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Zaami S, Driul L, Sansone M, Scatena E, Andersson KL, Marinelli E. ART Innovations: Fostering Women's Psychophysical Health between Bioethics Precepts and Human Rights. Healthcare (Basel) 2021; 9:healthcare9111486. [PMID: 34828532 PMCID: PMC8623993 DOI: 10.3390/healthcare9111486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022] Open
Abstract
Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights.
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Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
- Correspondence:
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, Hospital of Udine, DAME, University of Udine, 33100 Udine, Italy;
| | - Milena Sansone
- Department of Obstetrics and Gynecology, Sant’Eugenio Hospital, 00144 Rome, Italy;
| | - Elisa Scatena
- Department of Gynecology and Obstetrics, Santo Stefano Hospital, 59100 Prato, Italy;
| | - Karin Louise Andersson
- Department of Territory Health, Azienda Sanitaria Toscana Centro, 50012 Florence, Italy;
| | - Enrico Marinelli
- Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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Murtagh M, Blondeel K, Peeling RW, Kiarie J, Toskin I. The relevance of target product profiles for manufacturers, experiences from the World Health Organization initiative for point-of-care testing for sexually transmitted infections. Arch Public Health 2021; 79:187. [PMID: 34706763 PMCID: PMC8549211 DOI: 10.1186/s13690-021-00708-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are a significant global public health issue that cause a high burden of disease, especially in low- and middle-income countries. Screening of key populations and early and accurate diagnosis of infection are critical. Testing for syphilis, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, curable STIs, as well as the human papillomavirus (HPV), is frequently unavailable in low-resource settings. Tests for these STIs that can be used at the point of patient care (POCTs) are needed. In recent years, there has been increased attention for STI POCTs, but technical guidance, financial resources and advocacy for additional platforms/tests are required in order to foster the development of STI POCTs. The WHO Department of Sexual and Reproductive Health and Research (SRH) has developed target product profiles (TPPs), a form of technical guidance, for these STI diagnostics. Methods SRH conducted a survey of selected companies that are developing POCTs for one or more of the STIs mentioned above to better understand how these TPPs influence the diagnostic development process – to assess their impact. Results Survey respondents indicated that the STI POCT TPPs provided good guidance with respect to performance expectations and operational characteristics for the tests/platforms. In particular, optimal metrics for sensitivity, specificity, sample types, and time to result were considered to be very useful. Respondents also suggested ways to improve the relevance of the STI POCT TPPs. For example, since it is often not possible for developers to achieve every desired standard, it would be useful to prioritize each performance/operational characteristic of the test and to provide a rationale as to why certain characteristics are considered important. Respondents also emphasized the need to encourage industry participation in the TPP development process and to find creative ways, including via targeted emails, a WHO webpage directed at industry, or a coordinated communications plan to increase awareness of the TPPs. Conclusions Companies value the STI POCT TPPs and want them to continue. In order to maximize impact, WHO should consider the proposals from the manufacturers in the interest of increasing and accelerating access to STI diagnostics and treatment in low-resource settings.
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Affiliation(s)
- Maurine Murtagh
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Karel Blondeel
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland. .,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | | | - James Kiarie
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Igor Toskin
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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103
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Boiko I, Krynytska I, Kohut I, Bezkorovaina H, Stepanenko V. Diagnostics of Gonococcal Infection in Ukraine: Current Challenges in Resource-Constrained Settings. Eurasian J Med 2021; 53:180-184. [PMID: 35110093 PMCID: PMC9879215 DOI: 10.5152/eurasianjmed.2021.20043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the compliance of laboratory diagnostics of gonorrhoea in Ukraine with the World Health Organization (WHO) laboratory manual. MATERIALS AND METHODS A quantitative non-randomised cross-sectional descriptive postal survey was conducted to evaluate the diagnostics of gonorrhoea in sexually transmitted infections (STI) clinics in Ukraine. RESULTS The survey provided data about diagnostics of Neisseria gonorrhoeae in STI clinics from 14 regions of Ukraine from January 2013 to September 2014. The clinics performed microscopy, culture, and point-ofcare- testing in 100%, 85.7%, and 7.1% of the cases, respectively. None of the respondents had the option of performing nucleic acid amplification tests and antimicrobial susceptibility testing. Two regions reported their participation in the collaborative project by WHO on antimicrobial resistance investigation, as national antimicrobial susceptibility surveillance program had not been established in Ukraine. A "three-site testing" (urogenital, pharyngeal, and rectal specimens) in symptomatic heterosexuals was conducted by 25%, "twosite testing" (urogenital and pharyngeal specimens) was conducted by 41.7%, and "one-site testing" (urogenital specimen) was conducted by 33.3% of the respondents. External quality control of laboratory tests for the detection of N. gonorrhoeae was not performed in 50% of the regions in Ukraine. Non-selective culture media for isolation of N. gonorrhoeae and culture media in tubes instead of the recommended Petri dishes were used in 16.7% and 58.3% of the laboratories, respectively. CONCLUSION Increased adherence to evidence-basedWHO and/or nationally adapted management guidelines is essential for monitoring gonorrhoea and preventing antimicrobial resistance of N. gonorrhoeae in Ukraine.
