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Article ; Online: Randomized Multicenter Trial for the Validation of an Easy to Administer Algorithm to Define Penicillin Allergy Status in Sexually Transmitted Infection Clinic Outpatients.

Lillis, Rebecca A / Barbee, Lindley A / McNeil, Candice J / Newman, Lori / Fortenberry, J Dennis / Alvarez-Arango, Santiago / Zenilman, Jonathan M

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2024

Abstract: Background: Approximately 15% of patients in sexually transmitted infection (STI) clinics report penicillin allergies, complicating treatment for syphilis and gonorrhea. Nonetheless, > 90% do not have a penicillin allergy when evaluated. We developed ... ...

Abstract	Background: Approximately 15% of patients in sexually transmitted infection (STI) clinics report penicillin allergies, complicating treatment for syphilis and gonorrhea. Nonetheless, > 90% do not have a penicillin allergy when evaluated. We developed and validated an algorithm to define which patients reporting penicillin allergy can be safely treated at STI clinics with these drugs. Methods: RCT to assess feasibility and safety of penicillin allergy evaluations in STI clinics. Participants with reported penicillin allergy answered an expert-developed questionnaire to stratify risk. Low-risk participants underwent penicillin skin testing (PST) followed by amoxicillin 250 mg challenge or a graded oral challenge (GOC)-amoxicillin 25 mg followed by 250 mg. Reactions were recorded, and participant/provider surveys were conducted. Results: Of 284 participants, 72 (25.3%) were deemed high-risk and were excluded. Of 206 low-risk participants, 102 (49.5%) underwent PST without reactions and 3 (3%) had mild reactions during the oral challenge. Of 104 (50.5%) participants in the GOC, 95 (91.3%) completed challenges without reaction, 4 (4.2%) had mild symptoms after 25 mg and 4 (4.2%) after 250 mg doses. Overall, 195 participants (94.7%) successfully completed the study and 11 (5.3%) experienced mild symptoms. Of 14 providers, 12 (85.7%) completed surveys and 11 (93%) agreed on the safety/effectiveness of penicillin allergy assessment in STI clinics. Conclusion: An easy-to-administer risk assessment questionnaire can safely identify patients for penicillin allergy evaluation in STI clinics by PST or GOC, with GOC showing operational feasibility. Using this approach, 67% of participants with reported penicillin allergy could safely receive first-line treatments for gonorrhea or syphilis.
Language	English
Publishing date	2024-02-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciae064
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Article ; Online: Reconsidering Presumptive Neisseria gonorrhoeae Treatment For Women With Cervicitis.

Nsuami, M Jacques / Lillis, Rebecca A / Martin, David H

Sexually transmitted diseases

2020 Volume 47, Issue 6, Page(s) 383–386

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Azithromycin/therapeutic use ; Ceftriaxone/therapeutic use ; Doxycycline/therapeutic use ; Female ; Gonorrhea/drug therapy ; Humans ; Neisseria gonorrhoeae/drug effects ; Neisseria gonorrhoeae/isolation & purification ; Uterine Cervicitis/drug therapy ; Uterine Cervicitis/microbiology
Chemical Substances	Anti-Bacterial Agents ; Ceftriaxone (75J73V1629) ; Azithromycin (83905-01-5) ; Doxycycline (N12000U13O)
Language	English
Publishing date	2020-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001156
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Article ; Online: A Comparison of Single-Dose Versus Multidose Metronidazole by Select Clinical Factors for the Treatment of Trichomonas vaginalis in Women.

Muzny, Christina A / Mena, Leandro A / Lillis, Rebecca A / Schmidt, Norine / Martin, David H / Kissinger, Patricia

Sexually transmitted diseases

2021 Volume 49, Issue 3, Page(s) 231–236

Abstract: Background: In a randomized controlled trial of 2 g (single-dose) metronidazole (MTZ) versus 500 mg twice daily for 7 days (multidose) for Trichomonas vaginalis treatment, multidose was superior. We examined if the effect was similar by select clinical ... ...

