Urethral Samples Research Articles

Comparative analysis of the testicular and uretral microbiota in azoospermia patients using next generation sequencing (NGS)

Aim. To determine the role of taxonomic bacterial diversity of the urethral and testicular microbiota in the development of male infertility using high-throughput next-generation sequencing (NGS).Material and methods. In the period between 2018 and 2022 we examined 53 patients. Three study groups were formed: Infertile patients with nonobstructive azoospermia and concomitant varicocele (n = 13) – group 1; Infertile patients with obstructive azoospermia (n = 29) – group 2; Fertile patients with confirmed paternity and testicular pathology requiring histological verification to exclude testicular oncopathology (n = 11) – group 3. Each patient underwent TESE with testicular both and urethral tissue sampling in order to compare the bacterial landscape and control the purity of the method. The obtained material was sequenced using a high-throughput method (NGS).Results.According to our findings, the testicular tissue of obstructive azoospermia patients had significantly depleted bacterial diversity in comparison to nonobstructive azoospermia and concomitant varicocele ones. Also, the fertile group turned out to be the most diverse in its taxonomic community. These results may suggest the bacterial microbiome’s influence on men’s reproductive health.Discussion.Our urogenital bacterial diversity analysis showed that human testicular tissue is not a microbiologically sterile environment and also presented new data associated with testicular tissue and its possible relations with male infertility.Conclusion. A focus on the qualitative and quantitative composition of the testicular microbial community may form the new basis in the diagnosis and treatment of male infertility associated with various types of azoospermia

Trends of Antimicrobial Susceptibility of Neisseria gonorrhoeae Isolates Between 2012 and 2023: Results From an Open Italian Cohort.

Neisseria gonorrhoeae (Ng) is a public health priority because of the rapid evolution of antimicrobial resistance, the emergence of antibiotic resistance, and the absence of a vaccine against Ng. The aim of this study was to investigate trends in the minimum inhibitory concentration and resistance (R) or reduced susceptibility (DS) of Ng cases to ceftriaxone (CRO), azithromycin (AZM), tetracycline (TET), benzylpenicillin (PenG), and ciprofloxacin (CIP) during a 10-year period. We conducted a retrospective analysis on an open cohort of Ng cases diagnosed on rectal, urethral, and pharyngeal samples at San Raffaele Scientific Institute, between September 2012 and February 2023. Minimum inhibitory concentrations of antibiotics were determined by gradient-test strips. Bivariate linear regression models were applied on logarithmic minimum inhibitory concentrations values; Cochran-Armitage test was used to determine a linear trend in the proportions of resistant strains. A total of 436 Ng isolates from 352 individuals were analyzed. Minimum inhibitory concentrations of CRO and PenG reduced over time ( P < 0.001, P = 0.030), AZM increased ( P = 0.001), and CIP and TET did not change ( P = 0.473, P = 0.272). The percentages of resistant strains were as follows: PenG, 89.9%; TET, 90.8%; CIP, 48.2%; AZM, and 4.4%. CRO-DS strains were 8.7%, and only 1 case of CRO-R was identified. The proportion of resistant strains increased over time for AZM ( P = 0.007), TET ( P = 0.001), and CIP ( P < 0.001), whereas it decreased for PenG ( P < 0.001) and CRO-DS/R strains ( P < 0.001). Ng strains showed high susceptibility to CRO, although we identified cases of DS/R and observed high levels of susceptibility to AZM. Overall, the recommended primary regimen for Ng treatment was confirmed to be effective.

Genotypic study of Chlamydia trachomatis for lymphogranuloma venereum diagnosis in rectal specimens from men who have sex with men: a cost-effectiveness analysis

PurposeThe significant proportion of asymptomatic patients and the scarcity of genotypic analysis of lymphogranuloma venereum (LGV), mainly among men who have sex with men (MSM), triggers a high incidence of underdiagnosed patients, highlighting the importance of determining the most appropriate strategy for LGV diagnosis, at both clinical and economical levels.Materials and methodsWe conducted L1-L3 serovar detection by molecular biology in stored Chlamydia trachomatis-positive samples from MSM patients with HIV, another STI or belonging to a Pre-exposure prophylaxis program, to make a cost effectiveness study of four diagnostic strategies with a clinical, molecular, or mixed approach.ResultsA total of 85 exudates were analyzed: 35urethral (31 symptomatic/4 positive) and 50 rectal (22 symptomatic/25 positive), 70/85 belonging to MSM with associated risk factors. The average cost per patient was €77.09 and €159.55 for clinical (Strategy I) and molecular (Strategy IV) strategies respectively. For molecular diagnosis by genotyping of all rectal exudate samples previously positive for CT (Strategy II), the cost was €123.84. For molecular diagnosis by genotyping of rectal and/or urethral exudate samples from all symptomatic patients (proctitis or urethritis) with a previous positive result for CT (Strategy III), the cost was €129.39. The effectiveness ratios were 0.80, 0.95, 0.91, and 1.00 for each strategy respectively. The smallest ICER was €311.67 for Strategy II compared to Strategy I.ConclusionsWith 30% asymptomatic patients, the most cost-effective strategy was based on genotyping all rectal exudates. With less restrictive selection criteria, thus increasing the number of patients with negative results, the most sensitive strategies tend to be the most cost-effective, but with a high incremental cost-effectiveness ratio.