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Affiliation(s)
- Iryna Boiko
- Department of Functional and Laboratory Diagnostics, I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine,Correspondence to: Iryna Boiko
| | - Inna Krynytska
- Department of Functional and Laboratory Diagnostics, I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Ihor Kohut
- Department of Infectious Diseases with Epidemiology, Skin and Sexually Transmitted Diseases, I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Halyna Bezkorovaina
- Department of Pathophysiology, I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Viktor Stepanenko
- Department of Dermatology and Venereology, Bogomolets National Medical University, Kyiv, Ukraine
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Patel SK, Valicherla GR, Micklo AC, Rohan LC. Drug delivery strategies for management of women's health issues in the upper genital tract. Adv Drug Deliv Rev 2021; 177:113955. [PMID: 34481034 DOI: 10.1016/j.addr.2021.113955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/23/2021] [Accepted: 08/28/2021] [Indexed: 02/08/2023]
Abstract
The female upper genital tract (UGT) hosts important reproductive organs including the cervix, uterus, fallopian tubes, and ovaries. Several pathologies affect these organ systems such as infections, reproductive issues, structural abnormalities, cancer, and inflammatory diseases that could have significant impact on women's overall health. Effective disease management is constrained by the multifaceted nature of the UGT, complex anatomy and a dynamic physiological environment. Development of drug delivery strategies that can overcome mucosal and safety barriers are needed for effective disease management. This review introduces the anatomy, physiology, and mucosal properties of the UGT and describes drug delivery barriers, advances in drug delivery technologies, and opportunities available for new technologies that target the UGT.
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Abstract
Gonorrhea and chlamydia rates have risen to record-high levels in the United States over the past decade. Because these infections are often asymptomatic, effective clinical management relies on screening of asymptomatic patients, particularly women younger than 25 years and men who have sex with men. If undetected and untreated, gonorrhea and chlamydia can lead to infertility, ectopic pregnancy, and chronic pelvic pain and can facilitate HIV acquisition and transmission. Primary care providers need to be aware of recent changes in recommended treatments for both infections.
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Affiliation(s)
- Julia C Dombrowski
- University of Washington and Public Health - Seattle & King County, Seattle, Washington (J.C.D.)
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106
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Desdorf R, Andersen NM, Chen M. Mycoplasma genitalium prevalence and macrolide resistance-associated mutations and coinfection with Chlamydia trachomatis in Southern Jutland, Denmark. APMIS 2021; 129:706-710. [PMID: 34580906 PMCID: PMC9297889 DOI: 10.1111/apm.13174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 09/16/2021] [Indexed: 11/26/2022]
Abstract
This study aims to investigate prevalence of Mycoplasma genitalium and macrolide resistance‐associated mutations and coinfection with other sexually transmitted bacteria in Southern Jutland, Denmark, where this information is very limited. Urinary samples from patients suspected of sexually transmitted bacterial infections collected at primary healthcare facilities in Southern Jutland are routinely tested for Chlamydia trachomatis and Neisseria gonorrhoeae. 601 of these samples were analysed with SpeeDx MG+23S reagents, which can detect M. genitalium and macrolide resistance‐mediating mutations in the 23S rRNA gene. Moreover, 147 C. trachomatis positive urinary samples from routine test were also analysed with the PCR assay to detect M. genitalium. 72 out of 601 samples were detected positive for C. trachomatis (12%), five samples (0.83%) positive for N. gonorrhoeae and 25 samples positive for M. genitalium (4.2%). 14 of the 25 M. genitalium samples were detected having 23S rRNA gene mutations associated with macrolide resistance (56%). 25 of 147 C. trachomatis positive samples were tested positive for M. genitalium (17%) and two of them were positive for M. genitalium and N. gonorrhoeae (1.4%). The high prevalence of M. genitalium and macrolide resistance‐associated mutation and the coinfection with C. trachomatis in the region suggesting that M. genitalium testing should be included in routine sexually transmitted infection screening.
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Affiliation(s)
- Rasmus Desdorf
- Focused Research Unit in Molecular Diagnostic and Clinical Research, IRS-Center Southern Jutland, University of Southern Denmark, Soenderborg, Denmark.,Department of Clinical Microbiology, Hospital of Southern Jutland, Soenderborg, Denmark
| | - Niles Moller Andersen
- Focused Research Unit in Molecular Diagnostic and Clinical Research, IRS-Center Southern Jutland, University of Southern Denmark, Soenderborg, Denmark.,Department of Clinical Microbiology, Hospital of Southern Jutland, Soenderborg, Denmark
| | - Ming Chen
- Focused Research Unit in Molecular Diagnostic and Clinical Research, IRS-Center Southern Jutland, University of Southern Denmark, Soenderborg, Denmark.,Department of Clinical Microbiology, Hospital of Southern Jutland, Soenderborg, Denmark
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Chambers GM, Choi SKY, Irvine K, Venetis C, Harris K, Havard A, Norman RJ, Lui K, Ledger W, Jorm LR. A bespoke data linkage of an IVF clinical quality registry to population health datasets; methods and performance. Int J Popul Data Sci 2021; 6:1679. [PMID: 34549093 PMCID: PMC8436881 DOI: 10.23889/ijpds.v6i1.1679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction Assisted reproductive technologies (ART), such as in-vitro fertilisation (IVF), have revolutionised the treatment of infertility, with an estimated 8 million babies born worldwide. However, the long-term health outcomes for women and their offspring remain an area of concern. Linking IVF treatment data to long-term health data is the most efficient method for assessing such outcomes. Objectives To describe the creation and performance of a bespoke population-based data linkage of an ART clinical quality registry to state-based and national administrative datasets. Methods The linked dataset was created by deterministically and probabilistically linking the Australia and New Zealand Assisted Reproduction Database (ANZARD) to New South Wales (NSW) and Australian Capital Territory (ACT) administrative datasets (performed by NSW Centre for Health Record Linkage (CHeReL)) and to national claims datasets (performed by Australian Institute of Health and Welfare (AIHW)). The CHeReL’s Master Linkage Key (MLK) was used as a bridge between ANZARD’s partially identifiable patient data (statistical linkage key) and NSW and ACT administrative datasets. CHeReL then provided personal identifiers to the AIHW to obtain national content data. The results of the linkage were reported, and concordance between births recorded in ANZARD and perinatal data collections (PDCs) was evaluated. Results Of the 62,833 women who had ART treatment in NSW or ACT, 60,419 could be linked to the CHeReL MLK (linkage rate: 96.2%). A reconciliation of ANZARD-recorded births among NSW residents found that 94.2% (95% CI: 93.9–94.4%) of births were also recorded in state/territory-based PDCs. A high concordance was found in plurality status and birth outcome ≥99% agreement rate, Cohen’s kappa ranged: 0.78–0.98) between ANZARD and PDCs. Conclusion The data linkage resource demonstrates that high linkage rates can be achieved with partially identifiable data and that a population spine, such as the CHeReL’s MLK, can be successfully used as a bridge between clinical registries and administrative datasets.