Abstract	Background: In a randomized controlled trial of 2 g (single-dose) metronidazole (MTZ) versus 500 mg twice daily for 7 days (multidose) for Trichomonas vaginalis treatment, multidose was superior. We examined if the effect was similar by select clinical factors to determine if treatment recommendations could be targeted. Methods: The primary outcome was T. vaginalis repeat infection at test-of-cure (TOC) 4 weeks after completion of therapy. Analyses were stratified by T. vaginalis history, baseline genital symptoms, and concurrent diagnosis of bacterial vaginosis (BV) per Nugent score at baseline. Results: Women who returned for TOC (n = 540) were included. At baseline, 52.9% had a self-reported history of T. vaginalis; 79.3%, genital symptoms; 5.8%, a gonorrhea diagnosis; and 47.5%, BV. During follow-up, 97.4% took all MTZ as instructed and 34.5% had interval condomless sex with a baseline partner. At TOC, 14.8% tested positive for T. vaginalis. In stratified analysis, women randomized to single-dose MTZ had a higher rate of TOC T. vaginalis positivity than those randomized to multidose if they were symptomatic at baseline (21.4% vs. 10.8%, P = 0.003) or had a reported history of T. vaginalis (24.1% vs. 12.6%, P = 0.01). Test-of-cure T. vaginalis positivity was higher for women receiving a single dose (18.9%) versus multidose (10.8%), irrespective of baseline BV status (P > 0.06). In multivariable analysis, only a history of T. vaginalis and single-dose MTZ were independently associated with a positive TOC for T. vaginalis. Conclusions: Although multidose MTZ is recommended for all women with T. vaginalis, it is especially important for women with a T. vaginalis history and, given high posttreatment infection rates, a TOC should be performed.
MeSH term(s)	Female ; Humans ; Metronidazole ; Trichomonas Vaginitis/complications ; Trichomonas Vaginitis/diagnosis ; Trichomonas Vaginitis/drug therapy ; Trichomonas vaginalis ; Vaginosis, Bacterial/complications ; Vaginosis, Bacterial/diagnosis ; Vaginosis, Bacterial/drug therapy
Chemical Substances	Metronidazole (140QMO216E)
Language	English
Publishing date	2021-11-20
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001574
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Article ; Online: Mycoplasma genitalium Infections in Women Attending a Sexually Transmitted Disease Clinic in New Orleans.

Lillis, Rebecca A / Martin, David H / Nsuami, M Jacques

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2018 Volume 69, Issue 3, Page(s) 459–465

Abstract: Background: Mycoplasma genitalium has been significantly and nonsignificantly associated with cervicitis, urethritis, or vaginal discharge. This study examined the associations of M. genitalium with selected sexually transmitted infections (STIs) and ... ...

Abstract	Background: Mycoplasma genitalium has been significantly and nonsignificantly associated with cervicitis, urethritis, or vaginal discharge. This study examined the associations of M. genitalium with selected sexually transmitted infections (STIs) and demographic, behavioral, and clinical factors among women attending a sexually transmitted disease (STD) clinic in New Orleans. Methods: Women aged ≥18 years who presented to the New Orleans STD clinic provided sociodemographic data and sexual behavior; STI, obstetric, and gynecologic history; and urine, vaginal, endocervical, and rectal specimens. Specimens were tested for M. genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma species, and yeast. Bacterial vaginosis (BV) was diagnosed by Nugent score, and cervicitis was defined as ≥30 polymorphonuclear leukocytes per high-power microscopic field on a cervical Gram stain or yellow mucopus on an endocervical swab. Results: Among 400 women studied, M. genitalium was independently significantly associated with age <25 years (P < .03) and with ≥2 sexual partners in the last 12 months (P < .003). Neisseria gonorrhoeae (adjusted odds ratio [AOR], 1.75; P = .103), C. trachomatis (AOR, 1.43; P = .247), and T. vaginalis (AOR, 1.60; P = .120) independently increased the odds of infection with M. genitalium. Controlling for other STIs and BV, there was a positive trend for M. genitalium to predict cervicitis (AOR, 3.18 [95% confidence interval, .99-10.2]; P = .05). Conclusions: Mycoplasma genitalium in our study displayed the clinical features of C. trachomatis and N. gonorrhoeae, the 2 organisms that drive research agendas in diagnosis, treatment, and prevention of bacterial STIs.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Cervix Uteri/microbiology ; Cross-Sectional Studies ; Female ; Humans ; Middle Aged ; Mycoplasma Infections/epidemiology ; Mycoplasma Infections/microbiology ; Mycoplasma genitalium ; New Orleans/epidemiology ; Prevalence ; Prospective Studies ; Sexual Partners ; Sexually Transmitted Diseases, Bacterial/epidemiology ; Sexually Transmitted Diseases, Bacterial/microbiology ; Vagina/microbiology ; Vaginosis, Bacterial/epidemiology ; Young Adult
Language	English
Publishing date	2018-10-17
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciy922
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Article ; Online: A novel

