Sexually Transmitted Infections最新文献

{"title":"Infections detected in women with pelvic inflammatory disease: a retrospective case series.","authors":"Kay Htaik, Catriona S Bradshaw, Erica L Plummer, Laura Grimminck Matthews, Nishtha Malhotra, Natasha L Wild, Eric P F Chow, Lenka A Vodstrcil","doi":"10.1136/sextrans-2026-056959","DOIUrl":"https://doi.org/10.1136/sextrans-2026-056959","url":null,"abstract":"<p><strong>Objectives: </strong><i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> are established causes of pelvic inflammatory disease (PID), but up to 70% of cases with PID have neither infection detected. We determined the prevalence of and trends in <i>Mycoplasma genitalium</i> and bacterial vaginosis (BV) detection among women with non-<i>C. trachomatis</i>/<i>N. gonorrhoeae</i> PID to inform testing and treatment strategies.</p><p><strong>Methods: </strong>We conducted a retrospective case series to determine the number of cases with PID (defined by presence of a minimum of uterine, adnexal or cervical motion tenderness) with <i>C. trachomatis</i>, <i>N. gonorrhoeae</i>, <i>M. genitalium</i> and/or BV detected between 2014 and 2024 at Melbourne Sexual Health Centre (MSHC). We examined trends in testing and detection of each infection over time and, among cases with PID tested for all four infections, determined the proportion with each infection detected.</p><p><strong>Results: </strong>There were 3000 cases with PID during the study period. Over the 11 years, the proportion of cases with PID tested for <i>C. trachomatis</i> and <i>N. gonorrhoeae</i> was stable and high, with rises in their detection (range=7%-19%, P_trend=0.021; 1%-7%, P_trend<0.001, respectively). Both the proportion tested for BV and <i>M. genitalium</i> (89%-95%, 91%-97%, P_trend=<0.001, respectively) and with BV and <i>M. genitalium</i> detected (22%-37%, 6%-14%, P_trend<0.001, respectively) significantly increased over time. Among 2557 (85%) cases tested for all four infections, 927 (36%) had 1 and 256 (10%) had >1 infection detected. Among 2149 (84%) non-<i>C. trachomatis</i>/<i>N. gonorrhoeae</i> cases with PID, 26% had BV, 6% had <i>M. genitalium</i> and 4% were co-infected with BV and <i>M. genitalium</i>; >50% had none of the infections detected.</p><p><strong>Conclusions: </strong>In this retrospective study of cases with PID attending MSHC between 2014 and 2024, <i>C. trachomatis</i> and/or <i>N. gonorrhoeae</i> were detected in <20% of all cases. Among non-<i>C. trachomatis</i>/<i>N. gonorrhoeae</i> cases with PID, BV and <i>M. genitalium</i> detection was common and increased over time. Prospective case-control and sequencing studies are needed to determine the aetiologic contribution of BV, <i>M. genitalium</i> and other additional candidate organisms to PID.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STI-driven antibiotic exposure may shape macrolide and tetracycline resistance in nasal <i>Staphylococcus aureus</i> among MSM receiving HIV pre-exposure prophylaxis.","authors":"Valeria Gaspari, Claudio Foschi, Tiziana Lazzarotto, Marielle Ezekielle Djusse, Antonella Marangoni, Simone Ambretti","doi":"10.1136/sextrans-2026-056978","DOIUrl":"10.1136/sextrans-2026-056978","url":null,"abstract":"<p><strong>Background: </strong>HIV pre-exposure prophylaxis (PrEP) programmes are associated with intensified sexually transmitted infection (STI) screening and increased incidence of bacterial STIs, resulting in repeated antibiotic exposure. The ecological impact of STI-driven antimicrobial use on resistance in commensal bacteria remains insufficiently characterised, particularly in populations with high antimicrobial exposure such as men who have sex with men (MSM).</p><p><strong>Objective: </strong>To evaluate differences in nasal <i>Staphylococcus aureus</i> antimicrobial resistance between MSM receiving PrEP and HIV-negative MSM not on PrEP and to explore behavioural and antibiotic exposure factors associated with resistance.</p><p><strong>Methods: </strong>In this exploratory cross-sectional study, 153 HIV-negative MSM attending an STI clinic in Italy were enrolled (80 PrEP users; 73 controls). Participants underwent nasal swabbing for culture-based isolation and antimicrobial susceptibility testing of <i>S. aureus</i>. Antibiotic exposure, behavioural variables and STI history were collected via structured questionnaire.