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Affiliation(s)
- Georgina M Chambers
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stephanie K Y Choi
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Katie Irvine
- Centre for Health Record Linkage, Ministry of Health, New South Wales, Australia
| | - Christos Venetis
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Katie Harris
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Alys Havard
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Robert J Norman
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kei Lui
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - William Ledger
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Louisa R Jorm
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Sun Z, Meng J, Wang S, Yang F, Liu T, Zeng X, Zhang D, Zhu H, Chi W, Liu Y, Jiang W, Ding L, Miao Y, Wu Y, Zhao H, Zhang Y. A New Multiplex Genetic Detection Assay Method for the Rapid Semi-Quantitative Detection of Six Common Curable Sexually Transmitted Pathogens From the Genital Tract. Front Cell Infect Microbiol 2021; 11:704037. [PMID: 34497776 PMCID: PMC8420868 DOI: 10.3389/fcimb.2021.704037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are some of the most common communicable conditions and exert impact on the health and lives of many hundreds of millions of people across the world every year. Screening high-risk populations and conducting comprehensive detection tests would lead to a significant improvement in preventing the transmission of STIs and help us to provide rapid treatment to those affected. Here, we successfully established and validated a novel high-throughput multiplex gene detection system (HMGS) for the simultaneous and semiquantitative detection of six important curable sexually transmitted pathogens in a single reaction from secretions samples. Method Fluorescently labeled primers were designed to target specific conserved and single-copy gene fragments of Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis (M. hominis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Trichomonas vaginalis (T. vaginalis), and Treponema pallidum (T. pallidum). The specificity and sensitivity of the STI-HMGS was validated and optimized using plasmids and quantitative genomic DNA. Next, we validated the performances of the STI-HMGS for clinical application by testing samples of clinical secretions collected from patients who visited the gynecology and urology outpatient clinics of our reproductive medicine center. Results derived from the STI-HMGS were then compared with three approved commercialized kits that used to detect U. urealyticum, C. trachomatis and N. gonorrhoeae, respectively, followed by further validation with Sanger sequencing for all pathogens. Finally, a comprehensive analysis of epidemiology was performed among different subgroups to investigate the association between infection rates and clinically-relevant information. Results The sensitivity of STI-HMGS for six target genes was 10 copies/µL. Data derived from the detection of 381 clinical secretions demonstrated that the STI-HMGS exhibited high concordance rate compared with approved commercialized kits and almost 100% sensitivity and specificity for the detection of six sexually transmitted pathogens when validated by Sanger sequencing. Semi-quantitative analysis found that STIs caused by N. gonorrhoeae had a significantly higher (P<0.05) pathogen load than the other pathogens. Infections caused by C. trachomatis were significantly more common in younger individuals (P<0.05). We also found that U. urealyticum infections were more likely to happen in females; while the males were more affected by N. gonorrhoeae (P<0.05). Conclusions STI-HMGS proved to be an efficient method for the semi-quantitative detection of six important curable sexually transmitted pathogens and therefore represents an alternative method for the clinical detection and monitoring of STIs.
