DOCSLIB.ORG

2020 European Guideline for the Diagnosis and Treatment of Gonorrhoea in Adults (Unemo M, Et Al

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
2020 European Guideline for the Diagnosis and Treatment of Gonorrhoea in Adults (Unemo M, Et Al Guidelines International Journal of STD & AIDS 0(0) 1–17 2020 European guideline for the diagnosis ! The Author(s) 2020 Article reuse guidelines: and treatment of gonorrhoea in adults sagepub.com/journals-permissions DOI: 10.1177/0956462420949126 journals.sagepub.com/home/std M Unemo1 , JDC Ross2, AB Serwin3, M Gomberg4, M Cusini5 and JS Jensen6 Abstract Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended treatment regimens have been used. Improvements in access to appropriate testing, test performance, diagnostics, antimicrobial susceptibility surveillance and treatment, and follow-up of gonorrhoea patients are essential in controlling gonorrhoea and to mitigate the emergence and/or spread of ceftriaxone resistance and multidrug-resistant and extensively drug-resistant gonorrhoea. For detailed back- ground, evidence base and discussions, see the background review for the present 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults (Unemo M, et al. Int J STD AIDS. 2020). Keywords Neisseria gonorrhoeae, gonorrhoea, sexually transmitted infection, Europe, management, diagnosis, antimicrobial resis- tance, treatment Date received: 14 July 2020; accepted: 16 July 2020 1WHO Collaborating Centre for Gonorrhoea and other STIs, National The present evidence-based guideline represents an Reference Laboratory for STIs, Department of Laboratory Medicine, updated version of the ‘2012 European guideline on Microbiology, Orebro€ University Hospital and Faculty of Medicine and € € the diagnosis and treatment of gonorrhoea in Health, Orebro University, Orebro, adults’.1 For detailed background, evidence base and Sweden 2University Hospital Birmingham NHS Foundation Trust, Birmingham, UK discussions, see the background review for the present 3Department of Dermatology and Venereology, Medical University of 2020 European guideline for the diagnosis and treat- Białystok, Białystok, Poland ment of gonorrhoea in adults (Unemo M, et al. Int J 4Moscow Scientific and Practical Center of Dermatovenereology and STD AIDS. 2020). Cosmetology, Moscow, Russia 5Department of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Policlinico, Milano, Italy Aetiology, transmission, and epidemiology 6Infection Preparedness, Research Unit for Reproductive Tract Microbiology, Statens Serum Institut, Copenhagen, Denmark • Gonorrhoea (gonococcal infection) is caused by the obligate human pathogenic, Gram-negative bacteri- Corresponding author: um Neisseria gonorrhoeae;2 M Unemo, WHO Collaborating Centre for Gonorrhoea and other STIs, • National Reference Laboratory for STIs, Department of Laboratory Infection predominantly involves the epithelium of Medicine, Microbiology, Orebro€ University Hospital, Orebro,€ Sweden. the urethra, endocervix, rectum, oropharynx, and Email: [email protected] 2 International Journal of STD & AIDS 0(0) conjunctivae. Infection can ascend to the upper gen- the cervix, sometimes accompanied with hyperaemia ital tract to cause pelvic inflammatory disease (PID) and contact bleeding of the endocervix. and epididymo-orchitis;1–3 • Transmission is by direct inoculation of infected Complications and sequelae secretions from one mucosa to another, i.e., • PID in women, potentially resulting in ectopic preg- genital-urogenital, urogenital-anorectal, oro- urogenital, or oro-anal contact, or by mother-to- nancy and infertility, and epididymo-orchitis in men child transmission at birth;1–7 are complications of infection ascending to the • In the European Union (EU)/European Economic upper genital tract; • 17,18 Area (EEA), gonorrhoea is the second (after Gonococcal bacteraemia is generally rare, but Chlamydia trachomatis infection) most frequently can be more common in high-prevalent gonorrhoea reported bacterial sexually transmitted infection areas and may be expected to increase when the 19 (STI), and the incidence has increased by 240% gonorrhoea incidence increases. This is usually since 2008.8 In 2018, 76% of gonorrhoea cases manifested by skin lesions, fever, arthralgia, acute