Molecular typing reveals that CipR within the tested population is maintained by strain turnover between resistant genogroups. Despite early recommendation in 2002 to stop ciprofloxacin use in California, CipR in SF increased through 2006. The subsequent decrease in CipR corresponds with the 2007 national recommendation to cease ciprofloxacin treatment of gonorrhea, which suggests that national recommendations are potentially more effective at reducing CipR than regional recommendations in areas with high strain turnover.

Conclusion These data may imply that the traditional understanding of a gonococcal transmission pattern from west to east cannot accurately depict the strain flow of N. gonorrhoeae isolates within these populations. Our data revealed a large amount of strain turnover in both metropolitan areas by year. This raises questions about the entry and transmission of N. gonorrhoeae within the U.S., and the implications of this turnover in regards to the evolution of this organism. Background The effects of hormonal contraception and pregnancy on the vaginal microbiome (by molecular methods), acquisition and persistence of sexually transmitted infections (STIs), and genitourinary mucosal immunology are still largely unknown. Methods HIV-negative, non-pregnant female sex workers (n = 397) in Kigali, Rwanda, were followed for two years. Demographic, behavioural, clinical, STI and pregnancy data were collected at regular intervals. The vaginal microbiome was cross-sectionally determined using a phylogenetic microarray (n = 174). Women with STIs were purposefully oversampled in this subsample. Inflammatory cytokines were measured in cervicovaginal fluid using Luminex and ELISA methodology (n = 343). Hormonal exposure was defined as use of hormonal contraception (oral or injectable) or a positive urine pregnancy test. Women in the exposure groups were compared to non-pregnant women who did not use hormonal contraception. Adjustments were made for demographic data and sexual risk taking. Results At baseline, 12% of the women used hormonal injectables, and 6% oral contraceptives (OC); 7.7% was pregnant. OC use was associated with higher HPV prevalence (aOR 3.09; 95% CI 1.42-7.72), higher Chlamydia trachomatis incidence (aOR 7.13; 95% CI 1.40-36.30), and lower syphilis prevalence (0% vs 7.2% in controls) and incidence (0% vs 1.2%). Hormonal injectables were associated with higher HSV-2 prevalence (aOR 2.08; 95% CI 1.23-3.50). Pregnancy was weakly associated with higher Trichomonas vaginalis (aOR 1.67; 95% CI 0.97-2.88) and vaginal yeast (aOR 1.95; 95% CI 0.99-3.82) incidence. Six vaginal microbiome clusters were identified. No associations between hormonal exposure status and vaginal microbiome clusters were found; however, pregnant women had lower Gardnerella vaginalis levels. Pregnant women had higher IL-8 levels in cervicovaginal fluids than non-exposed women. Conclusions Both hormonal contraception and pregnancy were associated with higher STI incidence. Overall, vaginal inflammation and microbiome composition were similar among groups, but pregnant women had lower Gardnerella and higher IL-8 levels. O.04 -Vaginal infections and PIDhOrmOnal cOnTracepTIOn IS aSSOcIaTed wITh a reduced rISk Of bacTerIal VagInOSIS: a SySTemaTIc reVIew and meTa-analySIS

The only significant risk factors for developing urosepsis or positive culture check are atherosclerosis (p[0.012), right sided stents (p[0.014), and prolonged length of stay (p<0.001) (Table 1).CONCLUSIONS: Despite sterile ureteral stenting and adequate antibiotic prophylaxis, a significant portion of patients still develop urosepsis or positive culture checks. Surprisingly, this also applies to patients who were initially stented for non-infectious indications. Given the morbidity and mortality of urosepsis, further research to decrease urosepsis rates following URS is needed.