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151. O08.2 Sexual behaviour, risk and sexually transmitted infections before and after the introduction of the PrEP impact trial

Author

Turner, Katy, primary, Harryman, Lindsey, additional, Speare, Nathan, additional, Horner, Paddy, additional, MacGregor, Louis, additional, Horwood, Jeremy, additional, Kesten, Jo, additional, Gardiner, Rebecca, additional, North, Paul, additional, Muir, Peter, additional, Vickerman, Peter, additional, Gompels, Mark, additional, May, Margaret, additional, and Nicholls, Jane, additional

Published
2019
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155. No widespread dissemination of Chlamydia trachomatisdiagnostic-escape variants and the impact of Neisseria gonorrhoeaepositivity on the Aptima Combo 2 assay

Author

Cole, Michelle Jayne, Davis, Grahame S, Fifer, Helen, Saunders, John Michael, Unemo, Magnus, Hadad, Ronza, Roberts, David J, Fazal, Mohammed, Day, Michaela Joanne, Minshull, Jack, Muir, Peter, Horner, Paddy J, Gill, Noel O, and Folkard, Kate

Abstract

ObjectivesA Finnish Chlamydia trachomatis(CT) new variant was detected in 2019 that escaped detection in the Hologic Aptima Combo 2 (AC2) assay due to a C1515T mutation in the CT 23S rRNA target region. Reflex testing of CT-negative/CT-equivocal specimens as well as those positive for Neisseria gonorrhoeae(NG) with the Hologic Aptima CT (ACT) assay was recommended to identify any CT variants.MethodsFrom June to October 2019, specimens with discrepant AC2/ACT CT results were submitted to Public Health England and screened for detectable CT DNA using an inhouse real-time (RT)-PCR. When enough DNA was present, partial CT 23S rRNA gene sequencing was performed. Analysis of available relative light units and interpretative data was performed.ResultsA total of 317 discordant AC2/ACT specimens were collected from 315 patients. Three hundred were tested on the RT-PCR; 53.3% (n=160) were negative and 46.7% (n=140) were positive. Due to low DNA load in most specimens, sequencing was successful for only 36 specimens. The CT 23S rRNA wild-type sequence was present in 32 specimens, and two variants with C1514T or G1523A mutation were detected in four specimens from three patients. Of the discordant specimens with NG interpretation, 36.6% of NG-negative/CT-negative AC2 specimens had detectable CT DNA on the inhouse RT-PCR vs 53.3% of NG-positive/CT-negative specimens.ConclusionsNo widespread dissemination of AC2 diagnostic-escape CT variants has occurred in England. We however identified the impact of NG positivity on the discordant AC2/ACT specimens; a proportion appeared due to NG positivity and the associated NG signal, rather than any diagnostic-escape variants or low DNA load. Several patients with gonorrhoea may therefore receive false-negative AC2 CT results. Single diagnostic targets and multiplex diagnostic assays have their limitations such as providing selection pressure for escape mutants and potentially reduced sensitivity, respectively. These limitations must be considered when establishing diagnostic pathways.

Published
2022
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156. Relationship between microbiology of throat swab and clinical course among primary care patients with acute cough: a prospective cohort study.

Author

Ordóñez-Mena, José M, Fanshawe, Thomas R, Butler, Chris C, Mant, David, Longhurst, Denise, Muir, Peter, Vipond, Barry, Little, Paul, Moore, Michael, Stuart, Beth, Hay, Alastair D, Thornton, Hannah V, Thompson, Matthew J, Smith, Sue, Bruel, Ann Van den, Hardy, Victoria, Cheah, Laikin, Crook, Derrick, Knox, Kyle, and Van den Bruel, Ann

Subjects
NUCLEIC acid amplification techniques, PRIMARY care, RESPIRATORY infections, LONGITUDINAL method, COHORT analysis, COUGH, ANTIBIOTICS, PHARYNX, RESEARCH, VIRUSES, RESEARCH methodology, REGRESSION analysis, MEDICAL cooperation, EVALUATION research, PRIMARY health care, COMPARATIVE studies, RESEARCH funding, BACTERIAL diseases, BACTERIA
Abstract