Elnaggar, Jacob H / Ardizzone, Caleb M / Cerca, Nuno / Toh, Evelyn / Łaniewski, Paweł / Lillis, Rebecca A / Herbst-Kralovetz, Melissa M / Quayle, Alison J / Muzny, Christina A / Taylor, Christopher M

Frontiers in cellular and infection microbiology

2023 Volume 13, Page(s) 1198113

Abstract: Bacterial vaginosis (BV) is the most common vaginal dysbiosis. In this condition, a polymicrobial biofilm develops on vaginal epithelial cells. Accurately quantifying the bacterial burden of the BV biofilm is necessary to further our understanding of BV ... ...

Abstract	Bacterial vaginosis (BV) is the most common vaginal dysbiosis. In this condition, a polymicrobial biofilm develops on vaginal epithelial cells. Accurately quantifying the bacterial burden of the BV biofilm is necessary to further our understanding of BV pathogenesis. Historically, the standard for calculating total bacterial burden of the BV biofilm has been based on quantifying
MeSH term(s)	Female ; Humans ; Gardnerella/genetics ; Lactobacillus/genetics ; Reproducibility of Results ; Gardnerella vaginalis/genetics ; Prevotella/genetics ; RNA, Ribosomal, 16S/genetics ; Escherichia coli/genetics ; Vagina/microbiology ; Bacteria/genetics ; Vaginosis, Bacterial/microbiology ; Microbiota/genetics
Chemical Substances	RNA, Ribosomal, 16S
Language	English
Publishing date	2023-06-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2023.1198113
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Article ; Online: Clinical Evaluation of a New Molecular Test for the Detection of Organisms Causing Vaginitis and Vaginosis.

Lillis, Rebecca A / Parker, R Lamar / Ackerman, Ronald / Ackerman, Jamie / Young, Stephen / Weissfeld, Alice / Trevino, Ernest / Nachamkin, Irving / Crane, LaShonda / Brown, Jacqueline / Huang, Christina / Liu, Xiaohong / Van Der Pol, Barbara

Journal of clinical microbiology

2023 Volume 61, Issue 3, Page(s) e0174822

Abstract: In this prospective, observational, method comparison clinical study, the Xpert Xpress MVP test (MVP) was evaluated using both clinician-collected (CVS) and self-collected vaginal swabs (SVS) collected in a clinical setting. The study was conducted at 12 ...

Abstract	In this prospective, observational, method comparison clinical study, the Xpert Xpress MVP test (MVP) was evaluated using both clinician-collected (CVS) and self-collected vaginal swabs (SVS) collected in a clinical setting. The study was conducted at 12 sites, including point-of-care (POC) settings, from geographically diverse locations in the United States. Participants were biologically female patients ≥ 14 years old with signs and/or symptoms of vaginitis/vaginosis. MVP test results for BV were compared to the BD MAX Vaginal Panel (BDVP). Results for Candida group and Candida glabrata and Candida krusei targets (species not differentiated) were assessed relative to yeast culture followed by mass spectrometry for species identification. Trichomonas vaginalis (TV) results were compared relative to a composite method that included results from the BDVP and InPouch TV culture. The investigational test demonstrated high positive percent agreement ranging from 93.6 to 99.0%, and negative percent agreement ranging from 92.1% to 99.8% for both CVS and SVS specimens, indicating it may be a valuable tool for the diagnosis of vaginitis/vaginosis in laboratory and POC settings.
MeSH term(s)	Humans ; Female ; Adolescent ; Trichomonas Vaginitis/diagnosis ; Candidiasis, Vulvovaginal/diagnosis ; Vaginosis, Bacterial/diagnosis ; Prospective Studies ; Vagina ; Trichomonas vaginalis/genetics
Language	English
Publishing date	2023-02-28
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/jcm.01748-22
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Article ; Online: Characteristics of Mpox Infections in Louisiana in the 2022 Outbreak.