</p><p><strong>Results: </strong>PrEP users reported more sexual partners in the last 6 months (p=0.0009) and higher antibiotic use in the preceding year (p=0.004). Doxycycline postexposure prophylaxis (Doxy-PEP) use was more frequent among PrEP users (16% vs 7%; p=0.08). The cumulative 2-year STI burden was higher in the PrEP group (p<0.0001), driven by <i>Neisseria gonorrhoeae</i> infections. <i>S. aureus</i> colonisation prevalence did not differ significantly between groups (p=0.17). However, erythromycin (p=0.0008), clindamycin (p=0.004) and tetracycline resistance (p=0.03) were more frequent among PrEP users. Tetracycline exposure was independently associated with tetracycline resistance (p=0.03), whereas PrEP status was not.</p><p><strong>Conclusions: </strong>Among MSM, higher antimicrobial resistance in nasal <i>S. aureus</i> may be associated with antibiotic exposure rather than PrEP use per se. These exploratory findings should be interpreted with caution given the limited sample size and lack of detailed exposure quantification but support the need to integrate antimicrobial stewardship into PrEP and Doxy-PEP implementation frameworks. Longitudinal studies are needed to better disentangle the roles of antimicrobial exposure and transmission dynamics.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community peer-led STI/HIV point-of-care testing and knowledge, attitude and practice (KAP) survey in men who have sex with men (MSM) attending an NGO-led clinic in the outskirts of Beirut (Lebanon).","authors":"William Abou Shahla, Isotta Rossoni, Valeska Padovese","doi":"10.1136/sextrans-2025-056894","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056894","url":null,"abstract":"<p><strong>Objective: </strong>This pilot study assesses HIV, syphilis and hepatitis point-of-care test (POCT) utility in men who have sex with men (MSM) attending a non-governmental organisation-led clinic in Beirut and evaluates knowledge, attitudes and practices in relation to sexual health.</p><p><strong>Methods: </strong>A cross-sectional study was conducted over 4 months. A physician offered sexual health consultations and sexually transmitted infection (STI)/HIV testing and administered an anonymous questionnaire assessing demographics, STI knowledge and practices, condom use, chemsex, experiences of sexual violence and perceived HIV-related stigma.</p><p><strong>Results: </strong>The cohort consisted predominantly of young, highly educated, working-age men: 91.2% were male and 86.4% identified as MSM, with most participants aged 26-40 years. The majority were Lebanese (79.6%), while 18.4% were Syrian. Overall, 21.4% were persons living with HIV. High levels of STI/HIV awareness coexisted with condomless sex and recreational drug use. Perceived community beliefs and stigma emerged as notable barriers to testing. The use of POCT facilitated same-day counselling and linkage to care for individuals with positive results.</p><p><strong>Conclusions: </strong>This study highlights the substantial HIV-related stigma experienced by MSM, which is linked to risky behaviours. Incorporating POCT into sexual health services allows for rapid on-site diagnosis and immediate counselling as well as linkage to confirmatory testing and care.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal detection and clearance of mpox virus DNA in saliva and semen: a prospective cohort study.","authors":"Nicolás de Loredo, Aida Peiró-Mestres, Irene Fuertes, Mireia Navarro, Laura Rodriguez-Elena, David García-Hernández, Josep Riera, Alba Català, Enrique Maldonado, Gisela Petiti, Vanessa Guilera Castells, Leire Berrocal, José Luis Blanco, Miguel J Martínez","doi":"10.1136/sextrans-2026-057018","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057018","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding the dynamics of mpox virus (MPXV) DNA detection in non-lesional compartments may help inform clinical management and sexual health counselling during mpox outbreaks. To describe the longitudinal detection and clearance kinetics of MPXV DNA in saliva and semen from individuals with confirmed mpox.