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1. Development and Characterization of a Novel Composite Hydrogel Biomaterial for Improved Mucoperiosteal Wound Repair.

Author

Wang, Q., Dunnwald, M., Kacmarynski, D. S. F., and Worthington, K. S.

Subjects
FIBRIN tissue adhesive, WOUND healing, TISSUE adhesions, CLEFT palate, HISTOCOMPATIBILITY, HYDROCOLLOID surgical dressings, PALATE surgery
Abstract

Mucoperiosteal wound healing, as it occurs after pediatric cleft palate surgery, can be challenging due to the limitations of current treatments such as tissue flaps secured with sutures and fibrin glue. In this study, we characterized the in vitro performance of a novel composite hydrogel biomaterial designed to be employed as an in situ wound filler and enhance mucoperiosteal wound healing. We evaluated a range of photopolymerizable formulations containing methacrylated gelatin (GelMA), glycol chitosan, and bioglass microparticles. Our aim was to identify one or more formulations with an appropriate balance of properties against a set of functional requirements that we established for this application. To test the formulations against these criteria, we measured photopolymerization kinetics, mechanical properties, degradation rate, in vitro biocompatibility, and ex vivo tissue adhesion. All formulations polymerized in less than 90 s using violet light. In addition, we found that GelMA‐based hydrogels were more adhesive to mucoperiosteal tissue than clinical standard fibrin glue. Inclusion of small amounts of bioglass in the formulation increased mechanical compatibility with mucoperiosteal tissue, enhanced cytoconductivity, and promoted cell proliferation. Taken together, our results support the suitability of these photopolymerized composite hydrogels as in situ mucoperiosteal wound fillers. Overall, this study lays the groundwork for investigating the in vivo, pre‐clinical effectiveness of these composite hydrogels in improving mucoperiosteal wound healing outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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5. The acceptability and cost of a home-based chlamydia retesting strategy: findings from the REACT randomised controlled trial.

Author

Smith, K. S., Kaldor, J. M., Hocking, J. S., Jamil, M. S., McNulty, A. M., Read, P., Bradshaw, C. S., Chen, M. Y., Fairley, C. K., Wand, H., Worthington, K., Blake, S., Knight, V., Rawlinson, W., Saville, M., Tabrizi, S. N., Garland, S. M., Donovan, B., and Guy, R.

Subjects
CHLAMYDIA infection treatment, HOME care services, MEDICAL care costs, RANDOMIZED controlled trials, HETEROSEXUAL men, HEALTH, CHLAMYDIA infection diagnosis, CHLAMYDIA infection prevention, CHLAMYDIA infections, CHLAMYDIA trachomatis, COST effectiveness, DIAGNOSTIC reagents & test kits, MEDICAL screening, PATIENT compliance, PATIENT satisfaction, HEALTH self-care
Abstract

Background: Chlamydia retesting three months after treatment is recommended to detect reinfections, but retesting rates are typically low. The REACT (retest after Chlamydia trachomatis) randomised trial demonstrated that home-based retesting using postal home-collection kits and SMS reminders, resulted in substantial improvements in retesting rates in women, heterosexual men and men who have sex with men (MSM), with detection of more repeat positive tests compared with SMS reminder alone. In the context of this trial, the acceptability of the home-based strategy was evaluated and the costs of the two strategies were compared.Methods: REACT participants (200 women, 200 heterosexual men, 200 MSM) were asked to complete an online survey that included home-testing acceptability and preferred methods of retesting. The demographics, sexual behaviour and acceptability of home collection were compared between those preferring home-testing versus clinic-based retesting or no preference, using a chi-square test. The costs to the health system of the clinic-based and home retesting strategies and the cost per infection for each were also compared.Results: Overall 445/600 (74 %) participants completed the survey; 236/445 from the home-testing arm, and 141 of these (60 %) retested at home. The majority of home arm retesters were comfortable having the kit posted to their home (86 %); found it easy to follow the instructions and collect the specimens (96 %); were confident they had collected the specimens correctly (90 %); and reported no problems (70 %). Most (65 %) preferred home retesting, 21 % had no preference and 14 % preferred clinic retesting. Comparing those with a preference for home testing to those who didn't, there were significant differences in being comfortable having a kit sent to their home (p = 0.045); not having been diagnosed with chlamydia previously (p = 0.030); and living with friends (p = 0.034). The overall cost for the home retest pathway was $154 (AUD), compared to $169 for the clinic-based retesting pathway and the cost per repeat infection detected was $1409 vs $3133.Conclusions: Among individuals initially diagnosed with chlamydia in a sexual health clinic setting, home-based retesting was shown to be highly acceptable, preferred by most participants, and cost-efficient. However some clients preferred clinic-based testing, often due to confidentiality concerns in their home environment. Both options should be provided to maximise retesting rates.Trial Registration: The trial was registered with the Australia New Zealand Clinical Trials Registry on September 9, 2011: ACTRN12611000968976. [ABSTRACT FROM AUTHOR]

Published
2016
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7. A reverse transcriptase-polymerase chain reaction survey of infectious bronchitis virus genotypes in Western Europe from 2002 to 2006.

Author

Worthington, K. J., Currie, R. J. W., and Jones, R. C.

Subjects
*ANIMAL culture, *POULTRY disease diagnosis, *AVIAN infectious bronchitis, *BRONCHITIS, *POLYMERASE chain reaction, *GENETIC research, *GENETIC polymorphisms, *VACCINATION, RESEARCH & economics
Abstract

A survey of infectious bronchitis virus (IBV) genotypes in poultry flocks in selected countries in Western Europe was carried out between March 2002 and December 2006. Identification of IBV was by reverse transcriptase-polymerase chain reaction of RNA extracted from oropharyngeal swabs taken from poultry flocks exhibiting signs of clinical disease thought to be attributable to IBV. Part of the hypervariable S1 gene of IBV was sequenced to differentiate between the various genotypes. During the survey, 4103 samples were processed, of which 2419 (59%) were positive for IBV. The predominant IBV genotypes detected were 793B and Massachusetts. The third and fourth most common genotypes were two new economically important field types: Italy02, and a virus similar to genotypes originally detected in China called QX. Analysis of the partial S1 sequences of the genotypes detected suggested that approximately 50% of all 793B, Massachusetts types and D274 IBVs were identical to the homologous commercially available live vaccines. Since 2004 the prevalence of Italy02 (present in all countries from which samples were received) has been declining in all countries except Spain, where it appeared to be the predominant genotype. Since 2004 an IBV genotype has been detected in Holland, Germany, Belgium and France similar to QX and the incidence has increased. QX was not detected in the United Kingdom or Spain. When detections thought to be attributable to vaccines were removed, the dominant genotype in France and Europe overall was 793B; in Germany, Holland and Belgium, it was QX-like IBV; and in the United Kingdom and Spain the dominant genotype was Italy02. The present study is the first to identify the prevalence of both Italy02 and QX field-type variants in poultry flocks in Western Europe. Several novel genotypes have also been detected. [ABSTRACT FROM AUTHOR]

Published
2008
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8. Avian pneumovirus infection in broiler chicks inoculated with Escherichia coli at different time intervals.