Essajee, Nabil M / Oddo-Moise, Hope / Hagensee, Michael E / Lillis, Rebecca A / Maffei, Joanne / Butler, Isolde / Lovett, Aish / Sokol, Theresa / Clement, Meredith E

AIDS research and human retroviruses

2023 Volume 39, Issue 11, Page(s) 587–592

Abstract: The 2022 outbreak of mpox in Louisiana was limited to just >300 cases, perhaps an unexpected outcome given the state's high rates of HIV and other sexually transmitted infections (STIs). We aimed to describe the local outbreak within two health centers ... ...

Abstract	The 2022 outbreak of mpox in Louisiana was limited to just >300 cases, perhaps an unexpected outcome given the state's high rates of HIV and other sexually transmitted infections (STIs). We aimed to describe the local outbreak within two health centers in the New Orleans region, partnering with the Louisiana Department of Health to offer additional statewide data. We reviewed charts of persons testing positive for mpox in New Orleans from July to November 2022 at two local health centers that together accounted for half of local cases. We abstracted data on HIV status, immune function [CD4 count, viral load (VL)], antiretroviral therapy regimen, symptoms and severity of infection, vaccination status, and whether tecovirimat was administered. We present local data relative to statewide data (July 2022-January 2023). Of 103 individuals in our network for whom charts were reviewed, 96 (93%) identified as male, 52 (50%) were Black, and 69 (67%) had HIV, including 12 (17%) with uncontrolled HIV (CD4 < 200 cells/mm
MeSH term(s)	Humans ; Male ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Mpox (monkeypox) ; Sexually Transmitted Diseases/epidemiology ; Louisiana/epidemiology ; CD4 Lymphocyte Count
Language	English
Publishing date	2023-08-07
Publishing country	United States
Document type	Review ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639130-8
ISSN	1931-8405 ; 0889-2229
ISSN (online)	1931-8405
ISSN	0889-2229
DOI	10.1089/AID.2023.0011
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Article ; Online: Association of

Ardizzone, Caleb M / Taylor, Christopher M / Toh, Evelyn / Lillis, Rebecca A / Elnaggar, Jacob H / Lammons, John W / Mott, Patricia Dehon / Duffy, Emily L / Shen, Li / Quayle, Alison J

Frontiers in cellular and infection microbiology

2023 Volume 13, Page(s) 1289449

Abstract: Bacterial vaginosis (BV), a dysbiosis of the vaginal microbiota, is a common coinfection ... ...

Abstract	Bacterial vaginosis (BV), a dysbiosis of the vaginal microbiota, is a common coinfection with
MeSH term(s)	Female ; Humans ; Vaginosis, Bacterial/diagnosis ; Metronidazole/pharmacology ; Metronidazole/therapeutic use ; Chlamydia trachomatis/genetics ; RNA, Ribosomal, 16S/genetics ; Vagina/microbiology ; Microbiota
Chemical Substances	Metronidazole (140QMO216E) ; RNA, Ribosomal, 16S
Language	English
Publishing date	2023-12-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2023.1289449
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Article ; Online: Human genital antibody-mediated inhibition of Chlamydia trachomatis infection and evidence for ompA genotype-specific neutralization.

Ardizzone, Caleb M / Albritton, Hannah L / Lillis, Rebecca A / Bagnetto, Caitlyn E L / Shen, Li / Cavacini, Lisa A / Kozlowski, Pamela A / Quayle, Alison J

PloS one

2021 Volume 16, Issue 10, Page(s) e0258759

Abstract: The endocervix, the primary site of Chlamydia trachomatis (Ct) infection in women, has a unique repertoire of locally synthesized IgG and secretory IgA (SIgA) with contributions from serum IgG. Here, we assessed the ability of genital and serum-derived ... ...