Background: Acute lower respiratory tract infections (ALRTIs) account for most antibiotics prescribed in primary care despite lack of efficacy, partly due to clinician uncertainty about aetiology and patient concerns about illness course. Nucleic acid amplification tests could assist antibiotic targeting.Methods: In this prospective cohort study, 645 patients presenting to primary care with acute cough and suspected ALRTI, provided throat swabs at baseline. These were tested for respiratory pathogens by real-time polymerase chain reaction and classified as having a respiratory virus, bacteria, both or neither. Three hundred fifty-four participants scored the symptoms severity daily for 1 week in a diary (0 = absent to 4 = severe problem).Results: Organisms were identified in 346/645 (53.6%) participants. There were differences in the prevalence of seven symptoms between the organism groups at baseline. Those with a virus alone, and those with both virus and bacteria, had higher average severity scores of all symptoms combined during the week of follow-up than those in whom no organisms were detected [adjusted mean differences 0.204 (95% confidence interval 0.010 to 0.398) and 0.348 (0.098 to 0.598), respectively]. There were no differences in the duration of symptoms rated as moderate or severe between organism groups.Conclusions: Differences in presenting symptoms and symptoms severity can be identified between patients with viruses and bacteria identified on throat swabs. The magnitude of these differences is unlikely to influence management. Most patients had mild symptoms at 7 days regardless of aetiology, which could inform patients about likely symptom duration. [ABSTRACT FROM AUTHOR]

Published
2020
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159. Use of a platelet-rich plasma-collagen scaffold as a bioenhanced repair treatment for management of partial cruciate ligament rupture in dogs

Author

Sample, Susannah J., primary, Racette, Molly A., additional, Hans, Eric C., additional, Volstad, Nicola J., additional, Schaefer, Susan L., additional, Bleedorn, Jason A., additional, Little, Jeffrey P., additional, Waller, Kenneth R., additional, Hao, Zhengling, additional, Block, Walter F., additional, and Muir, Peter, additional

Published
2018
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165. The Effects of LAIV on Nasopharyngeal Bacteria in Healthy 2-4 Year Olds:a Randomized Controlled Trial

Author

Thors, Valtyr, Christensen, Hannah, Morales-Aza, Begonia, Vipond, Ian, Muir, Peter, and Finn, Adam H R

Subjects
Live attenuated influenza vaccine, Bacterial colonization, Children, Bacterial density
Abstract

Rationale: Viral infections of the upper respiratory tract may influence the commensal nasopharyngeal bacteria. Changes in the bacterial niche could affect transmission dynamics. Attenuated vaccine viruses can be used to investigate this empirically in humans. Methods: We used trivalent Live Attenuated Influenza Vaccine (LAIV) to evaluate the effects of viral infection on bacterial carriage and density of S.pneumoniae, M.catarrhalis, H.influenzae and S.aureus. 151 healthy children were randomized 1:1 to receive the vaccine starting either at recruitment (n=74) or 28 days later (n=77) in a stepped wedge fashion, allowing comparisons between recipients and non-recipients as well as whole-group comparisons pre- and post- vaccination. Bacterial carriage and density were determined using qPCR assays. Measurement & Main Results: 151 children were recruited, 77 in the LAIV group and 74 controls. LAIV recipients (n=63 analysed) showed an apparent transient increase in H.influenzae carriage but no further significant differences in carriage prevalence of the four bacterial species compared to controls (n=72 analyzed). S.pneumoniae density was substantially higher in vaccine recipients (16687 vs 1935 GC/ml) 28 days after the first dose (p

Published
2016
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166. Additional file 1: of Hepatitis C â Assessment to Treatment Trial (HepCATT) in primary care: study protocol for a cluster randomised controlled trial