</p><p><strong>Methods: </strong>We conducted a prospective cohort study including 73 laboratory-confirmed mpox cases in Barcelona, Spain (May-September 2022). A total of 204 longitudinal samples (106 saliva and 98 semen) were analysed by quantitative PCR, and cycle threshold (Ct) values <35 were assessed over time.</p><p><strong>Results: </strong>MPXV DNA was detected in 34% (36/106) of saliva and 27% (26/98) of semen samples. Median Ct values were lower in saliva than in semen. Viral DNA remained detectable up to day 56 in saliva and day 75 in semen after symptom onset, although Ct values <35 were observed only up to day 52 and day 38, respectively. Low Ct values were predominantly observed during the first 3 weeks, although some late samples showed relatively high viral DNA loads. Both PCR positivity and viral DNA loads declined over time.</p><p><strong>Conclusions: </strong>MPXV DNA may persist in saliva and semen beyond the acute phase of infection, with low Ct values observed in a subset of samples. Further studies incorporating viral culture are needed to clarify the clinical and transmission relevance of prolonged PCR positivity and to better inform public health recommendations.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexually transmitted infection prevalence following azithromycin mass drug administration for trachoma in Nauru: a before-and-after cross-sectional survey.","authors":"Lucia Romani, Sue Chen Apadinuwe, Aisling Byrne, Justine C Marshall, Mitchell Starr, Kathleen D Lynch, Handan Wand, Susan Star, Philip Cunningham, Stephen B Lambert, John Kaldor, Susana Vaz Nery","doi":"10.1136/sextrans-2025-056858","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056858","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted infections (STIs) are a major public health problem globally, particularly in low and middle-income countries. In the Western Pacific region, including Nauru, STIs are highly prevalent. Syndromic management misses a high proportion of infections and screen-and-treat strategies are not currently feasible at scale in these settings. Mass drug administration (MDA), widely used for control of neglected tropical diseases, may provide an alternative approach to the population control of STIs.</p><p><strong>Methods: </strong>We used a before-and-after study design to evaluate the impact of azithromycin MDA for trachoma control on STI prevalence in Nauru. The study enrolled 381 participants aged 18-29 years before MDA and 360 participants 6 months after MDA, with similar age distribution but a higher proportion of women post-MDA. Urine specimens were tested for <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i>, <i>Mycoplasma genitalium</i> and <i>Trichomonas vaginalis</i>.</p><p><strong>Findings: </strong>At baseline, <i>C. trachomatis</i> infection was present in 21.7% of participants followed by <i>T. vaginalis</i> and <i>M. genitalium</i> (21.2% and 10.9%, respectively), while <i>N. gonorrhoeae</i> was detected in 2.7% of participants. At 6 months after azithromycin MDA, prevalence declined for all STIs except <i>T. vaginalis</i>. Relative reductions were 35% (95% CI 9.7 to 52.8) for <i>C. trachomatis</i>, 67% (-15.2 to 91.1) for <i>N. gonorrhoeae</i> and 47% (10.7 to 68.2) for <i>M. genitalium</i>. Reductions in prevalence following MDA were greater in men than women but CIs overlapped.</p><p><strong>Interpretation: </strong>This study provides the first evaluation among both men and women of changes in STI prevalence following azithromycin MDA in a high-prevalence general population. The potential role of this strategy in STI control needs further exploration.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in and correlates of trichomoniasis diagnoses among people attending sexual health services, England, 2012-2023.","authors":"Ana-Karina Harb, George Baldry, Laura Viviani, Stephanie Migchelsen, Michelle Jayne Cole, Rachel Pitt-Kendall, Hamish Mohammed","doi":"10.1136/sextrans-2025-056727","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056727","url":null,"abstract":"<p><strong>Objective: </strong>We assessed trends in and correlates of trichomoniasis at sexual health services (SHS) in England since the scale-up of molecular testing and after changes in testing policy.