were reported in men,8 reflecting the high prevalence arthritis, and tenosynovitis (disseminated gonococ- 3,17–21 in men who have sex with men (MSM) and the cal infection [DGI]). higher proportion of diagnosed symptomatic uro- genital infections in men. In 2018, the highest inci- Indications for testing [2C] dence of gonorrhoea in the EU/EEA was among 25– • 34 year olds, closely followed by 15–24 year olds Symptoms or signs of urethral discharge in men; • and, in many countries, there is a disproportionate Cervical or vaginal discharge with a risk factor for < burden of infection in MSM and/or ethnic minority STI (age 30 years, new sexual contact in the last 8,22–24 groups.8–10 year, or more than one partner in the last year); • Mucopurulent cervicitis; • 1–3,11–16 Persons newly diagnosed with other STIs; Clinical features • Sexual contact of persons with an STI or PID; Symptoms and physical signs of gonorrhoea reflect • Acute epididymo-orchitis in a male aged <40 years localised inflammation of infected mucosal surfaces in or with other risk factors for STIs (e.g., new sexual the urogenital tract and several other STIs cause simi- contact in the last year, or more than one partner in lar symptoms. the last year);8,22–24 • Acute pelvic pain or signs of PID; Symptoms • When performing an STI screen in young adults (<25 years of age) or MSM; • In men, acute urethritis is predominant with symp- • When performing an STI screen in individuals with toms of urethral discharge (>80%) and dysuria > new or multiple recent sexual contacts; ( 50%), usually starting within 2–8 days of expo- • Purulent conjunctivitis in a neonate or adult; sure. Asymptomatic urethral infection in men is rare • Mother of a newborn with ophthalmia neonatorum; < ( 10% of infections); • Unplanned termination of pregnancy in areas or • In women, endocervical and urethral infection populations of high gonorrhoea prevalence; include symptoms such as increased or altered vag- • Any intrauterine interventions or manipulations in inal discharge (50%), lower abdominal pain areas or populations of high gonorrhoea (25%), dysuria (10–15%), and occasionally inter- prevalence.25,26 menstrual bleeding or menorrhagia. Endocervical infection is frequently asymptomatic (50%); • Rectal and oropharyngeal infections in men and Testing and diagnosis women are usually asymptomatic. Rare symptoms • Diagnosis of uncomplicated gonorrhoea is estab- include anal discharge and perianal/anal pain or dis- lished by identification of N. gonorrhoeae in urogen- comfort and sore throat, respectively. ital, rectal, oropharyngeal, or ocular secretions;2,27 • N. gonorrhoeae can be detected by nucleic acid Physical signs amplification tests (NAATs) or culture. The bacte- • In men, mucopurulent urethral discharge is most rium can also be visualized by microscopy of a common, which may be accompanied by erythema stained anogenital tract smear to facilitate rapid of the urethral meatus; diagnosis in symptomatic patients; • In women, urogenital examination may be normal • Microscopy (31000) using Gram or methylene blue or a mucopurulent discharge may be evident from staining for identification of characteristic Unemo et al. 3 intracellular diplococci within polymorphonuclear gonorrhoea,1,2,27,32,35–38,46,49,50,56–62 and appropri- leukocytes offers adequate sensitivity (90-95%) and ately-validated and quality-assured NAATs are rec- specificity (>99%) as a rapid diagnostic test in ommended for testing and/or screening for symptomatic men with urethral discharge [1C].1– infections at these sites.1,2,35–38,63,64 However, most 3,12,27,28 Microscopy has a low sensitivity in asymp- commercially available gonococcal NAATs are not tomatic men (50-75%) and from endocervical (16- licensed for testing oropharyngeal and rectal speci- 50%) or rectal (40%) sites, and microscopy is not mens, and differ in their sensitivity and especially recommended as a test of exclusion in these patients specificity,1,2,27,33,37,65–69 particularly when examin- [1C].1–3,12,14,27–31 Microscopy is also not recom- ing oropharyngeal specimens due to the frequent mended for detection of oropharyngeal gonorrhoea presence of non-gonococcal Neisseria species. due to low specificity and sensitivity; • NAAT confirmatory testing: The positive predictive • Culture, including appropriate species confirmation, value (PPV) of NAAT testing to detect N. gonor- is a highly specific test, and relatively sensitive for rhoeae should exceed 90%. The PPV is highly influ- urogenital specimens, provided that specimen collec- enced by the gonorrhoea prevalence
