Clinical and public health significance of bacterial sexually transmitted infections

Spolno prenosive infekcije su zarazne bolesti koje se prenose sa zaraţene na zdravu osobu spolnim kontaktom, a takoĎer se mogu prenijeti i neizravnim kontaktom te s majke na dijete. Uzročnici infekcija mogu biti različiti mikroorganizimi kao što su bakterije, virusi, gljive i paraziti. Spadaju u najvaţnije javnozdravstvene izazove. Na globalnoj razini više od 440 milijuna osoba godišnje oboli od spolno prenosivih infekcija, a oko 60% tih infekcija se pojavljuje kod osoba mlaĎih od 25 godina ţivota. U najčešće bakterijske spolno prenosive infekcije spadaju klamidija, gonoreja i sifilis. Najraširenija je klamidija koja je uzrokovana bakterijom Chlamydia trachomatis, pogotovo u adolescenata. U više od 80% ţena nema nikakvih simptoma te stoga i ima naziv „tiha upala“. Kapavac ili gonoreja zarazna je spolno prenosiva infekcija koju uzrokuje djelovanje mikroorganizma Neisseria gonnorhoeae. Muškarci imaju 20% šanse za obolijevanje nakon što se upuste u odnos sa zaraţenom ţenom, dok 50% ţena oboli nakon odnosa s muškarcem koji boluje od gonoreje. Gonoreja se takoĎer moţe prenijeti s majke na dijete prilikom poroda. Sifilis je kronična zarazna infekcija koja moţe zahvatiti različita tkiva i organe, a uzročnik je spiroheta Treponema pallidum. Mycoplasma genitalium je molikut koji moţe dobro moţe preţivjeti izvan i unutar stanice. Uzročnik je u 10-35% slučajeva uretritisa kod muškarca, a simptomi su dizurija i iscjedak. S napretkom tehnologije sekvencioniranja DNK napredovalo je i znanje o mikrobiomu rodnice. Vaginalna flora igra vaţnu ulogu u reproduktivnom zdravlju ţene, a bakterijska vaginoza se definira kao stanje u kojem dolazi do narušavanja njene ravnoteţe. Povezuje se s povećanim rizikom od zaraze spolno prenosivih infekcija što kasnije moţe izazivati zdjeličnu upalnu bolest, koja je jedna od najteţih komplikacija te prijevremeni poroĎaj. Zbog mogućih kasnijih komplikacija i posljedica milijuni ţena i muškaraca koji obole od spolno prenosivih infekcija ometeni su da ostvare sretno zajedništvo, obitelj i/ili društvenu ulogu. Kada je riječ o prevenciji spolno prenosivih infekcija, najvaţnija je edukacija, pogotovo meĎu mlaĎom populacijom.Sexually transmitted infections are infectious diseases that are transmitted from infected to a healthy person by sexual contact; still, it can also be transmitted through indirect contact and from mother to child. The infectious agents can be various microorganisms belonging to bacteria, viruses, fungi and parasites. These are the most important public health challenges. Globally, more than 440 million people suffer from sexually transmitted infections annually, and about 60% of these infections occur in people under 25 years of age. The most common bacterial sexually transmitted infections include chlamydia, gonorrhoea and syphilis. Chlamydia is the most common among them (most notably in adolescents), and it is caused by Chlamydia trachomatis. More than 80% of women have no symptoms, which is therefore referred to as “silent inflammation”. Gonorrhoea or clap is a contagious sexually transmitted infection caused by the microorganism Neisseria gonnorhoeae. Men have a 20% chance of getting infected after engaging in a relationship with an infected woman, whereas 50% of women become ill after having a relationship with a man suffering from gonorrhoea. Gonorrhoea can also be transmitted from mother to child at birth. Syphilis is a chronic infectious infection that can affect various tissues and organs, and is caused by the spirochete Treponema pallidum. Mycoplasma genitalium is a mollicute that can survive well outside and inside the cell; it is a causative agent in 10-35% of cases of urethritis in men, presenting with the symptoms of dysuria and discharge. With the advancement of DNA sequencing technology, knowledge of the vaginal microbiome has advanced as well. Vaginal flora plays an important role in women’s reproductive health, and bacterial vaginosis is defined as a condition in which the balance of this flora is disturbed. It is associated with an increased risk of contracting sexually transmitted infections, which can later cause pelvic inflammatory disease, one of the most serious complications and preterm birth. Due to the possible subsequent complications and consequences, millions of women and men suffering from sexually transmitted infections are hindered from having a happy community, family and/or social role. When it comes to the prevention of sexually transmitted infections, education is paramount, especially among the younger population