O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)
Identifieur interne : 000623 ( Istex/Corpus ); précédent : 000622; suivant : 000624O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)
Auteurs : D. Mallikarachchi ; L. Hodson ; C. Duckett ; G. Weerasinghe ; K. Buddhakorale ; M. Mcclure ; G. Taylor ; C. TippleSource :
- Sexually Transmitted Infections [ 1368-4973 ] ; 2013-07.
English descriptors
- KwdEn :
- Teeft :
Abstract
Background The bacterium Treponema pallidum ( T. pallidum) causes syphilis. Penicillin is effective treatment, but azithromycin (a macrolide) is a single-dose oral alternative for those with allergy. Unfortunately, macrolide resistance secondary to one of two 23S ribosomal RNA (rRNA) point mutations (A2058G and A2059G) is now wide-spread. Molecular strain-typing suggests that epidemics and macrolide resistance are unlikely the spread of single clones. We present typing and macrolide resistance data from two geographically distinct populations: Colombo, Sri Lanka and London, UK. Methods Cross-sectional studies were conducted at the Colombo District STD clinics and St Mary’s Hospital, London. Ulcer exudate and/or blood were collected from patients with microbiologically confirmed syphilis. Presence of T. pallidum DNA ( tpp047 gene) was confirmed with PCR. Next, using published techniques, the 23SrRNAgene was PCR-amplified for a point-mutation assay and tpp0548, arp and tprE,G& Jamplicons were used for strain-typing. Results Sri Lanka: 24 T. pallidum PCR-positive samples were collected. Patients were men (45.9% MSM) and 91.6% Sinhalese with a mean age of 28 (range 29). None were HIV-1 infected. Two strain types were discovered (14b/f and 13b/f), neither harbouring macrolide resistance. London: 43 men were recruited, 18 in 2006–8 and 25 in 2011–12. Mean age was 37.5 (range 43); 95.2% were MSM and 62.8% were HIV-1 infected. Half (22/43) were white British. A total of 5 full and 14 partial strain types were identified, of which 6 were unique. Macrolide resistance increased from 66.7%(12/18) in 2006–8 to 80%(20/25) in 2011–12. Conclusion Colombo T. pallidumstrains have limited diversity with no macrolide resistance. London strains are more varied and increasingly macrolide-resistant. Ethnic diversity in London exceeds Colombo’s and may explain increased strain diversity. In contrast to Sri Lanka, azithromycin is widely used to treat Chlamydia and non-specific urethritis in the UK thus selection pressure may be driving macrolide resistance.
Url:
DOI: 10.1136/sextrans-2013-051184.0208
Links to Exploration step
ISTEX:8E4C004D62B8DA37B3DB67788B37960128AC9E49Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title><author><name sortKey="Mallikarachchi, D" sort="Mallikarachchi, D" uniqKey="Mallikarachchi D" first="D" last="Mallikarachchi">D. Mallikarachchi</name><affiliation><mods:affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</mods:affiliation></affiliation></author><author><name sortKey="Hodson, L" sort="Hodson, L" uniqKey="Hodson L" first="L" last="Hodson">L. Hodson</name><affiliation><mods:affiliation>Imperial College Healthcare NHS Trust, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Duckett, C" sort="Duckett, C" uniqKey="Duckett C" first="C" last="Duckett">C. Duckett</name><affiliation><mods:affiliation>Imperial College Healthcare NHS Trust, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Weerasinghe, G" sort="Weerasinghe, G" uniqKey="Weerasinghe G" first="G" last="Weerasinghe">G. Weerasinghe</name><affiliation><mods:affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</mods:affiliation></affiliation></author><author><name sortKey="Buddhakorale, K" sort="Buddhakorale, K" uniqKey="Buddhakorale K" first="K" last="Buddhakorale">K. Buddhakorale</name><affiliation><mods:affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</mods:affiliation></affiliation></author><author><name sortKey="Mcclure, M" sort="Mcclure, M" uniqKey="Mcclure M" first="M" last="Mcclure">M. Mcclure</name><affiliation><mods:affiliation>Imperial College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Taylor, G" sort="Taylor, G" uniqKey="Taylor G" first="G" last="Taylor">G. Taylor</name><affiliation><mods:affiliation>Imperial College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Tipple, C" sort="Tipple, C" uniqKey="Tipple C" first="C" last="Tipple">C. Tipple</name><affiliation><mods:affiliation>Imperial College London, London, UK</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:8E4C004D62B8DA37B3DB67788B37960128AC9E49</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/sextrans-2013-051184.0208</idno><idno