Contributions of each authorMJB was the PI; CF was the lead author for the paper, JPG contributed for the design of the study and study analysis; RP, MB, CF performed all the typing techniques, AP performed the bacterial detection and antimicrobial testing; BN performed the statistical analysis; and MJB, CF and JPG contributed to the write up.The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd to permit this article (if accepted) to be published in STI and any other BMJPGL products and sub-licences such use and exploit all subsidiary rights, as set out in our licence http://group.bmj.com/products/journals/instructions-for-authors/licence-forms. peer-00576095, version 1 -12 Mar 2011Author manuscript, published in "Sexually Transmitted Infections 86, 6 (2010) Methods: A total of 236 N. gonorrhoeae isolates were typed through NG-MAST. The polymorphism degree and the phylogenetic relatedness among NG-MAST STs were evaluated by MEGA4 software on concatenated sequences of por and tbpb alleles. Etest was used to determine the susceptibility to ceftriaxone, ciprofloxacin, penicillin, and spectinomycin. Results:No isolates displayed resistance to spectinomycin and ceftriaxone whereas 79.1% and 37.4% were resistant to penicillin and ciprofloxacin, respectively. We found 104 different STs (1 ST per 2.3 isolates), where the most frequent were ST210 (8.1%) and ST225 (7.6%). STs formed two major groups separated by 159.8 [SE 8.9] nucleotide differences, yielding several subgroups, one of them including the worldwide prevalent ST225. The probability of ciprofloxacin resistance among isolates within this subgroup was 73.5-fold higher than for the remaining isolates. Indeed, for the genetically closest subgroup, which includes the most prevalent ST210, only 8.0% of isolates were resistance to ciprofloxacin. There was a non-homogeneous distribution per year for ST225 (p<0.001), ST210 (p=0.011), and ST2 (p=0.007). Conclusions:The heterogeneous STs scenario may represent the "tip of the iceberg", reflecting a high number of undiagnosed and not reported gonorrhoea cases. A laboratory-based national surveillance of N. gonorrhoeae infections is mandatory to provide a broader spectrum of isolates that will allow the establishment of the scenario of the Portuguese sexual networks.

Knowledge of the epidemiology of Streptococcus agalactiae in Portugal is limited: therefore, the present study aimed to investigate the carriage rate of S. agalactiae among Portuguese women of reproductive age and the prevalence of antibiotic resistance, as well as to perform a molecular characterization of the clinical isolates. S. agalactiae was recovered from 6.2% of 4269 women during the period 2005-2007, with a predominance of capsular genotypes III (35%), V (33%), Ia (16%) and II (10%) in a sample of 100 isolates. To our knowledge, this is the first report of the S. agalactiae colonization rate in Portugal determined according to CDC guidelines. All isolates were susceptible to penicillin and vancomycin, whereas resistance to clindamycin and erythromycin was detected in 10% and 19% of isolates, respectively. Among the 19 erythromycin-resistant isolates, ten (53%) displayed the constitutive MLS B phenotype (conferring highlevel resistance to macrolides), eight (42%) had the inducible MLS B , and the M phenotype accounted for one isolate (5%). erm methylase genes were exclusively associated with MLS B phenotype isolates, whereas the M phenotype was a result of the presence of mefA.Multilocus sequence typing analysis of the genetic relatedness among isolates presenting resistance to erythromycin demonstrated a novel association between erythromycin resistance and the subtype III-1/ST-19 genetic clone family.

The sensitivity of two urine pool sizes versus individual testing, to detect Chlamydia trachomatis urogenital infection, was evaluated using the Gen-Probe AMP-CT assay. Thirty-three (33) known polymerase chain reaction (PCR) positive urine specimens were combined with 231 fresh first-catch urine (FCU) samples in 33 groups of four and 33 groups of eight, to make up 4X and 8X pooled samples, respectively. Gen-Probe AMP-CT assay was performed on pools as well as on individual samples at the same time. For the discrepant cases, the known positive samples were diluted 1:4 and 1:8 using the manufacturer's dilution buffer and were retested. Additional positive specimens found among fresh FCU samples were also tested by the Amplicor-PCR assay to confirm their positivity. The sensitivities of 8X pooling, 4X pooling and individual testing were 86.5%, 94.3% and 91.9%, respectively. The Gen-Probe AMP-CT assay applied to a 4X urine pooling model was highly sensitive and may be useful for a population based screening programme.

Knowledge of the epidemiology of Streptococcus agalactiae in Portugal is limited: therefore, the present study aimed to investigate the carriage rate of S. agalactiae among Portuguese women of reproductive age and the prevalence of antibiotic resistance, as well as to perform a molecular characterization of the clinical isolates. S. agalactiae was recovered from 6.2% of 4269 women during the period 2005-2007, with a predominance of capsular genotypes III (35%), V (33%), Ia (16%) and II (10%) in a sample of 100 isolates. To our knowledge, this is the first report of the S. agalactiae colonization rate in Portugal determined according to CDC guidelines. All isolates were susceptible to penicillin and vancomycin, whereas resistance to clindamycin and erythromycin was detected in 10% and 19% of isolates, respectively. Among the 19 erythromycin-resistant isolates, ten (53%) displayed the constitutive MLS B phenotype (conferring highlevel resistance to macrolides), eight (42%) had the inducible MLS B , and the M phenotype accounted for one isolate (5%). erm methylase genes were exclusively associated with MLS B phenotype isolates, whereas the M phenotype was a result of the presence of mefA. Multilocus sequence typing analysis of the genetic relatedness among isolates presenting resistance to erythromycin demonstrated a novel association between erythromycin resistance and the subtype III-1/ST-19 genetic clone family.

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