Author

Al-Ankari, Abdul-Rahman, Bradbury, J. M., Naylor, C. J., Worthington, K. J., Payne-Johnson, C., and Jones, R. C.

Subjects
BROILER chicken diseases, RESPIRATORY infections, VIRAL pneumonia, ESCHERICHIA coli diseases, BACTERIAL diseases
Abstract

The effects of dual infection of 1-day-old broiler chicks with a chicken isolate of avian pneumovirus (APV) and a pool of pathogenic Escherichia coli strains were studied by supraconjunctival application of the bacteria simultaneously with the virus, or at 4, 7 or 11 days afterwards. When the agents were given together, the clinical disease was significantly more severe than that caused by the virus alone, but when the bacterium was given later the signs were less severe. None of the infections resulted in swollen head syndrome by 32 days. All mixed infections caused moderate to severe congestion in the turbinates, when birds were examined at 32 days of age, at which time no such lesions were present in birds having been infected with APV alone. E. coli was isolated from almost 100% of birds with mixed infections, while rates of those given only E. coli isolation varied between 56 and 67%. Furthermore, E. coli colony counts were consistently higher from mixed infection groups. Virus persistence in the choanal cleft was slightly prolonged in birds with the simultaneous mixed infection. Although the pool of E. coli included O2, O78 and O18 serotypes, only those of the O2 serotype and a small number of untypable strains were re-isolated from selected mixed and single E. coli-infected groups. Mixed APV and E. coli infection did not affect APV enzyme-linked immunosorbent assay antibody titres at 21 or 32 days. Thus, experimental infection of broiler chicks with APV and E. coli, simultaneously or at intervals afterwards, demonstrated a synergistic effect between the two agents, but none of the infection protocols caused swollen head syndrome. [ABSTRACT FROM AUTHOR]

Published
2001
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11. Activation and release of proteolytic kinin-forming enzymes from rat jejunal loops perfused with hyperosmolar glucose solutions.

Author

Worthington, K J and Cuschieri, A

Abstract

Loops of rat jejunum were perfused in vivo for one hour with de Jalon solutions of increasing glucose concentration. The esterolytic activity of the perfusate and of the extracted loop was measured using benzoyl arginine ethyl ester (BAEe) as substrate. The enzymes lactate dehydrogenase, isocitrate dehydrogenase, and acid phosphatase were measured in the perfusate to estimate the degree of cellular damage. There was a significant depletion of kallikrein from the intestine and a raised level in the perfusate during the hyperosmolar perfusions. No significant difference in the kallikrein levels was observed between the normal jejunum and the iso-osmolar perfused jejunum. Prolonged contact with hyperosmolar solutions caused some cellular damage but this effect appeared to be distinct from the release of kallikrein, which occurred very rapidly during the first 20 minutes. These results confirm that hyperosmolar intestinal contents result in the release of kinin-forming proteolytic enzymes into the circulation and suggest that this mechanism is involved in the syndrome of vasomotor dumping after gastric surgery. [ABSTRACT FROM PUBLISHER]

Published
1977

14. Efficacy of live infectious bronchitis vaccines against a novel European genotype, Italy 02.

Author

Jones, R. C., Worthington, K. J., Capua, I., and Naylor, C. J.

Subjects
*VIRAL vaccines, *AVIAN infectious bronchitis, *CHICKS, *POULTRY diseases, *VETERINARY vaccines, *VETERINARY medicine, *DISEASES
Abstract

Cites a survey evaluating the efficacy of infectious bronchitis virus vaccines against a novel genotype, Italy 02, which appears to be widespread throughout Great Britain and western Europe. Vaccination of chicks by spray with a commercial dose of Poulvac IBMM + Ark and Poulvac IB Primer; Findings on the ability of both combination vaccines to give excellent protection against Italy 02 challenge; Clinical characteristics of Italy 02 virus.

Published
2005
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16. Stromal mesenchyme cell genes of the human prostate and bladder

Author

Pascal Laura E, Goodlett David R, Goo Young Ah, Worthington Kelsey D, Vessella Robert L, True Lawrence D, and Liu Alvin Y

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Stromal mesenchyme cells play an important role in epithelial differentiation and likely in cancer as well. Induction of epithelial differentiation is organ-specific, and the genes responsible could be identified through a comparative genomic analysis of the stromal cells from two different organs. These genes might be aberrantly expressed in cancer since cancer could be viewed as due to a defect in stromal signaling. We propose to identify the prostate stromal genes by analysis of differentially expressed genes between prostate and bladder stromal cells, and to examine their expression in prostate cancer. Methods Immunohistochemistry using antibodies to cluster designation (CD) cell surface antigens was first used to characterize the stromas of the prostate and bladder. Stromal cells were prepared from either prostate or bladder tissue for cell culture. RNA was isolated from the cultured cells and analyzed by DNA microarrays. Expression of candidate genes in normal prostate and prostate cancer was examined by RT-PCR. Results The bladder stroma was phenotypically different from that of the prostate. Most notable was the presence of a layer of CD13+ cells adjacent to the urothelium. This structural feature was also seen in the mouse bladder. The prostate stroma was uniformly CD13-. A number of differentially expressed genes between prostate and bladder stromal cells were identified. One prostate gene, proenkephalin (PENK), was of interest because it encodes a hormone. Secreted proteins such as hormones and bioactive peptides are known to mediate cell-cell signaling. Prostate stromal expression of PENK was verified by an antibody raised against a PENK peptide, by RT-PCR analysis of laser-capture microdissected stromal cells, and by database analysis. Gene expression analysis showed that PENK expression was down-regulated in prostate cancer. Conclusion Our findings show that the histologically similar stromas of the prostate and bladder are phenotypically different, and express organ-specific genes. The importance of these genes in epithelial development is suggested by their abnormal expression in cancer. Among the candidates is the hormone PENK and the down-regulation of PENK expression in cancer suggests a possible association with cancer development.

Published
2005
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33. A different kind of unity.