type="url">https://api.istex.fr/document/8E4C004D62B8DA37B3DB67788B37960128AC9E49/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000623</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000623</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title><author><name sortKey="Mallikarachchi, D" sort="Mallikarachchi, D" uniqKey="Mallikarachchi D" first="D" last="Mallikarachchi">D. Mallikarachchi</name><affiliation><mods:affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</mods:affiliation></affiliation></author><author><name sortKey="Hodson, L" sort="Hodson, L" uniqKey="Hodson L" first="L" last="Hodson">L. Hodson</name><affiliation><mods:affiliation>Imperial College Healthcare NHS Trust, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Duckett, C" sort="Duckett, C" uniqKey="Duckett C" first="C" last="Duckett">C. Duckett</name><affiliation><mods:affiliation>Imperial College Healthcare NHS Trust, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Weerasinghe, G" sort="Weerasinghe, G" uniqKey="Weerasinghe G" first="G" last="Weerasinghe">G. Weerasinghe</name><affiliation><mods:affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</mods:affiliation></affiliation></author><author><name sortKey="Buddhakorale, K" sort="Buddhakorale, K" uniqKey="Buddhakorale K" first="K" last="Buddhakorale">K. Buddhakorale</name><affiliation><mods:affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</mods:affiliation></affiliation></author><author><name sortKey="Mcclure, M" sort="Mcclure, M" uniqKey="Mcclure M" first="M" last="Mcclure">M. Mcclure</name><affiliation><mods:affiliation>Imperial College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Taylor, G" sort="Taylor, G" uniqKey="Taylor G" first="G" last="Taylor">G. Taylor</name><affiliation><mods:affiliation>Imperial College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Tipple, C" sort="Tipple, C" uniqKey="Tipple C" first="C" last="Tipple">C. Tipple</name><affiliation><mods:affiliation>Imperial College London, London, UK</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Sexually Transmitted Infections</title><title level="j" type="abbrev">Sex Transm Infect</title><idno type="ISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-07">2013-07</date><biblScope unit="volume">89</biblScope><biblScope unit="issue">Suppl 1</biblScope><biblScope unit="page" from="A68">A68</biblScope></imprint><idno type="ISSN">1368-4973</idno></series><idno type="istex">8E4C004D62B8DA37B3DB67788B37960128AC9E49</idno><idno type="DOI">10.1136/sextrans-2013-051184.0208</idno><idno type="href">sextrans-89-A68-2.pdf</idno><idno type="ArticleID">sextrans-2013-051184.0208</idno><idno type="local">sextrans;89/Suppl_1/A68-b</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1368-4973</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Active syphilis</term><term>Ambedkar center</term><term>Antibiotic</term><term>Antimicrobial resistance</term><term>Biomedical research</term><term>Colombo</term><term>Lanka</term><term>Macrolide</term><term>Macrolide resistance</term><term>Midwife</term><term>Mtrr</term><term>Mutant</term><term>Mutant mtrr</term><term>Mutation</term><term>Pallidum</term><term>Pregnant women</term><term>Syphilis</term><term>Wild type</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Active syphilis</term><term>Ambedkar center</term><term>Antibiotic</term><term>Antimicrobial resistance</term><term>Biomedical research</term><term>Colombo</term><term>Lanka</term><term>Macrolide</term><term>Macrolide resistance</term><term>Midwife</term><term>Mtrr</term><term>Mutant</term><term>Mutant mtrr</term><term>Mutation</term><term>Pallidum</term><term>Pregnant women</term><term>Syphilis</term><term>Wild type</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The bacterium Treponema pallidum ( T. pallidum) causes syphilis. Penicillin is effective treatment, but azithromycin (a macrolide) is a single-dose oral alternative for those with allergy. Unfortunately, macrolide resistance secondary to one of two 23S ribosomal RNA (rRNA) point mutations (A2058G and A2059G) is now wide-spread. Molecular strain-typing suggests that epidemics and macrolide resistance are unlikely the spread of single clones. We present typing and macrolide resistance data from two geographically distinct populations: Colombo, Sri Lanka and London, UK. Methods Cross-sectional studies were conducted at the Colombo District STD clinics and St Mary’s Hospital, London. Ulcer exudate and/or blood were collected from patients with microbiologically confirmed syphilis. Presence of T. pallidum DNA ( tpp047 gene) was confirmed with PCR. Next, using