Sexually Transmitted Diseases in the Emergency Department

Pfennig, Camiron L.

doi:10.1016/j.emc.2019.01.001

Cited by 10 publications

(11 citation statements)

References 47 publications

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“…This test is completed quickly, is appropriate for large-scale screenings, and allows for detection of previous treated infection with improved specificity. 27,28 Despite a more automated reverse testing algorithm compared with nontreponemal testing, 29,30 the challenge persists that treponemal IgG antibodies often remain positive for life and even after treatment, although 15%-25% of patients treated during the primary stage may be serologically nonreactive after 2 or 3 years. 26 If a history of past treatment is not known, the interpretation of treponemal IgG antibodies is difficult.…”

Section: Purposementioning

confidence: 99%

“…37 The model presented here can either be replicated as a standalone program or incorporated into an ED-based HIV screening program that uses serum-based testing. Although the model may be slightly more costly for EDs that do not bundle the cost of care, 14 it is designed to increase the definitive treatment of undiagnosed syphilis among vulnerable populations by minimizing barriers to screening, 28 which maximizes buy-in from ED providers. In addition, this model may facilitate buy-in by minimizing the work of testing follow-up by ED physicans, which is an unrealistic if not impossible task in the busy ED setting.…”

Section: Lessons Learnedmentioning

confidence: 99%

“…This test is completed quickly, is appropriate for large-scale screenings, and allows for detection of previous treated infection with improved specificity. 27,28…”

Section: Purposementioning

confidence: 99%

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A Model for Syphilis Screening in the Emergency Department

et al. 2020

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The incidence of syphilis infections is on the rise, particularly among African American men and men who have sex with men, and it is reaching epidemic levels in these communities throughout the United States. Although syphilis is relatively inexpensive to treat and cure and is a predictor for HIV incidence among men and transgender women who have sex with men, rates of co-screening for syphilis are low in the emergency department setting, with a dearth of literature on this topic since the 1990s and early 2000s. In this case study, we describe an operational model for routine syphilis screening implemented in June 2017 at the University Hospitals Cleveland Medical Center in Cleveland, Ohio. We describe the advantages of screening using a reverse testing algorithm rather than the traditional method and the necessity of partnering with the Cleveland Department of Public Health for both diagnostic and follow-up logistics.

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Section: Purposementioning

confidence: 99%

Section: Lessons Learnedmentioning

confidence: 99%

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A Model for Syphilis Screening in the Emergency Department

et al. 2020

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“…Chlamydia, a strict intracellular bacterial parasite (Sachse et al, 2015), causes uterine infection, premature birth, or miscarriage in humans (Moragianni et al, 2019), and in pigs, it causes respiratory diseases, diarrhea, conjunctivitis, and reproductive problems (Li et al, 2011). In females, Chlamydia infection is associated with sexual dysfunction and infertility (Pfennig, 2019). In the current study, Neisseria gonorrhoeae is a major cause of infertility in female (Costa-Lourenço et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the vaginal microbiome of giant pandas using metagenomics sequencing

Zhang

Zhai

et al. 2020

MicrobiologyOpen

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“…Management of these infections in the USA alone results in an annual expenditure in excess of $2 billion (3). Currently, azithromycin or doxycycline are first-line recommendations for treatment of non-pregnant patients with urogenital or oropharyngeal Chlamydia (4). However, since most infections are asymptomatic, many infected individuals are not treated, suggesting that the development and use of an effective vaccine may be the best approach for preventing these infections and the associated sequelae worldwide (5–7).…”

Section: Introductionmentioning

confidence: 99%

Route of Vaccine Administration Influences the Impact of Fms-Like Tyrosine Kinase 3 Ligand (Flt3L) on Chlamydial-Specific Protective Immune Responses

et al. 2019

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We tested the hypothesis that the impact of the Fms-like tyrosine kinase 3-ligand (Flt3L; FL) on recombinant Vibrio cholerae ghost (rVCG) vaccine-induced chlamydial immunity is influenced by route of vaccine delivery. Female C57BL/6J mice were immunized rectally (IR) or intramuscularly (IM) with rVCG co-expressing the Chlamydia trachomatis PmpD and PorB proteins (rVCG- PmpD/PorB) with and without FL or glycoprotein D of HSV-2 (rVCG-gD2) as antigen control. Vaccine evaluation was based on measurement of T cell proliferation, Th1/Th2 cytokine, and humoral responses at systemic and mucosal compartments, and protection against intravaginal challenge infection. Results revealed that high levels of CD4+ T cell-mediated and humoral immune responses, were elicited in mice as a function of both IR and IM immunization. Unexpectedly, co-administration of vaccine with FL enhanced specific Th1-type cytokine levels and T cell proliferative responses following IR but not IM immunization. While administration of vaccine with FL enhanced the specific mucosal and systemic IgA antibody responses following both immunization routes, IgG2c responses were not enhanced following IR delivery. The vaccine-induced immune effectors protected mice against live heterologous C. muridarum infection irrespective of route of vaccine administration, with the regimen incorporating FL having a protective advantage. Further evaluation showed that protection afforded by the FL adjuvanted vaccine was facilitated by CD4+ T cells, as indicated by reduction in the intensity and duration of genital chlamydial shedding by naïve mice following adoptive transfer of immune CD4+ T cells. Taken together, the results indicate that comparable protective immunity, which is enhanced by co-delivery with FL, is elicited in the female genital tract against Chlamydia infection after mucosal and systemic administration, highlighting the ability of FL to function as an effective immunostimulator at both mucosal and systemic sites. The differential modulation of humoral and cellular immune responses, and protective immunity afforded by the FL adjuvanted vaccine following IR administration indicates that the immunomodulatory impact of FL on chlamydial-specific immunity is influenced by the route of vaccine administration. Thus, targeting of VCG-based vaccines to antigen presenting cells by co-delivery with FL is a feasible immunization approach for inducing effective chlamydial immunity in the female genital tract.

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Sexually Transmitted Diseases in the Emergency Department

Cited by 10 publications

References 47 publications

A Model for Syphilis Screening in the Emergency Department

A Model for Syphilis Screening in the Emergency Department

Analysis of the vaginal microbiome of giant pandas using metagenomics sequencing

Route of Vaccine Administration Influences the Impact of Fms-Like Tyrosine Kinase 3 Ligand (Flt3L) on Chlamydial-Specific Protective Immune Responses

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