Load more

Recommended publications
  • Proctitis Associated with Neisseria Cinerea Misidentified As Neisseria Gonorrhoeae in a Child JOHN H
    JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 1985, p. 575-577 Vol. 21, No. 4 0095-1137/85/040575-03$02.00/0 Copyright C 1985, American Society for Microbiology Proctitis Associated with Neisseria cinerea Misidentified as Neisseria gonorrhoeae in a Child JOHN H. DOSSETT,' PETER C. APPELBAUM,2* JOAN S. KNAPP,3 AND PATRICIA A. TOTTEN3 Departments ofPediatrics (Infectious Diseases)' and Pathology (Clinical Microbiology),2 Hershey Medical Center, Hershey, Pennsylvania 17033, and Neisseria Reference Laboratory and Department of Medicine, University of Washington, Seattle, Washington 981953 Received 21 September 1984/Accepted 13 December 1984 An 8-year-old boy developed proctitis. Rectal swabs yielded a Neisseria sp. that was repeatedly identified by API (Analytab Products, Plainview, N.Y.), Minitek (BBL Microbiology Systems, Cockeysville, Md.), and Bactec (Johnston Laboratories, Towson, Md.) methods as Neisseria gonorrhoeae. Subsequent testing in a reference laboratory yielded an identification of Neisseria cinerea. It is suggested that identification of a Neisseria sp. isolated from genital or rectal sites in a child be confirmed by additional serological, growth, and antibiotic susceptibility tests and, if necessary, by a reference laboratory. The implications of such misidenti- fications are discussed. Gonococcal proctitis in children is usually considered to rectal scrubs. The child and his parents underwent extensive be sexually transmitted, just as it is in adults. Moreover, questioning in an effort to identify a source of infection. No gonorrhea in young boys is generally the result of homosex- clues were found. Both parents had negative examinations ual contact with an adult male. We herein report the case of and negative cultures. The patient's condition gradually a child with prolonged proctitis and perianal inflammation improved, and by 20 July his rectum and perirectum ap- from whom Neisseria sp.
    [Show full text]
  • Neisseria Infection of Rhesus Macaques As a Model to Study Colonization, Transmission, Persistence, and Horizontal Gene Transfer
    Neisseria infection of rhesus macaques as a model to study colonization, transmission, persistence, and horizontal gene transfer Nathan J. Weyanda,b,1, Anne M. Wertheimerc,d,e, Theodore R. Hobbsf,g, Jennifer L. Siskoa,b, Nyiawung A. Takua,b, Lindsay D. Gregstona,b, Susan Claryh, Dustin L. Higashia,b, Nicolas Biaisi,2, Lewis M. Browni,j, Shannon L. Planerg,k, Alfred W. Legasseg,k, Michael K. Axthelmg,k,l, Scott W. Wongg,h,l, and Magdalene Soa,b aBIO5 Institute and bDepartment of Immunobiology, University of Arizona, Tucson, AZ 85721; cArizona Center on Aging, dDepartment of Medicine and eDivision of Geriatrics General Internal and Palliative Medicine, University of Arizona, Tucson, AZ, 85719; fDivision of Animal Resources, kDivision of Pathobiology and Immunology, gOregon National Primate Research Center, and lVaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006; hDepartment of Molecular Microbiology and Immunology, L220, Oregon Health and Science University, Portland, OR 97239; and iDepartment of Biological Sciences and jQuantitative Proteomics Center, Columbia University, New York, NY 10027 Edited by Rino Rappuoli, Novartis Vaccines and Diagnostics, Siena, Italy, and approved January 10, 2013 (received for review October 9, 2012) The strict tropism of many pathogens for man hampers the de- may be possible to develop a model for studying Neisseria–host velopment of animal models that recapitulate important microbe– interactions in which there are no host-restriction barriers to host interactions. We developed a rhesus macaque model for study- overcome. ing Neisseria–host interactions using Neisseria species indigenous to The rhesus macaque (RM) has ∼93% DNA sequence identity the animal.
