Emerging and Reemerging Sexually Transmitted Infections- A N
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The 21st century has seen a global resurgence of sexually transmitted infections (STIs). From a nadir in the 1990s, the rates of gonorrhea, syphilis, and chlamydia infections have increased substantially in high-income countries, with particular increases among men who have sex with men (MSM). Concurrent with the increase in these established STIs are emerging epidemics and outbreaks of “nonclassical” sexually transmissible pathogens that cause a wide range of clinical syndromes.

These pathogens include enteric pathogens (e.g., shigella and hepatitis A virus), those spread by close contact (e.g., Neisseria meningitidis), and recently characterized pathogens that can spread through sexual contact (e.g., Zika virus). Furthermore, increases in antimicrobial resistance have heightened concern about ever more limited treatment options for STIs, particularly gonorrhea and Mycoplasma genitalium infection.

The factors contributing to sustained transmission of STIs within populations are multiple, complex, and context specific. In principle, these factors include the probability of transmission, the rate of change in sexual partners, and the duration of infectiousness. Examples of factors that have enhanced STI transmission include unprecedented connectivity between persons, facilitated by global travel and online social networking, and increasing use of preexposure prophylaxis against human immunodeficiency virus (HIV) infection.

The multitude of socioeconomic and structural variables that impede access to testing and treatment are important in sustaining epidemics of curable STIs. This review provides an overview of major pathogens that have emerged or reemerged as STIs over the past decade. It also discusses epidemiologic features of these infections, including insights provided by genomic technologies, diagnostic approaches, and practical issues relating to treatment and control.

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Source: https://www.nejm.org/doi/full/10.1056/NEJMra1907194?query=featured_home
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