Current challenges in the clinical management of sexually transmitted infections

Vries, Henry J. C. de

doi:10.1002/jia2.25347

Cited by 6 publications

(6 citation statements)

References 25 publications

(24 reference statements)

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“…Segundo a OMS, foram encontrados em 77 países cepas resistentes aos antimicrobianos da dupla terapia atual, tornando-os sem ação (CARDOSO A, et al, 2022). A bactéria desenvolveu resistência a todos os antibióticos recomendados no passado, como as penicilinas, tetraciclinas, macrolídeos e fluoroquinolonas (CARDOSO A, et al, 2022), e a maioria das diretrizes internacionais atuais recomenda a terapia dupla para tratamento de gonorreia com a cefalosporina de terceira geração ceftriaxona e os macrolídeos azitromicina ou doxiciclina (JC DE VRIES H, 2019).…”

Section: Resultados E Discussõesunclassified

Challenges and New Perspectives for the Management of Neisseria Gonorrhoeae Infection

Bopp,

Brant

2024

REASE

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Esse artigo buscou elucidar os atuais desafios e estratégias para o futuro do tratamento da infecção por Neisseria gonorrhoeae, agente etiológico da infecção sexualmente transmissível (IST) gonorreia, visto que há uma crescente tendência atual da ascensão de cepas multirresistentes à última linha de tratamento com antibióticos. A relação entre a infecção por gonorreia e o desenvolvimento de mecanismos de resistência tem sido objeto de estudo importante em diversos países. Assim, este artigo busca destacar os principais desafios para o tratamento e controle da infecção por gonorreia e os mais recentes estudos científicos e clínicos realizados como forma de sanar o problema de saúde pública que é a Neisseria gonorrhoeae. Foi realizada uma revisão integrativa da literatura, por meio da análise de 11 artigos, destacando os principais pontos relevantes frente aos desafios e novas perspectivas frente à este patógeno, seguindo os critérios de inclusão e exclusão selecionados pelo grupo. Foram revisados artigos dos últimos 5 anos, presentes nas bases de dados MedLINE, Scielo e UpToDate, utilizando cinco descritores principais: “gonorreia”, “farmacorresistência bacteriana”, “Neisseria”, “complicações” e “tratamento”. Os resultados desta revisão integrativa revelam uma variedade de desafios e novas perspectivas acerca da infecção por gonorreia. Dentre os principais tópicos abordados, destacam-se a resistência bacteriana, a subnotificação e subdiagnóstico da doença e o crescimento da prevalência das IST’s. Em síntese, é crucial entender os principais desafios e pontos chave frente à infecção por Neisseria gonorrhoeae, com vistas a promover o manejo adequado da doença. Profissionais de saúde devem estar cientes do cenário atual e das novas perspectivas, enfatizando uma abordagem clínica adequada e estratégias de prevenção.

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Section: Resultados E Discussõesunclassified

Challenges and New Perspectives for the Management of Neisseria Gonorrhoeae Infection

Bopp,

Brant

2024

REASE

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“…While young adults are tested at higher rates for more common STIs, such as gonorrhoea, the overall testing rates may be low compared with the need for testing. This is worrisome, as gonorrhoea is the second most commonly reported notifiable disease 3 (and second most common bacterial STI) 16 worldwide, is known to increase the transmission of HIV 17 and has resulted in many treatment failures from extended-spectrum cephalosporin resistance. 17 Additionally, given that molecular diagnostics are standard of care and most commercial vendors offer a Chlamydia trachomatis and Neisseria gonorrhoeae combination assay, it is unclear why there was a large difference in testing rates for chlamydia and gonorrhoea; however, this difference is similar to the difference seen in annual incidence rates of these two STIs.…”