Improving gonorrhoea molecular diagnostics: Genome mining-based identification of identical multi-repeat sequences (IMRS) in Neisseria gonorrhoeae

BackgroundCurable sexually transmitted infections (STIs), such as Neisseria gonorrhoeae (N. gonorrhoeae), are a major cause of poor pregnancy outcomes. The infection is often asymptomatic in pregnant women, and a syndrome-based approach of testing leads to a missed diagnosis. Culture followed by microscopy is inadequate and time-consuming. The gold standard nucleic acid amplification tests require advanced infrastructure settings, whereas point-of-care tests are limited to immunoassays with sensitivities and specificities insufficient to accurately diagnose asymptomatic cases. This necessitates the development and validation of assays that are fit for purpose. MethodsWe identified new diagnostic target biomarker regions for N. gonorrhoeae using an algorithm for genome mining of identical multi-repeat sequences (IMRS). These were then developed as DNA amplification primers to design better diagnostic assays. To test the primer pair, genomic DNA was 10-fold serially diluted (100 pg/μL to 1 × 10−3 pg/μL) and used as DNA template for PCR reactions. The gold standard PCR using 16S rRNA primers was also run as a comparative test, and both assay products were resolved on 1% agarose gel. ResultsOur newly developed N. gonorrhoeae IMRS-PCR assay had an analytical sensitivity of 6 fg/μL representing better sensitivity than the 16S rRNA PCR assay with an analytical sensitivity of 4.3096 pg/μL. The assay was also successfully validated using clinical urethral swab samples. We further advanced this technique by developing an isothermal IMRS, which was both reliable and sensitive for detecting cultured N. gonorrhoeae isolates at a concentration of 38 ng/μL. Combining isothermal IMRS with a low-cost lateral flow assay, we were able to detect N. gonorrhoeae amplicons at a starting concentration of 100 pg/μL. ConclusionTherefore, there is a potential to implement this concept within miniaturized, isothermal, microfluidic platforms, and laboratory-on-a-chip diagnostic devices for highly reliable point-of-care testing.

A national network of molecular tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae: a pilot implementation experience in Brazil

This study aimed to know the opinion of professionals participating in an experiment to implement a pilot for molecular tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae at the Brazilian Unified National Health System (SUS). The detection rate of C. trachomatis and/or N. gonorrhoeae and the factors associated with infection were determined. The strategy included laboratories belonging to the HIV and viral hepatitis viral load network. Testing targeted people who are more vulnerable to sexually transmitted infections and collected urine samples and/or vaginal, endocervical, and/or male urethral swabs. Questionnaires were sent to state managers and laboratory professionals about the implementation of the pilot. Reviews were overall positive. Weaknesses included difficulties changing work processes, lack of human resources, poorly sensitized care professionals, and absence of primary urine tubes, the only input not provided. Strengths included the centralized acquisition of tests, sharing of equipment, and storage of samples at room temperature. Of the 16,177 people who were tested, 1,004 (6.21%) were positive for C. trachomatis; 1,036 (6.4%), for N. gonorrhoeae; and 239 (1.48%), for C. trachomatis/N. gonorrhoeae . Detection of any infection occurred more frequently in young people (≤ 24 vs. > 24 years) (adjOR = 2.65; 95%CI: 2.38-2.96), men (adjOR = 1.95; 95%CI: 1.72-2.21), brown/black individuals (adjOR = 1.06; 95%CI: 1.05-1.11), those in Southeastern Brazil (adjOR = 1.08; 95%CI: 1.02-1.13), and in urethral secretion samples (adjOR = 1.46; 95%CI: 1.41-1.52). Results show the importance of making testing available nationwide, which supported the implementation of a definitive network to detection C. trachomatis/N. gonorrhoeae in SUS.