Author

Sherk, Lorraine M. and Worthington, K. Jane

Subjects
NURSES' attitudes
Abstract

Deals with a survey among nurses in the U.S. regarding the 1985 Proposal and the plea for unity of the American Nurses Association. Rate of nurses who opposed the 1985 Proposal; Reasons for the support to continued professional licensing for nurses; Implications of the proposal for the nursing profession.

Published
1982

39. Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

Author

Andrew J. Einstein, Cole Hirschfeld, Michelle C. Williams, Joao V. Vitola, Nathan Better, Todd C. Villines, Rodrigo Cerci, Leslee J. Shaw, Andrew D. Choi, Sharmila Dorbala, Ganesan Karthikeyan, Bin Lu, Valentin Sinitsyn, Alexey A. Ansheles, Takashi Kudo, Chiara Bucciarelli-Ducci, Bjarne Linde Nørgaard, Pál Maurovich-Horvat, Roxana Campisi, Elisa Milan, Lizette Louw, Adel H. Allam, Mona Bhatia, Lorenzo Sewanan, Eli Malkovskiy, Yosef Cohen, Michael Randazzo, Jagat Narula, Olga Morozova, Thomas N.B. Pascual, Yaroslav Pynda, Maurizio Dondi, Diana Paez, Gerd Hinterleitner, Yao Lu, Zhuoran Xu, Cole B. Hirschfeld, Ikenna Erinne, Mrinali Shetty, Andrew Choi, Juan Lopez-Mattei, Purvi Parwani, Artan Goda, Ervina Shirka, Salah Bouyoucef, Lydia Chelghoum, Farouk Mansouri, Abdelkader Medjahedi, Qais Naili, Mokhtar Ridouh, Diego Alasia, Lucia Alberghina, Natalia Aramayo, Diego Buchara, Franco Gabriel Busso, Jose Javier Bustos Rivadero, Jorge Camilletti, Hugo Campanelli, Ricardo Belisario Castro, Mariana Daicz, Horacio del Riego, Laura Dragonetti, Diego Echazarreta, Juan Erriest, Fernando Faccio, Adolfo Facello, Hugo Gallegos, Ricardo Geronazzo, Horacio Glait, Victor Hasbani, Victor Jäger, Julio Manuel Lewkowicz, Jose Lotti, Neiva Maciel, Osvaldo Masoli, Edgardo Mastrovito, Maria Medus, Maria Fernanda Merani, Susana Molteni, Marcos Montecinos, Gustavo Parisi, Claudio Pereyra Sueldo, Diego Perez de Arenaza, Luis Quintana, Alejandro Radzinschi, Marcela Redruello, Marina Rodríguez, Horacio Rojas, Arturo Romero Acuña, Daniel Schere, Sonia Traverso, Gustavo Vazquez, Susana Zeffiro, Mari Sakanyan, Scott Beuzeville, Raef Boktor, Michael Crowley, D'Arne Downie, Girish Dwivedi, Barry Elison, Omar Farouque, Kim Jasper, Subodh Joshi, Joseph Lee, Kenneth Lee, Elaine Lui, Peter Mcconachie, Joanne Meaker, Dee Nandurkar, Johanne Neill, Edward O'Rourke, Patricia O'Sullivan, George Pandos, Manuja Premaratne, David Prior, Natalie Rutherford, Connor Saunders, Kim Taubman, Andrew Tauro, Andrew Taylor, James Theuerle, Paul Thomas, Jonathan Tow, Anthony Upton, Shankar Vamadevan, Victor Wayne, Eva Alina Wegner, David Wong, John Younger, Dietrich Beitzke, Gudrun Feuchtner, Oliver Sommer, Konrad Weiss, Natallia Maroz-Vadalazhskaya, Uladzimir Tserakhau, Filip Homans, Caroline M. Van De Heyning, Raúl Araujo, Valentina Soldat-Stankovic, Sinisa Stankovic, Augusto Almeida, Carlos Anselmi, Guilherme S.A. Azevedo, Marcio Sommer Bittencourt, Diego Bromfman Pianta, Estevan Cabeda, Lara Carreira, Igor Coelho, Fernando de Amorim Fernandes, Andrea de Lorenzo, Roberta Delgado, Fernanda Erthal, Fabio Fernandes, Juliano Fernandes, Thiago Ferreira de Souza, Murilo Foppa, Wilson Furlan Matos Alves, Cibele Gontijo, Ilan Gottlieb, Gabriel Grossman, Maria Helena Albernaz Siqueira, Cesar Higa Nomura, Katia Hiromoto Koga, Ronaldo Lima, Rafael Lopes, Hugo Humberto Marçal Filho, Paulo Masiero, Luiz Mastrocola, Maria Eduarda Menezes de Siqueira, Claudio Mesquita, Danilo Naves, Filipe Penna, Ibraim Pinto, Thércio Rocha, Juliana Leal Rocha, Alfredo Rodrigues, Leila Salioni, Adelina Sanches, Marcelo Santos, Leonardo Sara Da Silva, Paulo Schvartzman, Cristina Sebastião Matushita, Tiago Senra, Marcelo Silva, Carlos Eduardo Soares, Bernardo Spiro, Carlos Eduardo Suaide Silva, Rafael Torres, Guilherme Urpia Monte, Andrea Vilela, Alexandre Volney Villa, Joao Vitola, Themissa Voss, Roberto Waltrick, Marcello Zapparoli, Hamid Naseer, Marina Garcheva-Tsacheva, Tiémégna Florence Ouattara, Sarameth Thou, Soley Varoeun, Gad Abikhzer, Rob Beanlands, Michael Chetrit, Dominique Dabreo, Carole Dennie, Matthias Friedrich, Mohmmed Nassoh Hafez, Kate Hanneman, Robert Miller, Anastasia Oikonomou, Idan Roifman, Gary Small, Vikas Tandon, Adwait Trivedi, James White, Katherine Zukotynski, Rita Alay, Carmen Concha, Teresa Massardo, Pedro Abad, Kelly Anzola, Harold Arturo, Luis Benitez, Alberto Cadena, Carlos Caicedo Zamudio, Antonio Calderón, Claudia T. Gutierrez Villamil, Claudia Jaimes, Juan L. Londono, Nelson Lopez, Sonia Merlano-Gaitan, Ramon Murgieitio-Cabrera, Manuel Valencia, Damiana Vergel, Alejandro Zuluaga Santamaria, Felix Solis, Tonci