published techniques, the 23SrRNAgene was PCR-amplified for a point-mutation assay and tpp0548, arp and tprE,G& Jamplicons were used for strain-typing. Results Sri Lanka: 24 T. pallidum PCR-positive samples were collected. Patients were men (45.9% MSM) and 91.6% Sinhalese with a mean age of 28 (range 29). None were HIV-1 infected. Two strain types were discovered (14b/f and 13b/f), neither harbouring macrolide resistance. London: 43 men were recruited, 18 in 2006–8 and 25 in 2011–12. Mean age was 37.5 (range 43); 95.2% were MSM and 62.8% were HIV-1 infected. Half (22/43) were white British. A total of 5 full and 14 partial strain types were identified, of which 6 were unique. Macrolide resistance increased from 66.7%(12/18) in 2006–8 to 80%(20/25) in 2011–12. Conclusion Colombo T. pallidumstrains have limited diversity with no macrolide resistance. London strains are more varied and increasingly macrolide-resistant. Ethnic diversity in London exceeds Colombo’s and may explain increased strain diversity. In contrast to Sri Lanka, azithromycin is widely used to treat Chlamydia and non-specific urethritis in the UK thus selection pressure may be driving macrolide resistance.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>syphilis</json:string><json:string>mtrr</json:string><json:string>macrolide</json:string><json:string>pallidum</json:string><json:string>macrolide resistance</json:string><json:string>lanka</json:string><json:string>colombo</json:string><json:string>mutant</json:string><json:string>mutation</json:string><json:string>active syphilis</json:string><json:string>mutant mtrr</json:string><json:string>wild type</json:string><json:string>biomedical research</json:string><json:string>ambedkar center</json:string><json:string>antimicrobial resistance</json:string><json:string>pregnant women</json:string><json:string>midwife</json:string><json:string>antibiotic</json:string></teeft></keywords><author><json:item><name>D Mallikarachchi</name><affiliations><json:string>National Centre for STD/AIDS Control, Colombo, Sri Lanka</json:string></affiliations></json:item><json:item><name>L Hodson</name><affiliations><json:string>Imperial College Healthcare NHS Trust, London, UK</json:string></affiliations></json:item><json:item><name>C Duckett</name><affiliations><json:string>Imperial College Healthcare NHS Trust, London, UK</json:string></affiliations></json:item><json:item><name>G Weerasinghe</name><affiliations><json:string>National Centre for STD/AIDS Control, Colombo, Sri Lanka</json:string></affiliations></json:item><json:item><name>K Buddhakorale</name><affiliations><json:string>National Centre for STD/AIDS Control, Colombo, Sri Lanka</json:string></affiliations></json:item><json:item><name>M McClure</name><affiliations><json:string>Imperial College London, London, UK</json:string></affiliations></json:item><json:item><name>G Taylor</name><affiliations><json:string>Imperial College London, London, UK</json:string></affiliations></json:item><json:item><name>C Tipple</name><affiliations><json:string>Imperial College London, London, UK</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>antibiotic resistance</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sri Lanka</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Syphilis</value></json:item></subject><articleId><json:string>sextrans-2013-051184.0208</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>abstract</json:string></originalGenre><abstract>Background The bacterium Treponema pallidum ( T. pallidum) causes syphilis. Penicillin is effective treatment, but azithromycin (a macrolide) is a single-dose oral alternative for those with allergy. Unfortunately, macrolide resistance secondary to one of two 23S ribosomal RNA (rRNA) point mutations (A2058G and A2059G) is now wide-spread. Molecular strain-typing suggests that epidemics and macrolide resistance are unlikely the spread of single clones. We present typing and macrolide resistance data from two geographically distinct populations: Colombo, Sri Lanka and London, UK. Methods Cross-sectional studies were conducted at the Colombo District STD clinics and St Mary’s Hospital, London. Ulcer exudate and/or blood were collected from patients with microbiologically confirmed syphilis. Presence of T. pallidum DNA ( tpp047 gene) was confirmed with PCR. Next, using published techniques, the 23SrRNAgene was PCR-amplified for a point-mutation assay and tpp0548, arp and tprE,G& Jamplicons were used for strain-typing. Results Sri Lanka: 24 T. pallidum PCR-positive samples were collected. Patients were men (45.9% MSM) and 91.6% Sinhalese