Сравнительный анализ микробиоты ткани яичка и уретры у пациентов с азооспермией методом секвенирования нового поколения (NGS)

Aim. To determine the role of taxonomic bacterial diversity of the urethral and testicular microbiota in the development of male infertility using high-throughput next-generation sequencing (NGS). Material and methods. In the period between 2018 and 2022 we examined 53 patients. Three study groups were formed: Infertile patients with nonobstructive azoospermia and concomitant varicocele (n = 13) – group 1; Infertile patients with obstructive azoospermia (n = 29) – group 2; Fertile patients with confirmed paternity and testicular pathology requiring histological verification to exclude testicular oncopathology (n = 11) – group 3. Each patient underwent TESE with testicular both and urethral tissue sampling in order to compare the bacterial landscape and control the purity of the method. The obtained material was sequenced using a high-throughput method (NGS). Results. According to our findings, the testicular tissue of obstructive azoospermia patients had significantly depleted bacterial diversity in comparison to nonobstructive azoospermia and concomitant varicocele ones. Also, the fertile group turned out to be the most diverse in its taxonomic community. These results may suggest the bacterial microbiome’s influence on men’s reproductive health. Discussion. Our urogenital bacterial diversity analysis showed that human testicular tissue is not a microbiologically sterile environment and also presented new data associated with testicular tissue and its possible relations with male infertility. Conclusion. A focus on the qualitative and quantitative composition of the testicular microbial community may form the new basis in the diagnosis and treatment of male infertility associated with various types of azoospermia

Infectious complications of transrectal prostate biopsy in patients receiving targeted antibiotic prophylaxis after urethral and rectal swab versus standard prophylaxis: A prospective comparative study

BackgroundTo evaluate the role of targeted antibiotic prophylaxis (TAP) after rectal and urethral swab cultures compared to empiric antibiotic prophylaxis (EAP) for the prevention of infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx). MethodsWe conducted a prospective comparative study on 141 patients who underwent TRUS-Bx and were allocated in two groups. The first group (n = 71) received EAP with ciprofloxacin and the second (n = 70) received TAP according to rectal and urethral cultures. Post-biopsy infectious complications rates were compared between the two groups. Fluoroquinolone resistance (FQ-R) in the urethral and rectal swabs was recorded. Baseline characteristics were analyzed to assess their relationship with infectious complications and antibiotic resistance. ResultsA total of 8 infectious complications were observed, 7 of them in the EAP group (9.85%) and 1 in the TAP group (1.4%). There was a statistically significant difference in febrile UTIs between the two groups (6 vs 0, P = 0.028). FQ-R rate was 4.3% and 12.9% for rectal and urethral samples, respectively. Recent antibiotic exposure was associated with higher post-biopsy infection rates for EAP group and FQ-R rates for TAP group. ConclusionCombination of rectal and urethral swab cultures for TAP was able to detect FQ-R bacteria carriers and was associated with fewer infectious complications compared to EAP.

Prevalence of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis in symptomatic and asymptomatic patients.

The purpose of the present study was to assess the prevalence of Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis (M. hominis) and Chlamydia trachomatis (C. trachomatis) in a Romanian population considering the presence or absence of genital symptoms. Urethral and vaginal samples were collected from patients presenting at 'Ponderas' Academic Hospital (Bucharest, Romania) from January 2021 to December 2021. A total of 266 samples were obtained from two groups of patients: Symptomatic subjects with urethritis, prostatitis, vaginitis or both urethritis and prostatitis (n=59; 22%), and asymptomatic subjects (n=207; 78%). Mycoplasma and Chlamydia kits were used to assess the presence of U. urealyticum and M. hominis, and C. trachomatis, respectively. The symptomatic subjects comprised 27 patients with urethritis symptoms, of whom 4 (15%) were infected with U. urealyticum and 1 (4%) was infected with C. trachomatis. In addition, 23 (9%) of the patients had prostatitis-like symptoms, which in 3 (13%) of the patients was associated with U. urealyticum and in 1 patient (4%) was associated with C. trachomatis. None of the symptomatic patients were infected with M. hominis. By contrast, 29 (14%) of the asymptomatic patients were discovered to be infected with U. urealyticum, 13 (6%) were coinfected with both Mollicutes and 4 (2%) were infected with C. trachomatis; only 1 patient was positive for M. hominis alone. Two patients (14%) who presented with U. urealyticum and M. hominis coinfection were also infected with C. trachomatis. No patient with U. urealyticum or M. hominis alone was also positive for C. trachomatis. Therefore, the most frequently identified pathogen populating the genital tract in both males and females was U. urealyticum, followed by coinfection with U. urealyticum and M. hominis, and C. trachomatis. As these infections are asymptomatic in numerous cases, this suggests that a thorough screening should be mandatory.

Viral load dynamics and shedding kinetics of mpox infection: a systematic review and meta-analysis.

