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Phenotypic and genetic characterisation of bacterial sexually transmitted infections in Bissau, Guinea-Bissau, West Africa: a prospective cohort study
Jönköping University, School of Health Science. Univ Orebro, Sch Hlth & Med Sci, Orebro, Sweden.
Lund Univ, Dept Clin Sci, Infect Dis Res Unit, Malmo, Sweden.
Natl Publ Hlth Lab LNSP, Bissau, Guinea Bissau.
Natl Publ Hlth Lab LNSP, Bissau, Guinea Bissau.
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2012 (English)In: BMJ Open, ISSN 2044-6055, Vol. 2, no 2, e000636- p.Article in journal (Refereed) Published
Abstract [en]

Background: Knowledge regarding characteristics and transmission of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium and antibiotic resistance in N gonorrhoeae in Guinea-Bissau, West Africa, is entirely lacking. Objectives: To characterise N gonorrhoeae, C trachomatis and M genitalium samples from Guinea-Bissau and to define bacterial populations, possible transmission chains and for N gonorrhoeae spread of antibiotic-resistant isolates. Design: Prospective cohort study. Setting: Two sexual health and family planning clinics, Bissau, Guinea-Bissau. Participants: Positive samples from 711 women and 27 men. Material and methods: Positive samples for N gonorrhoeae (n=31), C trachomatis (n=60) and M genitalium (n=30) were examined. The gonococcal isolates were characterised with antibiograms, serovar determination and N gonorrhoeae multiantigen sequence typing (NG-MAST). The C trachomatis ompA gene and the M genitalium mgpB gene were sequenced, and phylogenetic analyses were performed. Results: For N gonorrhoeae, the levels of resistance (intermediate susceptibility) to ciprofloxacin, erythromycin, rifampicin, ampicillin, tetracycline, penicillin G and cefuroxime were 10% (0%), 6% (10%), 13% (10%), 68% (0%), 74% (0%), 68% (16%) and 0% (84%), respectively. All isolates were susceptible to cefixime, ceftriaxone, spectinomycin and azithromycin, and the minimum inhibitory concentrations of kanamycin (range: 8-32 mg/l) and gentamicin (range: 0.75-6 mg/I) were low (no resistance breakpoints exist for these antimicrobials). 19 NC-MAST sequence types (STs) (84% novel STs) were identified. Phylogenetic analysis of the C trachomatis ompA gene revealed genovar G as most prevalent (37%), followed by genovar D (19%). 23 mgpB STs were found among the M genitalium isolates, and 67% of isolates had unique STs. Conclusions: The diversity among the sexually transmitted infection (STI) pathogens may be associated with suboptimal diagnostics, contact tracing, case reporting and epidemiological surveillance. In Guinea-Bissau, additional STI studies are vital to estimate the STI burden and form the basis for a national sexual health strategy for prevention, diagnosis and surveillance of STIs.

Place, publisher, year, edition, pages
2012. Vol. 2, no 2, e000636- p.
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Medical and Health Sciences
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URN: urn:nbn:se:hj:diva-22036DOI: 10.1136/bmjopen-2011-000636ISI: 000315042100037Local ID: HHJövrigtISOAI: oai:DiVA.org:hj-22036DiVA: diva2:650966
Available from: 2013-09-24 Created: 2013-09-24 Last updated: 2013-09-24Bibliographically approved

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