with a mean age of 28 (range 29). None were HIV-1 infected. Two strain types were discovered (14b/f and 13b/f), neither harbouring macrolide resistance. London: 43 men were recruited, 18 in 2006–8 and 25 in 2011–12. Mean age was 37.5 (range 43); 95.2% were MSM and 62.8% were HIV-1 infected. Half (22/43) were white British. A total of 5 full and 14 partial strain types were identified, of which 6 were unique. Macrolide resistance increased from 66.7%(12/18) in 2006–8 to 80%(20/25) in 2011–12. Conclusion Colombo T. pallidumstrains have limited diversity with no macrolide resistance. London strains are more varied and increasingly macrolide-resistant. Ethnic diversity in London exceeds Colombo’s and may explain increased strain diversity. In contrast to Sri Lanka, azithromycin is widely used to treat Chlamydia and non-specific urethritis in the UK thus selection pressure may be driving macrolide resistance.</abstract><qualityIndicators><score>4.961</score><pdfVersion>1.5</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>2068</abstractCharCount><pdfWordCount>961</pdfWordCount><pdfCharCount>6195</pdfCharCount><pdfPageCount>1</pdfPageCount><abstractWordCount>300</abstractWordCount></qualityIndicators><title>O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title><genre><json:string>abstract</json:string></genre><host><title>Sexually Transmitted Infections</title><language><json:string>unknown</json:string></language><issn><json:string>1368-4973</json:string></issn><eissn><json:string>1472-3263</json:string></eissn><publisherId><json:string>sextrans</json:string></publisherId><volume>89</volume><issue>Suppl 1</issue><pages><first>A68</first></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>infectious diseases</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>public health & health services</json:string><json:string>public health</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string><json:string>nephrologie. maladies des voies urinaires</json:string></inist></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1136/sextrans-2013-051184.0208</json:string></doi><id>8E4C004D62B8DA37B3DB67788B37960128AC9E49</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/8E4C004D62B8DA37B3DB67788B37960128AC9E49/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/8E4C004D62B8DA37B3DB67788B37960128AC9E49/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8E4C004D62B8DA37B3DB67788B37960128AC9E49/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title><respStmt><resp>Références bibliographiques récupérées via GROBID</resp><name resp="ISTEX-API">ISTEX-API (INIST-CNRS)</name></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>© 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</p></availability><date>2013-07-13</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title><author xml:id="author-1" corresp="yes"><persName><forename type="first">D</forename><surname>Mallikarachchi</surname></persName><affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</affiliation></author><author xml:id="author-2"><persName><forename type="first">L</forename><surname>Hodson</surname></persName><affiliation>Imperial College Healthcare NHS Trust, London, UK</affiliation></author><author xml:id="author-3"><persName><forename type="first">C</forename><surname>Duckett</surname></persName><affiliation>Imperial College Healthcare NHS Trust, London, UK</affiliation></author><author xml:id="author-4"><persName><forename type="first">G</forename><surname>Weerasinghe</surname></persName><affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</affiliation></author><author xml:id="author-5"><persName><forename type="first">K</forename><surname>Buddhakorale</surname></persName><affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</affiliation></author><author xml:id="author-6"><persName><forename type="first">M</forename><surname>McClure</surname></persName><affiliation>Imperial College London, London, UK</affiliation></author><author xml:id="author-7"><persName><forename type="first">G</forename><surname>Taylor</surname></persName><affiliation>Imperial College London, London, UK</affiliation></author><author xml:id="author-8"><persName><forename type="first">C</forename><surname>Tipple</surname></persName><affiliation>Imperial College London, London, UK</affiliation></author></analytic><monogr><title level="j">Sexually Transmitted Infections</title><title level="j" type="abbrev">Sex Transm Infect</title><idno type="pISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-07"></date><biblScope unit="volume">89</biblScope><biblScope unit="issue">Suppl 