Viral load dynamics and shedding kinetics are critical factors for studying infectious diseases. However, evidence on the viral dynamics of mpox remains limited and inconclusive. Thus, we aimed to provide a comprehensive understanding of viral load and viability of the re-emerged mpox virus since 2022. For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, and Google Scholar for published articles which are related to mpox viral dynamics up to April, 2023. From 19 studies, 880 samples and 1477 specimens were collected. The pooled median Ct values appeared in the following order: skin lesion (Ct value 21.7 [IQR 17.8-25.5]), anorectal (22.3 [16.9-27.6]), saliva (25.9 [22.5-31.1]), oral (29.0 [24.5-32.8]), semen (29.6 [25.9-33.4]), urine (30.5 [24.6-36.4]), pharyngeal (31.9 [26.5-37.3]), urethra (33.0 [28.0-35.0]), and blood (33.2 [30.4-36.1]). People living with HIV have lower Ct value in the skin (skin HIV+, 19.2 [18.3-20.0] versus skin HIV-, 25.4 [21.2-29.0]). From the Ct values and test day since symptom onset, we identified temporal trends of viral load for each specimen type. Changes in the trend were observed at 4days in saliva, 5days in blood, 6days in skin, 7days in anorectal, urine, semen, pharyngeal, and 8days in urethra. We determined optimal Ct cutoff values for anorectal (34.0), saliva (27.7), and urethra (33.0) specimens, where a Ct value above each cutoff suggests minimal viral viability. Using these cutoff values, we derived the duration of viable viral isolation in each specific specimen type (anorectal 19days; saliva 14days; and urethra 14days). Skin lesion, anorectal, and saliva samples contained the highest viral load. The peak viral load manifests within 4-8days after symptom onset, and viable virus detection was presumed to cease within 14-19days from symptom onset in anorectal, saliva and urethra samples.

Finite element analysis of the interaction between high-compliant balloon catheters and non-cylindrical vessel structures: towards tactile sensing balloon catheters.

Aiming for sensing balloon catheters which are able to provide intraoperative information of the vessel stiffness and shape, the present study uses finite element analysis(FEA) to evaluate the interaction between high-compliant elastomer balloon catheters with the inner wall of a non-cylindrical-shaped lumen structure. The contact simulations are based on 3D models with varying balloon thicknesses and varying tissue geometries to analyse the resulting balloon and tissue deformation as well as the inflation pressuredependent contact area. The wrinkled tissue structure is modelled by utilizing a two-layer fibre-based Holzapfel-Gasser-Ogden constitutive model and the model parameters are adapted based on available biomechanical data for human urethral vessel samples. The balloon catheter structure is implemented as a high-compliant hyper-elastic silicone material (based on polydimethylsiloxane (PDMS)) with a varying catheter wall thickness between 0.5 and 2.5µm. Two control parameters are introduced to describe the balloon shape adaption in reaction to a wrinkled vessel wall during the inflation process. Basic semi-quantitative relations are revealed depending on the evolving balloon deformation and contact surface. Based on these relations some general design guidelines for balloon-based sensor catheters are presented. The results of the conducted in-silico study reveal some general interdependencies with respect to the compliance ratio between balloon and tissue and also in respect of the tissue aspect ratio. Further they support the proposed concept of high-compliant balloon catheters equipped for tactile sensing as diagnosis approach in urology and angioplasty.

MONKEYPOX VIRUS (MPXV) INFECTION AND SEXUALLY TRANSMITTED INFECTIONS (STIs): A CROSS-SECTIONAL STUDY FROM A SECONDARY HOSPITAL IN THE MAY-SEPTEMBER 2022 INTERNATIONAL OUTBREAK.

The aim of our study is to describe the characteristics of patients infected by MPXV in our setting, determine the prevalence of MPXV in samples which are classically used for diagnosing sexually transmitted infections (STIs) such as anal, urethral, pharyngeal and urine, and assess the prevalence of coinfection with STIs in the same samples. A cross-sectional study was conducted, collecting all confirmed cases of MPXV between June and July 2022 using polymerase chain reaction (PCR). Sociodemographic data, HIV and other STIs status, prevalence of MPXV and STIs in urethral, anal, pharyngeal or urine samples, were collected. Data from 22 patients were extracted, all of whom were MSM and 54,5% were previously HIV positive. The median age was 43 years. All the skin samples were positive for MPXV, followed by anal samples (n = 10) (45,5%). MPXV was isolated in 2 or more samples simultaneously in 12 (54%) cases. 9 (41%) patients were positive for an STI and 4 of them had more than one STI (18,2%). Human monkeypox has been epidemiologically significant among MSM. MPXV should be investigated not only in skin lesions but also in samples classically used for STI. MPXV, like other STIs, share ways of transmission and coinfection may be underdiagnosed.