Batinic, Maja Franceschi, Maja Hrabak Paar, Marina Prpic, Cuba: Juan Felipe Batista, Lazaro Omar Cabrera, Amalia Peix, Yamilé Peña, Luis Manuel Rochela Vázquez, Ioannis Ntalas, Milan Kaminek, Vladimir Kincl, Otto Lang, Jawdat Abdulla, Morten Bøttcher, Martin Busk, Uka Geisler, Lars C. Gormsen, Nicolaj Hansson, Søren Hess, Jens Hove, Lars Thorbjoern Jensen, Magnus T. Jensen, Kristian Hay Kragholm, Bjarne L. Nørgaard, Kristian Øvrehus, Jan Rasmussen, Niels Peter Rønnow Sand, Hanne Sondergaard, Tomas Zaremba, Herwin Speckter, Nelson Amores, Mayra Sanchez Velez, Taghreed Abd Alrahman, Sherif Abd Elsamad, Alia Abdelfattah, Adel Allam, Sameh Elkaffas, Mona Hassan, Elshaymaa Hussein, Ahmed Ibrahim, Ahmed Kandeel, Mohamed Mandour Ali, Mahmoud Shaaban, Camila Flores, Verónica Vanesa Gómez Leiva, Anita Liiver, Martti Larikka, Valtteri Uusitalo, Denis Agostini, Clothilde Berger, Matthieu Dietz, Fabien Hyafil, Mickaël Ohana, Kevin Prigent, Hamza Regaieg, Laure Sarda-Mantel, Darach O. H-Ici, Harold Ayetey, George Angelidis, Christina Fragkaki, Chrysoula Fragkiadaki, Panagiotis Georgoulias, Maria Koutelou, Elena Kyrozi, Niki Lama, Vassilis Prassopoulos, Michael Spartalis, Theodora Zaglavara, Carla Gonzalez, Goleat Gutierrez, Alejandro Maldonado, Yassine Martinez, Attila Kovács, Bálint Szilveszter, Nilesh Banthia, Vivek Bhat, Partha Choudhury, Vijay Sai Chowdekar, Johann Christopher, Tushar Garg, Naresh Kumar Goyal, Ripen Kumar Gupta, Abhishek Gupta, Julie Hephzibah, Shashank Jain, Jesu Krupa, Parveen Kumar, Sukriti Kumar, Arati Lalchandani, Animesh Mishra, Vivaswan Dutt Mishra, Parul Mohan, Ahmad Ozair, Shivani Pandey, Ramanathapuram Parameswaran, Chetan Patel, Tapan Patel, Shivani Patel, Leena Robinson Vimala, Dr Pradosh Kumar Sarangi, Shantanu Sengupta, Arvind Sethi, Amit Sharma, Awadhesh Kumar Sharma, Punit Sharma, Apurva Shrigiriwar, Santosh Singh, Harpreet Singh, Ashwani Sood, Atul Verma, Ajay Vyas, Erwin Affandi Soeriadi, Edison Bun, Febby Hutomo, Hilman Syawaluddin, Ryan Yudistiro, Amjed Albadr, Majid Assadi, Farshad Emami, Alireza Emami-Ardekani, Saeed Farzanehfar, Ramezan Jafari, Reyhaneh Manafi-Farid, Maryam Tajik, Yoav Arnson, Shmuel Fuchs, Ronen Goldkorn, John Kennedy, Marina Leitman, Aryeh Shalev, Wanda Acampa, Domenico Albano, Pierpaolo Alongi, Gaspare Arnone, Roberta Assante, Anna Baritussio, Matteo Bauckneht, Francesco Bianco, Rachele Bonfiglioli, Francesco Bovenzi, Isabella Bruno, Andrea Bruno, Elena Busnardo, Elena Califaretti, Roberta Casoni, Vittorio Censullo, Franca Chierichetti, Marcello Chiocchi, Corrado Cittanti, Alberto Clemente, Alberto Cuocolo, Maria Luisa De Rimini, Giuseppe De Vincentis, Veronica Della Tommasina, Santo Dellegrottaglie, Paola Anna Erba, Laura Evangelista, Lara Faggi, Evelina Faragasso, Luigia Florimonte, Viviana Frantellizzi, Marco Gatti, Angela Gaudiano, Fabrizia Gelardi, Alberto Gerali, Alessia Gimelli, Marco Guglielmo, Lucia Leccisotti, Riccardo Liga, Carlo Liguori, Giampiero Longo, Margherita Maffione, Claudio Marcassa, Giovanni Matassa, Donato Mele, Luca Mircoli, Andrea Paccagnella, Sara Pacella, Federica Padovano, Dario Pellegrini, Valeria Pergola, Luca Pugliese, Natale Quartuccio, Lucia Rampin, Fabrizio Ricci, Giuseppe Rubini, Vincenzo Russo, Gianmario Sambuceti, Alessandra Scatteia, Roberto Sciagrà, Gianluca Spidalieri, Antonella Stefanelli, Carlo Tedeschi, Guido Ventroni, Dainia Baugh, Ernest Madu, Tadao Aikawa, Hiroshi Asano, Shinichiro Fujimoto, Koichiro Fujise, Yoshimitsu Fukushima, Kae Fukuyama, Yasutaka Ichikawa, Reiko Ideguchi, Nobuo Iguchi, Masamichi Imai, Hayato Ishimura, Satoshi Isobe, Kimiteru Ito, Yu Izawa, Toshiaki Kadokami, Tokuo Kasai, Takao Kato, Takashi Kawamoto, Shigeru Kiryu, Shinichiro Kumita, Osamu Manabe, Hirotaka Maruno, Naoya Matsumoto, Masao Miyagawa, Masao Moroi, Shigeki Nagamachi, Kenichi Nakajima, Ryo Nakazato, Mamoru Nanasato, Masanao Naya, Takashi Norikane, Yasutoshi Ohta, Yoichi Otomi, Hideki Otsuka, Noriko Oyama-Manabe, Masaki Saito, Masayoshi Sarai, Junichi Sato, Daisuke Sato, Shinya Shiraishi, Kentaro Takanami, Kazuya Takehana, Yasuyo Taniguchi, Hiroki Teragawa, Nobuo Tomizawa, Kyoko Umeji, Yasushi Wakabayashi, Shinichiro Yamada, Shinya Yamazaki, Tatsuya Yoneyama, Mohammad Rawashdeh, Tairkhan Dautov, Khalid Makhdomi, Mostafa Abass, Masoud Garashi, Qaisar Siraj, Marika Kalnina, Mohamad Haidar, Renata Komiagiene, Giedre Kviecinskiene, Donatas Vajauskas, Noor Khairiah A. Karim, Mady Doucoure, Luise Reichmuth, Anthony Samuel, Mohamed Lemine Dieng, Ambedhkar Shantaram Naojee, Estrella Aguilera Hernandez, Cesar Rene Alducin Tellez, Erick Alexánderson-Rosas, Erika