Impact of a genetic variant of Chlamydia trachomatis on national detection rates in Sweden.
Explore the source record for details and available documents.
Chlamydia Infections↗
Biomedical subjects
H Fredlund
Publications and source records attributed to H Fredlund.
Global transmission of prolyliminopeptidase-negative Neisseria gonorrhoeae strains: implications for changes in diagnostic strategies.
BACKGROUND: Species confirmation of Neisseria gonorrhoeae is commonly performed with biochemical kits, rely on the activity of the enzyme prolyliminopeptidase (PIP). This enzyme has previously been considered to be almost universally present in N gonorrhoeae. However, increasing numbers of N gonorrhoeae isolates lacking PIP activity have been identified. OBJECTIVES: To investigate the possibility of a widespread transmission of one or several N gonorrhoeae PIP-negative strains among several countries worldwide. METHODS: PIP-negative N gonorrhoeae isolates cultured from 2001 to 2004 in Australia, New Zealand and Scotland were comprehensively characterised and compared with previous data from England and Denmark. All isolates were characterised by antibiotic susceptibility testing, serovar determination, pulsed-field gel electrophoresis (PFGE), opa-typing, sequencing of the entire porB gene and N gonorrhoeae multiantigen sequence typing (NG-MAST). RESULTS: Most (83%) of the viable Australian isolates, and all the New Zealand and Scottish isolates were assigned serovar IB-4, with similar antibiograms, nearly identical porB1b gene sequences, identical (ST210) or highly related (ST292, ST1259) NG-MAST STs, and indistinguishable or related PFGE fingerprints as well as opa-types. The isolates showed characteristics indistinguishable or highly related to the previously described English and Danish outbreak strain. CONCLUSIONS: A comprehensive characterisation indicates a widespread dissemination, mainly among men who have sex with men (MSM), of indistinguishable and highly related genotypes that have evolved from a single N gonorrhoeae PIP-negative serovar IB-4 strain among several countries worldwide. An increased awareness of PIP-negative N gonorrhoeae strains is crucial and changes in the diagnostic strategies may need to be considered.
Aminopeptidases↗
Phenotypic and genotypic characterization of prolyliminopeptidase-negative Neisseria gonorrhoeae isolates in Denmark.
In the study presented here 26 recent Danish clinical isolates of prolyliminopeptidase (PIP)-negative Neisseria gonorrhoeae were phenotypically and genotypically characterized to investigate whether one or more PIP-negative strains are circulating in the Danish community. The profiles of these isolates were compared with those of three isolates from a recent outbreak of PIP-negative N. gonorrhoeae infection in the UK. Twenty-five of the Danish isolates and all three UK isolates had similar antibiograms and were designated serovar IB-4. Genotypic characterization by pulsed-field gel electrophoresis, porB1b gene sequencing, and opa-typing revealed that these isolates were indistinguishable or closely related. The results indicate that at least one PIP-negative N. gonorrhoeae strain is currently circulating in the Danish community, and this strain is indistinguishable from the one that caused an outbreak in the UK.
Adult↗
Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection.
OBJECTIVES: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme. METHODS: A cross sectional study among female STD clinic attendees in Orebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis. RESULTS: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80). CONCLUSIONS: M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection.
Adolescent↗
Similar inflammatory response in human whole blood to live Streptococcus pneumoniae of different serotypes.
Differences in inflammatory responses in human adult whole blood to live pneumococcal serotypes 3, 7F, 9V and 23F were investigated. Using flow cytometry and ELISA, oxidative burst, expression of activation markers CD11b/CD18, and in-vitro production of tumour necrosis factor-alpha, interleukin-6 (IL-6) and interleukin-8 were measured. There was no significant difference between the serotypes regarding any of the variables investigated, although there was a trend towards higher concentrations of IL-6 induced by serotypes 9V and 23F. In the present experimental model, the serotypes of Streptococcus pneumoniae shown previously to cause different degrees of inflammation were found to cause a similar inflammatory response in human whole blood.
CD11b Antigen↗
Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis.