Application of the UPOINT classification to determine indications for antibacterial therapy of chronic inflammatory process

Background. Patients with chronic prostatitis (CP) represent the majority of urological referral. The most patients, independent of their age, visit attending urologists constantly.&#x0D; Aim. To evaluate the rate of antibiotics prescriptions based on the UPOINTS chronic prostatitis classification and the estimation of its efficacy.&#x0D; Materials and methods. In 2022–2023 there were enrolled 92 CP patients in the Pletnev City Clinical Hospital and Vishnevsky National Medical Research Center for High Medical Technologies – Central Military Clinical Hospital. The age varies from 22 to 46 year (mean 34±8). The diagnosis lifespan was – 11+16.5 mo. The NIH-CPSI score was 23±6.1 (pain 8±5.5, urination – 7±2.4, life quality 8±3.6). The prostate volume was 26±8 cc. The positive Meares-Stamey test was occurred in 38/92 (41%) cases. The positive prostate or sperm culture were found in 18/92 (20%) pts. The positive PCR-tests were obtained in 32/42 (76%) urethral samples, prostate secretes 23/42 (55%) and sperm – 20/42 (48%). Fluorochinilones were prescribed in all 92 (100%) cases, tetracycline (66 patients, 72%) and macrolides – 48 patients, 52%.&#x0D; Results. Sixty eight (74%) pts have passed the follow-up. The total NIH-CSPI score decreased to 15±5.3 (pain – 6±3.6, urination – 5±2.1, life quality 4±2). The average prostate volume was 23±4 cc, at 86% (58) cases were achieved the laboratory tests normalization. The fluorchinolones efficacy was – 29% (17 patients), tetracycline – 41% (24 patients), macrolides – 29% (17 patients).&#x0D; Conclusion. The UPOINT classification use allows optimize the CP management. PCR-tets are the most sensitive in terms of the I-type CP diagnosis. The administration of Doxycycline Express® in the I-type of CP treatment is the most effective (41%) in the comparison to the other antibiotics.

HLA-G Alleles Impact the Perinatal Father-Child HPV Transmission.

The host factors that influence father-to-child human papillomavirus (HPV) transmission remain unknown. This study evaluated whether human leukocyte antigen (HLA)-G alleles are important in father-to-child HPV transmission during the perinatal period. Altogether, 134 father-newborn pairs from the Finnish Family HPV Study were included. Oral, semen and urethral samples from the fathers were collected before the delivery, and oral samples were collected from their offspring at delivery and postpartum on day 3 and during 1-, 2- and 6-month follow-up visits. HLA-G alleles were tested by direct sequencing. Unconditional logistic regression was used to determine the association of the father-child HLA-G allele and genotype concordance with the father-child HPV prevalence and concordance at birth and during follow-up. HLA-G allele G*01:01:03 concordance was associated with the father's urethral and child's oral high-risk (HR)-HPV concordance at birth (OR 17.00, 95% CI: 1.24-232.22). HLA-G allele G*01:04:01 concordance increased the father's oral and child's postpartum oral any- and HR-HPV concordance with an OR value of 7.50 (95% CI: 1.47-38.16) and OR value of 7.78 (95% CI: 1.38-43.85), respectively. There was no association between different HLA-G genotypes and HPV concordance among the father-child pairs at birth or postpartum. To conclude, the HLA-G allele concordance appears to impact the HPV transmission between the father and his offspring.

(109) Analysis of Patient-Specific Microbiome Profiles and Possible Association with Sexual Dysfunction After Cervical Dysplasia Treatment