Barragan, Manuel Cabada, Daniel Calderón, Isabel Carvajal-Juarez, José Esparza, Manlio Gerardo Gama-Moreno, Virginia Garcia Quinto, Nelsy Coromoto Gonzalez, Mary Carmen Herrera-Zarza, Aloha Meave, Jesus Gregorio Medina Verdugo, Gabriela Melendez, Rafael Humberto Morales Murguia, Carlos Salvador Navarro Quiroz, Mario Ornelas, Andres Preciado-Anaya, Oscar Ulises Preciado-Gutiérrez, Adriana Puente, Aristóteles Ramírez Salazar, Sandra Graciela Rosales Uvera, Sandra Rosales-Uvera, Jose Antonio Serna Macias, Lilia Sierra-Galan, Lilia M. Sierra-Galan, Juan Carlos Tirado Alderete, Enrique Vallejo, Marc Faraggi, Erdenechimeg Sereegotov, Nouzha Ben Rais, Nadia Ismaili Alaoui, Thiri Kyiphyu, Su Thet Oo, Soe Myat Win, Htin Zar, Ram Ghimire, Madhu Neupane, Andor Glaudemans, Riemer Slart, Derk Verschure, Berry Allen, John Edmond, Clare Mckenzie, Stuart Tie, Niels Van Pelt, Kirsten Worthington, Calum Young, Idrissa Adamou Soli, Shehu Kana, Uchenna Onubogu, Mahmoud Sani, Anders Tjellaug Bråten, Arve Jørgensen, Hanne-Elin Vassbotn, Humoud Al Dhuhli, Zabah Jawa, Naima Tag, Shazia Fatima, Muhammad Babar Imran, Muhammad Numair Younis, Mohammad Saadullah, Yariela Herrera Malo, Dora Lenturut-Katal, Manuel Castillo, José Ortellado, Afroza Akhter, F. Aaysha Cader, Raihan Hussain, Saidur Rahman Khan, Tapati Mandal, Faria Nasreen, Yunqiang An, Dianbo Cao, Lianggeng Gong, Yang Hou, Chongfu Jia, Tao Li, Caiying Li, Hui Liu, Wenya Liu, Jinkang Liu, Ming-Yen Ng, Heshui Shi, Chunxiang Tang, Ximing Wang, Zhaoqian Wang, Yining Wang, Jiang Wu, Yan Yi, Li Yuan, Tong Zhang, Longjiang Zhang, Edith Chavez, Carlos Cruz, Christian Llontop, Rosanna Morales, Paz Abrihan, Asela Bustos-Barroso, Michele Duldulao-Ogbac, Christopher Eduarte, Jerry Obaldo, Alvin Quinon, Belinda San Juan, Carlo Joe San Juan, Marie Rhiamar Sauler-Gomez, Mila Uy, Magdalena Kostkiewicz, Jolanta Kunikowska, Anna Teresinska, Tomasz Urbanik, Nuno Bettencourt, Ricardo Fontes-Carvalho, Cristina Gavina, Lino Gonçalves, Filipe Macedo, Nuno Moreno, Carla Sousa, Ana Teresa Timoteo, Maria João Vidigal, Mahmoud Al Heidous, Subramaniyan Ramanathan, Samer Arnous, Said Aytani, Angela Byrne, Tadhg Gleeson, David Kerins, Julie O'Brien, Ji-In Bang, Henry Bom, Miju Cheon, Gi Jeong Cheon, Sang-Geon Cho, Chae Moon Hong, Yong Hyu Jeong, Won Jun Kang, Yeon-Koo Kang, Ji-Young Kim, So Won Oh, Young So, Ho-Chun Song, Kyoung Sook Won, Soo Woong Yoo, Irena Mitevska, Marija Vavlukis, Barbara Gužic Salobir, Monika Štalc, Theodora Benedek, Marian Pop, Claudiu Stan, Alexey Ansheles, Olga Dariy, Nina Gagarina, Irina Itskovich, Anatoliy Karalkin, Alexander Kokov, Gulya Marina, Ekaterina Migunova, Viktor Pospelov, Daria Ryzhkova, Guzaliya Sayfullina, Vladimir Sergienko, Irina Shurupova, Margarita Vakhromeeva, Nailia Valiullina, Konstantin Zavadovsky, Kirill Zhuravlev, Rami Abazid, Turki Al Garni, Mirvat Alasnag, Ahmed Aljizeeri, Hamid Amer, Ahmad Amro, Hesham Hamdy, Osama Smettei, Dragana Sobic Saranovic, Marina Vlajkovic, Felix Keng, Jason See, Zuzana Berecova, Jana Polakova Mistinova, Osayande Evbuomwan, Nerisha Govender, Jonathan Hack, Bawinile Hadebe, Khanyisile Hlongwa, Mitchell Kaplan, Hoosen Lakhi, Katarina Milos, Moshe Modiselle, Stuart More, Ntanganedzeni Muambadzi, Leonie Scholtz, Manuel Barreiro-Perez, Isabel Blanco, Jordi Broncano, Alicia Camarero, Irene Casáns-Tormo, Javier De Haro, Albert Flotats, Elia García, Ceferino Gutierrez Mendiguchia, Amelia Jimenez-Heffernan, Ruben Leta, Javier Lopez Diaz, Luis Lumbreras Vega, Ana Manovel-Sánchez, Amparo Martinez Monzonis, Bianca Patrut, Virginia Pubul, Ricardo Ruano Perez, Nahla Zeidan, Damayanthi Nanayakkara, Ahmed Suliman, Henrik Engblom, Mustafa Murtadha, Ellen Ostenfeld, Magnus Simonsson, Hatem Alkadhi, Ronny Ralf Buechel, Peter Burger, Christoph Gräni, Christel Kamani, Nadine Kawel-Böhm, Bernd Klaeser, Robert Manka, John Prior, Tawika Kaewchur, Benjapa Khiewvan, Arpakorn Kositwattanarerk, Sirianong Namwongprom, Tanyaluck Thientunyakit, Haluk Burcak Sayman, Mahmut Yüksel, Mugisha Julius Sebikali, Emmy Okello, Pavlo Korol, Iryna Noverko, Maryna Satyr, Tahir Ahmad, Khaled Alfakih, Ivo Andrade, Susan Buckingham, Anda Bularga, John-Paul Carpenter, Graham Cole, David Cusack, Sarojini David, Patrick Davis, Timothy Fairbairn, Arjun Ghosh, Prasad Guntur Ramkumar, Mark Hamilton, Faisal Haque, Benjamin Hudson, Annette Johnstone, V.J. 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Sewanan, Lorenzo, Malkovskiy, Eli, Cohen, Yosef, Randazzo, Michael, Narula, Jagat, Morozova, Olga, Pascual, Thomas N B, Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, and Cuocolo, Alberto