Author

Roberts, Kirsty, Macleod, John, Metcalfe, Chris, Simon, Joanne, Horwood, Jeremy, Hollingworth, William, Marlowe, Sharon, Gordon, Fiona, Muir, Peter, Coleman, Barbara, Vickerman, Peter, Harrison, Graham, Cherry-Ann Waldron, Irving, William, and Hickman, Matthew

Abstract

HepCATT study algorithm (Read codes). (DOC 118Â kb)

Published
2016
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167. Additional file 2: of Hepatitis C â Assessment to Treatment Trial (HepCATT) in primary care: study protocol for a cluster randomised controlled trial

Author

Roberts, Kirsty, Macleod, John, Metcalfe, Chris, Simon, Joanne, Horwood, Jeremy, Hollingworth, William, Marlowe, Sharon, Gordon, Fiona, Muir, Peter, Coleman, Barbara, Vickerman, Peter, Harrison, Graham, Cherry-Ann Waldron, Irving, William, and Hickman, Matthew

Abstract

SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 121 kb)

Published
2016
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168. Gordon Matta-Clark? Conical Intersect : 'Sculpture, Space, and the Cultural Value of Urban Imagery '

Author

Muir, Peter and Muir, Peter

Abstract

In this in-depth analysis, Peter Muir argues that Gordon Matta-Clark?s Conical Intersect (1975) is emblematic of Henri Lefebvre?s understanding of art?s function in relation to urban space. By engaging with Lefebvre?s theory in conjunction with the perspectives of other writers, such as Michel de Certeau, Jacques Derrida, and George Bataille, the book elicits a story that presents the artwork?s significance, origins and legacies. Conical Intersect is a multi-media artwork, which involves the intersections of architecture, sculpture, film, and photography, as well as being a three-dimensional model that reflects aspects of urban, art, and architectural theory, along with a number of cultural and historiographic discourses which are still present and active. This book navigates these many complex narratives by using the central?hole? of Conical Intersect as its focal point: this apparently vacuous circle around which the events, documents, and other historical or theoretical references surrounding Matta-Clark?s project, are perpetually in circulation. Thus, Conical Intersect is imagined as an insatiable absence around which discourses continually form, dissipate and resolve. Muir argues that Conical Intersect is much more than an?artistic hole.? Due to its location at Plateau Beaubourg in Paris, it is simultaneously an object of art and an instrument of social critique.

Published
2014

172. Cross-sectional study to evaluate Trichomonas vaginalis positivity in women tested for Neisseria gonorrhoeae and Chlamydia trachomatis, attending genitourinary medicine and primary care clinics in Bristol, South West England

Author

Nicholls, Jane E, primary, Turner, Katy M E, additional, North, Paul, additional, Ferguson, Ralph, additional, May, Margaret T, additional, Gough, Karen, additional, Macleod, John, additional, Muir, Peter, additional, and Horner, Patrick J, additional

Published
2017
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174. Radiographic and magnetic resonance imaging predicts severity of cruciate ligament fiber damage and synovitis in dogs with cranial cruciate ligament rupture

Author

Sample, Susannah J., primary, Racette, Molly A., additional, Hans, Eric C., additional, Volstad, Nicola J., additional, Holzman, Gerianne, additional, Bleedorn, Jason A., additional, Schaefer, Susan L., additional, Waller, Kenneth R., additional, Hao, Zhengling, additional, Block, Walter F., additional, and Muir, Peter, additional

Published
2017
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176. Genome-wide association analysis in dogs implicates 99 loci as risk variants for anterior cruciate ligament rupture

Author

Baker, Lauren A., primary, Kirkpatrick, Brian, additional, Rosa, Guilherme J. M., additional, Gianola, Daniel, additional, Valente, Bruno, additional, Sumner, Julia P., additional, Baltzer, Wendy, additional, Hao, Zhengling, additional, Binversie, Emily E., additional, Volstad, Nicola, additional, Piazza, Alexander, additional, Sample, Susannah J., additional, and Muir, Peter, additional

Published
2017
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178. Throat swabs in children with respiratory tract infection: associations with clinical presentation and potential targets for point-of-care testing

Author

Thornton, Hannah V, primary, Hay, Alastair D, additional, Redmond, Niamh M, additional, Turnbull, Sophie L, additional, Christensen, Hannah, additional, Peters, Tim J, additional, Leeming, John P, additional, Lovering, Andrew, additional, Vipond, Barry, additional, Muir, Peter, additional, and Blair, Peter S, additional

Published
2017
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180. The Long Haul.

