Coinfections with multiple sexually transmitted pathogens in Republic of Korea, 2018–2020

Abstract

Background Sexually transmitted infections (STIs) can have serious consequences, and the global STI incidence remains high. However, there is little information on the frequency of STIs with multiple pathogens according to age. Accordingly, we conducted a study to determine the trends of coinfection with sexually transmitted pathogens according to age in the Republic of Korea from 2018 to 2020. Methods From January 2018 to December 2020, 65,191 samples of swab, urine, and other types submitted for STI screening were obtained from U2Bio Co. Ltd. (Seoul, Republic of Korea). Multiplex polymerase chain reaction, a sensitive and rapid method for simultaneous detection of STIs caused by multiple different pathogens, was performed using an AccuPower STI4C‐Plex Real‐Time PCR kit, AccuPower STI8A‐Plex Real‐Time PCR kit, and AccuPower STI8B‐Plex Real‐Time PCR kit with an Exicycler 96 Real‐Time Quantitative Thermal Block. Results Of the 65,191 samples tested, 35,366 (54.3%) tested positive for one or more sexually transmitted pathogens. The prevalence of coinfections with two or more sexually transmitted pathogens was inversely proportional to age. Furthermore, the rates of coinfection with sexually transmitted pathogens and age distribution differed according to sex and the sexually transmitted pathogen type. Conclusion This study confirmed that a significant proportion of patients with STIs are coinfected with multiple pathogens. Public health managers could use these results to recognize and prevent STIs according to age.

Etiología de las infecciones de transmisión sexual (ITS) diagnosticadas por la técnica de PCR múltiple-hibridación en población colombiana de la ciudad de Medellín atendida en el Laboratorio Clínico VID

“…En este estudio, se observó que C. trachomatis (A-K) fue el microorganismo más prevalente causante de ITS, seguido de N. gonorrhoeae en ambos grupos de hombres, y VHS-2 en las mujeres, muy similar a lo reportado a nivel mundial [1]. En este estudio también destacamos que en los tres grupos de pacientes se detectaron infecciones mixtas, hallazgo que ha sido reportado por otros estudios previamente [3,4,6,7,17,18].…”

“…El diagnóstico de infección por T. vaginalis se puede realizar según los niveles de atención. Para el primer y segundo nivel de atención, se realiza examen directo en solución salina, en tanto que para el tercer nivel de atención, se utiliza la amplificación de ácidos nucleicos por PCR, siendo esta la más sensible de todas las pruebas [9,18,25]. Es de resaltar que este microorganismo en estudios previos es de muy baja prevalencia en Colombia, como se observó en este estudio y en otros previamente publicados [30].…”

When Bacteria and Viruses Collide: A Tale of Chlamydia trachomatis and Sexually Transmitted Viruses

“…In 2018, the direct medical costs of new STI cases in the United States of America (USA) alone amounted to approximately $16 billion [ 3 ]. A high proportion of patients with STIs are co-infected with multiple pathogens [ 4 , 5 , 6 , 7 , 8 ]. Sexually transmitted co-infections are common because the pathogens share transmission routes and the majority of infections are asymptomatic, which results in patients not seeking treatment [ 8 , 9 ].…”

“…A high proportion of patients with STIs are co-infected with multiple pathogens [ 4 , 5 , 6 , 7 , 8 ]. Sexually transmitted co-infections are common because the pathogens share transmission routes and the majority of infections are asymptomatic, which results in patients not seeking treatment [ 8 , 9 ]. High-risk sexual behavior including having sex with multiple partners, inconsistent condom use, and belonging to specific sexual networks such as men who have sex with men (MSM) are associated with increased risk of co-infection with multiple pathogens [ 10 , 11 , 12 , 13 ].…”

“…The simultaneous presence of sexually transmitted pathogens in co-infections can result in heightened infectivity, exacerbated symptoms, increased odds of pathogen transmission, and reduced effectiveness of treatment and prevention interventions [ 8 , 9 , 17 , 18 , 19 ]. Previous findings indicate that the concordance of sexually transmitted pathogens within sexual partnerships is poor, and the limited concordance of infection is exacerbated by the presence of a single infection in one person and co-infection with multiple pathogens in the other [ 20 , 21 , 22 , 23 , 24 ].…”