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Affiliation(s)
- Zhaoyang Sun
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Jun Meng
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Su Wang
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Feng Yang
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Tao Liu
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Xianping Zeng
- Department of Research and Development, Ningbo HEALTH Gene Technologies Co., Ltd, Ningbo, China
| | - Dijun Zhang
- Department of Research and Development, Ningbo HEALTH Gene Technologies Co., Ltd, Ningbo, China
| | - Haowei Zhu
- Department of Research and Development, Ningbo HEALTH Gene Technologies Co., Ltd, Ningbo, China
| | - Wenjing Chi
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Yixin Liu
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Wenrong Jiang
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Li Ding
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Yingxin Miao
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Yong Wu
- Department of Research and Development, Ningbo HEALTH Gene Technologies Co., Ltd, Ningbo, China
| | - Hu Zhao
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Yanmei Zhang
- Department of Laboratory Medicine, Huadong Hospital, Affiliated With Fudan University, Shanghai, China.,Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, China.,Research Center on Aging and Medicine, Fudan University, Shanghai, China
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Ciavattini A, Marconi C, Giannella L, Delli Carpini G, Sopracordevole F, Di Giuseppe J. The Impact of 9-Valent HPV Vaccination on Couple Infertility Prevention: A Comprehensive Review. Front Med (Lausanne) 2021; 8:700792. [PMID: 34485336 PMCID: PMC8415838 DOI: 10.3389/fmed.2021.700792] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
A comprehensive literature review was performed to determine the relationship between HPV infection and infertility and the eventual role of the 9-valent vaccine for infertility prevention. The search was extended from January 1997 through July 2021. Data collected from selected articles focused on three main topics: statistical associations between HPV prevalence and assisted reproductive technology (ART) outcome, association between HPV and characteristics of semen, and associations between HPV and miscarriage. Articles that identified HPV genotypes were selected for this review to study the possible role of the 9-valent vaccine in infertility prevention. To date, there is no agreement on the implication HPV female infection has on the fertility and miscarriage rate. Although it can be stated that HPV prevalence among couples with infertility undergoing ART treatment is consistent, it does not seem to affect the performance of oocytes. Otherwise, HPV infection affects sperm parameters, in particular spermatozoa motility. When an association can be found, most cases of HR-HPV involved are those included in the 9-valent vaccine. The correlation between HPV male infection both with asthenozoospermia and increased risk of pregnancy loss could recommend the extension of anti-HPV vaccination to adolescent males along with cancer prevention. Despite the fact that the relation between 9-valent HPV genotypes involved in female infection and miscarriage/infertility is not clear, the impact of this virus on health reproduction is evident. Considering this, the importance of HPV vaccination in adolescent females is confirmed. A vaccine efficacy study could be useful to confirm the importance of primary prevention for couple reproductive health.
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Affiliation(s)
- Andrea Ciavattini
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Chiara Marconi
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Luca Giannella
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Delli Carpini
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Francesco Sopracordevole
- Gynecological Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico (IRCCS CRO) Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Jacopo Di Giuseppe
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
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Whelan J, Ghoniem M, Médoc N, Apicella M, Beck E. Applying a novel approach to scoping review incorporating artificial intelligence: mapping the natural history of gonorrhoea. BMC Med Res Methodol 2021; 21:183. [PMID: 34488645 PMCID: PMC8418964 DOI: 10.1186/s12874-021-01367-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/02/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Systematic and scoping literature searches are increasingly resource intensive. We present the results of a scoping review which combines the use of a novel artificial-intelligence-(AI)-assisted Medline search tool with two other 'traditional' literature search methods. We illustrate this novel approach with a case study to identify and map the range of conditions (clinical presentations, complications, coinfections and health problems) associated with gonorrhoea infection. METHODS To fully characterize the range of health outcomes associated with gonorrhoea, we combined a high yield preliminary search with a traditional systematic search, then supplemented with the output of a novel AI-assisted Medline search tool based on natural language processing methods to identify eligible literature. RESULTS We identified 189 health conditions associated with gonorrhoea infection of which: 53 were identified through the initial 'high yield' search; 99 through the systematic search; and 124 through the AI-assisted search. These were extracted from 107 unique references and 21 International Statistical Classification of Diseases and Related Health Problems Ninth and Tenth Revision (ICD 9/10) or Read codes. Health conditions were mapped to the urogenital tract (n = 86), anorectal tract (n = 6) oropharyngeal tract (n = 5) and the eye (n = 14); and other conditions such as systemic (n = 61) and neonatal conditions (n = 7), psychosocial associations (n = 3), and co-infections (n = 7). The 107 unique references attained a Scottish Intercollegiate Guidelines Network (SIGN) score of ≥2++ (n = 2), 2+ (14 [13%]), 2- (30 [28%]) and 3 (45 [42%]), respectively. The remaining papers (n = 16) were reviews. CONCLUSIONS Through AI screening of Medline, we captured - titles, abstracts, case reports and case series related to rare but serious health conditions related to gonorrhoea infection. These outcomes might otherwise have been missed during a systematic search. The AI-assisted search provided a useful addition to traditional/manual literature searches especially when rapid results are required in an exploratory setting.
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Affiliation(s)
| | - Mohammad Ghoniem
- Luxembourg Institute of Science and Technology, Esch-sur-Alzette, Luxembourg
| | - Nicolas Médoc
- Luxembourg Institute of Science and Technology, Esch-sur-Alzette, Luxembourg
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Al-Hussaini TK. High dose letrozole in infertile women with unilateral tubal block: a preliminary report. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021. [DOI: 10.1186/s43043-021-00074-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Till now, there is no universal agreement on the best management of women with unilateral blocked tube. The aim of this study was to evaluate the use of high dose letrozole in infertile women with one blocked tube. This prospective non-randomized study was conducted at a university-affiliated infertility unit. It included 15 women with one blocked tube (proximal or mid segmental block) with a period of 1–6 years of infertility. Letrozole (10 mg/day for 5 days) was prescribed for all of them for a maximum of three cycles. The primary outcome was Live birth rate.
Results
Nine out of the 15 women conceived (60%). Live birth rate was 53% (8/15). All women had a good response to this regimen. None complained of side effects of this dose. No multiple pregnancies and/or congenital anomalies were reported.
Conclusions
This preliminary report showed that treatment of infertile women, with unilateral tubal block, with high dose letrozole is effective. To our knowledge, this is the first report in the English literature on the use of high dose of letrozole in such cases.