1</biblScope><biblScope unit="page" from="A68">A68</biblScope></imprint></monogr><idno type="istex">8E4C004D62B8DA37B3DB67788B37960128AC9E49</idno><idno type="DOI">10.1136/sextrans-2013-051184.0208</idno><idno type="href">sextrans-89-A68-2.pdf</idno><idno type="ArticleID">sextrans-2013-051184.0208</idno><idno type="local">sextrans;89/Suppl_1/A68-b</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013-07-13</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background The bacterium Treponema pallidum ( T. pallidum) causes syphilis. Penicillin is effective treatment, but azithromycin (a macrolide) is a single-dose oral alternative for those with allergy. Unfortunately, macrolide resistance secondary to one of two 23S ribosomal RNA (rRNA) point mutations (A2058G and A2059G) is now wide-spread. Molecular strain-typing suggests that epidemics and macrolide resistance are unlikely the spread of single clones. We present typing and macrolide resistance data from two geographically distinct populations: Colombo, Sri Lanka and London, UK. Methods Cross-sectional studies were conducted at the Colombo District STD clinics and St Mary’s Hospital, London. Ulcer exudate and/or blood were collected from patients with microbiologically confirmed syphilis. Presence of T. pallidum DNA ( tpp047 gene) was confirmed with PCR. Next, using published techniques, the 23SrRNAgene was PCR-amplified for a point-mutation assay and tpp0548, arp and tprE,G& Jamplicons were used for strain-typing. Results Sri Lanka: 24 T. pallidum PCR-positive samples were collected. Patients were men (45.9% MSM) and 91.6% Sinhalese with a mean age of 28 (range 29). None were HIV-1 infected. Two strain types were discovered (14b/f and 13b/f), neither harbouring macrolide resistance. London: 43 men were recruited, 18 in 2006–8 and 25 in 2011–12. Mean age was 37.5 (range 43); 95.2% were MSM and 62.8% were HIV-1 infected. Half (22/43) were white British. A total of 5 full and 14 partial strain types were identified, of which 6 were unique. Macrolide resistance increased from 66.7%(12/18) in 2006–8 to 80%(20/25) in 2011–12. Conclusion Colombo T. pallidumstrains have limited diversity with no macrolide resistance. London strains are more varied and increasingly macrolide-resistant. Ethnic diversity in London exceeds Colombo’s and may explain increased strain diversity. In contrast to Sri Lanka, azithromycin is widely used to treat Chlamydia and non-specific urethritis in the UK thus selection pressure may be driving macrolide resistance.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>antibiotic resistance</term></item><item><term>Sri Lanka</term></item><item><term>Syphilis</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2013-07-13">Created</change><change when="2013-07">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2017-01-19">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/8E4C004D62B8DA37B3DB67788B37960128AC9E49/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="abstract" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">sextrans</journal-id><journal-id journal-id-type="nlm-ta">Sex Transm Infect</journal-id><journal-id journal-id-type="publisher-id">sextrans</journal-id><journal-title>Sexually Transmitted Infections</journal-title><abbrev-journal-title abbrev-type="publisher">Sex Transm Infect</abbrev-journal-title><abbrev-journal-title>Sex Transm Infect</abbrev-journal-title><issn pub-type="ppub">1368-4973</issn><issn pub-type="epub">1472-3263</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">sextrans-2013-051184.0208</article-id><article-id pub-id-type="doi">10.1136/sextrans-2013-051184.0208</article-id><article-id pub-id-type="other">sextrans;89/Suppl_1/A68-b</article-id><article-id pub-id-type="other">sextrans;sextrans-2013-051184.0208</article-id><article-id pub-id-type="other">A68.2</article-id><article-id pub-id-type="other">sextrans-2013-051184.0208</article-id><article-categories><subj-group subj-group-type="heading"><subject>O.21 - Antimicrobial resistance mechanisms in STI pathogens</subject></subj-group></article-categories><title-group><article-title>O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" xlink:type="simple"><name name-style="western"><surname>Mallikarachchi</surname><given-names>D</given-names></name><xref ref-type="aff" rid="AF0001"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hodson</surname><given-names>L</given-names></name><xref ref-type="aff" rid="AF0002"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Duckett</surname><given-names>C</given-names></name><xref