Abstract Introduction Electrocautery of the cervix during the loop electrosurgical excision procedure (LEEP) effectively treats cervical dysplasia (CD). Most patients do not report adverse symptoms post-operatively. However, a subset of patients has reported sexual issues and psychosexual sequalae, including some impact to their quality of life. The etiology of these symptoms has not been investigated, especially in a functional capacity. Moreover, there is some evidence that LEEP alters the cervical microbiome, from a small number of studies. Given the close anatomical relatedness of the pelvis, regions in close proximity to the cervix should also be considered, such as the vagina and urethra. Together, these three regions comprise the female urogenital tract (FUT), which should be examined for persistent inflammatory bacterial profiles post-LEEP. Correlations between LEEP patient-reported symptoms of psychological and sexual issues, and bacterial microbiome profiles, have not yet been investigated. Objective To analyze overall and individualized bacterial profiles (cervix, vagina, urethra) of patients with CD before and after treatment with LEEP and investigate associations with sexual functioning. Methods Women with typical female internal organs and external genitalia, undergoing LEEP treatment for CD, were recruited to participate in the study. Urethral samples, in addition to vaginal and cervical swabs, were collected immediately before treatment and 3 months post-treatment. Bacterial community analysis was characterized by 16S ribosomal RNA gene analysis. Self-report online surveys assessing demographics, medical history, and sexual function (FSFI) were completed by participants at the same time intervals. Chi square analyses and t-tests were conducted. Results Alpha diversity (observed species richness) revealed a significant decrease in species richness in the FUT microbiome post-LEEP (P &amp;lt; 0.05). Beta diversity demonstrated significant differences between the cervical, urinary, and vaginal microbiomes pre- and post-LEEP (P &amp;lt; 0.05). Lactobacillus was observed to be significantly higher in the cervical microbiome (P &amp;lt; 0.05), and Prevotella, Dialister, and Ruminococcus were significantly lower in the cervical microbiome (P &amp;lt; 0.05), when compared to the urinary and vaginal microbiomes pre- and post-LEEP. Analysis of individual microbiome patient profiles revealed individuals who showed discordant trends when compared to data summarizing averages. Namely, a subset of participants experienced a significant increase (P &amp;lt; 0.05) in pro-inflammatory bacteria post-LEEP with correlative changes in SD. These results suggest there may be a non-uniform healing response post-LEEP, and that individualized microbiome analysis could reveal regional dysbiosis that could be subsequently treated and managed. Conclusions A diverse inflammatory bacterial community characterizes CD in the FUT, and treatment with LEEP mostly returns the microbiomes to a healthy state. However, some participants showed increased inflammatory bacterial profiles post-LEEP, potentially demonstrating a non-uniform healing response. This study provides a basis for future studies to screen and restore FUT microbiomes post-LEEP, with the aim of detecting and treating any bothersome symptoms reported by patients. Disclosure No

Prevalence of Mollicutes among men who have sex with men and transgender women aged 15 to 19 years in Salvador, North-eastern Brazil

BackgroundSome species of Mollicutes have been associated with different pathologies of the urogenital tract in humans, with a high prevalence among adult men who have sex with men (MSM) and transgender women (TGW). However, few studies have been performed to investigate its prevalence among adolescents. In this study, we estimated the initial prevalence of Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Ureaplasma parvum (UP); the rate of misdiagnosis at different anatomical sites; and the associated factors with positive tests for Mollicutes among MSM and TGW aged 15 to 19 years enrolled in the PrEP1519 study.MethodsPrEP-1519 is the first study to investigate the effectiveness of pre-exposure prophylaxis for human immunodeficiency virus among adolescent MSM and TGW aged 15 to 19 in Latin America. Oral, anal, and urethral swabs were taken from 246 adolescents upon enrolment in the study to detect MG, MH, UU, and UP by quantitative polymerase chain reaction (qPCR). Bivariate and multivariate analyses were conducted by Poisson regression and 95% confidence intervals (95% CI) were estimated.ResultsThe prevalence of Mollicutes was 32.1%. UU was the most prevalent species (20.7%), followed by MH (13.4%), MG (5.7%), and UP (3.2%); 67.3% of the positive samples would have been missed if only urethral samples had been taken. Receptive anal sex (prevalence ratio [PR] = 1.79; 95% CI = 1.07–3.01) and clinical suspicion of sexually transmitted infection (PR = 1.62; 95% CI = 1.01–2.61) were factors associated with the detection of Mollicutes in general. Group sex (PR = 1.98; 95% CI = 1.12–3.50) and receptive anal sex (PR = 2.36; 95% CI = 0.95–5.86) were associated with the detection of Mycoplasma spp. No sociodemographic, clinical, or behavioural variable was significantly associated with the detection of Ureaplasma spp.ConclusionsA high prevalence of Mollicutes was observed among adolescent MSM and TGW, especially at extragenital sites. Further research is required to understand the epidemiological profile of high-risk adolescents in different regions and contexts, and to investigate the pathogenesis of Mollicutes in the oral and anal mucosa before routine screening can be recommended in clinical practice.