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112
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Nyemba DC, Medina-Marino A, Peters RPH, Klausner JD, Ngwepe P, Myer L, Johnson LF, Davey DJ. Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa. Sex Transm Infect 2021; 97:375-381. [PMID: 33004610 PMCID: PMC8012394 DOI: 10.1136/sextrans-2020-054631] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/08/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE STIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors. METHODS We combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models. RESULTS We enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence. CONCLUSION Our study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.
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Affiliation(s)
- Dorothy Chiwoniso Nyemba
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Andrew Medina-Marino
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
- Research Unit, Foundation for Professional Development, East London, South Africa
| | - Remco P H Peters
- Research Unit, Foundation for Professional Development, East London, South Africa
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
- Department of Medical Microbiology, CAPHRI School of Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jeffrey D Klausner
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Phuti Ngwepe
- Research Unit, Foundation for Professional Development, East London, South Africa
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Leigh Francis Johnson
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Dvora Joseph Davey
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
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113
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Zhao PZ, Wang YJ, Cheng HH, Zhang Y, Tang WM, Yang F, Zhang W, Zhou JY, Wang C. Uptake and correlates of chlamydia and gonorrhea testing among female sex workers in Southern China: a cross-sectional study. BMC Public Health 2021; 21:1477. [PMID: 34320978 PMCID: PMC8320049 DOI: 10.1186/s12889-021-11526-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 07/20/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Female sex workers (FSW) are highly susceptible to chlamydia and gonorrhea infection. However, there is limited literature examining their testing uptake to date. This study aimed to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China. METHODS A cross-sectional study with convenience sampling was performed in five cities in Southern China. Data on socio-demographic characteristics, sexual behaviors, chlamydia and gonorrhea testing, and the utilization of health care services from participants were collected through face-to-face interviews. Univariate and multivariable logistic regressions were used to determine factors associated with chlamydia and gonorrhea testing, respectively. RESULTS Overall, 1207 FSWs were recruited, with the mean age of 30.7 ± 6.8 years and an average number of clients of 7.0 (4.0-10.0) per week. 65.4% participants constantly used condoms with clients during the past month. Only 7.5 and 10.4% had been tested for chlamydia and gonorrhea in the last year, respectively. Multivariable analysis indicated that FSW who worked at low tiers (adjusted Odds Ratio (aOR) = 2.36, 95%CI:1.23-10.14), had more clients in the last month (aOR = 1.03, 95%CI:1.01-1.05), used condoms consistently (aOR = 1.79, 95%CI:1.12-2.86), had STD symptoms (aOR = 4.09,95%CI:2.62-6.40), had been tested for HIV (aOR = 5.16, 95%CI:3.21-8.30) or syphilis (aOR = 6.90, 95%CI:4.21-11.22) in the last year were more likely to have chlamydia testing. In addition, FSW who had more clients in the past month (aOR = 1.02,95%CI:1.00-1.04), had STD symptoms (aOR = 3.33, 95%CI:2.03-5.46), had been tested for HIV (aOR = 3.94, 95%CI:2.34-6.65) and syphilis (aOR = 3.27, 95%CI:1.96-5.46) in the last year were more likely to have gonorrhea testing. CONCLUSIONS The testing rates of chlamydia and gonorrhea are low among Chinese FSW. Integrating chlamydia and gonorrhea testing into HIV testing promotion programs may help bridge the gap among FSW.
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Affiliation(s)
- Pei Zhen Zhao
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China
| | - Ya Jie Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China
| | - Huan Huan Cheng
- The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ye Zhang
- Kirby Institute, New South Wales University, Sydney, Australia
| | - Wei Ming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Fan Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Wei Zhang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ji Yuan Zhou
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China.
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China.
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114
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Hong X, Zhao J, Zhu X, Dai Q, Zhang H, Xuan Y, Yin J, Zhang Y, Yang X, Fang S, Wang Q, Shen H, Zhang Y, Yan D, Wang Y, Peng Z, Zhang Y, Wang B, Ma X. The association between the vaginal microenvironment and fecundability: a register-based cohort study among Chinese women. BJOG 2021; 129:43-51. [PMID: 34258836 DOI: 10.1111/1471-0528.16843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the association between the vaginal microenvironment and fecundability among women. DESIGN Register-based nationwide cohort study. SETTING Chinese National Free Pre-conception Check-up Project from 2015 to 2018. POPULATION Our study included a total of 3 388 554 eligible women who were attempting to become pregnant. METHOD We assessed the vaginal microenvironment at baseline by considering four indices: vaginal pH, clue cell examination, whiff test and vaginal cleanliness grading. If any of these indicators was abnormal, the vaginal microenvironment was defined as poor. Propensity score matching was used to control for potential confounders and reduce bias. Logistic models were used to estimate the fecundability odds ratios (FORs) after adjustment for covariates. MAIN OUTCOME MEASURES Achievement of a pregnancy within 1 year. RESULTS Of the total study population, 379 718 women (11.2%) had a poor vaginal microenvironment and their pregnancy rate after 1 year was significantly lower than the group with a normal microenvironment (71.8% versus 76.1%, P < 0.001). After adjusting for potential confounders, the women with a poor vaginal microenvironment were associated with a 9% reduction in fecundability compared with the normal microenvironment group (FOR 0.91, 95% CI 0.90-0.92). The adverse effects of a poor vaginal microenvironment were stronger among multipara (FOR 0.89, 95% CI 0.87-0.90) or women with irregular menstruation (FOR 0.86, 95% CI 0.84-0.89). CONCLUSION There was a negative association between a poor vaginal microenvironment and the fecundability of women. These findings highlight the significance of assessing the vaginal microenvironment during pre-pregnancy health examinations. TWEETABLE ABSTRACT Women with a poor vaginal microenvironment were associated with a reduction in fecundability.