ref-type="aff" rid="AF0002"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Weerasinghe</surname><given-names>G</given-names></name><xref ref-type="aff" rid="AF0001"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Buddhakorale</surname><given-names>K</given-names></name><xref ref-type="aff" rid="AF0001"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>McClure</surname><given-names>M</given-names></name><xref ref-type="aff" rid="AF0003"><sup>3</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Taylor</surname><given-names>G</given-names></name><xref ref-type="aff" rid="AF0003"><sup>3</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Tipple</surname><given-names>C</given-names></name><xref ref-type="aff" rid="AF0003"><sup>3</sup></xref></contrib></contrib-group><aff id="AF0001"><sup>1</sup>National Centre for STD/AIDS Control, Colombo, Sri Lanka</aff><aff id="AF0002"><sup>2</sup>Imperial College Healthcare NHS Trust, London, UK</aff><aff id="AF0003"><sup>3</sup>Imperial College London, London, UK</aff><pub-date pub-type="ppub"><month>07</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>13</day><month>7</month><year>2013</year></pub-date><volume>89</volume><volume-id pub-id-type="other">89</volume-id><volume-id pub-id-type="other">89</volume-id><issue>Suppl 1</issue><issue-id pub-id-type="other">sextrans;89/Suppl_1</issue-id><issue-id pub-id-type="other" content-type="supplement">Suppl_1</issue-id><issue-id pub-id-type="other">89/Suppl_1</issue-id><issue-title>STI & AIDS World Congress 2013 July 14-17 Vienna, Austria</issue-title><fpage seq="2">A68</fpage><permissions><copyright-statement>© 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="sextrans-89-A68-2.pdf"></self-uri><abstract><sec><title>Background</title><p>The bacterium <italic> Treponema pallidum</italic> (<italic> T. pallidum</italic>) causes syphilis. Penicillin is effective treatment, but azithromycin (a macrolide) is a single-dose oral alternative for those with allergy. Unfortunately, macrolide resistance secondary to one of two 23S ribosomal RNA (rRNA) point mutations (A2058G and A2059G) is now wide-spread. Molecular strain-typing suggests that epidemics and macrolide resistance are unlikely the spread of single clones.</p><p>We present typing and macrolide resistance data from two geographically distinct populations: Colombo, Sri Lanka and London, UK.</p></sec><sec><title>Methods</title><p>Cross-sectional studies were conducted at the Colombo District STD clinics and St Mary’s Hospital, London. Ulcer exudate and/or blood were collected from patients with microbiologically confirmed syphilis. Presence of <italic> T. pallidum</italic> DNA (<italic> tpp047</italic> gene) was confirmed with PCR. Next, using published techniques, the <italic> 23SrRNA</italic>gene was PCR-amplified for a point-mutation assay and <italic> tpp0548</italic>, <italic> arp</italic> and <italic> tprE,G</italic>&<italic> J</italic>amplicons were used for strain-typing.</p></sec><sec><title>Results</title><p>Sri Lanka: 24 <italic> T. pallidum</italic> PCR-positive samples were collected. Patients were men (45.9% MSM) and 91.6% Sinhalese with a mean age of 28 (range 29). None were HIV-1 infected. Two strain types were discovered (14b/f and 13b/f), neither harbouring macrolide resistance.</p><p>London: 43 men were recruited, 18 in 2006–8 and 25 in 2011–12. Mean age was 37.5 (range 43); 95.2% were MSM and 62.8% were HIV-1 infected. Half (22/43) were white British. A total of 5 full and 14 partial strain types were identified, of which 6 were unique. Macrolide resistance increased from 66.7%(12/18) in 2006–8 to 80%(20/25) in 2011–12.</p></sec><sec><title>Conclusion</title><p>Colombo<italic> T. pallidum</italic>strains have limited diversity with no macrolide resistance. London strains are more varied and increasingly macrolide-resistant. Ethnic diversity in London exceeds Colombo’s and may explain increased strain diversity. In contrast to Sri Lanka, azithromycin is widely used to treat Chlamydia and non-specific urethritis in the UK thus selection pressure may be driving macrolide resistance.