Subjects
cardiac testing, Health Personnel, delivery of health care, coronavirus, COVID-19, global health, 610 Medicine & health, cardiovascular disease, health personnel, humans, pandemics, surveys and questionnaires, coronaviru, Surveys and Questionnaires, Humans, Cardiology and Cardiovascular Medicine, Delivery of Health Care, Pandemics, COVID-19/epidemiology
Abstract

BACKGROUND: The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES: The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS: Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS: Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing.

Published
2022

41. Improving reproductive success in captive marmosets through active female choice.

Author

Drazan TM, Bradley SP, Jones A, Allen-Worthington K, and Chudasama Y

Abstract

The recent upsurge in the use of common marmosets (Callithrix jacchus) as a desirable model for high priority biomedical research has challenged local and global suppliers struggling to provide sufficient numbers of marmosets for large scale projects. Scientific research laboratories are increasingly establishing institutional breeding colonies, in part to combat the resulting shortage and high cost of commercially available animals, and in part to have maximum control over research lines involving reproduction and development. For such laboratories, efficient marmoset breeding can be challenging and time consuming. Random male/female pairings are often unsuccessful, with intervals of several months before attempting alternate pairings. Here we address this challenge through a behavioral task that promotes self-directed female selection of potential mates to increase the efficiency of breeding in captive marmosets. We created a partner preference test ('love maze') in which nulliparous females (n=12) had the opportunity to select between two eligible males (n=23) at a time, in a forced choice test. In this test, both males usually displayed sexual solicitations. However, the female would clearly indicate her preference for one. Most commonly, the female actively ignored the non-preferred male and directed overt prosocial behaviors (e.g. proceptive tongue-flicking, approach and grooming) to the preferred male. Moreover, once a male was selected in this context, the female would continue to prefer him over other males in three consecutive testing sessions. Compared with random pairings, this directed female choice showed a 2.5-fold improvement in breeding within 90 days compared to random pairings. This cost-effective and straightforward pairing practice can be used to enhance breeding efficiency in both small and large marmoset colonies.

Published
2024
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42. Enzyme-Responsive Nanoparticles for the Targeted Delivery of an MMP Inhibitor to Acute Myocardial Infarction.

Author

Sullivan HL, Liang Y, Worthington K, Luo C, Gianneschi NC, and Christman KL

Subjects
Rats, Animals, Matrix Metalloproteinase Inhibitors pharmacology, Matrix Metalloproteinase Inhibitors therapeutic use, Drug Delivery Systems, Peptides therapeutic use, Micelles, Myocardial Infarction drug therapy, Nanoparticles
Abstract

Herein, we have developed a drug-loaded matrix metalloproteinase (MMP)-responsive micellar nanoparticle (NP) intended for minimally invasive intravenous injection during the acute phase of myocardial infarction (MI) and prolonged retention in the heart for small-molecule drug delivery. Peptide-polymer amphiphiles (PPAs) bearing a small-molecule MMP inhibitor (MMPi), PD166793, were synthesized via ring-opening metathesis polymerization (ROMP) and formulated into spherical micelles by transitioning to aqueous solution. The resulting micellar NPs underwent MMP-induced aggregation, demonstrating enzyme responsiveness. Using a rat MI model, we observed that these NPs were capable of successfully extravasating into the infarcted region of the heart where they were retained due to the active, enzyme-mediated targeting, remaining detectable after 1 week post administration without increasing macrophage recruitment. Furthermore, in vitro studies show that these NPs demonstrated successful drug release following MMP treatment and maintained drug bioactivity as evidenced by comparable MMP inhibition to free MMPi. This work establishes a targeted NP platform for delivering small-molecule therapeutics to the heart after MI, opening possibilities for myocardial infarction treatment.

Published
2023
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43. Inflammation-Responsive Micellar Nanoparticles from Degradable Polyphosphoramidates for Targeted Delivery to Myocardial Infarction.

Author

Liang Y, Sullivan HL, Carrow K, Mesfin JM, Korpanty J, Worthington K, Luo C, Christman KL, and Gianneschi NC

Subjects
Rats, Animals, Micelles, Tissue Distribution, Peptides, Inflammation, Matrix Metalloproteinases, Myocardial Infarction, Nanoparticles
Abstract

Nanoparticles that undergo a localized morphology change to target areas of inflammation have been previously developed but are limited by their lack of biodegradability. In this paper, we describe a low-ring-strain cyclic olefin monomer, 1,3-dimethyl-2-phenoxy-1,3,4,7-tetrahydro-1,3,2-diazaphosphepine 2-oxide (MePTDO), that rapidly polymerizes via ring-opening metathesis polymerization at room temperature to generate well-defined degradable polyphosphoramidates with high monomer conversion (>84%). Efficient MePTDO copolymerizations with norbornene-based monomers are demonstrated, including a norbornenyl monomer functionalized with a peptide substrate for inflammation-associated matrix metalloproteinases (MMPs). The resulting amphiphilic peptide brush copolymers self-assembled in aqueous solution to generate micellar nanoparticles (30 nm in diameter) which exhibit excellent cyto- and hemocompatibility and undergo MMP-induced assembly into micron-scale aggregates. As MMPs are upregulated in the heart postmyocardial infarction (MI), the MMP-responsive micelles were applied to target and accumulate in the infarcted heart following intravenous administration in a rat model of MI. These particles displayed a distinct biodistribution and clearance pattern in comparison to nondegradable analogues. Specifically, accumulation at the site of MI competed with elimination predominantly through the kidney rather than the liver. Together, these results suggest this as a promising new biodegradable platform for inflammation targeted delivery.

Published
2023
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44. Strategies to Help CWS-Involved Parents Complete Substance Use Treatment and Protect their Children in Hawai'i.

