SCREENING FOR ASYMPTOMATIC STDS AND STAPHYLOCOCCUS CARRIAGE IN HIV INFECTED MEN

筛查艾滋病毒感染男性中的无症状性传播疾病和葡萄球菌携带情况

• 批准号: 7376078
• 负责人: GUNTER RIEG
• 金额: $ 0.68万
• 依托单位: LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376078
• 关键词: SCREENING; ASYMPTOMATIC; STDS; STAPHYLOCOCCUS; CARRIAGE

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Sexually transmitted diseases (STDs) have been shown to be increasing, particularly in men who have sex with men (MSM). The presence of STDs correlates with unsafe sexual practices in the community and can contribute to HIV transmission. Moreover, there is an increasing frequency of asymptomatic infections with gonorrhea and Chlamydia. Consequently, recent Centers of Disease Control and Prevention (CDC) STD guidelines recommend assessment of sexual risk, client centered prevention, and STD screening to include testing of urethral, pharyngeal and rectal sites in at-risk MSM. It is suggested that screening be performed at least annually, and more frequently in those considered to be at the highest risk. Since there are few data regarding how to define the optimal frequency for screening and what group constitutes those at the highest risk, the guidelines are primarily on expert opinion. Our study will explore these issues by studying HIV-infected MSM over time to determine how often new cases of asymptomatic infection are identified and whether there are select groups whose behaviors predict that they are at the greatest risk for STDs. To assess the risk for HIV transmission in asymptomatic STDs, we will measure the HIV load in genital secretion in patients with asymptomatic STD before and after therapy. The second part of the study will focus on asymptomatic colonization of Methicillin resistant Staphylococcus aureaus (MRSA) colonization in the nasal cavity. Recently there have been increases locally and nationally of antibiotic (methicillin)-resistant Staphylococcus aureus (MRSA) infections among men who have sex with men. These MRSA infections appear to be possibly more serious and contagious than typical S. aureus infections. Additionally, there ar edata suggesting that transmission from person to person among MSM occurs in a similar fashion to sexually transmitted diseases. It is suspected that Staphylococcus aureus (S. aureus) and MRSA infections occur after nasal colonization with S. aureus established. However, little is known about the persistence of S. aureus colonization in the nose. To better understand the prevalence of S. aureus and MRSA nasal colonization among MSM, its acquisition and its persistence, we will perform a longitudinal survey of nasal colonization with S. aureus in noses of patients. At each study visit, participants will undergo nasal swabbing of both nostrils and these swabs will be tested for the presence of S. aureus bacteria and the presence of drug-resistant S. aureus/MRSA. Additionally, these S. aureus isolates will be tested for strain type to see if the strains colonizing a patient persist in the same patient or are replaced with other S. aureus strains and to understand the relatedness of the local strains of S. aureus among different persons. Additionally, we will ask the participants to donate blood and serum samples for future testing. The field of infections is developing rapidly. Newly recognized pathogens are likely to be discovered as well as known pathogen will become clinically significant in the future. Stored blood and serum sample from participants of this longitudinal study will be very valuable in the future to answer questions regarding prevalence and incidence of potential new infections.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。性传播疾病（STD）已被证明在增加，特别是在男男性行为者（MSM）中。性传播疾病的存在与社区中不安全的性行为有关，并可能导致艾滋病毒的传播。此外，淋病和衣原体无症状感染的频率越来越高。因此，最近的疾病控制和预防中心（CDC）STD指南建议评估性风险，以客户为中心的预防和STD筛查，包括在高危MSM的尿道，咽和直肠部位的测试。建议至少每年进行一次筛查，并且在被认为风险最高的人群中更频繁。由于关于如何确定筛查的最佳频率以及哪些人群构成最高风险人群的数据很少，因此指南主要是专家意见。 我们的研究将探讨这些问题，通过研究艾滋病毒感染的男男性行为者随着时间的推移，以确定如何经常发现新的无症状感染病例，以及是否有选择的群体，其行为预测他们是在最大的风险性病。为了评估无症状性传播疾病中艾滋病毒传播的风险，我们将测量治疗前后无症状性传播疾病患者生殖器分泌物中的艾滋病毒载量。研究的第二部分将重点关注鼻腔中耐甲氧西林金黄色葡萄球菌（MRSA）定植的无症状定植。最近，在地方和全国范围内，男男性行为者中耐抗生素（甲氧西林）金黄色葡萄球菌（MRSA）感染的人数有所增加。这些MRSA感染似乎比典型的S.金黄色葡萄球菌感染此外，有数据表明，男男性行为者之间的人与人之间的传播方式与性传播疾病相似。怀疑金黄色葡萄球菌（S.金黄色葡萄球菌）和MRSA感染发生在用S.金黄色葡萄球菌建立。然而，对S的持久性知之甚少。金黄色葡萄球菌在鼻内定植。为了更好地了解S.金黄色葡萄球菌和MRSA鼻腔定植的MSM，它的收购和它的持久性，我们将进行纵向调查鼻腔定植与S。患者鼻内金黄色葡萄球菌。在每次研究访视时，受试者将接受两个鼻孔的鼻拭子，这些拭子将用于检测是否存在S。金黄色葡萄球菌和耐药S.金黄色葡萄球菌/MRSA。此外，这些S。将对金黄色葡萄球菌分离株进行菌株类型检测，以确定在患者体内定植的菌株是否在同一患者体内持续存在或被其他金黄色葡萄球菌取代。金黄色葡萄球菌菌株，并了解本地菌株的相关性。金黄色葡萄球菌在不同的人。 此外，我们将要求参与者捐献血液和血清样本用于未来的测试。感染领域发展迅速。新认识的病原体很可能会被发现，以及已知的病原体将成为临床意义的未来。这项纵向研究参与者储存的血液和血清样本在未来对于回答有关潜在新感染的患病率和发生率的问题将非常有价值。