To study the prevalence and clinical features of extragenital forms of sexually transmitted infections (prospective observational clinical and laboratory study)

Background. In preventing the spread of sexually transmitted infections (STIs), timely detection of extragenital localization of the pathogen is important. Modern studies demonstrate a wide prevalence of extragenital forms of STIs not only in men who practice sex with men, but also in heterosexual men and women. However, according to Russian and a number of foreign clinical guidelines, the basis of STI screening includes studies of only urethral, vaginal and cervical samples, which leads to incomplete registration of extragenital infections and contributes to their further spread.&#x0D; Aims. To study the frequency of prevalence and clinical features of extragenital forms of STIs in heterosexual men and women and men who have sex with men.&#x0D; Materials and methods. A prospective observational clinical and laboratory study included 57 patients with a history of unprotected orogenital and/or anogenital sexual contacts: group I (n = 20) women practicing heterosexual sexual contacts, group II (n = 9) men practicing heterosexual sexual contacts, group III (n = 28) men who have sex with men (MSM). The identification of STIs was conducted by the polymerase chain reaction method and the ribosomal RNA NASBA detection method was used as an independent additional direct method.&#x0D; Results. A high level of detection of STIs of extragenital localization has been established: in heterosexual women in the rectum (10; 76.9%), in the oropharynx (9; 69.2%) and in the conjunctiva (2; 15.4%); in heterosexual men in the rectum (2; 40%), in the conjunctiva (2; 40%) and in the oropharynx (1; 20%); in MSM in the rectum (15; 75%), in the oropharynx (11; 55%) and in the conjunctiva (5; 25%); in 14 (36.8%) patients, STI infection of more than 2 localizations was found. In extragenital foci of chlamydia trachomatis infection in group I was most frequently detected (5; 38.5%), in group II gonococcal infection (2; 40%), in group III syphilis (9; 45%), gonococcal infection (8; 40%) and chlamydia trachomatis infections (8; 40%). Asymptomatic infections in conjunctiva were detected in 4 (10.5%) patients, in oropharynx in 15 (39.5%), in rectum in 22 (57.9%) patients.&#x0D; Conclusions. The high level of detection of extragenital STIs and their frequent asymptomatic course dictates the need to study clinical samples from the oropharynx, rectum and conjunctiva not only when detecting objective and/or subjective symptoms of diseases, but also when there is a history of unprotected orogenital and/or anogenital sexual contacts, as well as when detected infections of genital localization.

Meningococcal carriage in men who have sex with men presenting at a sexual health unit in Spain.

Neisseria meningitidis (Nm) is asymptomatically carried in the nasopharynx of 5-10% adults, although certain populations, such as men who have sex with men (MSM), exhibit a higher colonisation rate. Interest in Nm carriage has been renewed, owed to meningitis outbreaks within populations of MSM. The aim of this study was to characterise Nm isolates and risk factors for its carriage among MSM attending a sexual health unit. A retrospective cross-sectional study was undertaken between June 2018 and December 2021. We took anal, oropharyngeal, urethral, and blood samples as part of the sexually transmitted infection screening procedures routinely implemented. Nm isolates were subjected to antimicrobial susceptibility testing; the serogroup and genogroup were determined by multi-locus sequence typing. A total of 399 subjects were recruited, and the Nm oropharyngeal carriage rate was 29%, similar among both people living with HIV (PLWH) and uninfected individuals. Nm carriage was less common in vaccinated individuals, especially those who had received the tetravalent vaccine (2.6% vs. 10.6%, p = 0.008). The most frequent serogroups were B (40%) and non-groupable (45%). Most of the isolates were susceptible to ciprofloxacin (96%) and ceftriaxone (100%). However, we identified 21 strains (20%) belonging to hyperinvasive lineages (CC11, CC4821, CC32, CC41/44, CC213, and CC269), most of which belonged to serogroup B. Given that vaccination with MenACWY was associated with a low Nm carriage, we encourage routine vaccination of all MSM. Moreover, the administration of the meningitis B vaccine should also be assessed considering that several invasive lines included in serogroup B are circulating among MSM.

Rapid point of care testing for four bacterial sexually transmitted infections using the portable isothermal loop-mediated nucleic acid amplification eazyplex platform

PurposeTo analyze sensitivity and specificity of the rapid point-of-care (POC) eazyplex testing platform for bacterial sexually transmitted infections (STI) among men who have sex with men (MSM).Methods272 anal, urethral, and pharyngeal swabs collected from 153 MSM were tested by both the eazyplex platform and an in-house PCR or culture in the university microbiology reference laboratory.ResultsCompared to the reference diagnostic method, the overall sensitivity/specificity of eazyplex was 88%/98% for N. gonorrhoeae, 82%/100% for C. trachomatis, 70%/ > 99% for U. urealyticum, and 85%/98% for M. hominis, respectively. Sensitivity for N. gonorrhoeae and U. urealyticum in urethral samples was 100%.ConclusionWith good to very good sensitivity depending on the sampling site and pathogen as well as very good specificity overall the eazyplex platform is a useful rapid diagnostic method for POC bacterial STI-testing especially for N. gonorrhoeae and C. trachomatis, allowing for almost immediate treatment initiation.

