33 Matching Annotations
  1. May 2017
    1. Pharyngitis — Gonococcal infection of the pharynx is usually acquired by oral sexual exposure [42]; it is acquired more efficiently by fellatio than by cunnilingus [27,42]. Based on studies of women presenting to sexually transmitted infection (STI) clinics, the prevalence of pharyngeal gonorrhea has been estimated at two to six percent [43,44]. In a study of over 14,000 men who have sex with men (MSM) presenting to STI clinics in the United States, eight percent tested positive for pharyngeal gonococcal infection [34].The majority of oropharyngeal infections with N. gonorrhoeae are asymptomatic, although sore throat, pharyngeal exudates, and/or cervical lymphadenitis are present in some cases. In a study of 192 men and women seeking care for sore throat in a general medicine setting, one percent overall had a positive throat culture for N. gonorrhoeae [45]. Although bacterial concentrations in the pharynx are generally lower than in the rectum and genitals, the pharynx is thought to be the site where horizontal transfer of gonococcal antimicrobial resistance genes commonly occurs [46].

      could be useful during the case assessment

    1. All isolates were sensitive to vancomycin, ofloxacin, ampicillin, ciprofloxacin, nitrofurantoin and penicillin. However, the following number of clinical isolates exhibited intermediate or decreased sensitivity, nine (17%) to ampicillin, eight (15%) to penicillin, 14 (32%) to ciprofloxacin and one (2%) to nitrofurantoin. Thirty-one percent of the isolates were resistant to azithromycin and ceftriaxone, 19% to clindamycin, 15% to cefazolin and 13% to cefamandole. Eighteen (35%) of the clinical isolates tested were resistant to 6 of the 12 antibiotics tested.

      Antibiotic Resistance

    1. The proportions of GBS isolates with in vitro resistance to clindamycin or erythromycin have increased over the past 20 years. The prevalence of resistance among invasive GBS isolates in the United States ranged from 25% to 32% for erythromycin and from 13% to 20% for clindamycin in reports published during 2006–2009 (19,106,108).

      Antibiotic resistance prevalence

    1. During a group B strep test, your health care provider will swab your vagina and rectum and send the samples to a lab for testing. In some cases, you might receive instructions on how to collect the samples yourself. Because you can test positive at certain times and negative at other times, you'll need to repeat the group B strep test each time you're pregnant.

      lab test -- probably a culture

    1. Because the gastrointestinal tract is a primary source of this organism, the appropriate specimens for culture are a vaginal swab and a rectal swab. The specimens should be cultured using a selective enrichment broth.

      how to culture GBS

    1. Primary advantages over an ampicillin-gentamicincombination are its narrower spectrum of antimicrobial activity and lower cost. However, high doses of penicillin G must be used for the treatment of Group B streptococcal disease for two reasons. First, the MIC of penicillin G for Group B Streptococcus is relatively high, 4-10 fold greater (range 0.01-0.4 µg/ml) than that for group A streptococcal strains

      Antibiotic treatment for Strep B