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Affiliation(s)
- X Hong
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - J Zhao
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - X Zhu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Q Dai
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - H Zhang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - Y Xuan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - J Yin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yue Zhang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - X Yang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - S Fang
- The Mount Sinai Health System, New York, NY, USA
| | - Q Wang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - H Shen
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - D Yan
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Y Wang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - Z Peng
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
| | - B Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - X Ma
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Centre, Beijing, China
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115
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Paira DA, Molina G, Tissera AD, Olivera C, Molina RI, Motrich RD. Results from a large cross-sectional study assessing Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis urogenital infections in patients with primary infertility. Sci Rep 2021; 11:13655. [PMID: 34211075 PMCID: PMC8249471 DOI: 10.1038/s41598-021-93318-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/22/2021] [Indexed: 12/11/2022] Open
Abstract
Female and male infertility have been associated to Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis urogenital infections. However, evidence from large studies assessing their prevalence and putative associations in patients with infertility is still scarce. The study design was a cross-sectional study including 5464 patients with a recent diagnosis of couple's primary infertility and 404 healthy control individuals from Cordoba, Argentina. Overall, the prevalence of C. trachomatis, Ureaplasma spp. and M. hominis urogenital infection was significantly higher in patients than in control individuals (5.3%, 22.8% and 7.4% vs. 2.0%, 17.8% and 1.7%, respectively). C. trachomatis and M. hominis infections were significantly more prevalent in male patients whereas Ureaplasma spp. and M. hominis infections were more prevalent in female patients. Of clinical importance, C. trachomatis and Ureaplasma spp. infections were significantly higher in patients younger than 25 years. Moreover, Ureaplasma spp. and M. hominis infections were associated to each other in either female or male patients being reciprocal risk factors of their co-infection. Our data revealed that C. trachomatis, Ureaplasma spp. and M. hominis are prevalent uropathogens in patients with couple's primary infertility. These results highlight the importance of including the screening of urogenital infections in the diagnostic workup of infertility.
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Affiliation(s)
- Daniela Andrea Paira
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5016HUA, Córdoba, Argentina
| | - Guillermo Molina
- Servicio de Urología y Andrología, Hospital Privado Universitario de Córdoba, 5016, Córdoba, Argentina
| | | | - Carolina Olivera
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5016HUA, Córdoba, Argentina
| | - Rosa Isabel Molina
- Laboratorio de Andrología y Reproducción (LAR), 5000, Córdoba, Argentina
| | - Ruben Dario Motrich
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de La Torre y Medina Allende, Ciudad Universitaria, X5016HUA, Córdoba, Argentina.
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116
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Cabello-Garcia E, Ferriols-Pérez E, Urpí-Tosar B, González-Comadran M. Pelvic inflammatory disease presenting 16 months after vaginal hysterectomy: A case report and literature review. Case Rep Womens Health 2021; 31:e00335. [PMID: 34178608 PMCID: PMC8214030 DOI: 10.1016/j.crwh.2021.e00335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/12/2022] Open
Abstract
Pelvic inflammatory disease after hysterectomy is rare and the underlying route of infection is highly heterogeneous. We report the case of a 52-year-old woman with a history of vaginal hysterectomy for uterine prolapse admitted to the emergency department with acute abdominal pain and fever. Vaginal discharge and pelvic tenderness were evident in the clinical examination. Ultrasound and computed tomography scans showed a cystic pelvic mass in contact with the vaginal cuff, suggesting the diagnosis of pelvic inflammatory disease. Laparoscopic examination revealed a bilateral tubo-ovarian abscess firmly attached and fistulized to the vaginal cuff, and after tubal removal and antibiotic coverage the patient had an optimal recovery. We performed a review of the case reports published on this subject, and concluded that pelvic inflammatory disease should not be excluded in patients with a history of hysterectomy when symptoms and findings are compatible. Pelvic inflammatory disease can develop in patients with previous hysterectomy. There are few cases reported in the literature of pelvic inflammatory disease after hysterectomy Pelvic inflammatory disease must be considered when symptoms suggest so, regardless of previous history of hysterectomy
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Affiliation(s)
- Eloy Cabello-Garcia
- Obstetrics and Gynecology Department, Consorci Parc de Salut MAR, Universitat Autònoma de Barcelona, Barcelona, Passeig marítim 25-29 (08003), Spain
| | - Elena Ferriols-Pérez
- Obstetrics and Gynecology Department, Consorci Parc de Salut MAR, Universitat Autònoma de Barcelona, Barcelona, Passeig marítim 25-29 (08003), Spain.,GRI-BCN, Barcelona Infertility Research Group, IMIM, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Dr. Aiguader Street, 88 (08003), Spain
| | - Berta Urpí-Tosar
- Obstetrics and Gynecology Department, Consorci Parc de Salut MAR, Universitat Autònoma de Barcelona, Barcelona, Passeig marítim 25-29 (08003), Spain
| | - Mireia González-Comadran
- Obstetrics and Gynecology Department, Consorci Parc de Salut MAR, Universitat Autònoma de Barcelona, Barcelona, Passeig marítim 25-29 (08003), Spain.,GRI-BCN, Barcelona Infertility Research Group, IMIM, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Dr. Aiguader Street, 88 (08003), Spain
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117