</p></sec></abstract><kwd-group><kwd>antibiotic resistance</kwd><kwd>Sri Lanka</kwd><kwd>Syphilis</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">D</namePart><namePart type="family">Mallikarachchi</namePart><affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L</namePart><namePart type="family">Hodson</namePart><affiliation>Imperial College Healthcare NHS Trust, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Duckett</namePart><affiliation>Imperial College Healthcare NHS Trust, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G</namePart><namePart type="family">Weerasinghe</namePart><affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K</namePart><namePart type="family">Buddhakorale</namePart><affiliation>National Centre for STD/AIDS Control, Colombo, Sri Lanka</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">McClure</namePart><affiliation>Imperial College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G</namePart><namePart type="family">Taylor</namePart><affiliation>Imperial College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Tipple</namePart><affiliation>Imperial College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="abstract" displayLabel="abstract"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2013-07</dateIssued><dateCreated encoding="w3cdtf">2013-07-13</dateCreated><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Background The bacterium Treponema pallidum ( T. pallidum) causes syphilis. Penicillin is effective treatment, but azithromycin (a macrolide) is a single-dose oral alternative for those with allergy. Unfortunately, macrolide resistance secondary to one of two 23S ribosomal RNA (rRNA) point mutations (A2058G and A2059G) is now wide-spread. Molecular strain-typing suggests that epidemics and macrolide resistance are unlikely the spread of single clones. We present typing and macrolide resistance data from two geographically distinct populations: Colombo, Sri Lanka and London, UK. Methods Cross-sectional studies were conducted at the Colombo District STD clinics and St Mary’s Hospital, London. Ulcer exudate and/or blood were collected from patients with microbiologically confirmed syphilis. Presence of T. pallidum DNA ( tpp047 gene) was confirmed with PCR. Next, using published techniques, the 23SrRNAgene was PCR-amplified for a point-mutation assay and tpp0548, arp and tprE,G& Jamplicons were used for strain-typing. Results Sri Lanka: 24 T. pallidum PCR-positive samples were collected. Patients were men (45.9% MSM) and 91.6% Sinhalese with a mean age of 28 (range 29). None were HIV-1 infected. Two strain types were discovered (14b/f and 13b/f), neither harbouring macrolide resistance. London: 43 men were recruited, 18 in 2006–8 and 25 in 2011–12. Mean age was 37.5 (range 43); 95.2% were MSM and 62.8% were HIV-1 infected. Half (22/43) were white British. A total of 5 full and 14 partial strain types were identified, of which 6 were unique. Macrolide resistance increased from 66.7%(12/18) in 2006–8 to 80%(20/25) in 2011–12. Conclusion Colombo T. pallidumstrains have limited diversity with no macrolide resistance. London strains are more varied and increasingly macrolide-resistant. Ethnic diversity in London exceeds Colombo’s and may explain increased strain diversity. In contrast to Sri Lanka, azithromycin is widely used to treat Chlamydia and non-specific urethritis in the UK thus selection pressure may be driving macrolide resistance.</abstract><subject><genre>keywords</genre><topic>antibiotic resistance</topic><topic>Sri Lanka</topic><topic>Syphilis</topic></subject><relatedItem type="host"><titleInfo><title>Sexually Transmitted Infections</title></titleInfo><titleInfo type="abbreviated"><title>Sex Transm Infect</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1368-4973</identifier><identifier type="eISSN">1472-3263</identifier><identifier type="PublisherID">sextrans</identifier><identifier type="PublisherID-hwp">sextrans</identifier><identifier type="PublisherID-nlm-ta">Sex Transm Infect</identifier><part><date>2013</date><detail type="title"><title>STI & AIDS World Congress 2013 July 14-17 Vienna, Austria</title></detail><detail type="volume"><caption>vol.</caption><number>89</number></detail><detail type="issue"><caption>no.</caption><number>Suppl 1</number></detail><extent unit="pages"><start>A68</start></extent></part></relatedItem><identifier type="istex">8E4C004D62B8DA37B3DB67788B37960128AC9E49</identifier><identifier type="DOI">10.1136/sextrans-2013-051184.0208</identifier><identifier type="href">sextrans-89-A68-2.pdf</identifier><identifier type="ArticleID">sextrans-2013-051184.0208</identifier><identifier type="local">sextrans;89/Suppl_1/A68-b</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000623 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 000623 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaGhanaV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:8E4C004D62B8DA37B3DB67788B37960128AC9E49
|texte= O21.6 A Tale of Two Cities: Treponema Pallidum Macrolide Resistance in Colombo (Sri Lanka) and London (United Kingdom)
}}
| This area was generated with Dilib version V0.6.31. |  |