RESUMO
Purpose: The purpose of this study was to explore risk factors for HIV and sexually transmitted infections (STIs) among transgender women (TW) in Lima, Peru. Methods: HIV-negative or serostatus unknown TW reporting recent condomless receptive anal intercourse underwent testing for STIs and HIV and completed a sociobehavioral survey. Results: Among 120 TW, 29.6% had rectal Neisseria gonorrhoeae (GC) or Chlamydia trachomatis (CT) and 12.6% had HIV. Age and migrant status were associated with rectal GC/CT, and rectal GC/CT predicted HIV infection. Conclusions: Further study is needed to understand individual and social factors that contribute to HIV/STI vulnerability among TW.
Assuntos
Chlamydia trachomatis/crescimento & desenvolvimento , HIV/crescimento & desenvolvimento , Neisseria gonorrhoeae/crescimento & desenvolvimento , Doenças Retais/etiologia , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Pessoas Transgênero , Adolescente , Adulto , Fatores Etários , Canal Anal , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/etiologia , Infecções por Chlamydia/microbiologia , Preservativos , Feminino , Gonorreia/epidemiologia , Gonorreia/etiologia , Gonorreia/microbiologia , Infecções por HIV/epidemiologia , Infecções por HIV/etiologia , Infecções por HIV/virologia , Humanos , Pessoa de Meia-Idade , Peru/epidemiologia , Doenças Retais/epidemiologia , Doenças Retais/microbiologia , Doenças Retais/virologia , Reto/microbiologia , Reto/virologia , Fatores de Risco , Infecções Sexualmente Transmissíveis/etiologia , Infecções Sexualmente Transmissíveis/microbiologia , Infecções Sexualmente Transmissíveis/virologia , Migrantes , Sexo sem Proteção , Adulto JovemRESUMO
OBJECTIVES: This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. SETTING: Cross-sectional study in Lima, Peru. PARTICIPANTS: We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. PRIMARY AND SECONDARY OUTCOME MEASURES: Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. RESULTS: Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. CONCLUSIONS: The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. TRIAL REGISTRATION NUMBER: NCT00670163; Results.
Assuntos
Canal Anal/microbiologia , Infecções por Chlamydia/epidemiologia , Gonorreia/epidemiologia , Homossexualidade Masculina , Faringe/microbiologia , Pessoas Transgênero , Adolescente , Adulto , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/crescimento & desenvolvimento , Estudos Transversais , Feminino , Gonorreia/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neisseria gonorrhoeae/crescimento & desenvolvimento , Peru/epidemiologia , Prevalência , Características de Residência , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to assess the cervicovaginal levels of proinflammatory cytokines in women with Chlamydia trachomatis (CT) infection in the presence of bacterial vaginosis (BV) and normal flora and to compare with those negative for CT. MATERIALS AND METHODS: In this cross-sectional study, nonpregnant women were enrolled at 2 outpatient clinics and at 1 primary medical care unit in São Paulo State, Brazil. Cervicovaginal samples from 256 women with BV, of which 68 (26.6%) had concomitant CT infection and 188 (73.4%) were CT-negative, were measured for interleukin-1ß (IL-1ß), IL-6, and IL-8 by enzyme-linked immunosorbent assay. A matching number of samples from women with normal flora, CT-positive (n = 68) and negative (n = 188), were evaluated as control. Cytokine levels were compared by Mann-Whitney test and differences were considered significant at p < .05. RESULTS: In CT-negative women, IL-1ß was increased in BV (p < .001) when compared to normal flora, while the levels of IL-6 and IL8 were unchanged. The presence of CT infection was not associated with differences on cytokine levels in women with normal flora. However, women with BV had higher levels of IL-1ß (p = .02), IL-6 (p = .02), and IL-8 (p = .03) in the presence of CT when compared to those who tested negative for CT. CONCLUSIONS: Detection of endocervical CT is associated with increased cervicovaginal IL-1ß, IL-6, and IL-8 levels in women with concomitant BV but not in those with normal flora.