OBJECTIVES: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in men attending a Swedish STD clinic and to study the criteria for urethritis. METHODS: A cross sectional study among STD clinic attendees in Orebro, Sweden. Attendees were examined for microscopic urethritis and first void urine (FVU) was tested for M genitalium and C trachomatis. RESULTS: The prevalence of M genitalium and C trachomatis was 7% (34/512) and 12% (61/512), respectively. Dual infection was diagnosed in four men. In both infections 90% of the patients had signs of microscopic urethritis. M genitalium positive men had symptomatic urethritis significantly more often than those infected with C trachomatis (73% v 40%, RR 1.8; 95% CI 1.2 to 2.7). 63% of female partners of men infected with M genitalium were infected with M genitalium compared with chlamydial infection in 67% of female partners of men infected with C trachomatis. Non-chlamydial non-gonococcal urethritis without evidence of M genitalium infection was diagnosed in 180 men (35%). Symptoms and/or visible discharge were reported in 49% in this group. CONCLUSIONS: M genitalium is a common infection associated with symptomatic urethritis and with a high prevalence of infected sexual partners supporting its role as a sexually transmitted infection.
Adolescent↗
Microbiological etiology in clinically diagnosed community-acquired pneumonia in primary care in Orebro, Sweden.
OBJECTIVE: To study the etiology of clinically diagnosed community-acquired pneumonia (CAP) in antibiotically naive patients attending a primary care center and treated at their homes. METHODS: A three-year prospective study was carried out, and 177 patients presenting with clinical signs of CAP were included. All patients had chest X-rays after inclusion, and 82 (46%) showed infiltrates. Nasopharyngeal swab culture was performed on all patients, and 51% produced a representative sputum sample. Paired sera were obtained from 176 patients. RESULTS: Among the 82 patients with radiographically proven CAP, Streptococcus pneumoniae was detected in 26 patients (32%), Haemophilus influenzae in 23 (28%), Mycoplasma pneumoniae in 15 (18%), and Chlamydia pneumoniae in four (5%). Serologic evidence of a viral infection was found in 13 patients (16%). Among the 95 patients without infiltrates, S. pneumoniae was found in 21 (22%), H. influenzae in 14 (15%), M. pneumoniae in two (2%), and C. pneumoniae in five (5%). Viral infection was detected in 19 (20%) of these 95 patients. CONCLUSION: In primary care in Sweden, the initial antibiotic treatment in any patient with pneumonia should be effective against S. pneumonia and H. influenzae. In addition, M. pneumoniae should be targeted during recurrent epidemics. C. pneumoniae, and especially Legionella, seem to be uncommon in primary care.
Community-Acquired Infections↗
Tetracycline treatment does not eradicate Mycoplasma genitalium.
OBJECTIVES: To study the treatment efficacy of tetracyclines and azithromycin in Mycoplasma genitalium positive patients attending an STD clinic. METHODS: All M genitalium positive patients (34 men and 26 women) attending an STD clinic during a 6 month period were treated with antibiotics. All patients known to be partners of M genitalium positive patients and those who were M genitalium positive, but not initially treated, were treated with azithromycin. Patients with urethritis and/or cervicitis were treated with tetracyclines before their M genitalium status was known. RESULTS: 10 of 14 women (71%) and 10 of 16 men (63%) treated with tetracyclines were M genitalium positive at follow up, whereas all patients treated with azithromycin (16 men and 20 women) were M genitalium negative, at the 4 week follow up visit. CONCLUSIONS: These results suggest that tetracyclines are not sufficient to eradicate M genitalium. Randomised controlled treatment trials are urgently needed.
Anti-Bacterial Agents↗
Activation of granulocytes in patients treated with chemotherapy.
It is well known that patients with granulocytopenia due to chemotherapy are susceptible to life-threatening infections. To determine whether or not granulocyte function is also impaired by chemotherapy, respiratory burst, CD11b and CD18 expression were analysed by flow cytometry in granulocytes from 10 patients with haematological malignancies: before and after the commencement of high-dose chemotherapy and in the recovery phase. As a comparison, the same granulocytic functions were analysed in patients treated with low-dose hydroxyurea and in healthy volunteers. The granulocytes were activated by Staphylococcus aureus and Staphylococcus epidermidis. A decreased ability to mobilize CD18 in the recovery phase was seen, but the significance of this finding must be evaluated carefully owing to the small patient number.
