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PubMed2006

Expression of Haemophilus ducreyi collagen binding outer membrane protein NcaA is required for virulence in swine and human challenge models of chancroid.

Haemophilus ducreyi, the etiologic agent of the sexually transmitted genital ulcer disease chancroid, has been shown to associate with dermal collagen fibers within infected skin lesions. Here we describe NcaA, a previously uncharacterized outer membrane protein that is important for H. ducreyi collagen binding and host colonization. An H. ducreyi strain lacking the ncaA gene was impaired in adherence to type I collagen but not fibronectin (plasma or cellular form) or heparin. The mutation had no effect on serum resistance or binding to HaCaT keratinocytes or human foreskin fibroblasts in vitro. Escherichia coli expressing H. ducreyi NcaA bound to type I collagen, demonstrating that NcaA is sufficient to confer collagen attachment. The importance of NcaA in H. ducreyi pathogenesis was assessed using both swine and human experimental models of chancroid. In the swine model, 20% of lesions from sites inoculated with the ncaA mutant were culture positive for H. ducreyi 7 days after inoculation, compared to 73% of wild-type-inoculated sites. The average number of CFU recovered from mutant-inoculated lesions was also significantly reduced compared to that recovered from wild-type-inoculated sites at both 2 and 7 days after inoculation. In the human challenge model, 8 of 30 sites inoculated with wild-type H. ducreyi progressed to the pustular stage, compared to 0 of 30 sites inoculated with the ncaA mutant. Together these results demonstrate that the collagen binding protein NcaA is required for H. ducreyi infection.

Adhesins, Bacterial↗
PubMed1979

Rising incidence of chancroid in Rotterdam. Epidemiological, clinical, diagnostic, and therapeutic aspects.

The incidence of chancroid in Rotterdam has increased by more than five-fold during 1977-78. In a retrospective study of 53 patients with chancroid seen at this clinic during this period, the results of smears were positive in 82% and of cultures in 84% (of those for whom cultures had been performed). Symptoms were generally mild. Treatment with co-trimoxazole was highly effective clinically, as confirmed by in-vitro sensitivity studies.

Adult↗
PubMed1988

Treating chancroid with enoxacin.

Increasing resistance of Haemophilus ducreyi to antimicrobials necessitates further trials of new antimicrobial agents for treating chancroid. Enoxacin has excellent in vitro activity against H ducreyi, and a randomised clinical trial of three doses of enoxacin 400 mg at intervals of 12 hours compared with a single dose of trimethoprim/sulphametrole (TMP/SMT) 640/3200 mg was therefore conducted. Of 169 men enrolled in the study, 86 received enoxacin and 83 received TMP/SMT. Ulcers were improved or cured in 65/73 men treated with enoxacin and 57/70 men treated with TMP/SMT. This difference was not significant. At 72 hours after treatment, H ducreyi was eradicated from ulcers of 72/77 men treated with enoxacin and of 67/74 of those treated with TMP/SMT. Patients with buboes responded equally well to both treatments. Of 100 H ducreyi strains tested, all were susceptible to both 0.25 mg/l enoxacin and the combination of 0.25 mg/l TMP and 5 mg/l SMT. Although most men treated with either regimen were cured, neither regimen appeared to be the optimum treatment for chancroid. This study shows the efficacy of enoxacin for a soft tissue infection caused by Gram negative organisms.

Adolescent↗
PubMed2003

Chancroid: clinical manifestations, diagnosis, and management.

Chancroid is a sexually transmitted disease (STD) caused by the Gram negative bacterium Haemophilus ducreyi and is characterised by necrotising genital ulceration which may be accompanied by inguinal lymphadenitis or bubo formation. H ducreyi is a fastidious organism which is difficult to culture from genital ulcer material. DNA amplification techniques have shown improved diagnostic sensitivity but are only performed in a few laboratories. The management of chancroid in the tropics tends to be undertaken in the context of syndromic management of genital ulcer disease and treatment is usually with erythromycin. A number of single dose regimens are also available to treat H ducreyi infection. Genital ulceration as a syndrome has been associated with increased transmission of human immunodeficiency virus (HIV) infection in several cross sectional and longitudinal studies. Effective and early treatment of genital ulceration is therefore an important part of any strategy to control the spread of HIV infection in tropical countries.

Anti-Bacterial Agents↗
PubMed1999

The cytolethal distending toxin from the chancroid bacterium Haemophilus ducreyi induces cell-cycle arrest in the G2 phase.