Assuntos
Líquidos Corporais/química , Infecções por Chlamydia/diagnóstico , Interleucina-1beta/análise , Interleucina-6/análise , Interleucina-8/análise , Vagina/patologia , Vaginose Bacteriana/diagnóstico , Adolescente , Adulto , Brasil , Infecções por Chlamydia/patologia , Chlamydia trachomatis/crescimento & desenvolvimento , Chlamydia trachomatis/isolamento & purificação , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactobacillus/crescimento & desenvolvimento , Lactobacillus/isolamento & purificação , Pessoa de Meia-Idade , Vaginose Bacteriana/patologia , Adulto JovemRESUMO
Chlamydia trachomatis, an obligate intracellular pathogen, survives within host cells in a special compartment named 'inclusion' and takes advantage of host vesicular transport pathways for its growth and replication. Rab GTPases are key regulatory proteins of intracellular trafficking. Several Rabs, among them Rab11 and Rab14, are implicated in chlamydial development. FIP2, a member of the Rab11-Family of Interacting Proteins, presents at the C-terminus a Rab-binding domain that interacts with both Rab11 and Rab14. In this study, we determined and characterized the recruitment of endogenous and GFP-tagged FIP2 to the chlamydial inclusions. The recruitment of FIP2 is specific since other members of the Rab11-Family of Interacting Proteins do not associate with the chlamydial inclusions. The Rab-binding domain of FIP2 is essential for its association. Our results indicate that FIP2 binds to Rab11 at the chlamydial inclusion membrane through its Rab-binding domain. The presence of FIP2 at the chlamydial inclusion favours the recruitment of Rab14. Furthermore, our results show that FIP2 promotes inclusion development and bacterial replication. In agreement, the silencing of FIP2 decreases the bacterial progeny. C. trachomatis likely recruits FIP2 to hijack host intracellular trafficking to redirect vesicles full of nutrients towards the inclusion.
Assuntos
Proteínas de Transporte/metabolismo , Chlamydia trachomatis/crescimento & desenvolvimento , Chlamydia trachomatis/patogenicidade , Interações Hospedeiro-Patógeno , Corpos de Inclusão/microbiologia , Proteínas de Membrana/metabolismo , Células HeLa , Humanos , Ligação Proteica , Mapeamento de Interação de Proteínas , Proteínas rab de Ligação ao GTP/metabolismoRESUMO
Introducción: Las infecciones vulvo-cérvico-vaginales constituyen la causa más común por la que las mujeres en edad fértil acuden al Ginecólogo. Los agentes etiológicos involucrados incluyen a Chlamydia trachomatis, Trichomonas vaginalis, Cándida albicans, entre otros. La sospecha de vulvo-cervico-vaginitis debe orientar a la realización de estudios de secreción vaginal y muestreo endocervical a fin de detectar el agente causal, establecer un tratamiento específico y disminuir la prevalencia de los mismos así como las complicaciones. Objetivos: Determinar la prevalencia de esporos micóticos, Trichomonas vaginalis y Chlamydia trachomatis en mujeres en edad fértil. Materiales y Métodos: Estudio observacional, descriptivo, de corte transversal y prospectivo, con cuestionario realizado a mujeres en edad fértil que acudieron a los hospitales Materno Infantil San Pablo y Regional de San Lorenzo entre los meses de diciembre de 2010 a febrero de 2011. Resultados: De las 148 pacientes estudiadas, se observó una prevalencia de 27,7% de esporos micóticos, 2% de Trichomonas vaginalis y 4,1% de Chlamydia trachomatis. De las pacientes estudiadas, la mayoría tenían entre 25 a 29 años (26%). Conclusión:La prevalencia de esporos micóticos fue 27,7%, Trichomonas vaginalis 2% y Chlamydia trachomatis 4,1%.
