(P365) Etiological molecular identification of sexually transmitted infections that cause urethral discharge and genital ulcer in Brazilian men: a nationwide study.

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Maria Luiza Bazzo, Ph.D (she/her/hers)

Professor
Molecular Biology, Microbiology and Serology Laboratory (LBMMS), Federal University of Santa Catarina, Santa Catarina, Brazil

Co-author(s)

Hd

Hanalydia de Melo Machado, M.Sc

Molecular Biology, Microbiology, and Serology Laboratory (LBMMS), Federal University of Santa Catarina, Florianopolis, Brazil, United States
JM

Jessica Motta Martins

Molecular Biology, Microbiology, and Serology Laboratory (LBMMS), Federal University of Santa Catarina, Florianopolis, Brazil, United States
Marcos A. Schörner, Ph.D

Pharmacist
Molecular Biology, Microbiology, and Serology Laboratory (LBMMS), Federal University of Santa Catarina, Florianopolis, Brazil
Florianópolis, Santa Catarina, Brazil
KB

Ketlyn Buss

Pharmacist
Federal University of Santa Catarina, United States
Fernando Hartmann Barazzetti

Biologist
Molecular Biology, Microbiology, and Serology Laboratory (LBMMS), Federal University of Santa Catarina, Bioinformatics Laboratory, Postgraduate Program in Biotechnology and Biosciences, Federal University of Santa Catarina, Florianopolis, Brazil
Florianopolis, Brazil
Pamela Cristina Gaspar, MSc

Technical Consultant
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health/ Public Health Postgraduate Program at Brasília University
Brasilia, Distrito Federal, Brazil
�B

Álisson Bigolin, Ph.D

Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
Angélica E. Miranda, MD, PhD (she/her/hers)

Coordinator
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health
Brasilia, Brazil

Background: Epidemiological data on the etiology of urethral discharge (UD) syndrome and genital ulcers (GU) is scarce in Brazil due to limited access to tests and in general treatment is based on the syndromic approach. This first nationwide etiological study for UD and GU was performed to update Brazilian treatment guidelines according to the current scenario.

Methods: Male participants with UD and/or GU complaints attended by twelve representative sentinel sites were enrolled. Between 2018-2020, a total of 1,129 UD and 209 GU samples were collected in a UTM-RT medium (Copan). A multiplex qPCR kit (Seegene) was used to detect UD: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Ureaplasma parvum (UP), Ureaplasma urealyticum (UU) and another kit to detect GU: Cytomegalovirus (CMV), Haemophilus ducreyi (HD), Herpes simplex virus type 1 (HSV1), Herpes simplex virus type 2 (HSV2), Lymphogranuloma venereum (LGV), Treponema pallidum (TP), Varicella-zoster virus (VZV).

Results: In UD samples, NG was the pathogen found most frequently, corresponding to 78.38% (885/1,129) of the samples. Pathogens detected frequency were CT: 25.59%, MG: 8.32%, UU: 10.36%, UP: 3.45%, MH: 3.45%, and TV: 0.88%. Co-infection was assessed in 30.90% of samples. NG/CT co-infection was assessed in 14.26% of samples. The most frequent pathogen identified in GU was HSV2, present in 40.77% of the samples followed by TP at 24.75%, LGV and CMV at 0.97%, and HSV1 at 0.48%. In 27.66% of the samples, no pathogen was detected. Co-infection of TP/HSV2 was detected in nine samples. VZV and HD were not detected.

Conclusion: This study provided the acquisition of unprecedented nationwide data on the etiology of UD and GU in Brazil and demonstrated the presence of a variety of pathogens in both samples, and reaffirmed the etiologies known to be most prevalent globally. This experience also reinforces the importance of decentralizing testing to increase the etiological approach in the country.