</p><p><strong>Methods: </strong>We derived gender-stratified trends in trichomoniasis diagnoses at SHS in England from 2012 to 2023 using data from the Genitourinary Medicine Clinic Activity Dataset (GUMCAD) sexually transmitted infection (STI) surveillance system. We determined demographic correlates of trichomoniasis diagnoses in 2023 using gender-stratified univariate and multivariable generalised estimated equations logistic regression models.</p><p><strong>Results: </strong>Nationally, trichomoniasis diagnoses increased by 38% between 2012 and 2019 (6950 to 9490 diagnoses); after a drop in 2020 due to COVID-19 related disruptions to services, diagnoses increased by 54% between 2021 and 2023 (5907 to 9102 diagnoses). In 2023, there were 9102 trichomoniasis diagnoses (86.8% in women, 9.5% in men). Among women, trichomoniasis diagnoses were associated with older age (aged 45+ years, adjusted OR: 2.75 (95% CI 2.53 to 2.98) vs 15-24 years). Women of most minoritised ethnic groups (Asian, black, mixed or 'Other') had higher odds of trichomoniasis diagnoses than white British women. Trichomoniasis was associated with living in the most deprived areas (vs least deprived; 3.25 (2.91-3.63)), living in the West Midlands (2.12 (1.96-2.28)) and in Yorkshire and the Humber (1.44 (1.31-1.58)) (vs London). Similar associations were found with trichomoniasis diagnoses in men.</p><p><strong>Discussion: </strong>The introduction of molecular testing and recommendations for targeted screening since 2014 has likely contributed to the increase in diagnoses since then. Our understanding of trichomoniasis trends will be improved with the addition of a testing code for this STI to GUMCAD in 2024. The higher likelihood of trichomoniasis among some racially minoritised groups partly reflects targeted testing patterns, but it also highlights a health inequality that requires tailored, culturally competent interventions.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New era in STI prevention: early adoption of doxyPEP and 4CMenB vaccination among a community sample of men and gender-diverse people having sex with men in England-findings from a large, cross-sectional survey in 2025.","authors":"Dana Ogaz, Dolores Mullen, Giulia Habib Meriggi, Carina Hoerst, David Reid, Danielle Jayes, Mandy Yung, Erna Buitendam, Natasha Ratna, Marta Checchi, Shamez N Ladhani, Gwenda Hughes, Catherine M Lowndes, Sema Mandal, Benjamin Weil, Will Nutland, Catherine H Mercer, Helen Fifer, John Saunders, Hamish Mohammed","doi":"10.1136/sextrans-2026-057007","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057007","url":null,"abstract":"<p><strong>Objectives: </strong>In 2025, England commenced doxycycline postexposure prophylaxis (doxyPEP) for people at elevated syphilis risk and a 4CMenB vaccination programme for gonorrhoea prevention. We examine early adoption of these new preventative interventions within a community sample.</p><p><strong>Methods: </strong>We analysed data from 'Reducing inequalities in Sexual Health', an online community survey of men and gender-diverse people who have sex with men, conducted in November-December 2025. We describe doxyPEP use (past 3-4 months) and 4CMenB vaccination (≥1 dose ever) among England-resident participants, including those reporting suggested eligibility criteria under national guidance (≥5 male condomless anal sex partners and/or a recent bacterial sexually transmitted infection diagnosis, herein 'intervention-eligible'). Among intervention-eligible participants, associations between doxyPEP use and 4CMenB vaccination with sociodemographic characteristics, clinical and behavioural history and well-being measures were assessed using Pearson's χ² tests.