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2.  Non-specific vaginitis. 
PMCID: PMC1046203  PMID: 6871656
3.  Sheffield medium for cultivation of Haemophilus ducreyi. 
Our interest in the role of Haemophilus ducreyi in genital ulceration led us to examine the various media commonly used for the cultivation of the organism. We describe an improved medium for the routine isolation of H ducreyi. In comparative studies using 50 test strains originally isolated in the United Kingdom, Canada, the United States of America, and Kenya, the new medium proved superior to three standard media in requiring a shorter incubation period to first visible growth, giving larger colonies in the same period, and making possible a starch aggregation test which we have found helpful in the presumptive identification of H ducreyi from clinical material.
PMCID: PMC1046300  PMID: 6610455
4.  Anaerobes in genitourinary infections in men. 
Urethral and sub-preputial swabs from 150 men were examined. There was a strong association between the isolation of anaerobic bacteria, particularly Bacteroides spp, and a clinical diagnosis of balanoposthitis, non-specific urethritis (NSU), or both. Aerobic bacteria formed the predominant flora in 28 healthy controls whereas anaerobes were predominant in specimens from 79 patients with balanoposthitis, from 24 with NSU, and from 19 with both. Bacteroides spp were the commonest isolates in all patient groups; B asaccharolyticus, B melaninogenicus ss intermedius, B ureolyticus, and B bivius were the most common species. The results obtained with the two swabs were identical except that Gardnerella vaginalis was isolated from the urethral swab only in five patients.
PMCID: PMC1046195  PMID: 6871653
5.  Pathogenic microbial flora of genital ulcers in Sheffield with particular reference to herpes simplex virus and Haemophilus ducreyi. 
The pathogenic microbial flora of genital ulcers in 161 (80 men and 81 women) unselected patients was studied prospectively. In only one case was Treponema pallidum responsible whereas herpes simplex virus was considered to be the cause of 130 (80.8%) genital ulcers. H ducreyi was isolated from 46 (28.6%) patients, most commonly as a secondary pathogen in herpetic lesions. Two or more pathogens were isolated from the ulcers in 67 (41.6%) patients, and in 21 (13%) patients no pathogens were isolated. Our results indicate an urgent need for antiviral treatment to reduce the local reservoir of genital herpes, challenge traditional concepts about the prevalence of H ducreyi in Britain, and call for a reappraisal of its role in the causation of genital ulcers.
PMCID: PMC1046106  PMID: 6293639
7.  Balanoposthitis associated with Gardnerella vaginalis infection in men. 
Fourteen of 194 (7.2%) consecutive unselected men had positive culture results from genital swabs for Gardnerella vaginalis. A higher yield of isolates was obtained from preputial (93%) than from urethral swabs (64%). Of the 14 men, two had no detectable genital abnormality, eight non-gonococcal urethritis, and nine balanoposthitis. The urethral isolation rates for G vaginalis in men with and without non-gonococcal urethritis were not significantly different, but preputial isolation rates were significantly higher (p less than 0.001) in men with balanoposthitis than in those without. The prevalence rate for G vaginalis in men with non-candidal balanoposthitis was 31%. In a second study, concomitant Bacteroides species were isolated in preputial swabs from nine of 12 (75%) men with G vaginalis-associated balanoposthitis and may play a role in its pathogenesis.
PMCID: PMC1046023  PMID: 6978164
8.  Incidence of herpes simplex virus types 1 and 2 isolated in patients with herpes genitalis in Sheffield. 
Thirty-one strains of herpesvirus (HSV), isolated from patients presenting with the clinical features of herpes genitalis, were typed by polypeptide analysis of virus proteins in sodium dodecyl sulphate polyacrylamide gels. Nineteen (61.3%) of the isolates were shown to be HSV type 1 and 12 (38.7%) HSV type 2. There was no obvious difference in the incidence of HSV-1 in primary or recurrent infections and no apparent correlation between the genital site of isolation and virus type. The high incidence of genital HSV-1 infection in this group of patients is probably due to the increased practice of oro-genital contact and has possible implications for the future development of drugs and vaccines in the control of genital herpes.
PMCID: PMC1045999  PMID: 6275940
9.  Chancroid in Sheffield. A report of 22 cases diagnosed by isolating Haemophilus ducreyi in a modified medium. 
The causative organism of chancroid, Haemophilus ducreyi, is generally considered to be very fastidious and its isolation, maintenance, and detailed study very demanding. In this study a modified medium was developed, which allowed the organism to be isolated more frequently than previously would have been expected. Twenty-two cases of chancroid were confirmed by the isolation of H ducreyi in 160 patients with genital ulceration examined over a one-year period. The cases were apparently unrelated, and in only five was there a history of recent sexual contact abroad. Concurrent infection with other sexually transmitted diseases was present in 18 (81.8%) patients, and in 14 (63.6%) both H ducreyi and herpes simplex virus were isolated form the same genital ulcers. Thus, these findings indicate that chancroid is underdiagnosed in England and that H ducreyi may frequently occur as a secondary invader of damaged genital skin and mucosa.
PMCID: PMC1045980  PMID: 6976815
10.  Oral contraceptive use and prevalence of infection with Chlamydia trachomatis in women. 
One thousand eight non-pregnant women aged 16-34 years, presenting for the first time at a clinic for sexually transmitted diseases (STD), were examined and screened for infection with Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Candida species. The respective prevalence rates were 21.1%, 20.7%, 13.4%, and 27.8%. Isolation rates for C trachomatis, either occurring alone or in association with other genital infections, were significantly greater in women using oral contraceptive agents. This was not because oral contraceptive users were more promiscuous. The findings strengthen the case for providing a routine chlamydial culture service for women attending STD clinics. They also indicate that the likelihood of chlamydial infection in women taking oral contraceptives is increased.
PMCID: PMC1045914  PMID: 7237082
11.  Prevalence of rectal and pharyngeal infection in women with gonorrhoea in Sheffield. 
The prevalence of gonococcal infection of the rectum and pharynx in 239 consecutive women with gonorrhoea presenting as named contacts was 47% and 10% respectively. In 2% of all patients the rectum and pharynx were each the sole sites of infection. Treatment failure occurred in three patients given a single dose of aqueous procaine penicillin 2.4 megaunits intramuscularly, two of whom had rectal infections; no treatment failures occurred in patients with pharyngeal infections. The incidence of rectal gonorrhoea significantly increased with the duration of infection (P less than 0.001). This suggests that autoinoculation from infected vaginal material is of major importance in the transmission of gonococcal infection to the rectum.
PMCID: PMC1045698  PMID: 526843
12.  Postgonococcal urethritis. Relationship to penicillin sensitivity of the gonococcus. 
Postgonococcal urethritis (PGU) occurred in 69 (21.3%) of 344 men with urethral gonorrhoea. Each case of gonorrhoea was treated with intramuscular procaine penicillin 2.4 megaunits and the penicillin sensitivity was determined. All 69 of the isolates from patients with PGU were fully sensitive to penicillin (IC50 less than 0.08 iu penicillin per ml). Twenty-eight (10.2%) of 275 cases of gonorrhoea which were not followed by PGU were relatively resistant to penicillin. The persistence of gonococcal L-forms is therefore not likely to be a main cause of PGU. An incidental finding was that significantly more of the 69 men who developed PGU had a history of non-specific urethritis compared with the 224 men who fully recovered (P less than 0.01).
PMCID: PMC1046372  PMID: 416877

Results 1-12 (12)