Prevalence and risk factors of Mycoplasma genitalium infection in patients attending a sexually transmitted infection clinic in Reunion Island: a cross-sectional study (2017–2018)

International audienceBackground: Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) for whose management remains controversial. We aimed to assess the prevalence and risk factors of MG infection in patients attending an STI clinic in Reunion Island. Methods: Between January 2017 and December 2018, all patients attending the Saint-Pierre STI clinic in Reunion Island were screened for MG, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Urogenital, pharyngeal and/or anal samples were collected based on sexual behaviour and analysed by triplex PCR. Risk factors were identified using a Poisson regression for binary outcome. Results: Among 2069 screened subjects, the overall prevalence of MG was 4.88% [95% Confidence Interval (CI) 3.98-5.93]. The prevalence of urogenital MG was 4.38%, with women being more affected than men (5.33% vs 3.22%, prevalence ratio (PR) 1.66, p = 0.02). The prevalence of anal MG was 3.06% and that of pharyngeal MG was 0.61%, with men being more affected in both cases. Infection with MG was independently associated with multiple partners (6-10 partners: adjusted prevalence ratio-aPR 2.55, p 10 partners: aPR 4.33, p < 0.004), previous history of STI (aPR 1.89, p = 0.026), non-use of condoms (aPR 2.56, p < 0.003) and co-infection with CT (aPR 2.56, p < 0.017). Conclusion: Compared to other countries, the prevalence of MG is high in Reunion Island, especially in women aged under 25 years, and co-infection with CT is common. Routine MG screening and treatment should be performed in at-risk women and co-infection with MG should be considered when deciding on treatment for CT, particularly in regions where azithromycin is still in use

Increased levels of soluble forms of E-selectin and ICAM-1 adhesion molecules during human leptospirosis

<div><p>Leptospirosis is a multisystemic zoonotic disease with infiltration of visceral organs by <i>Leptospira</i>. The capacity of the vascular endothelium to grant immune cell recruitment and activation in target organs during the disease course remains poorly characterized. We ascertained the levels of expression of several soluble cell adhesion molecules (CAM) notably expressed by endothelial cells in human leptospirosis. We prospectively enrolled 20 hospitalized patients and compared them to 10 healthy controls. Disease severity was defined by one or more organ failures, or death. Plasmatic concentrations of soluble CAM were assessed by multiplex bead assay at the time of patient presentation (M0) and 1 month after hospital discharge. The levels of soluble E-selectin (sCD62E) and soluble intercellular adhesion molecule 1 (sICAM-1, sCD53) were significantly increased in patients compared to controls (p<0.0001) and at 1 month (p<0.0001) with median values at 978 ng/ml (interquartile ranges 787–1164; sCD62E) and 1021 ng/ml (690–1428; sCD53). At M0, Soluble P-selectin level (sCD62P) was found to be decreased with levels at 60 ng/ml (0–631) versus 711 ng/ml (343–1113) for healthy controls (p<0.05). Levels of sICAM-3 (sCD50), sVCAM-1 (vascular cell adhesion molecule, sCD106) and sPECAM-1 (platelet endothelial cell adhesion molecule, sCD31) were not different from healthy subjects at M0. This study shows that two adhesion molecules, shed as soluble forms, are elevated during the acute phase of leptospirosis: E-selectin and s-ICAM1. These molecules may interfere with the process of immune cell recruitment to clear <i>Leptospira</i> at tissue levels.</p></div

Characteristics of leptospirosis patient group at admittance and comparison to healthy subjects.

<p>Characteristics of leptospirosis patient group at admittance and comparison to healthy subjects.</p

Levels of soluble E-selectin and soluble ICAM-1 are increased during the acute phase of human leptospirosis.

<p>Levels of soluble (shed) adhesion molecules are determined in patients and controls using multiplex microbeads array. Circles represent controls (n = 10), empty triangles: patients during acute phase (n = 20) and black triangles: patients at M1 convalescent phase (n = 10). The largest horizontal bars indicate the median value, upper and lower bars the interquartile ranges. Comparisons with non-parametric Mann-Whitney test. *, **, **** indicate P-value inferior to 0.05, 0.01 and 0.0001 respectively.</p

Distinct associations between shed adhesion molecules and organ injuries in 20 leptospirosis patients.

<p>Levels of soluble (shed) adhesion molecules are determined among leptospirosis M0 group (n = 20) using multiplex microbeads array. The largest horizontal bars indicate the median value, upper and lower bars the interquartile ranges. Comparisons with non-parametric Mann-Whitney test. * and ** indicate P-value inferior to 0.05 and 0.01 respectively. CPK = creatine phosphokinase; ULR = upper limit range.</p

Ophthalmic complications during the dengue epidemic in Reunion Island in 2020: a case series and review of the literature

Abstract Introduction Dengue is an arboviral disease transmitted by the dengue virus, whose vectors are Aedes aegypti and Aedes albopictus. The acute phase with its cohort of well-known symptoms is usually spontaneously favorable. Since 2020 in Reunion Island, a new symptom has appeared: the ocular damage of dengue fever, which has already been described in South Asia and South-East Asia. We therefore decided to describe the clinical, biological, ophthalmological, therapeutic, and outcomes of patients with ocular manifestations during dengue fever in Reunion Island in 2020. Patients and methods This was a retrospective observational study. Patients were included from January 2020 to August 2020 and then reassessed by teleconsultation 1 year later. The patients were identified from the French public health surveillance network by all ophthalmologists on the island. Medical data were collected directly from medical records. Results Twenty-eight patients were included. The mean age was 41.9 years. Ocular involvement occurred approximately 9.2 days after the onset of dengue symptoms. The main symptoms were scotoma (71.4%) and sudden decrease of visual acuity (39.2%). Eighteen patients (64.2%) had macular involvement. Fourteen patients were treated with oral or intravenous corticosteroids. Twenty-two (78.5%) patients were evaluated by telephone one year later. Scotoma and decreased visual acuity persisted in 15 patients. Thirteen patients (59%) were bothered by night driving, 32% of patients had reading difficulties and 27% of patients became sensitive to prolonged exposure to screens. Conclusion Ocular complications of dengue require early and collegial management to limit the risk of long-term sequelae. Further studies on the characteristics and complications of dengue fever are needed to better understand this disease

Circulating CXCL8 (interleukin 8) levels are not significantly elevated in leptospirosis cases.

<p>CXCL8 levels were assessed by ELISA of plasma from healthy control individuals (circles, n = 13) and leptospirosis cases (squares, n = 15). For leptospirosis cases, assessment was performed with sampling at hospital admittance corresponding to acute phase (M0), with PCR positive patients. Comparison between two groups with non-parametric Mann-Whitney U-test showed no significant difference.</p

Neutrophil levels at admittance and during the disease course of leptospirosis patients.

<p>(A) Counts of immune cells for healthy controls (circles) and leptospirosis patients (squares) at admittance (M0). (B) The maximal value of PMN count reached during hospital stay was compared between mild and severe forms. For A and B, the largest horizontal bars indicate the median value, upper and lower bars the interquartile ranges. Comparisons with non-parametric Mann-Whitney test. *, *** indicate P-value inferior to 0.05 and 0.0001 respectively. (C) Among the patients with leptospirosis, the maximal value of PMN was correlated to the maximal value of creatinine with Spearman test.</p