Tissue S100/calgranulin expression and blood neutrophil-to-lymphocyte ratio (NLR) in dogs with lower urinary tract urothelial carcinoma

BackgroundUrothelial carcinoma (UC) is the most common neoplasm of the canine lower urinary tract, affecting approximately 2% of dogs. Elderly female patients of certain breeds are predisposed, and clinical signs of UC can easily be confused with urinary tract infection or urolithiasis. Diagnosis and treatment are challenging given the lack of disease-specific markers and treatments. The S100A8/A9 complex and S100A12 protein are Ca2+-binding proteins expressed by cells of the innate immune system and have shown promise as urinary screening markers for UC. The neutrophil-to-lymphocyte ratio (NLR) can also aid in distinguishing certain neoplastic from inflammatory conditions. Our study aimed to evaluate the tissue expression of S100/calgranulins and the blood NLR in dogs with UC. Urinary bladder and/or urethral tissue samples from dogs with UC (n = 10), non-neoplastic inflammatory lesions (NNUTD; n = 6), and no histologic changes (n = 11) were evaluated using immunohistochemistry. Blood NLRs were analyzed in dogs with UC (n = 22) or NNUTD (n = 26).ResultsTissue S100A12-positive cell counts were significantly higher in dogs with lower urinary tract disease than healthy controls (P = 0.0267 for UC, P = 0.0049 for NNUTD), with no significant difference between UC and NNUTD patients. Tissue S100A8/A9-positivity appeared to be higher with NNUTD than UC, but this difference did not reach statistical significance. The S100A8/A9+-to-S100A12+ ratio was significantly decreased in neoplastic and inflamed lower urinary tract tissue compared to histologically normal specimens (P = 0.0062 for UC, P = 0.0030 for NNUTD). NLRs were significantly higher in dogs with UC than in dogs with NNUTD, and a cut-off NLR of ≤ 2.83 distinguished UC from NNUTD with 41% sensitivity and 100% specificity. Higher NLRs were also associated with a poor overall survival time (P = 0.0417).ConclusionsThese results confirm that the S100/calgranulins play a role in the immune response to inflammatory and neoplastic lower urinary tract diseases in dogs, but the tissue expression of these proteins appears to differ from their concentrations reported in urine samples. Further investigations of the S100/calgranulin pathways in UC and their potential as diagnostic or prognostic tools and potential therapeutic targets are warranted. The NLR as a routinely available marker might be a useful surrogate to distinguish UC from inflammatory conditions.

Mechanical Behaviour of Human and Porcine Urethra: Experimental Results, Numerical Simulation and Qualitative Analysis

Low urinary tract dysfunctions and symptoms (LUTS) affect both men and woman, with the incidence increasing with age. Among the LUTS, urinary incontinence (UI) is a common dysfunction, characterised by the involuntary loss of urine. These medical conditions become debilitating, with a severe impact on patients’ routines and overall well-being. To mitigate LUTS-associated symptoms, the mechanical behaviour of both normal and LUTS-affected urethrae can be an important tool. The current work approaches the porcine urethra as a mechanical replacement candidate for the human urethra. It aims to provide a framework based on in silico (numerical) simulations and experimental data, to compare the candidate’s mechanical behaviour against the human urethra. Porcine urethral samples were mechanically evaluated through low-cycle fatigue tests in both circumferential and longitudinal orientations. The specimens were collected from porcine urethrae from crossbred pigs raised for human consumption. The experimental results were compared with human references found in the literature, with similar experimental conditions. The experimental data were used as the input for the mechanical properties estimation (nonlinear fitting to hyperelastic constitutive models) and for the simulation of the urethral tensile behaviour, using those models. In the longitudinal orientation, the results for the porcine and human urethra were in good agreement, while in the circumferential direction, the differences increased with deformation. Previous data on the mechanical behaviour of the equine urethra is in line with these findings. The nonlinear mechanical behaviour of a porcine urethra was modelled using the finite element method (FEM) and hyperelastic constitutive models. For the longitudinal urethra, the simulation results approximate experimental data for stretches up to λ≈1.5 (50% deformations), whereas for the circumferential urethra, the same was true for stretches up to λ≈1.35 (35% deformations). The hyperelastic models with a higher number of parameters performed better with the third-order Ogden model (six parameters), displaying the best performance among the studied models. The pig urethra is a suitable candidate for an implant targeted at human urethra replacement or as a model to study the human urinary system. Nevertheless, the data available on the circumferential mechanical behaviour need to be consolidated with additional mechanical tests. The tensile behaviour of the porcine urethra over large deformations can be modelled using the third-order Ogden model; however, to extend the modelling capabilities to larger deformations requires the use of hyperelastic models more adequate to soft tissue behaviour.