Antineoplastic Agents↗
[Important progress presented at a European conference on meningococcal disease].
Explore the source record for details and available documents.
Communicable Disease Control↗
[Prevention and early diagnosis of cancer. What do we know? What do we think? Reports from the Lakardagarna in Orebro].
Läkardagarna (physician days) in Orebro is an annual course arranged by the Orebro Society of Medicine in collaboration with The Swedish Society of Medicine. In the year 2000 the title was "Prevention and early diagnosis of cancer. What do we know? What do we believe? What do we do?" With general practitioners as the target audience, the course covered basic biological science, risk factors, screening, ethical questions and the general practitioner's dilemma. This article reviews four selected contributions: 1) What is cancer? 2) Possible importance of the fetal stage for later risk of cancer; 3) Infections as a cause of cancer; and 4) Screening for cancer.
Health Knowledge, Attitudes, Practice↗
The effects of live Streptococcus pneumoniae and tumor necrosis factor-alpha on neutrophil oxidative burst and beta 2-integrin expression.
OBJECTIVE: To study the effects of TNF-alpha and live Streptococcus pneumoniae on human neutrophil oxidative burst and beta 2-integrin expression using flow cytometry. METHODS: Six clinical isolates of S. pneumoniae (serotypes 3, 19A, 22F, 6A, 33F and 9N) from patients with bacteremic pneumonia or upper respiratory tract infections were studied. Whole blood was incubated either alone, with TNF-alpha or with S. pneumoniae or with both TNF-alpha and pneumococci at a ratio of one neutrophil per 1--5 bacteria. After 30 min of incubation, the tubes were put into ice, fixed and analysed. RESULTS: S. pneumoniae caused an increase in oxidative burst but not greater than that caused by TNF-alpha alone. When whole blood was preincubated with TNF-alpha for 30 min before the addition of pneumococci, a further increase in the oxidative burst response was seen. The variation in CD11b expression was not significant. Both S. pneumoniae and TNF-alpha caused increases in CD18 expression. The addition of TNF-alpha directly with the bacteria caused no further increase, but preincubation of blood with TNF-alpha 30 min before the addition of the bacteria caused a significant increase in CD18 expression. CONCLUSIONS: Live S. pneumoniae stimulates polymorphonuclear leukocytes to produce an oxidative burst and increases expression of CD18, and these effects are enhanced by TNF-alpha.
Bacteremia↗
Epidemiology of the reemergence of gonorrhea in Sweden.
BACKGROUND: After many years of decline, the incidence of gonorrhea in Sweden reached an all-time low of 2.4 cases per 100,000 inhabitants in 1996; however, the incidence has been increasing since 1997. GOAL: To describe the reemergence of gonorrhea in Sweden using clinical epidemiologic data and microbiologic characterization of isolated strains of Neisseria gonorrhoeae. STUDY DESIGN: N gonorrhoeae strains isolated in Sweden from February 1998 to January 1999 were serotyped and an epidemiologic data questionnaire was sent to each clinician reporting a case of gonorrhea. RESULTS: Epidemiologic and microbiologic data were obtained for 357 cases (91% of all cases diagnosed during the period). Domestic cases had significantly increased since 1997. Serovar IB-3 was the most common isolate in domestic cases of heterosexually exposed teenagers, and serovar IB-2 was the most frequent isolate in domestic cases of homosexually exposed men. Of the imported cases, 47% were exposed in Asia and 6.5% were exposed in Eastern Europe. CONCLUSION: The increase of gonorrhea in Sweden is due to an increase of domestic cases. Heterosexual teenagers and homosexual men were identified as core groups infected by different serovars of N gonorrhoeae.
Adolescent↗
Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted disease patients in Sweden.