    [Show full text]
  • A New Symbiotic Lineage Related to Neisseria and Snodgrassella Arises from the Dynamic and Diverse Microbiomes in Sucking Lice
    bioRxiv preprint doi: https://doi.org/10.1101/867275; this version posted December 6, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. A new symbiotic lineage related to Neisseria and Snodgrassella arises from the dynamic and diverse microbiomes in sucking lice Jana Říhová1, Giampiero Batani1, Sonia M. Rodríguez-Ruano1, Jana Martinů1,2, Eva Nováková1,2 and Václav Hypša1,2 1 Department of Parasitology, Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic 2 Institute of Parasitology, Biology Centre, ASCR, v.v.i., České Budějovice, Czech Republic Author for correspondence: Václav Hypša, Department of Parasitology, University of South Bohemia, České Budějovice, Czech Republic, +42 387 776 276, [email protected] Abstract Phylogenetic diversity of symbiotic bacteria in sucking lice suggests that lice have experienced a complex history of symbiont acquisition, loss, and replacement during their evolution. By combining metagenomics and amplicon screening across several populations of two louse genera (Polyplax and Hoplopleura) we describe a novel louse symbiont lineage related to Neisseria and Snodgrassella, and show its' independent origin within dynamic lice microbiomes. While the genomes of these symbionts are highly similar in both lice genera, their respective distributions and status within lice microbiomes indicate that they have different functions and history. In Hoplopleura acanthopus, the Neisseria-related bacterium is a dominant obligate symbiont universally present across several host’s populations, and seems to be replacing a presumably older and more degenerated obligate symbiont.
    [Show full text]
  • Applications of Genomics to Slow the Spread of Multidrug‐Resistant
    Ann. N.Y. Acad. Sci. ISSN 0077-8923 ANNALS OF THE NEW YORK ACADEMY OF SCIENCES Special Issue: Antimicrobial Therapeutics Reviews REVIEW Applications of genomics to slow the spread of multidrug-resistant Neisseria gonorrhoeae Tatum D. Mortimer 1 and Yonatan H. Grad 1,2 1Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 2Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Address for correspondence: Yonatan H. Grad, Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, 665 Huntington Ave., Building 1, Room 715, Boston, MA 02115. [email protected] Infections with Neisseria gonorrhoeae, a sexually transmitted pathogen that causes urethritis, cervicitis, and more severe complications, are increasing. Gonorrhea is typically treated with antibiotics; however, N. gonorrhoeae has rapidly acquired resistance to many antibiotic classes, and lineages with reduced susceptibility to the currently recommended therapies are emerging worldwide. In this review, we discuss the contributions of whole genome sequencing (WGS) to our understanding of resistant N. gonorrhoeae. Genomics has illuminated the evolutionary origins and population structure of N. gonorrhoeae and the magnitude of horizontal gene transfer within and between Neisseria species. WGS can be used to predict the susceptibility of N. gonorrhoeae based on known resistance determinants, track the spread of these determinants throughout the N. gonorrhoeae population, and identify novel loci contributing to resistance. WGS has also allowed more detailed epidemiological analysis of transmission of N. gonorrhoeae between individuals and populations than previously used typing methods. Ongoing N.
