STIs Flashcards
reportable stis
chlamydia gonorrhea NGU/MPC syphilis HIV/AIDS LGV chancroid more than 70% of all reportable diseases in alberta are stis
non-reportable stis
genital warts (HPV) genital herpes (HSV) yeast infection B.V. (molluscum contagiosum) trichomoniasis crabs scabies
HPV and herpes
extremely common
about 70% of adults will have been exposed and infected with at some point
about 25% carry the herpes virus and only about 10% realize they have an infection
treatment recommendations for most non-reportable stis available in 2018 alberta treatment guidelines
what 2018 treatment guidelines has
outline treatment
follow ups
reporting responsibilities
supporting considerations and resources for process
chlamydia
obligate intracellular bacteria
requires columnar epithelial cells for reproduction
most common of the reportable stis
most infections are asymptomatic
symptoms of chlamydia
burning itching discomfort discharge pain and/or swelling in testicles friable cervix pelvic inflammatory disease
testing for chlamydia
appropriate to test 48 hours or more after a possible exposure
most common test is nucleic acid amplification testing (NAAT)
most often urine samples, vaginal swabs and/or cervical swabs
culture testing is still done for sexual assaults
treatment of chlamydia
ablerta has specific guidelines for all reportable stis
azithromycin (zithromax) 1gram as a single dose is the preferred first line medication for most infections
doxycycline 100mg twice a day for 7 days is now recommended for rectal infections of chlamydia
sti medication
provided for free by AHS sti services and are replaced when the notifiable disease report is received
gonorrhea
another common sti caused by a cocci style bacteria that always appears in pairs (diplococci)
block your immune system from creating immune memory
may be asymptomatic especially when infections occur in throat or rectum (more difficult to treat)
gonorrhea symptoms
purulent discharge painful urination lymphadenopathy pain and/or swelling in testicles pelvic inflammatory disease
testing for gonorrhea
appropriate to test 48 hours or more after a possible exposure
most common test is nucleic acid amplification testing (NAAT)
most often urine samples or cervical swabs
culture testing is still done to determine antibiotic resistance and for sexual assaults
treatment for gonorrhea
heterosexual/pregnant women = cefixime (suprax) 800mg PO plus azithromycin 1g PO as a single dose is preferred treatment
men who have sex with men = ceftriaxone 250mg IM plus azithromycin 1g PO as a single dose is the preferred treatment
starting to see cephalosporin resistance
what did we do before antibiotics
disseminated GC GC septic arthritis PID/Fitzhugh Curtis epididymitis infertility urethral structure months of pain
tests of cure
should be considered for all chlamydia and gonorrhea infections
if infection is found in a pregnant women and/or her partner a test of cure is required
if infection site is non-genital site a test of cure is also required
all tests of cure should be done 28 days after treatment is completed
stages of syphilis
primary (chancre)
secondary (rash, alopecia, bone pain , condyloma lata)
latent (asymptomatic)
tertiary (neurosyphilis, caridvascular, gummatous (benign late syphilis))
congenital
neurosyphilis
asymptomatic meningovascular general paresis of the insane tabes dorsalis gummatous neurosyphilis
syphilis diagnosis
clinical diagnosis
darkfield microscopy
serologic diagnosis (non-treponemal tests (RPR, VDRL), specifical treponemal tests (MHA-TP, FTA-ABS, TTPA, EIA, inno-LIA))
congenital syphilis
placenta infected during infectious stage
untreated primary or secondary syphilis in pregnancy infects 100% of fetuses and 40-50% result in premature delivery or perinatal death
in pre-antibiotic era 40% of still births were due to congenital syphilis
syphilis treatment
benzathine penicillin
what can we do with this knowledge
see trends (assessment) check assumptions (hypothesize) figure out what and where we can do better (plan) act (implement) evaluate
plan
find gaps and changes
look for patterns and new outbreaks
mitigate risk of spread
educate/relationship building
improved compliance and positive re-enforcement
support the front line work
engage community partners and reduce duplication
evaluate
how did things go this time
are we seeing/experiencing changes
prevention
risk reduction
get tested regularly
condoms or other barrier methods
know you partners