Author

Calistro YT and Worthington K

Subjects
Humans, Child, Hawaii, Parents, Child Welfare, Child Abuse, Substance-Related Disorders therapy
Abstract

Each year in Hawai'i, an estimated 500 - 650 children (about half of confirmed cases of child abuse or neglect) are at high risk of entering foster care because of their parent's substance use disorder (SUD). Children in foster care because of parental SUD are less likely to be reunified with their parents. Experiences in foster care may cause long-term negative health consequences for the children. Early identification and engagement of parents in SUD treatment can improve outcomes for parents and children. The child welfare and SUD treatment systems in Hawai'i are not set up to work together to maximize the likelihood that parents will complete treatment and families will stay together. This article recommends evidence-based interventions including recovery coaches, peer partners, and Family Drug Courts (FDCs). Recovery coaches and peer partners support parents in early engagement and completion of SUD treatment. FDCs provide an interdisciplinary approach that successfully serves parents involved with Child Welfare Services (CWS) who have complex needs. Effectively implementing these interventions in Hawai'i requires an improved infrastructure to collect and analyze data about parents with SUD and their children, parents' SUD needs and status in treatment, and families' level of CWS involvement. Data about the availability and delivery of services for CWS-involved parents with SUD are also needed to understand service efficiency and effectiveness. These suggested interventions would help more parents in Hawai'i complete treatment and keep their children safely with them, thereby protecting children's current and long-term health., (©Copyright 2022 by University Health Partners of Hawai‘i (UHP Hawai‘i).)

Published
2022

45. Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes.

Author

Huston WM, Lawrence A, Wee BA, Thomas M, Timms P, Vodstrcil LA, McNulty A, McIvor R, Worthington K, Donovan B, Phillips S, Chen MY, Fairley CK, and Hocking JS

Subjects
Female, Humans, Cohort Studies, Chlamydia trachomatis genetics, Azithromycin therapeutic use, Chlamydia Infections
Abstract

Chlamydia trachomatis , the most common bacterial sexually transmitted infection worldwide, is responsible for considerable health burden due to its significant sequelae. There are growing concerns about chlamydial treatment and management due to widely documented increasing burden of repeat infections. In the current study, a cohort study design of 305 women with urogenital chlamydial infections demonstrated that 11.8% of women experienced repeat infections after treatment with azithromycin. The chlamydial DNA load measured by quantitative PCR was higher in women who experienced a repeat infection ( p = 0.0097) and repeat infection was associated with sexual contact. There was no genomic or phenotypic evidence of azithromycin resistance within the chlamydial isolates. During repeat infection, or repeat positive tests during follow up, vaginal chlamydial gene expression ( ompA, euo, omcB, htrA, trpAB ) was markedly higher compared to baseline, and two of the selected immune genes analyzed had significantly lower expression at the time of repeat infection. Overall, there are two implications of these results. The results could be generalized to all recent infections, or repeat positive events, and indicate that chlamydial infections are have higher transcriptional activity of select genes early in the infection in women. Alternatively, after azithromycin treatment, repeat infections of Chlamydia may be more transcriptionally active at certain genes, and there may be post-treatment immunological alterations that interplay into repeat exposures establishing an active infection. The potential that recent infections may involve a higher level of activity from the organism may have implications for management by more regular testing of the most at risk women to reduce the risk of sequelae., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Huston, Lawrence, Wee, Thomas, Timms, Vodstrcil, McNulty, McIvor, Worthington, Donovan, Phillips, Chen, Fairley and Hocking.)

Published
2022
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46. Development of an educational package for the universal human papillomavirus (HPV) vaccination programme: a co-production study with young people and key informants.

Author

Fisher H, Chantler T, Finn A, Kesten J, Hickman M, Letley L, Mounier-Jack S, Thomas C, Worthington K, Yates J, and Audrey S

Abstract

Background: The English schools-based human papillomavirus (HPV) vaccination programme is routinely offered to all young people aged 12-13 years, to prevent cancers affecting the cervix, vulva, vagina, penis, anus and mouth. Lower uptake among some population groups has been identified, in part, because of unmet information needs among young people. To address these unmet needs we report intervention planning and development processes to co-produce an educational package about the HPV vaccine., Methods: We used co-production research methodologies and the 'person-based approach' involving the following iterative stages: (i) collating and analysing primary and secondary evidence, including HPV vaccine communication materials, interviews and workshops; (ii) developing guiding principles; (iii) undertaking a behavioural analysis informed by the Behaviour Change Wheel and the Behaviour Change Technique taxonomy; (iv) development of a preliminary logic model; (v) co-production of resources, and; (vi) refinement of resources informed by feedback from young people and key informants., Results: We co-produced EDUCATE, a theory-based educational package, that is designed to be delivered to young people prior to being offered the HPV vaccine to support uptake. Young people and key informants identified the following key issues to include as content: (i) HPV-related information; (ii) how vaccines work; (iii) safety and side-effects of the HPV vaccine; (iii) eligibility for the HPV vaccination programme, and; (iv) preparation of young people to receive the HPV vaccine. A manual for professionals (e.g. immunisation nurses, school staff) delivering the intervention and a PowerPoint presentation, interspersed with five short films, were co-produced with young people and key informants. Following feedback, the content of the EDUCATE package was refined to increase acceptability, engagement, and persuasiveness to the target users., Conclusion: Engagement with young people and key informants was integral to the development of our rigorously developed, theory-based intervention to address young people's information needs about the HPV vaccination programme. The acceptability and persuasiveness of the package has been maximised by working closely with young people and key informants to develop the content. An implementation study to examine how the EDUCATE package is implemented in practice and the impact on uptake of the HPV vaccination programme is underway., (© 2022. The Author(s).)

Published
2022
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47. Current practices in nutrition management and disease incidence of common marmosets (Callithrix jacchus).

Author

Goodroe A, Wachtman L, Benedict W, Allen-Worthington K, Bakker J, Burns M, Diaz LL, Dick E, Dickerson M, Eliades SJ, Gonzalez O, Graf DJ, Haroush K, Inoue T, Izzi J, Laudano A, Layne-Colon D, Leblanc M, Ludwig B, Mejia A, Miller C, Sarfaty A, Sosa M, Vallender E, Brown C, Forney L, Schultz-Darken N, Colman R, Power M, Capuano S, Ross C, and Tardif S

Subjects
Animals, Diet veterinary, Incidence, Obesity, Bone Diseases, Metabolic, Callithrix
Abstract

Background: A survey was developed to characterize disease incidence, common pathology lesions, environmental characteristics, and nutrition programs within captive research marmoset colonies., Methods: Seventeen research facilities completed the electronic survey., Results: Nutritional management programs varied amongst research institutions housing marmosets; eight primary base diets were reported. The most common clinical syndromes reported were gastrointestinal disease (i.e. inflammatory bowel disease like disease, chronic lymphocytic enteritis, chronic malabsorption, chronic diarrhea), metabolic bone disease or fracture, infectious diarrhea, and oral disease (tooth root abscesses, gingivitis, tooth root resorption). The five most common pathology morphologic diagnoses were colitis, nephropathy/nephritis, enteritis, chronic lymphoplasmacytic enteritis, and cholecystitis. Obesity was more common (average 20% of a reporting institution's population) than thin body condition (average 5%)., Conclusions: Through review of current practices, we aim to inspire development of evidence-based practices to standardize husbandry and nutrition practices for marmoset research colonies., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2021
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48. Knowledge of Health Insurance Terms and the Affordable Care Act in Racially and Ethnically Diverse Urban Communities.