    [Show full text]
  • Atypical, Yet Not Infrequent, Infections with Neisseria Species
    pathogens Review Atypical, Yet Not Infrequent, Infections with Neisseria Species Maria Victoria Humbert * and Myron Christodoulides Molecular Microbiology, School of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine, Southampton General Hospital, Southampton SO16 6YD, UK; [email protected] * Correspondence: [email protected] Received: 11 November 2019; Accepted: 18 December 2019; Published: 20 December 2019 Abstract: Neisseria species are extremely well-adapted to their mammalian hosts and they display unique phenotypes that account for their ability to thrive within niche-specific conditions. The closely related species N. gonorrhoeae and N. meningitidis are the only two species of the genus recognized as strict human pathogens, causing the sexually transmitted disease gonorrhea and meningitis and sepsis, respectively. Gonococci colonize the mucosal epithelium of the male urethra and female endo/ectocervix, whereas meningococci colonize the mucosal epithelium of the human nasopharynx. The pathophysiological host responses to gonococcal and meningococcal infection are distinct. However, medical evidence dating back to the early 1900s demonstrates that these two species can cross-colonize anatomical niches, with patients often presenting with clinically-indistinguishable infections. The remaining Neisseria species are not commonly associated with disease and are considered as commensals within the normal microbiota of the human and animal nasopharynx. Nonetheless, clinical case reports suggest that they can behave as opportunistic pathogens. In this review, we describe the diversity of the genus Neisseria in the clinical context and raise the attention of microbiologists and clinicians for more cautious approaches in the diagnosis and treatment of the many pathologies these species may cause. Keywords: Neisseria species; Neisseria meningitidis; Neisseria gonorrhoeae; commensal; pathogenesis; host adaptation 1.
    [Show full text]
  • System for the Identification of Neisseria and Haemophilus SUMMARY and EXPLANATION API NH® Is a Standardized System for The
    10 400 07487P - en - 2016/12 ® NH System for the identification of Neisseria and Haemophilus SUMMARY AND EXPLANATION During incubation, metabolism produces color changes API NH® is a standardized system for the identification of that are either spontaneous or revealed by the addition of Neisseria, Haemophilus (and related genera) and reagents. Moraxella catarrhalis (Branhamella catarrhalis), which The reactions are read according to the Reading Table uses miniaturized tests, as well as a specially adapted and the identification is obtained by consulting the profile database. The complete list of those organisms that it is list in the package insert or using the identification possible to identify with this system is given in the software. Identification Table at the end of the package insert. API NH also enables the biotyping of Haemophilus CONTENT OF THE KIT (Kit for 10 Tests) influenzae and Haemophilus parainfluenzae, as well as - 10 API NH strips (STR) the detection of a penicillinase. - 10 ampules of API NaCl 0.85 % Medium (2 mL) (MED) - 1 ampule of JAMES reagent (R1) solvent + 1 bottle PRINCIPLE of JAMES (R2) reagent (JAMES) The API NH strip consists of 10 microtubes containing - 1 ampule of ZYM B (R1) solvent + 1 bottle of ZYM B dehydrated substrates, which enable the performance (R2) reagent (ZYMB) of 12 identification tests (enzymatic reactions or sugar - 10 incubation boxes (INCUB) fermentations), as well as the detection of a penicillinase - 10 result sheets (SHEET) (particular interest in Haemophilus influenzae, Haemo- - 1 package insert provided in the kit or downloadable philus parainfluenzae, Moraxella catarrhalis (Branhamella from www.biomerieux.com/techlib catarrhalis) and Neisseria gonorrhoeae).
    [Show full text]
  • Neisseria Spp. and Branhamella Catarrhalis WILLIAM M
    JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 1987, p. 203-206 Vol. 25, No. 2 0095-1137/87/020203-04$02.00/0 Copyright © 1987, American Society for Microbiology API QuadFERM + with Rapid DNase for Identification of Neisseria spp. and Branhamella catarrhalis WILLIAM M. JANDA,l 2* KATHY L. ZIGLER,' AND JOANNE J. BRADNA' Departments of Medical Laboratory Sciences' and Pathology,2 The University ofIllinois at Chicago, Chicago, Illinois 60612 Received 7 August 1986/Accepted 5 November 1986 The QuadFERM+ system (Analytab Products, Plainview, N.Y.), a 2-h carbohydrate degradation method for the identification of Neisseria spp., was evaluated along with a rapid DNase test for confirmation of Branhamella catarrhalis. QuadFERM+ identified 100% of 82 N. gonorrhoeae and 96% of 54 N. meningitidis strains. The two misidentified meningococcal strains were biochemically atypical and were also misidentified by the conventional method. Of 26 N. lactamica strains, 25 (96%) were correctly identified. Of 21 Neisseria spp., 14 (67%) produced carbohydrate reactions in agreement with the conventional procedure, and 7 strains produced detectable acid in the QuadFERM + from maltose and sucrose but not glucose. All 9 N. cinerea and 30 B. catarrhalis strains were asaccharolytic by QuadFERM+. The rapid DNase test was positive for all B. catarrhalis strains and negative for all other organisms. Two beta-lactamase-positive N. gonorrhoeae strains and 25 (93%) of 27 beta-lactamase-positive B. catarrhalis strains were detected by the 2-h acidometric beta-lactamase test on the strip. QuadFERM+ with rapid DNase is a simple and easily interpretable method for identification of these organisms in the clinical laboratory.
