Introduction: Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) are potentially pathogenic organisms commonly found in the urogenital tract, with colonisation rates up to 80% and 40% worldwide, respectively. The aim of this study was to estimate antimicrobial resistance by UU and MH, and identify the antimicrobial agents involved in bacterial resistance.MethodsA cross-sectional study, with data obtained retrospectively through medical records review. We analysed 140 patients whose women’s endocervical samples and men’s urine tested positive for MH and UU. The test used for the diagnosis and evaluation of antimicrobial resistance was the MYCOFAST Screening EvolutioN 3 kit.ResultsThe majority of patients were female (90.7%), 57.9% of the patients had >29 years of age and 84.3% did not have a stable union. About 70.0% of the patients tested positive for UU, 3.0% for MH, and 27.0% for both. HIV co-infection was seen in 32.1% and HPV in 30.0%. Absence of current history of Chlamydia trachomatis was a protective factor for the acquisition of azithromycin resistance (p=0.04). As for the antimicrobials, doxycycline showed sensitivity rates higher than 96% for both infections, while azithromycin showed 86.8% of sensitivity for UU, but resistance of 75% for MH. Ciprofloxacin showed sensitivity rates lower than 15% for both infections, while less than 35% were strains sensible to ofloxacin. Erythromycin resistance rates ranged over 65% for the UU-MH coinfection, while over 90% of sample was sensible to tetracycline and clarithromycin resistance rates ranged from 7.1% for UU to 100% for MH.ConclusionThe use of ciprofloxacin and ofloxacin is highly debatable considering the high rates of total and intermediate resistance. In our population, doxycycline showed high efficiency and is therefore recommended for the treatment of UU and MH infections. Monitoring antimicrobial resistance is ?fundamental for the adequacy of the therapeutic recommendations.

IntroductionThe maternal HIV viral load (VL) is a major predictor of mother to child transmission (MTCT). Therefore, it is necessary a rapid decrease of VL among late-presenting (LP) (after 28 weeks) pregnant women living with HIV (PWLH) aiming viral suppression (VS). We aimed to identify the population of LP-PWLH and compare the VS to the group who had earlier access (EA) to prenatal care.MethodsA retrospective cohort carried out at the major HIV reference centre in Bahia, Brazil. Medical records of PWLH attended at prenatal care were reviewed from January 2011 to December 2013. HIV VL and TCD4+ count data were obtained from the national database. Statistical analyses were performed with SPSS 20.0.ResultsA total of 235 PWLH enrolled in the study, of which 29.4% were LP. Among the latter, the mean age was 28.3 (±6.9) years, similar to the EA group. Thirty four percent of the LP had <8 schooling years (p=0.16), 40.7% were single (p=0.64), 24.6% reported alcohol use (p=0.15), 1.6% drug use (p=0.44) and only 16.7% regular condom use (p=0.92). The majority of LP (62.9%) had partners with unknown serological status, 25.7% had seroconcordant and 11.4% had serodiscordant partners (p<0.01). LP predominantly had HIV diagnosis during pregnancy (60.9%; p<0.01) and were ARV naïve (78.3%; p<0.01), while only 14.5% were on ART at conception (p<0.01). As for the initial ART regimen during pregnancy, 89.9% of LP were using a protease inhibitor based regimen and 11.6% had had regimen changes during pregnancy (p=0.36). LP had a higher initial VL (log10 3.4; p<0.01) and those with recent diagnosis also had higher VL (log10 3.8; p=0.02). LP were more likely to not have a second VL during pregnancy or early peripartum (33.3%; p<0.01). VS was less achieved (34.8% vs 71.8%; p<0.01; OR 4.7, CI95% 2.36–9.66) by the LP group.ConclusionLP showed an increased risk of MTCT, with recent HIV diagnosis, higher VL at prenatal onset and a lower rate of VS. Thus, the use of integrase inhibitors would be a better choice for this population, since it promotes a quickly decrease of VL.

IntroductionSyphilis persists as a major and ascendant health issue. However, the impact of this disease during the adolescence, a period of behavioural, sexual and psychologic vulnerabilities, is still underexplored. We aimed to evaluate the follow-up of syphilis infected adolescents attended at a reference service of sexually transmitted infections (STI).MethodsA retrospective cohort study using data from medical records of adolescents (10 to 19 years old) with diagnosis of syphilis attended at the states STI reference centre, from January to August 2012.ResultsAmong 776 adolescents attending the service, 58 had a diagnosis of syphilis (7.47%). The majority was male (51.7%), mean age was 16.8 (±1.35) years, 92.3% attended school, and 58.1% had ≤8 years of schooling; 39.4% referred drinking alcohol and 39.5% drug use. Among the adolescents, 98.3% had already initiated sexual life, with the mean age of sexual debut of 14.2 (±1.48) years, with an average of 2.33 (±2.55) lifetime sexual partners. About 14.0% declared to be homosexual, 85.4% referred irregular condom use, 22.2% of the girls were pregnant, with mean age at first gestation of 16.0 (±1.09) years. A parcel of 4.8% of the adolescents were HIV-infected, 31.0% reported a previous STI (p=0.02, OR 2.68, 95% CI 1.16–6.17), and 52.3% had another current STI. The mean number of medical visits was 2.33, 22.8% had primary syphilis, 17.5% had the secondary phase of the disease and 59.6% had latent or late syphilis. The social and demographic variables were not statistically different among the adolescents in the different stages of syphilis. The genital ulcer complaint was related to the diagnosis of primary or secondary syphilis (p=0.01, OR 8.53, 95% CI 1.61–45.1). 91.4% of adolescents received treatment for syphilis and 56.6% performed a cure control.ConclusionThe high prevalence of other STIs associated with syphilis in adolescents demonstrates the limited knowledge of this population to care and prevention strategies, and remains a challenge for specialised services in the diagnosis and treatment of STI/HIV.