inflammatory diseases was 37.4 ± 1.3, while the average age of patients treated conservatively reached 32.2 ± 1.4 years. The patients were in the hospital for 4 to 10 days, on average - 6.9 ± 0.4 days. In patients who underwent conservative treatment, the level of procalcitonin averaged 1.14 ± 0.3 ng / L, while in operated women, it was 3.67 ± 0.6 ng / L. At the same time, the average index of the leukocyte index of intoxication in women receiving conservative therapy was 2.2 ± 0.1, and in patients who were subsequently operated on 2.9 ± 0.2. A comparative assessment determines the strong and direct relationship between procalcitonin and leukocyte intoxication index (rS = 0.78; p &lt;0.05). There was a significant increase in the level of procalcitonin and the leukocytic index of intoxication in women who were subsequently operated on OR = 2.0; RR = 7.2.Conclusions1. In a comparative assessment of the severity state, strong and direct relationships between procalcitonin and the leukocyte intoxication index (rS = 0.78; p &lt;0.05) are determined in women with pyoinflammatory diseases of the pelvic organs.2. In women who were subsequently operated on, a significant increase in the level of procalcitonin and the leukocyte index of intoxication OR = 2.0 was revealed; RR = 7.2.3. The analysis for the content of procalcitonin in most cases requires time (up to 1 working day), which is sometimes unacceptable when it is necessary to make a clinical decision on further treatment tactics.4. The data for calculating the leukocyte index of intoxication can be used after receiving the results of a general blood test. But the calculation of the leukocyte index of intoxication also takes time and is not always convenient. Therefore, it makes sense to use a simplified and more mobile intoxication index.5. The data obtained require more extensive and detailed analysis and should be used in a prospective study with a larger sample to choose the tactics for treating women with pelvic inflammatory diseases and the possibility of predicting postoperative purulent-septic complications.

Chlamydia trachomatis and Mycoplasma genitalium prevalence and associated factors among women presenting to a pregnancy termination and contraception clinic, 2009–2019

BackgroundRisk of pelvic inflammatory disease associated with Chlamydia trachomatis and Mycoplasma genitalium is increased after termination of pregnancy (TOP) and may be increased after insertion of intrauterine devices (IUDs). Screening...

Prevalence and Epidemiology of Mycoplasma genitalium in a Pacific-Region Military Population.

Mycoplasma genitalium is an important emerging sexually transmitted pathogen commonly causing urethritis in men, cervicitis, and pelvic inflammatory disease in women with potential of infertility. Accumulating evidence identifies the prevalence of M. genitalium similar to long recognized pathogens, Chlamydia trachomatis and Neisseria gonorrhoeae. The purpose of this study was to establish the prevalence and epidemiology of M. genitalium in a mid-Pacific military population. A prospective analysis was conducted from routine specimens collected as standard of care for sexually transmitted infection (STI) testing at Tripler Army Medical Center on Oahu, HI. The prevalence of M. genitalium was determined using the Aptima M. genitalium assay, a transcription-mediated amplification test. A multivariate analysis was performed to assess the associations for this infection with other STIs and demographic factors. A total of 1876 specimens were tested in a 6-month period including 6 sample types from 1158 females and 718 males. Subject ages ranged from 18 to 76 years, with a median of 24 years (interquartile range, 21-29 years). The prevalence of M. genitalium was 8.8% overall (n = 165), 7.1% in females and 11.6% in males. Coinfection with M. genitalium occurred with another sexually-transmitted pathogen in 43 patients (18.3%), with C. trachomatis as the most common organism (n = 38). These data contribute to the evidence base for M. genitalium and STI screening in an active-duty military.

1532. Demographics and Population Epidemiology of Mycoplasma genitalium infection: Correlation to Co-Infection and prior STI history

BackgroundDespite reports in the past few years that Americans are having less sex, the US Centers for Disease Control and Prevention (CDC) recently reported in 2019 that sexually transmitted infection (STI) cases are at an all-time high in the United States. The CDC report included statistics on confirmed cases of Chlamydia trachomatis and Neisseria gonorrhoeae, but did not include data for Trichomonas vaginalis and Mycoplasma genitalium. Although Trichomonas vaginalis and Mycoplasma genitalium are generally recognized agents responsible for STI’s, there is limited prevalence data in the United States.MethodsHerein we present STI prevalence and socio-demographic epidemiological data associated with patients enrolled in a multicenter STI study using the automated multiplex qualitative CE marked assay, Alinity m STI. The enrolled study population reflected a diverse number of participants with an approximately equal male to female ratio, prior STI history, single and married, education levels from primary to post-graduate, as well as different ethnicities.ResultsParticipants in this study population who have previously been diagnosed with an STI had an overall Mycoplasma genitalium prevalence rate that was approximately double those who have not been previously diagnosed with an STI. Furthermore, the co-infection rate for Mycoplasma genitalium and Trichomonas vaginalis was as high as 2.5% for vaginal swab specimens with an overall Mycoplasma genitalium prevalence of 11.6%. The overall prevalence of Trichomonas vaginalis in women was 12.3%. Neisseria gonorrhoeae had the lowest overall prevalence in men and women at 2.4%, and Chlamydia trachomatis at had an overall prevalence of 9.8%.ConclusionMycoplasma genitalium infections are generally asymptomatic in both men and women that contributes to up to 35% of non‐chlamydial non‐gonococcal urethritis in men and linked to cervicitis and pelvic inflammatory disease in women. Left untreated or not accurately diagnosed, STIs can cause significant, serious long-term health consequences including sexual, reproductive, and psychological well-being that present an extensive challenge and burden to public health in the United States.DisclosuresJose Santiago, PhD, Abbott (Employee)

Alternative conformation of the C-domain of the P140 protein from Mycoplasma genitalium.

The human pathogen Mycoplasma genitalium is responsible for urethritis in men, and for cervicitis and pelvic inflammatory disease in women. The adherence of M.genitalium to host target epithelial cells is mediated through an adhesion complex called Nap, which is essential for infectivity. Nap is a transmembrane dimer of heterodimers of the immunodominant proteins P110 and P140. The M.genitalium genome contains multiple copies of portions that share homology with the extracellular regions of P140 and P110 encoded by the genes mg191 and mg192, respectively. Homologous recombination between the genes and the copies allows the generation of a large diversity of P140 and P110 variants to overcome surveillance by the host immune system. Interestingly, the C-terminal domain (C-domain) of the extracellular region of P140, which is essential for thefunction of Nap by acting as a flexible stalk anchoring the protein to the mycoplasma membrane, presents a low degree of sequence variability. In the present work, the X-ray crystal structures of two crystal forms of a construct of the P140 C-domain are reported. In both crystal forms, the construct forms a compact octamer with D4 point-group symmetry. The structure of the C-domain determined in this work presents significant differences with respect to the structure of the C-domain found recently in intact P140. The structural plasticity of the C-domain appears to be a possible mechanism that may help in the functioning of the mycoplasma adhesion complex.

Management of endometriosis-related infertility: Considerations and treatment options.

Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.