</p><p><strong>Results: </strong>Among 1518 England-resident participants (87% white; median age 49 years (IQR 38-59)), 18% reported doxyPEP use (95% CI 16% to 20%; 279/1518) and 21% reported 4CMenB vaccination (95% CI 19% to 23%; 318/1518). Of 421 intervention-eligible participants (28%), 39% reported doxyPEP use (95% CI 35% to 44%; 165/421) and 41% reported 4CMenB vaccination (95% CI 36% to 46%; 173/421). DoxyPEP use and 4CMenB vaccination among those offered these interventions were high (exceeding 88% in those intervention-eligible). Among intervention-eligible participants, doxyPEP use was significantly higher (p<0.05) among London residents (50% vs 35% outside London), those with degree-level education (46% vs 30%) and those employed (43% vs 31%). 4CMenB vaccination was largely consistent across subgroups except by age (45% in ≥45 year-olds vs 24% in 16-29 year-olds). Those reporting recent HIV pre-exposure prophylaxis use were more likely to report adoption of both interventions.</p><p><strong>Conclusions: </strong>Findings indicate substantial early adoption of doxyPEP and 4CMenB vaccination in England, with early 4CMenB vaccination appearing more uniform relative to doxyPEP. Ongoing monitoring is essential to identify emerging inequities and to understand factors driving them as rollout progresses.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in incidence and medical costs of human papillomavirus-related diseases in Korea: evidence from National Health Insurance claims.","authors":"Ji-Eun An, Chelim Cheong, Junwoo Jo, Su-Yeon Yu","doi":"10.1136/sextrans-2026-056914","DOIUrl":"https://doi.org/10.1136/sextrans-2026-056914","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) infection is a major cause of cervical, anal and oropharyngeal cancers. Although Korea has implemented a national HPV vaccination programme since 2016, nationwide evidence on incidence trends and medical costs of HPV-related diseases remains limited.</p><p><strong>Methods: </strong>This retrospective population-based study analysed Korean National Health Insurance Service claims data. Age-standardised incidence (ASI) rates of cervical intraepithelial neoplasia (CIN1 and CIN2/3), genital warts (GWs), and cervical, oropharyngeal and anal cancers from 2015 to 2022 were calculated using the 2022 Korean population as the standard. Trends in ASI were analysed using Joinpoint regression with a piecewise log-linear (Poisson) model. For diseases with and without statistically significant Joinpoints, trends were reported using pre-identified and post-identified segment-specific annual percentage changes (APCs) and the average annual percentage change (AAPC), respectively. Trends in total medical costs from 2015 to 2021 were evaluated using linear regression.</p><p><strong>Results: </strong>ASI trends differed by sex and disease type. Cervical cancer incidence among females declined significantly during 2015-2022 (AAPC; -4.2%, p<0.001). Joinpoint regression identified significant inflection points in 2019 for both female and male GWs. Female GW incidence increased during 2015-2019 (APC; 3.7%, p=0.010) and then decreased significantly during 2019-2022 (APC; -14.0%, p<0.001). Male GW incidence increased significantly during 2015-2019 (APC; 11.3%, p<0.001) and then showed no statistically significant change during 2019-2022 (APC; 1.4%, p=0.290).</p><p><strong>Conclusions: </strong>These descriptive findings provide population-level evidence on HPV-associated disease burden in Korea but cannot establish causal attribution to vaccination, screening or other preventive interventions, necessitating continued surveillance with individual-level data linkage.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single versus three doses of benzathine penicillin G for early syphilis in pregnancy: no added benefit in serological response or neonatal outcomes.","authors":"Konrad Kaminiów, Agnieszka Kotlarz, Martyna Kiołbasa, Maciej Pastuszczak","doi":"10.1136/sextrans-2025-056744","DOIUrl":"10.1136/sextrans-2025-056744","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether intensifying therapy with three weekly doses of benzathine penicillin G (BPG) improves maternal serological response in early syphilis during pregnancy compared with the standard single dose.