Introduction: the vulvo cervicovaginal infections are the most common reason that women of childbearing age go to the gynecologist. The ethiological agents involved are Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, among others. The suspicion of cervico-vulvo-vaginitis should guide the studies of vaginal discharge and endocervical sampling to detect the causative agent, to stablish specific treatment and reduce the prevalence of these infections and the complications. Objective: to determine the prevalence of fungal spores, Trichomonas vaginalis and Chlamydia trachomatis in women of childbearing age. Materials and Methods: observational, descriptive, cross-sectional and prospective study performed in women of childbearing age who attended the San Pablo Hospital and Regional of San Lorenzo between the months of December 2010 to February 2011. Results: 148 patients were studied, there was a 27.7% prevalence of fungal spores, 2% Trichomonas vaginalis and 4.1% Chlamydia trachomatis. Of the patients studied, most were between 25 to 29 years (26%). Conclusion: the prevalence of fungal spores was 27.7%, Trichomonas vaginalis 2% and Chlamydia trachomatis 4.1%.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Vaginite por Trichomonas/epidemiologia , Candidíase Vulvovaginal/epidemiologia , Infecções por Chlamydia/epidemiologia , Trichomonas vaginalis/crescimento & desenvolvimento , Candida albicans/crescimento & desenvolvimento , Chlamydia trachomatis/crescimento & desenvolvimento , Prevalência , Estudos Transversais , Estudos ProspectivosRESUMO
Chlamydia trachomatis are obligate intracellular bacteria that survive and replicate in a bacterial-modified phagosome called inclusion. As other intracellular parasites, these bacteria subvert the phagocytic pathway to avoid degradation in phagolysosomes and exploit trafficking pathways to acquire both energy and nutrients essential for their survival. Rabs are host proteins that control intracellular vesicular trafficking. Rab14, a Golgi-related Rab, controls Golgi to endosomes transport. Since Chlamydia establish a close relationship with the Golgi apparatus, the recruitment and participation of Rab14 on inclusion development and bacteria growth were analyzed. Time course analysis revealed that Rab14 associated with inclusions by 10 h post infection and was maintained throughout the entire developmental cycle. The recruitment was bacterial protein synthesis-dependent but independent of microtubules and Golgi integrity. Overexpression of Rab14 dominant negative mutants delayed inclusion enlargement, and impaired bacteria replication as determined by IFU. Silencing of Rab14 by siRNA also decreased bacteria multiplication and infectivity. By electron microscopy, aberrant bacteria were observed in cells overexpressing the cytosolic negative Rab14 mutant. Our results showed that Rab14 facilitates the delivery of sphingolipids required for bacterial development and replication from the Golgi to chlamydial inclusions. Novel anti-chlamydial therapies could be developed based on the knowledge of how bacteria subvert host vesicular transport events through Rabs manipulation.
Assuntos
Chlamydia trachomatis/crescimento & desenvolvimento , Complexo de Golgi/metabolismo , Esfingolipídeos/metabolismo , Proteínas rab de Ligação ao GTP/metabolismo , Proteínas de Bactérias/metabolismo , Transporte Biológico , Chlamydia trachomatis/metabolismo , Chlamydia trachomatis/fisiologia , Complexo de Golgi/ultraestrutura , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Células HeLa , Interações Hospedeiro-Patógeno , Humanos , Corpos de Inclusão/metabolismo , Corpos de Inclusão/ultraestrutura , Microscopia Confocal , Microscopia Eletrônica de Transmissão , Interferência de RNA , Proteínas rab de Ligação ao GTP/genéticaRESUMO
Se realizó un estudio prospectivo en el Hospital Universitario de La Misericordia de Santafé de Bogotá entre septiembre de 1992, en el cual fueron incluidos 43 pacientes de 4 a 24 semanas de edad que habían sido hospitalizados por presentar características clínicas sugestivas de infección por Chlamydia trachomatis. Los datos sobre los antecedentes y signos clínicos al momento del ingreso al hospital fueron consignados en un formulario previamente diseñado. Igualmente a todos los pacientes se les realizó cuadro hemático, radiografía de tórax, y se les tomaron muestras nasofaríngeas y de conjuntiva para el diagnóstico de la infección por Chlamydia trachomatis empleando cultivo, un ensayo inmunoenzimático (Elisa) e inmunofluorescencia directa (IFD). También se obtuvo una muestra de sangre en 42 de ellos, para determinar anticuerpos IgG anti-Chlamydia trachomatis. Con la prueba de Elisa se confirmaron 6 casos (14 por ciento) de neumonía por C. trachomatis, todos menores de 12 semanas, quienes presentaron tos predominantemente coqueluchoide, signos de dificultad respiratoria moderada y predominio del componente obstructivo bronquial, ausencia de fiebre o compromiso sistémico importante. En ningún caso se encontró eosinofilia absoluta y en los estudios radiológicos se evidenció hiperaireación en el 50 por ciento de los casos. Los anticuerpos específicos contra C. trachomatis fueron detectados en 4 (67 por ciento) de los pacientes en los que se confirmó el diagnóstico y en 7 (19 por ciento) del grupo negativo. La evolución intrahospitalaria fue satisfactoria a pesar de no haberse administrado un tratamiento antibiótico específico para C. trachomatis.