    [Show full text]
  • STUDIES of NEISSERIA MUSCULI TYPE IV PILUS and CAPSULE USING the NATURAL MOUSE MODEL of COLONIZATION and PERSISTENCE by Man Cheo
    Studies of Neisseria musculi Type IV Pilus and Capsule Using the Natural Mouse Model of Colonization and Persistence Item Type text; Electronic Dissertation Authors Ma, Man Cheong Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 27/09/2021 11:29:10 Link to Item http://hdl.handle.net/10150/634345 STUDIES OF NEISSERIA MUSCULI TYPE IV PILUS AND CAPSULE USING THE NATURAL MOUSE MODEL OF COLONIZATION AND PERSISTENCE by Man Cheong Ma Copyright © Man Cheong Ma 2019 A Dissertation Submitted to the Faculty of the DEPARTMENT OF IMMUNOBIOLOGY In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF PHILOSOPHY In the Graduate College THE UNIVERSITY OF ARIZONA 2019 2 3 Table of Contents List of Figures ................................................................................................................................6 List of Tables ..................................................................................................................................7 Abstract ...........................................................................................................................................8 Chapter 1- Introduction .....................................................................................................................
    [Show full text]
  • Bacterial Microbiota Analysis Present in the Nose and Pharynx of a Mexican Young Population
    Int.J.Curr.Microbiol.App.Sci (2016) 5(6): 223-235 International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 5 Number 6 (2016) pp. 223-235 Journal homepage: http://www.ijcmas.com Original Research Article http://dx.doi.org/10.20546/ijcmas.2016.506.026 Bacterial Microbiota Analysis Present in the Nose and Pharynx of a Mexican Young Population Ana Karina Rodríguez-Vicente1, Jaime Bustos-Martínez2, Dolores Reyes-Duarte3 and Teresita Sainz-Espuñes4* 1Doctorado en Ciencias Biológicas y de la Salud. Universidad Autónoma Metropolitana-Xochimilco. Mexico City, Mexico 2Departamento de Atención a la Salud. Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico 3Departamento de Procesos y Tecnología. Universidad Autónoma Metropolitana-Cuajimalpa, Mexico City, Mexico 4Departamento de Sistemas Biológicos. Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico *Corresponding author email id: ABSTRACT Culture-independent microbiota is relatively unexplored in Mexican population. The aim of this study was to characterize the microbiota of Mexican young healthy adults by means of K eywo rd s traditional culture and metagenomic analysis in order to provide novel insights and have a better understanding about the healthy baselines from which to detect differences associated Bacterial with diseases. The bacterial microbiota of the nose and pharynx from 75 healthy Microbiota, nonsmoking Mexican young adults was examined by conventional cultures and culture- Nose and independent methods. The hypervariable region (V6-V8) of the16S rRNA gene was PCR Pharynx , amplified from isolated DNA and DGGE analyzed, bands excised were sequenced and metagenomic phylogenetic analys is was done. The study showed that the bacterial microbiota of analysis . the pharynx was richer than that of the nose.
    [Show full text]
  • WO 2015/071474 A2 21 May 2015 (21.05.2015) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2015/071474 A2 21 May 2015 (21.05.2015) P O P C T (51) International Patent Classification: Krzysztof; Simmeringer Hauptstrasse 45/8, A-1 110 Vi C12N 15/11 (2006.01) enna (AT). FONFARA, Ines; Helmstedter Strasse 144, 38102 Braunschweig (DE). (21) International Application Number: PCT/EP2014/074813 (74) Agent: PILKINGTON, Stephanie Joan; Potter Clarkson LLP, The Belgrave Centre, Talbot Street, Nottingham NG1 (22) International Filing Date: 5GG (GB). 17 November 2014 (17.1 1.2014) (81) Designated States (unless otherwise indicated, for every (25) Filing Language: English kind of national protection available): AE, AG, AL, AM, (26) Publication Language: English AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, (30) Priority Data: DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, 61/905,835 18 November 2013 (18. 11.2013) US HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, (71) Applicant: CRISPR THERAPEUTICS AG [CH/CH]; KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, Aeschenvorstadt 36, CH-4051 Basel (CH). MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, (72) Inventors: CHARPENTIER, Emmanuelle; Boeckler- SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, strasse 18, 38102 Braunschweig (DE).