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Huang X, Tan J, Chen X, Liu M, Zhu H, Li W, He Z, Han J, Ma C. Akt Phosphorylation Influences Persistent Chlamydial Infection and Chlamydia-Induced Golgi Fragmentation Without Involving Rab14. Front Cell Infect Microbiol 2021; 11:675890. [PMID: 34169005 PMCID: PMC8218875 DOI: 10.3389/fcimb.2021.675890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/29/2021] [Indexed: 11/30/2022] Open
Abstract
Chlamydia trachomatis is an obligate intracellular bacterium that causes multiple diseases involving the eyes, gastrointestinal tract, and genitourinary system. Previous studies have identified that in acute chlamydial infection, C. trachomatis requires Akt pathway phosphorylation and Rab14-positive vesicles to transmit essential lipids from the Golgi apparatus in survival and replication. However, the roles that Akt phosphorylation and Rab14 play in persistent chlamydial infection remain unclear. Here, we discovered that the level of Akt phosphorylation was lower in persistent chlamydial infection, and positively correlated with the effect of activating the development of Chlamydia but did not change the infectivity and 16s rRNA gene expression. Rab14 was found to exert a limited effect on persistent infection. Akt phosphorylation might regulate Chlamydia development and Chlamydia-induced Golgi fragmentation in persistent infection without involving Rab14. Our results provide a new insight regarding the potential of synergistic repressive effects of an Akt inhibitor with antibiotics in the treatment of persistent chlamydial infection induced by penicillin.
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Affiliation(s)
- Xiaobao Huang
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jinfeng Tan
- Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaohong Chen
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingna Liu
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huiling Zhu
- Department of Dermatology, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
| | - Wenjing Li
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhenjian He
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiande Han
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunguang Ma
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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118
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Zhu B, Hu Y, Zhou X, Liu K, Wen W, Hu Y. Retrospective Analysis of Drug Sensitivity of Neisseria gonorrhoeae in Teaching Hospitals of South China. Infect Drug Resist 2021; 14:2087-2090. [PMID: 34113135 PMCID: PMC8184144 DOI: 10.2147/idr.s317032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/22/2021] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was retrospective analysis of drug sensitivity of Neisseria gonorrhoeae in two teaching hospitals of South China. A total of 304 Neisseria gonorrhoeae isolates obtained from patients in South China from 2016 to 2020 were evaluated. The MICs of penicillin, cefuroxime, ceftriaxone (CRO), cefepime, ciprofloxacin, ceftazidime and azithromycin (AZM) against the isolates were determined by the agar dilution method. Then, Neisseria gonorrhoeae isolates were categorized into sensitive, moderately sensitive and resistant according to MICs. Also, β-lactamases were detected by enzyme linked immunosorbent assay (ELISA). Ureaplasma urealyticum and Mycoplasma hominis were determined by culture in liquid medium, and Chlamydia was detected by rapid antigen test. The result showed there was 50.99%, 20.72%, 9.87%, 14.47%, 86.84%, 7.57%, 6.91%, 11.18% resistance to penicillin, cefuroxime, ceftriaxone, cefepime, ciprofloxacin, ceftazidime and azithromycin, respectively. Also, β-lactamase positivity was 53.29% and Chlamydia antigen positivity was 20.07%. Ureaplasma urealyticum and Mycoplasma hominis positivity was 11.84% and 6.25%, respectively. From 2016 to 2020, the resistant rate of ceftriaxone and azithromycin gradually increased. In conclusion, Southern China is among the area reporting gonococci with high-level resistance to AZM and CRO, so N. gonorrhoeae culture and drug sensitivity test will be vital for monitoring trends in antimicrobial resistance.
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Affiliation(s)
- Bingming Zhu
- Department of Clinical Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Yanqing Hu
- Department of Dermatology and Venereology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
| | - Xianyi Zhou
- Department of Dermatology and Venereology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
| | - Kangxing Liu
- Department of Dermatology and Venereology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
| | - Wangrong Wen
- Department of Clinical Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Yongxuan Hu
- Department of Dermatology and Venereology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
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Brawner BM, Jemmott LS, Hanlon AL, Lozano AJ, Abboud S, Ahmed C, Wingood G. Results from Project GOLD: A pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention for black youth. AIDS Care 2021; 33:767-785. [PMID: 33550841 PMCID: PMC8494072 DOI: 10.1080/09540121.2021.1874273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
Black youth face significant disparities in HIV/sexually transmitted infection (STI) disease burden. Mental illness and emotion regulation are ontributors to HIV/STI risk, yet many HIV/STI prevention interventions do not address these factors. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually active Black youth aged 14-17 (N = 108). Participants were recruited from outpatient mental health treatment programs and general community settings via community partner referrals, face-to-face encounters, flyers and social media. Assessments were conducted pretest, immediate posttest, and at 3-, 6-, and 12-month follow-up. Although there were no statistically significant differences in behavior change from baseline, there were practically significant effect sizes among HIV condition participants when compared to the general health condition (e.g., fewer sexual partners at 6 months). An increase in theoretical mediators (e.g., condom use negotiation beliefs) was sustained at 12 months. HIV condition participants also reported lower depressive symptom severity, with statistical significance noted at immediate post and at 3 months. The findings highlight the importance and challenges of engaging Black youth in culturally and contextually relevant, developmentally and psychologically appropriate HIV/STI prevention interventions.