Abstract	The endocervix, the primary site of Chlamydia trachomatis (Ct) infection in women, has a unique repertoire of locally synthesized IgG and secretory IgA (SIgA) with contributions from serum IgG. Here, we assessed the ability of genital and serum-derived IgG and IgA from women with a recent positive Ct test to neutralize Ct elementary bodies (EBs) and inhibit inclusion formation in vitro in human endocervical epithelial cells. We also determined if neutralization was influenced by the major outer membrane protein (MOMP) of the infecting strain, as indicated by ompA gene sequencing and genotyping. At equivalent low concentrations of Ct EB (D/UW-3/Cx + E/UW-5/Cx)-specific antibody, genital-derived IgG and IgA and serum IgA, but not serum IgG, significantly inhibited inclusion formation, with genital IgA being most effective, followed by genital IgG, then serum IgA. The well-characterized Ct genotype D strain, D/UW-3/Cx, was neutralized by serum-derived IgG from patients infected with genotype D strains, genital IgG from patients infected with genotype D or E strains, and by genital IgA from patients infected with genotype D, E, or F strains. Additionally, inhibition of D/UW-3/Cx infection by whole serum, rather than purified immunoglobulin, was associated with levels of serum EB-specific IgG rather than the genotype of infecting strain. In contrast, a Ct genotype Ia clinical isolate, Ia/LSU-56/Cx, was neutralized by whole serum in a genotype and genogroup-specific manner, and inhibition also correlated with EB-specific IgG concentrations in serum. Taken together, these data suggest that (i) genital IgA most effectively inhibits Ct infection in vitro, (ii) human antibody-mediated inhibition of Ct infection is significantly influenced by the ompA genotype of the infecting strain, (iii) the genital antibody repertoire develops or matures differently compared to systemic antibody, and (iv) ompA genotype-specificity of inhibition of infection by whole serum can be overcome by high concentrations of Ct-specific IgG.
MeSH term(s)	Adult ; Antibodies, Bacterial/blood ; Antibodies, Bacterial/metabolism ; Antibodies, Neutralizing/blood ; Antibodies, Neutralizing/metabolism ; Bacterial Outer Membrane Proteins/genetics ; Bacterial Outer Membrane Proteins/immunology ; Cell Line ; Cervix Uteri/cytology ; Cervix Uteri/immunology ; Cervix Uteri/virology ; Chlamydia Infections/immunology ; Chlamydia trachomatis/genetics ; Chlamydia trachomatis/immunology ; Epithelial Cells/cytology ; Epithelial Cells/immunology ; Epithelial Cells/virology ; Female ; Genotype ; Humans ; Immunoglobulin A/blood ; Immunoglobulin A/metabolism ; Immunoglobulin G/blood ; Immunoglobulin G/metabolism ; Phylogeny ; Sequence Analysis, DNA ; Young Adult
Chemical Substances	Antibodies, Bacterial ; Antibodies, Neutralizing ; Bacterial Outer Membrane Proteins ; Immunoglobulin A ; Immunoglobulin G ; OMPA outer membrane proteins (149024-69-1)
Language	English
Publishing date	2021-10-18
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0258759
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Article: Syphilis and HIV: a review for clinicians as this centuries-old disease makes a comeback.

Lillis, Rebecca A

HIV clinician

2005 Volume 17, Issue 3, Page(s) 1–4

MeSH term(s)	Europe/epidemiology ; HIV Infections/complications ; Humans ; Penicillin G Benzathine/therapeutic use ; Syphilis/complications ; Syphilis/diagnosis ; Syphilis/drug therapy ; Syphilis/epidemiology ; United States/epidemiology
Chemical Substances	Penicillin G Benzathine (RIT82F58GK)
Language	English
Publishing date	2005
Publishing country	United States
Document type	Newspaper Article
ISSN	1551-885X
ISSN	1551-885X
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