Author

MUIR, PETER

Subjects
ESPRESSO
Published
2020

182. Outcome in 12 Dogs with Chronic Radiographic Cranial Tibial Subluxation after Tibial Plateau Leveling Osteotomy (2019-2021)

Author

M. Harrison, Jacqueline and Muir, Peter

Abstract

Objective. The objective of this study was to examine outcomes in dogs with cruciate ligament rupture (CR) that had chronic radiographic cranial tibial subluxation at the time of osteotomy healing after tibial plateau leveling osteotomy (TPLO). Study Design. Retrospective case analysis of 12 dogs with prospective follow-up. Four of the 12 dogs were prospectively studied 12-24 months after surgery to assess long-term radiographic and clinical outcomes. Results. Three of the 4 dogs showed improvement in radiographic cranial tibial subluxation at long-term follow-up. In the other dog, minimally improved cranial tibial subluxation was associated with severe lameness. At long-term follow-up, gait analysis in 3 dogs with improved subluxation showed the symmetry of weight-bearing within 10% for peak vertical force, and no clinically lameness. Preoperative tibial plateau angle (TPA) and radiographic osteoarthritis in dogs with prospective follow-up and all dogs treated with TPLO surgery in the study period were not significantly different. Conclusion. Dogs with chronic radiographic cranial tibial subluxation are acceptable candidates for TPLO. Radiographic improvement in stifle reduction may take more than 10 weeks. The dog with long-term persistent subluxation also had a higher TPA over time, suggestive of ineffective surgical correction with TPLO and treatment failure.

Published
2024
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185. Density Distribution of Pharyngeal Carriage of Meningococcus in Healthy Young Adults

Author

Finn, Adam, primary, Morales-Aza, Begonia, additional, Sikora, Paulina, additional, Giles, Jessica, additional, Lethem, Ryan, additional, Marlais, Matko, additional, Thors, Valtyr, additional, Pollard, Andrew J., additional, Faust, Saul, additional, Heath, Paul, additional, Vipond, Ian, additional, Ferreira, Muriel, additional, Muir, Peter, additional, Januário, Luís, additional, and Rodrigues, Fernanda, additional

Published
2016
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187. Autologous Bone Marrow-Derived Mesenchymal Stem Cells Modulate Molecular Markers of Inflammation in Dogs with Cruciate Ligament Rupture

Author

Muir, Peter, primary, Hans, Eric C., additional, Racette, Molly, additional, Volstad, Nicola, additional, Sample, Susannah J., additional, Heaton, Caitlin, additional, Holzman, Gerianne, additional, Schaefer, Susan L., additional, Bloom, Debra D., additional, Bleedorn, Jason A., additional, Hao, Zhengling, additional, Amene, Ermias, additional, Suresh, M., additional, and Hematti, Peiman, additional

Published
2016
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189. Hepatitis C – Assessment to Treatment Trial (HepCATT) in primary care: study protocol for a cluster randomised controlled trial

Author

Roberts, Kirsty, primary, Macleod, John, additional, Metcalfe, Chris, additional, Simon, Joanne, additional, Horwood, Jeremy, additional, Hollingworth, William, additional, Marlowe, Sharon, additional, Gordon, Fiona H., additional, Muir, Peter, additional, Coleman, Barbara, additional, Vickerman, Peter, additional, Harrison, Graham I., additional, Waldron, Cherry-Ann, additional, Irving, William, additional, and Hickman, Matthew, additional

Published
2016
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192. Cross-sectional study to evaluate positivity in women tested for and , attending genitourinary medicine and primary care clinics in Bristol, South West England.