A method for detection and genotyping of genital Chlamydia trachomatis infections based on omp1 gene amplification and sequencing was developed. DNA was extracted from urogenital or urine samples using a Chelex-based method, and an approximately 1,100-bp-long fragment from the omp1 gene was directly amplified and sequenced. Genotyping was performed by BLAST similarity search, and phylogenetic tree analysis was used to illustrate the evolutionary relationships between clinical isolates and reference strains. The method was used to determine the genotypes of C. trachomatis in 237 positive urogenital and/or urine specimens collected at a Swedish sexually transmitted disease clinic during 1 year. The most common genotypes corresponded to serotypes E (47%) and F (17%). The omp1 gene was highly conserved for genotype E (106 of 112 samples without any mutation) and F (41 of 42 samples without any mutation) strains but appear slightly less conserved for genotypes G (n = 6) and H (n = 6), where the sequences displayed one to four nucleotide substitutions relative to the reference sequence. Genotyping of samples collected at the follow-up visit indicated that two patients had become reinfected, while three other patients suffered treatment failure or reinfection. One woman appeared to have a mixed infection with two different C. trachomatis strains. This omp1 genotyping method had a high reproducibility and could be used for epidemiological characterization of sexually transmitted Chlamydia infections.
Adolescent↗
Comparison of serogroup W-135 meningococci isolated in Sweden during a 23-year period and those associated with a recent hajj pilgrimage.
An outbreak of serogroup W-135 meningococcal disease was reported among pilgrims returning from the annual hajj (pilgrimage to Mecca) in mid-March 2000. Molecular characterization was used to investigate the similarity of the hajj-associated W-135 strains with those isolated in Sweden during a 23-year period (1978 to 2000). The same hajj-associated genosubtype, genosubtype P1.5,2,36b, has been documented in Sweden since 1979, while pulsed-field gel electrophoresis and the sulfadiazine resistance of the W-135 isolates indicated that the outbreak was probably due to a new clone of W-135 meningococci.
Disease Outbreaks↗
Labsystems enzyme immunoassay for Chlamydia pneumoniae also detects Chlamydia psittaci infections.
Explore the source record for details and available documents.
Antibodies, Bacterial↗
Immunization against Haemophilus influenzae type b in Sweden--a study of the introduction process.
AIMS: To study the introduction of Haemophilus influenzae type b (Hib) vaccination in Sweden, and to identify factors promoting and inhibiting the process. METHODS: The introduction of general childhood vaccination against Hib in Sweden in 1992-93 was studied using the Cultural Historical Activity Theory as a theoretical framework. RESULTS: Five activity systems were found to be involved in the introduction process, the systems of vaccine production, government administration, news distribution, science, and disease prevention. The critical factors for introduction of the programme were found to be the vaccine product, conception of the disease, government economy and public decision-making. CONCLUSIONS: The results show that a broad range of non-biomedical aspects must be considered when a public health intervention such as a general vaccination programme is introduced.
Child↗
The effects of live Neisseria meningitidis and tumour necrosis factor-alpha on neutrophil oxidative burst and beta2-integrin expression.
The effects of human recombinant tumour necrosis factor-alpha (TNF-alpha) on neutrophil (PMNL) oxidative burst and on CD11b/CD18 and CD14 expression after stimulation with pathogenic or nonpathogenic Neisseria meningitidis were studied using chemiluminescence and flow cytometry. PMNL oxidative burst increased more when stimulated with the apathogenic 29E strain than with the pathogenic B strain both when studied by chemiluminescence and by flow cytometry. When TNF-alpha was added to whole blood or PMNL together with bacteria a significant increase in the oxidative burst was seen for the B strain only. When whole blood was preincubated for 30 min with TNF-alpha the increase in oxidative burst was significant for both meningococcal strains. TNF-alpha caused a significant increase in PMNL CD 11b/CD18 expression after 30 min of incubation at 37 degrees C. TNF-alpha added simultaneously with the bacteria induced a significant increase in PMNL CD11b/CD18 in both strains. Incubation with the B strain alone caused a low but significant increase in CD11b/CD18 expression, but the addition of TNF-alpha increased this expression to the same high level as incubation with TNF-alpha alone or the 29E strain alone. Only TNF-alpha and the 29E strain caused significant increases in CD14 expression. In conclusion, human PMNLs react differentially when stimulated with pathogenic and nonpathogenic N. meningitidis and the activating effect of TNF-alpha is variable depending on the bacteria involved.
Antigens, CD↗