    [Show full text]
  • ID 6 | Issue No: 3 | Issue Date: 26.06.15 | Page: 1 of 29 © Crown Copyright 2015 Identification of Neisseria Species
    UK Standards for Microbiology Investigations Identification of Neisseria species Issued by the Standards Unit, Microbiology Services, PHE Bacteriology – Identification | ID 6 | Issue no: 3 | Issue date: 26.06.15 | Page: 1 of 29 © Crown copyright 2015 Identification of Neisseria species Acknowledgments UK Standards for Microbiology Investigations (SMIs) are developed under the auspices of Public Health England (PHE) working in partnership with the National Health Service (NHS), Public Health Wales and with the professional organisations whose logos are displayed below and listed on the website https://www.gov.uk/uk- standards-for-microbiology-investigations-smi-quality-and-consistency-in-clinical- laboratories. SMIs are developed, reviewed and revised by various working groups which are overseen by a steering committee (see https://www.gov.uk/government/groups/standards-for-microbiology-investigations- steering-committee). The contributions of many individuals in clinical, specialist and reference laboratories who have provided information and comments during the development of this document are acknowledged. We are grateful to the Medical Editors for editing the medical content. For further information please contact us at: Standards Unit Microbiology Services Public Health England 61 Colindale Avenue London NW9 5EQ E-mail: [email protected] Website: https://www.gov.uk/uk-standards-for-microbiology-investigations-smi-quality- and-consistency-in-clinical-laboratories PHE Publications gateway number: 2015013 UK Standards for Microbiology Investigations are produced in association with: Logos correct at time of publishing. Bacteriology – Identification | ID 6 | Issue no: 3 | Issue date: 26.06.15 | Page: 2 of 29 UK Standards for Microbiology Investigations | Issued by the Standards Unit, Public Health England Identification of Neisseria species Contents ACKNOWLEDGMENTS .........................................................................................................
    [Show full text]
  • Laboratorians Working with Infectious Agents Are Subject to Laboratory
    APPENDIX 1 Standard Safety Practices in the Microbiology Laboratory aboratorians working with infectious agents are subject to laboratory-acquired infections as a result of accidents or unrecognized incidents. The degree of Lhazard depends upon the virulence of the biological agent concerned and host resistance. Laboratory-acquired infections occur when microorganisms are inadvertently ingested, inhaled, or introduced into the tissues. Laboratorians are relatively safe when working with Haemophilus influenzae and Streptococcus pneumoniae; however, persons who work with aerosolized Neisseria meningitidis are at increased risk of acquiring a meningococcal infection. The primary laboratory hazard associated with enteric pathogens such as Shigella, Vibrio or Salmonella is accidental ingestion. Biosafety Level 2 (BSL-2) practices are suitable for work involving these agents that present a moderate potential hazard to personnel and the environment. The following requirements have been established for laboratorians working in BSL-2 facilities. • Laboratory personnel must receive specific training in handling pathogenic agents and be directed by competent scientists. •Access to the laboratory must be limited when work is being conducted. •Extreme precautions must be taken with contaminated sharp items. •Certain procedures involving the creation of infectious aerosols or splashes must be conducted by personnel who are wearing protective clothing and equipment. Standard microbiological safety practices The following safety guidelines listed below apply to all microbiology laboratories, regardless of biosafety level. Limiting access to laboratory Sometimes, people who do not work in the laboratory attempt to enter the laboratory to look for test results they desire. Although this occurs more frequently in clinical laboratories, access to the laboratory should be limited, regardless of the setting.
    [Show full text]