Author

Nicholls, Jane E., Turner, Katy M. E., North, Paul, Ferguson, Ralph, May, Margaret T., Gough, Karen, Macleod, John, Muir, Peter, and Horner, Patrick J.

Abstract

Background: Highly sensitive, commercial nucleic acid amplification tests (NAAT) for Trichomonas vaginalis have only recently been recommended for use in the UK. While testing for T. vaginalis is routine in symptomatic women attending genitourinary medicine (GUM) clinics, it is rare in asymptomatic women or those attending primary care. The aim of this study was to evaluate the positivity of T. vaginalis using a commercial NAAT, in symptomatic and asymptomatic women undergoing testing for chlamydia and gonorrhoea in GUM and primary care settings.Methods: Samples from 9186 women undergoing chlamydia and gonorrhoea testing in South West England between May 2013 and Jan 2015 were also tested for T. vaginalis by NAAT alongside existing tests.Results: T. vaginalis positivity using NAAT was as follows: in GUM 4.5% (24/530, symptomatic) and 1.7% (27/1584, asymptomatic); in primary care 2.7% (94/3499, symptomatic) and 1.2% (41/3573, asymptomatic). Multivariable regression found that in GUM older age, black ethnicity and deprivation were independent risk factors for T. vaginalis infection. Older age and deprivation were also risk factors in primary care. Testing women presenting with symptoms in GUM and primary care using TV NAATs is estimated to cost £260 per positive case diagnosed compared with £716 using current microbiological tests.Conclusions: Aptima TV outperforms existing testing methods used to identify T. vaginalis infection in this population. An NAAT should be used when testing for T. vaginalis in women who present for testing with symptoms in primary care and GUM, based on test performance and cost. [ABSTRACT FROM AUTHOR]

Published
2018
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193. Which azithromycin regimen should be used for treating ? A meta-analysis.

Author

Horner, Patrick, Ingle, Suzanne M., Garrett, Frederick, Blee, Karla, Kong, Fabian, Muir, Peter, and Moi, Harald

Subjects
ANTIBIOTICS, DNA, DRUG resistance in microorganisms, MACROLIDE antibiotics, META-analysis, MYCOPLASMA, MYCOPLASMA diseases, AZITHROMYCIN, TREATMENT effectiveness, GENOTYPES, PHARMACODYNAMICS, THERAPEUTICS
Abstract

Background: There is increasing evidence that azithromycin 1 g is driving the emergence of macrolide resistance in Mycoplasma genitalium worldwide. We undertook a meta-analysis of M. genitalium treatment studies using azithromycin 1 g single dose and azithromycin 500 mg on day 1 then 250 mg daily for 4 days (5-day regimen) to determine rates of treatment failure and resistance in both regimens.Methods: The online databases PubMed and Medline were searched using terms "Mycoplasma genitalium", "macrolide" or "azithromycin" and "resistance" up to April 2016. Studies were eligible if they: used azithromycin 1 g or 5 days, assessed patients for macrolide resistant genetic mutations prior to treatment and patients who failed were again resistance genotyped. Random effects meta-analysis was used to estimate failure and resistance rates.Results: Eight studies were identified totalling 435 patients of whom 82 (18.9%) had received the 5-day regimen. The random effects pooled rate of treatment failure and development of macrolide antimicrobial resistance mutations with azithromycin 1 g was 13.9% (95% CI 7.7% to 20.1%) and 12.0% (7.1% to 16.9%), respectively. Of individuals treated with the 5-day regimen, with no prior doxycycline treatment, fewer (3.7%; 95% CI 0.8% to 10.3%, p=0.012) failed treatment, all of whom developed resistance (p=0.027).Conclusion: Azithromycin 1 g is associated with high rates of treatment failure and development of macrolide resistance in M. genitalium infection with no pre-existing macrolide mutations. There is moderate but conflicting evidence that the 5-day regimen may be more effective and less likely to cause resistance. [ABSTRACT FROM AUTHOR]

Published
2018
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