Author

Patel MR, TerHaar L, Smith A, Tariq M, Worthington K, Hinton J, and Lichtenstein R

Subjects
Adolescent, Adult, Female, Humans, Insurance Coverage, Interviews as Topic, Male, Middle Aged, Qualitative Research, United States, Young Adult, Ethnicity, Health Knowledge, Attitudes, Practice, Insurance, Health, Patient Protection and Affordable Care Act, Racial Groups, Urban Population
Abstract

Confusion around health insurance reforms persist. The purpose of this study was to assess demographic differences in Affordable Care Act (ACA) and health insurance knowledge in a multi-ethnic urban sample. Data came from 243 adults from racial/ethnic communities. Participants were asked about elements of health insurance and the ACA. Generalized linear and logistic regression models were used to examine relationships between demographic predictors and knowledge domains. Female gender (p < 0.05) and Latino/Hispanic race/ethnicity (p < 0.001) were most predictive of lower eligibility knowledge, while non-citizen with residency status (p < 0.001) and other/not declared residency status (p < 0.001) were most predictive of lower insurance coverage knowledge. No demographic factors predicted enrollment knowledge. Latino/Hispanic race/ethnicity (p < 0.01) was most predictive of not knowing that more people can get insurance because of the ACA. In conclusion, there is variation in health insurance and ACA-related knowledge in multi-ethnic populations. More compatible health communication interventions are needed to support outreach to key demographic groups.

Published
2020
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49. Symptoms, Sites, and Significance of Mycoplasma genitalium in Men Who Have Sex with Men.

Author

Read TRH, Murray GL, Danielewski JA, Fairley CK, Doyle M, Worthington K, Su J, Mokany E, Tan LT, Lee D, Vodstrcil LA, Chow EPF, Garland SM, Chen MY, and Bradshaw CS

Subjects
Anti-Bacterial Agents pharmacology, Australia epidemiology, Coinfection, Cross-Sectional Studies, Drug Resistance, Bacterial, Humans, Male, Mycoplasma Infections epidemiology, Mycoplasma Infections transmission, Odds Ratio, Prevalence, Public Health Surveillance, Sexually Transmitted Diseases, Bacterial epidemiology, Sexually Transmitted Diseases, Bacterial transmission, Symptom Assessment, Homosexuality, Male, Mycoplasma Infections diagnosis, Mycoplasma Infections microbiology, Mycoplasma genitalium drug effects, Sexually Transmitted Diseases, Bacterial diagnosis, Sexually Transmitted Diseases, Bacterial microbiology
Abstract

During 2016-2017, we tested asymptomatic men who have sex with men (MSM) in Melbourne, Australia, for Mycoplasma genitalium and macrolide resistance mutations in urine and anorectal swab specimens by using PCR. We compared M. genitalium detection rates for those asymptomatic men to those for MSM with proctitis and nongonococcal urethritis (NGU) over the same period. Of 1,001 asymptomatic MSM, 95 had M. genitalium; 84.2% were macrolide resistant, and 17% were co-infected with Neisseria gonorrhoeae or Chlamydia trachomatis. Rectal positivity for M. genitalium was 7.0% and urine positivity was 2.7%. M. genitalium was not more commonly detected in the rectums of MSM (n = 355, 5.6%) with symptoms of proctitis over the same period but was more commonly detected in MSM (n = 1,019, 8.1%) with NGU. M. genitalium is common and predominantly macrolide-resistant in asymptomatic MSM. M. genitalium is not associated with proctitis in this population.

Published
2019
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50. Outcomes of Resistance-guided Sequential Treatment of Mycoplasma genitalium Infections: A Prospective Evaluation.

Author

Read TRH, Fairley CK, Murray GL, Jensen JS, Danielewski J, Worthington K, Doyle M, Mokany E, Tan L, Chow EPF, Garland SM, and Bradshaw CS

Subjects
Adult, Anti-Bacterial Agents pharmacology, Female, Humans, Macrolides pharmacology, Male, Mycoplasma Infections microbiology, Prospective Studies, Treatment Outcome, Young Adult, Anti-Bacterial Agents therapeutic use, Drug Monitoring methods, Drug Resistance, Bacterial, Macrolides therapeutic use, Mycoplasma Infections drug therapy, Mycoplasma genitalium drug effects, Mycoplasma genitalium isolation & purification
Abstract

Background: Rising macrolide and quinolone resistance in Mycoplasma genitalium necessitate new treatment approaches. We evaluated outcomes of sequential antimicrobial therapy for M. genitalium guided by a macrolide-resistance assay., Methods: In mid-2016, Melbourne Sexual Health Centre switched from azithromycin to doxycycline (100 mg twice daily for 7 days) for nongonococcal urethritis, cervicitis, and proctitis. Cases were tested for M. genitalium and macrolide-resistance mutations (MRMs) by polymerase chain reaction. Directly after doxycycline, MRM-negative infections received 2.5 g azithromycin (1 g, then 500 mg daily for 3 days), and MRM-positive infections received sitafloxacin (100 mg twice daily for 7 days). Assessment of test of cure and reinfection risk occurred 14-90 days after the second antibiotic., Results: Of 244 evaluable M. genitalium infections (52 women, 68 heterosexual men, 124 men who have sex with men) diagnosed from 20 June 2016 to 15 May 2017, MRMs were detected in 167 (68.4% [95% confidence interval {CI}, 62.2%-74.2%]). Treatment with doxycycline decreased bacterial load by a mean 2.60 log10 (n = 56; P < .0001). Microbiologic cure occurred in 73 of 77 MRM-negative infections (94.8% [95% CI, 87.2%-98.6%]) and in 154 of 167 MRM-positive infections (92.2% [95% CI, 87.1%-95.8%]). Selection of macrolide resistance occurred in only 2 of 76 (2.6% [95% CI, .3%-9.2%]) macrolide-susceptible infections., Conclusions: In the context of high levels of antimicrobial resistance, switching from azithromycin to doxycycline for presumptive treatment of M. genitalium, followed by resistance-guided therapy, cured ≥92% of infections, with infrequent selection of macrolide resistance.

Published
2019
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