The potent cytolethal distending toxin produced by Haemophilus ducreyi is a putative virulence factor in the pathogenesis of chancroid. We studied its action on eukaryotic cells, with the long-term goal of understanding the pathophysiology of the disease. Intoxication of cultured human epithelial-like cells, human keratinocytes, and hamster fibroblasts was irreversible, and appeared as a gradual distention of three- to fivefold the size of control cells. Organized actin assemblies appeared concomitantly with cell enlargement, promoted by a mechanism that probably does not involve small GTPases of the Rho protein family. Intoxicated cells did not proliferate. Similar to cells treated with other cytolethal distending toxins, these cells accumulated in the G2 phase of the cell cycle, demonstrating an increased level of the tyrosine phosphorylated (inactive) form of the cyclin-dependent kinase p34(cdc2). DNA synthesis was not affected until several hours after this increase, suggesting that the toxin acts directly on some kinase/phosphatase in the signaling network controlling the p34(cdc2) activity. We propose that this toxin has an important role both in the generation of chancroid ulcers and in their slow healing. The toxin may also be an interesting new tool for molecular studies of the eukaryotic cell- cycle machinery.

Animals↗
PubMedDate not supplied

Thiamphenicol in the treatment of chancroid. A study of 1,128 cases.

Thiamphenicol, an aminic derivate of hydrocarbilsulfonil propandiol, was used for the treatment of 1,171 chancroid bearing patients. Each patient was medicated with 5.0 g of granulated thiamphenicol, orally, in a single dose, and was reevaluated 3, 7 and 10 days after the treatment. Ten patients (0.89%) did not respond to the proposed treatment. 133 patients presented healed ulcers after 3 days of treatment, 976 patients healed chancres on the seventh day after the treatment, and 39 patients took 10 days to present healed chancres. The results of this study indicate that the rate of patients that were cured, the low incidence of side effects, and the practicality of administration make of thiamphenicol an excellent choice for the treatment of chancroid.

Adolescent↗
PubMed1977

A case of chancroid.

After a visit to Hong Kong, a 27-year-old salesman developed penile ulceration which failed to respond to three weeks' penicillin therapy. He then presented to hospital with acute paraphimosis. A clinical diagnosis of chancroid was confirmed by isolation of Haemophilus ducreyi. The ulcers healed after sulphonamide and streptomycin therapy. Although chancroid is an uncommon venereal disease in Australia, its incidence is still high in many tropical countries. It should be considered as a possible cause of genital ulceration in patients who have travelled overseas.

Adult↗
PubMed1992

[The reappearance of chancroid in Algeria].

After 35 observations of the chancroid observed in the department of dermato-venereology of the University Hospital of Tlemcen (West Algeria) from August 1988 to December 1991, we are led to analyze the flare of this sexual transmitted disease. The principal affected subjects are single male no older than 30 years, having had sexual intercourse with prostitutes (30/35). Less than 10 days (19/29) after the sexual contacts, the ulcer appears, and most often unique (25/35), mildly painful, accompanied frequently by adenopathies (31/35). The contamination took place mainly in Bel Abbès--city located at 90 km from Tlemcen--(12 cases), in Tlemcen (4 cases) and Morocco (5 cases). The treatment based on sulfonamides, erythromycin and tetracycline or doxycycline, has been constantly efficient. No concomitant HIV infection has been revealed. The chancroid is the first STD observed in our department in 1991, and also, the first cause for genital ulcer.

Adult↗
PubMed1990

Chancroid.

Although chancroid is still one of the minor sexually transmitted diseases in the United States, the incidence has increased, with over 3000 cases in 1986. Cases have been reported in 21 states, primarily among black and Hispanic heterosexual men. Patients may be asymptomatic, but frequently both primary and secondary sexual contacts have ulcers. Because confirmation of the diagnosis requires special laboratory conditions, diagnosis usually is based on characteristics of the lesions. Chancroid can be confused with other more common diseases, particularly genital herpes. Differential characteristics are incubation period, location and appearance of lesions, and the presence or absence of associated lymphadenopathy. A simple regimen of antibiotic therapy is highly effective, but control of outbreaks requires prompt identification, treatment of a patient's sexual contacts, and patient education about prevention.

Anti-Bacterial Agents↗
PubMed1989

Chancroid and granuloma inguinale.

Haemophilus ducreyi is a fastidious pathogen that can be routinely cultured with the appropriate media and incubation environment. Prostituted women appear to be the usual reservoir. In Africa, chancroid is emerging as the major risk factor for acquisition of HIV-1 following heterosexual intercourse. Despite the emergence of resistance to a number of antimicrobial agents, H. ducreyi remains susceptible to ceftriaxone, erythromycin, and ciprofloxacin. Control and eradication of outbreaks of chancroid have been successful on several occasions in Western societies; strategies to control epidemic genital ulcer disease are required in developing countries. Granuloma inguinale is caused by a small, gram-negative rod, which has never been well-characterized. The presence of Donovan bodies is a specific and sensitive diagnostic characteristic. Very little is known about the epidemiology of the disease. Specific treatment programs using trimethoprim-sulfamethoxazole or erythromycin seem to be quite effective. Control strategies have not been adequately investigated.