Assuntos
Humanos , Recém-Nascido , Lactente , Chlamydia trachomatis/classificação , Chlamydia trachomatis/crescimento & desenvolvimento , Chlamydia trachomatis/isolamento & purificação , Chlamydia trachomatis/patogenicidade , Pneumonia/classificação , Pneumonia/diagnóstico , Pneumonia/enfermagem , Pneumonia/etiologia , Pneumonia/mortalidade , Pneumonia/tratamento farmacológicoRESUMO
Se compararon 60 pacientes con problemas de infertilidad con 120 mujeres multíparas : se investigó la presencia de Chlamydia trachomatis tanto en el endometrio como en el endocervix, utilizando, la inmunofluorescencia directa (MICROTRAK). Los controles tenían significativamente mayor de edad, más años de vida sexual y mayor número de abortos. Con relación a la presencia de C. trachomatis se encontró mayor positividad en el grupo control tanto en el endocervix (33 por ciento Vs. 12 por ciento no significativamente), como el endometrio (38 por ciento Vs. 17 por ciento), como también mayor positividad simultánea en ambos sitios anatómicos, sin embargo sólo se encontró diferencia significativa (p 0.005 ) en cuanto a la muestra endometrial en favor del grupo control. Se llama la atención hacia la alta prevalencia de infección por C. trachomatis en la población de mujeres fértiles
Assuntos
Humanos , Feminino , Adulto , Chlamydia trachomatis/crescimento & desenvolvimento , Chlamydia trachomatis/imunologia , Chlamydia trachomatis/patogenicidade , Chlamydia trachomatis/fisiologiaAssuntos
Infecções por Chlamydia , Nasofaringe/microbiologia , Pneumonia/diagnóstico , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/crescimento & desenvolvimento , Chlamydia trachomatis/imunologia , Imunofluorescência , Humanos , Lactente , Microscopia de Fluorescência , Pneumonia/etiologiaRESUMO
We evaluated the fluorescein-conjugated monoclonal antibody (FA) test for screening for Chlamydia trachomatis endocervical infection in a general adolescent clinic. Three hundred sixty-three consecutive adolescent girls, ages 13 to 20 years (mean 17.3 years) were examined. Forty-five (12%) FA smears had insufficient cells. Reason for visit included non-lower genital tract-related disorders in 241 (76%) girls, and lower genital tract-related disorders in 77 (24%). C. trachomatis was isolated by tissue culture in 46 (14%) patients, and Neisseria gonorrhoeae by culture in 22 (7%), and Trichomonas vaginalis was identified by wet mount in 13 (5%). Compared with our tissue culture technique, the performance of the FA test was as follows: sensitivity 61% (28 of 46), specificity 97% (264 of 272), positive predictive value 78% (28 of 36), and negative predictive value 94% (264 of 282). There was no significant difference in test performance by race, although the sensitivity rate (64%) of the test in blacks was twice that (30%) in nonblacks. This apparent difference in test performance by race may actually represent variations in group characteristics, including exposure rate, susceptibility, and number of inclusion forming units available for tissue culture of Chlamydia in blacks compared with nonblacks. In our adolescent clinic, the tissue culture is superior to FA in detecting Chlamydia. We recommend that the FA test be used where tissue culture isolation for Chlamydia is not readily available, where known or predicted chlamydial infection rates are high, and where known or predicted numbers of inclusion forming units of Chlamydia in tissue culture are high.