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Phenotypic and genetic characterisation of bacterial sexually transmitted infections in Bissau, Guinea-Bissau, West Africa: a prospective cohort study

Olsen, B.; Månsson, Fredrik LU ; Camara, C.; Monteiro, M.; Biai, A.; Alves, A.; Andersson, S.; Norrgren, H. and Unemo, M. (2012) In BMJ Open 2(2). p.000636-000636
Abstract
BACKGROUND: Knowledge regarding characteristics and transmission of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium and antibiotic resistance in N gonorrhoeae in Guinea-Bissau, West Africa, is entirely lacking. OBJECTIVES: To characterise N gonorrhoeae, C trachomatis and M genitalium samples from Guinea-Bissau and to define bacterial populations, possible transmission chains and for N gonorrhoeae spread of antibiotic-resistant isolates. DESIGN: Prospective cohort study. SETTING: Two sexual health and family planning clinics, Bissau, Guinea-Bissau. PARTICIPANTS: Positive samples from 711 women and 27 men. MATERIAL AND METHODS: Positive samples for N gonorrhoeae (n=31), C trachomatis (n=60) and M genitalium (n=30) were... (More)
BACKGROUND: Knowledge regarding characteristics and transmission of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium and antibiotic resistance in N gonorrhoeae in Guinea-Bissau, West Africa, is entirely lacking. OBJECTIVES: To characterise N gonorrhoeae, C trachomatis and M genitalium samples from Guinea-Bissau and to define bacterial populations, possible transmission chains and for N gonorrhoeae spread of antibiotic-resistant isolates. DESIGN: Prospective cohort study. SETTING: Two sexual health and family planning clinics, Bissau, Guinea-Bissau. PARTICIPANTS: Positive samples from 711 women and 27 men. MATERIAL AND METHODS: Positive samples for N gonorrhoeae (n=31), C trachomatis (n=60) and M genitalium (n=30) were examined. The gonococcal isolates were characterised with antibiograms, serovar determination and N gonorrhoeae multiantigen sequence typing (NG-MAST). The C trachomatis ompA gene and the M genitalium mgpB gene were sequenced, and phylogenetic analyses were performed. RESULTS: For N gonorrhoeae, the levels of resistance (intermediate susceptibility) to ciprofloxacin, erythromycin, rifampicin, ampicillin, tetracycline, penicillin G and cefuroxime were 10% (0%), 6% (10%), 13% (10%), 68% (0%), 74% (0%), 68% (16%) and 0% (84%), respectively. All isolates were susceptible to cefixime, ceftriaxone, spectinomycin and azithromycin, and the minimum inhibitory concentrations of kanamycin (range: 8-32 mg/l) and gentamicin (range: 0.75-6 mg/l) were low (no resistance breakpoints exist for these antimicrobials). 19 NG-MAST sequence types (STs) (84% novel STs) were identified. Phylogenetic analysis of the C trachomatis ompA gene revealed genovar G as most prevalent (37%), followed by genovar D (19%). 23 mgpB STs were found among the M genitalium isolates, and 67% of isolates had unique STs. CONCLUSIONS: The diversity among the sexually transmitted infection (STI) pathogens may be associated with suboptimal diagnostics, contact tracing, case reporting and epidemiological surveillance. In Guinea-Bissau, additional STI studies are vital to estimate the STI burden and form the basis for a national sexual health strategy for prevention, diagnosis and surveillance of STIs. (Less)
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Contribution to journal
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published
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in
BMJ Open
volume
2
issue
2
pages
000636 - 000636
publisher
British Medical Journal Publishing Group
external identifiers
  • wos:000315042100037
  • scopus:84860893016
ISSN
2044-6055
DOI
10.1136/bmjopen-2011-000636
language
English
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yes
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0e468ae5-df0f-4479-86a5-73a1273c324f (old id 3167669)
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22436137
date added to LUP
2012-11-14 14:24:05
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2017-01-01 06:02:13
@article{0e468ae5-df0f-4479-86a5-73a1273c324f,
  abstract     = {BACKGROUND: Knowledge regarding characteristics and transmission of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium and antibiotic resistance in N gonorrhoeae in Guinea-Bissau, West Africa, is entirely lacking. OBJECTIVES: To characterise N gonorrhoeae, C trachomatis and M genitalium samples from Guinea-Bissau and to define bacterial populations, possible transmission chains and for N gonorrhoeae spread of antibiotic-resistant isolates. DESIGN: Prospective cohort study. SETTING: Two sexual health and family planning clinics, Bissau, Guinea-Bissau. PARTICIPANTS: Positive samples from 711 women and 27 men. MATERIAL AND METHODS: Positive samples for N gonorrhoeae (n=31), C trachomatis (n=60) and M genitalium (n=30) were examined. The gonococcal isolates were characterised with antibiograms, serovar determination and N gonorrhoeae multiantigen sequence typing (NG-MAST). The C trachomatis ompA gene and the M genitalium mgpB gene were sequenced, and phylogenetic analyses were performed. RESULTS: For N gonorrhoeae, the levels of resistance (intermediate susceptibility) to ciprofloxacin, erythromycin, rifampicin, ampicillin, tetracycline, penicillin G and cefuroxime were 10% (0%), 6% (10%), 13% (10%), 68% (0%), 74% (0%), 68% (16%) and 0% (84%), respectively. All isolates were susceptible to cefixime, ceftriaxone, spectinomycin and azithromycin, and the minimum inhibitory concentrations of kanamycin (range: 8-32 mg/l) and gentamicin (range: 0.75-6 mg/l) were low (no resistance breakpoints exist for these antimicrobials). 19 NG-MAST sequence types (STs) (84% novel STs) were identified. Phylogenetic analysis of the C trachomatis ompA gene revealed genovar G as most prevalent (37%), followed by genovar D (19%). 23 mgpB STs were found among the M genitalium isolates, and 67% of isolates had unique STs. CONCLUSIONS: The diversity among the sexually transmitted infection (STI) pathogens may be associated with suboptimal diagnostics, contact tracing, case reporting and epidemiological surveillance. In Guinea-Bissau, additional STI studies are vital to estimate the STI burden and form the basis for a national sexual health strategy for prevention, diagnosis and surveillance of STIs.},
  author       = {Olsen, B. and Månsson, Fredrik and Camara, C. and Monteiro, M. and Biai, A. and Alves, A. and Andersson, S. and Norrgren, H. and Unemo, M.},
  issn         = {2044-6055},
  language     = {eng},
  number       = {2},
  pages        = {000636--000636},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Phenotypic and genetic characterisation of bacterial sexually transmitted infections in Bissau, Guinea-Bissau, West Africa: a prospective cohort study},
  url          = {http://dx.doi.org/10.1136/bmjopen-2011-000636},
  volume       = {2},
  year         = {2012},
}