</p><p><strong>Methods: </strong>In this randomised, non-blinded, single-centre study, 23 pregnant women with secondary or early latent syphilis and no previous history of the disease were enrolled. Participants were assigned to receive either a single intramuscular 2.4 million International Units (MIU) dose of BPG (n=12) or 3 weekly intramuscular doses of 2.4 MIU (n=11). Venereal Disease Research Laboratory (VDRL) titres were measured at baseline, delivery and 2 months postpartum. Serological change (ΔVDRL) was defined as the number of twofold dilution decreases between baseline and follow-up. Neonates underwent clinical and serological evaluation at birth and were followed up to 6 months.</p><p><strong>Results: </strong>Median gestational age at treatment initiation was 16.5 weeks in the single-dose group and 19 weeks in the three-dose group. Baseline median VDRL titres were 1:16 and 1:8, respectively. By delivery, 60.9% of women showed no change in VDRL titre, and only a minority achieved a ≥2-dilution decrease. Two months postpartum, further declines were observed but most women still did not reach a fourfold decline. There were no significant differences in VDRL titres between groups at delivery (median 1:8 in both, p=0.66) or 2 months postpartum (median 1:4 in both, p=1.0). ΔVDRL was not associated with gestational age at treatment or treatment-to-delivery interval. All neonates were clinically healthy, had VDRL titres equal to or lower than their mothers at delivery and achieved complete seroreversion of both treponemal and non-treponemal tests by 6 months.</p><p><strong>Conclusions: </strong>This is the first randomised study evaluating intensified therapy for early syphilis in pregnancy. Three weekly BPG doses did not improve maternal serological response or neonatal outcomes compared with a single dose. These findings support current recommendations for single-dose therapy in early syphilis during pregnancy.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"305-309"},"PeriodicalIF":3.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145638164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive review of the evidence informing the standard of care penicillin treatment of congenital syphilis.","authors":"Jennifer Simone, Carol Cooke, Santina Lee, Jared Bullard","doi":"10.1136/sextrans-2025-056692","DOIUrl":"10.1136/sextrans-2025-056692","url":null,"abstract":"<p><p>Congenital syphilis (CS) has been rapidly re-emerging as a public health crisis across North America. The present standard of care treatment for CS involves a 10-day hospitalisation for intravenous penicillin G, which is costly for healthcare systems and families. Given these costs and the frequency of their application, the purpose of this study was to locate the evidence upon which the standard of care for CS has been founded and to assess its quality.A search of Embase and MEDLINE was conducted, and a total of 398 publications were evaluated for inclusion in this study. 54 publications met the inclusion criteria. Quality of data was appraised using the Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence 2011 and the American Academy of Family Physicians grades of strength of recommendation taxonomy (SORT). Levels of evidence in OCEBM 2011 are assigned a number from 1 (highest quality) to 5 (weakest). The strength of recommendations in SORT is assigned a letter from A (strongest recommendation) to C (weakest). Level 5 evidence and grade C recommendations were the most abundant results in this study. Additionally, the most common treatment regimens reported were intramuscular penicillin administration, in doses of 50 000-75 000 units/kg, for a duration of 10-14 days. Systematic statistical analyses could not be applied to the results due to inconsistency and arbitrary changes of treatment within the individual constituent studies. The results affirmed a gap in high-quality primary evidence behind the treatment of CS. Supporting literature is based on expert opinion, consensus and non-randomised studies. Overall, this project underscores the need for high-quality randomised controlled trials to understand the limitations of the current standard of care and to confirm the need for a 10-day course of intravenous penicillin G in hospital.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"333-338"},"PeriodicalIF":3.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}