Campylobacter↗
PubMed1987

Chancroid in the United States. Reestablishment of an old disease.

For 30 years, chancroid has been an uncommon and geographically localized disease in the United States; a mean of 878 cases were reported annually between 1971 and 1980. Since 1981, however, numerous outbreaks have established chancroid as an endemic disease in many additional areas and, in 1986, 3418 cases, the largest number since 1952, were reported. Cases are occurring preponderantly among men who patronize prostitutes, and infected individuals who have traveled from outbreak areas or from outside the United States are suspected of having contributed to the spread of disease. Efforts to eradicate disease in outbreak areas have been only occasionally effective and have been hampered by difficulty in locating potentially infected individuals and by travel by infected individuals. The failure to eradicate outbreaks leaves residual sources for new disease transmission into yet additional areas.

Black or African American↗
PubMed1988

Clinical and microbiological efficacy of a single dose of norfloxacin in the treatment of chancroid.

Forty-one men with a clinically and bacteriologically verified diagnosis of chancroid were given a single dose of 800 mg of norfloxacin and were examined clinically and bacteriologically four, seven and 14 days after treatment. Five patients were excluded from evaluation of efficacy due to concomitant infections or incomplete follow-up. Of the remaining 36 patients, 34 were cured and culture negative at follow-up controls. Another 15 men with culture-negative ulcers treated with 800 mg of norfloxacin as a single dose, were all cured clinically. The high cure rate and the good tolerability make norfloxacin a convenient and cheap alternative to intramuscular single dose therapy of chancroid.

Administration, Oral↗
PubMed1987

Ceftriaxone in the treatment of chancroid.

The treatment of non-complicated or complicated (by a bubo) chancroid with 1 single i.m. injection of 250 mg ceftriaxone gave excellent results. Treatment is simple and economical. This is particularly profitable in countries where chancroid is endemic.

Adolescent↗
PubMed1986

The treatment of chancroid.

Since the treatment of chancroid was reviewed in 1982, the results of subsequent treatment trials have offered the clinician additional therapeutic choices as well as shorter courses of therapy. Erythromycin (500 mg four times a day for seven days) provides consistently effective treatment for cases acquired throughout the world, although erythromycin-resistant strains have been isolated in Singapore. Sulfamethoxazole and trimethoprim (800 mg/160 mg orally twice a day for seven days), ceftriaxone (250 mg intramuscularly one time), and amoxicillin/clavulanic acid (500 mg/125 mg orally three times a day for seven days) are also efficacious. There is, however, significant geographic variability in the susceptibility of Haemophilus ducreyi to sulfamethoxazole and trimethoprim, suggesting this combination may become increasingly less effective, and a lack of in-depth experience in the treatment of chancroid with ceftriaxone and amoxicillin/clavulanic acid.

Amoxicillin↗
PubMed1979

Chancroid.

The mobility of our society may play an important part in the epidemic proportions of sexually transmitter diseases in the United States. Chancroid, one of the major venereal diseases, is caused by Hemophilus ducreyi and can be recognized clinically. Because the morbidity of chancroid is related to delay in treatment, awareness of this disease is mandatory. Definitive laboratory proof can be obtained in only 50 percent of the cases. Sulfisoxazole is the drug of choice.

Chancroid↗
PubMed1979

Treatment of chancroid with Bactrim.

Bacterim in either oral or intramuscular injection forms were given to 67 patients with Chancroid. It was found that after one week of treatment, clinical cure rate was 46.3% and bacteriological cure rate was 73.1%. After two weeks, the clinical cure rate was 77.6%. Three patients (4.5%) had persistent sores at the end of two weeks and only one of these (2.5%) was bacteriologically active. Twelve patients defaulted. Adverse side-effects were observed in five patients. The effectiveness of Streptomycin, Sulphonamide and Tetracyclines, the other commonly used therapeutic agents, was discussed and compared with Bactrim. It was concluded that Bactrim was a safe and effective drug to use, and recommended as an alternative to Streptomycin and Sulphonamides in the management of Chancroid.

Administration, Oral↗
PubMed1994

[Chancroid in Yaounde. Apropos of 42 cases].

In Yaoundé, chancroid occurs frequently among adolescents and young men (95 p. 100 of the cases) who have sexual contacts regularly with prostitutes. Apart of classical clinical forms complicated in 2/3 of cases by inguinal adenopathies, we have observed furuncular chancroid which is quite characteristic of the disease. Giemsa stain represents for us a simple and reliable diagnostic method for this disease because in 1/3 of smears, typical cultural aspects of Haemophilus ducreyi were seen.

Adolescent↗