Section: Discussionmentioning

confidence: 99%

“…This is worrisome, as gonorrhoea is the second most commonly reported notifiable disease 3 (and second most common bacterial STI) 16 worldwide, is known to increase the transmission of HIV 17 and has resulted in many treatment failures from extended-spectrum cephalosporin resistance. 17 Additionally, given that molecular diagnostics are standard of care and most commercial vendors offer a Chlamydia trachomatis and Neisseria gonorrhoeae combination assay, it is unclear why there was a large difference in testing rates for chlamydia and gonorrhoea; however, this difference is similar to the difference seen in annual incidence rates of these two STIs. Future NAMCS surveys would benefit from the collection of type of laboratory test used, as this information can be easily incorporated into patient medical records once reviewed by the healthcare provider.…”

Section: Discussionmentioning

confidence: 99%

Sexually transmitted infection laboratory testing and education trends in US outpatient physician offices, 2009–2016

et al. 2021

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ObjectiveTo describe national rates of sexually transmitted infection (STI) testing and education overall and among patient subgroups in US outpatient physician offices from 2009 to 2016.DesignThis was a cross-sectional study of the Centers for Disease Control and Prevention’s National Ambulatory Medical Care Survey from 2009 to 2016. Data weights were applied to extrapolate to national estimates.SettingData were collected from a systematic random sample of outpatient physician office visits throughout USA. Physician office types include free standing clinics, private or group setting practices, centres offering community and mental health services, family planning clinics and health maintenance organisations/other prepaid clinics.ParticipantsAll sampled patient visits were eligible for inclusion and were assessed for the provision of STI prevention education and STI testing for chlamydia, gonorrhoea, hepatitis, human papillomavirus (HPV) and HIV.ResultsOf 7.6 billion total visits, 123 million included an STI test. Hepatitis was the most commonly tested STI (9.12 per 1000), followed by chlamydia (6.67 per 1000), gonorrhoea (6.00 per 1000), HIV (5.40 per 1000) and HPV (5.03 per 1000). Testing rates for the three STIs measured for the entire 8-year period increased over time and peaked in 2015 compared with 2009: chlamydia (R2=0.36), HPV (R2=0.28) and HIV (R2=0.51). Testing was highest among women (21.93 per 1000), 15–24-year olds (46.04 per 1000), non-Hispanic blacks (37.33 per 1000) and those seen by obstetrics/gynaecology specialists (103.75 per 1000). STI prevention education was provided to 4.89 per 1000 patients and remained relatively unchanged from 2013 to 2016.ConclusionSTI testing in outpatient physician offices increased over the study period but varied by patient characteristics and site of care. Few patients received STI prevention education, highlighting a potential gap in resource utilisation in these settings.

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“…de Vries discusses the challenges that clinicians face in addressing STI in the current treatment-as-prevention era [17]. de Vries discusses the challenges that clinicians face in addressing STI in the current treatment-as-prevention era [17].…”

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confidence: 99%

“…The next set of papers focuses on clinical issues that are emerging regarding HIV and STI. de Vries discusses the challenges that clinicians face in addressing STI in the current treatment-as-prevention era [17]. Rojas Castro and colleagues discuss the patterns of STI that have been seen in individuals who use biomedical HIV prevention, that is, PrEP, and address the question of risk compensation versus risk maintenance when individuals who are at high risk for HIV/STI utilize interventions that can protect them against HIV but not STI [18].…”

mentioning

confidence: 99%

HIV and sexually transmitted infections: reconciling estranged bedfellows in the U = U and PrEP era

Mayer

Vries

2019

J Intern AIDS Soc

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Current challenges in the clinical management of sexually transmitted infections

Cited by 6 publications

References 25 publications

Challenges and New Perspectives for the Management of Neisseria Gonorrhoeae Infection

Challenges and New Perspectives for the Management of Neisseria Gonorrhoeae Infection

Sexually transmitted infection laboratory testing and education trends in US outpatient physician offices, 2009–2016

HIV and sexually transmitted infections: reconciling estranged bedfellows in the U = U and PrEP era

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