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Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America; Twitter: @DrBMBrawnerhttps://twitter.com/DrBMBrawner; Facebook: Dr. Bridgette M. Brawner https://www.facebook.com/DrBMBrawner/; LinkedIn: Bridgette M. Brawner, PhD, MDiv, APRN https://www.linkedin.com/in/bridgette-m-brawner-phd-mdiv-aprn-754a24109/
| | - Loretta Sweet Jemmott
- Department of Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, United States of America; Twitter: https://twitter.com/Dr_SweetJ
| | - Alexandra L. Hanlon
- Center for Biostatistics and Health Data Science, Department of Statistics, College of Science, Virginia Tech, Roanoke, Virginia, United States of America; Twitter: @al_hanlonhttps://twitter.com/al_hanlon
| | - Alicia J. Lozano
- Center for Biostatistics and Health Data Science, Department of Statistics, College of Science, Virginia Tech, Roanoke, Virginia, United States of America; Twitter: @aliciajlozanohttps://twitter.com/aliciajlozano
| | - Sarah Abboud
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, Illinois, United States of America; Twitter: @SarahAbboud78https://twitter.com/sarahabboud78
| | - Charisse Ahmed
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America; LinkedIn: https://www.linkedin.com/in/charisse-ahmed-2b341866/
| | - Gina Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
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The relationship between psychological coping and mood across the menstrual cycle among distressed women struggling to conceive. J Psychosom Res 2021; 145:110465. [PMID: 33820644 DOI: 10.1016/j.jpsychores.2021.110465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Infertility is disproportionately associated with distress in women yet there has been limited research focusing on the relationship between coping strategies and fertility-monitoring techniques on distress in women struggling to conceive naturally. METHODS Fifty-eight distressed women with infertility were recruited via social media. Every second day women's depressive and anxious mood was assessed in the morning and again in the evening along with their psychological coping strategies, the use of fertility monitoring techniques, and Fertility Quality of Life emotion subscale, over the course of one full menstrual cycle. RESULTS During menstruation and statistically adjusting for morning depressive mood, active coping (β(SE) = -1.35 (0.36), p < .001) and behavioural engagement (β(SE) = -0.98 (0.35), p = .006) were associated with less depressive mood in the evening. Across all phases, social support seeking was associated with greater anxiety (β(SE) = 0.50 (0.20), p = .013) and lower emotional quality of life (β(SE) = -0.82 (0.32), p = .011). Use of fertility monitoring techniques was associated with heightened anxiety (M(SE) = 6.7 (0.2) vs. 5.9 (0.2), p < .001). The use of avoidance strategies (β(SE) = 3.22 (1.29), p = .016), endorsement of optimism (β(SE) = -4.72 (1.78), p = .011) and social support seeking (β(SE) = 3.09 (1.18), p = .012) throughout the cycle were significantly predictive of depression ratings following a negative pregnancy test, despite statistically adjusting for mean depression ratings throughout the menstrual cycle. CONCLUSION These findings highlight a number of cognitive and behavioural strategies that could be manipulated via psychological interventions to improve distress among women struggling to conceive.
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Lokken EM, Manhart LE, Kinuthia J, Hughes JP, Jisuvei C, Mwinyikai K, Muller CH, Mandaliya K, Jaoko W, McClelland RS. Association between bacterial vaginosis and fecundability in Kenyan women planning pregnancies: a prospective preconception cohort study. Hum Reprod 2021; 36:1279-1287. [PMID: 33594429 DOI: 10.1093/humrep/deab002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/22/2020] [Indexed: 01/03/2023] Open
Abstract
STUDY QUESTION Is bacterial vaginosis (BV) associated with fecundability? SUMMARY ANSWER Women with BV may be at increased risk for sub-fecundity. WHAT IS KNOWN ALREADY While BV has been associated with poor IVF outcomes, the association between vaginal microbiota disruption and non-medically assisted conception has not been thoroughly explored. STUDY DESIGN, SIZE, DURATION Kenyan women with fertility intent were enrolled in prospective cohort that included monthly preconception visits with vaginal fluid specimen collection and pregnancy testing. Four hundred fifty-eight women attempting pregnancy for ≤3 menstrual cycles at enrollment were eligible for this fecundability analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS At monthly preconception visits, participants reported the first day of last menstrual period and sexual behavior, underwent pregnancy testing and provided vaginal specimens. Discrete time proportional probabilities models were used to estimate fecundability ratios (FRs) and 95% CI in menstrual cycles with and without BV (Nugent score ≥ 7) at the visit prior to each pregnancy test. We also assessed the association between persistent BV (BV at two consecutive visits) and fecundability. MAIN RESULTS AND THE ROLE OF CHANCE Participants contributed 1376 menstrual cycles; 18.5% (n = 255) resulted in pregnancy. After adjusting for age, frequency of condomless sex and study site, BV at the visit prior to pregnancy testing was associated with a 17% lower fecundability (adjusted FR (aFR) 0.83, 95% CI 0.6-1.1). Persistent BV was associated with a 43% reduction in fecundability compared to cycles characterized by optimal vaginal health (aFR 0.57, 95% CI 0.4-0.8). LIMITATIONS, REASONS FOR CAUTION Detection of vaginal microbiota disruption using Gram stain and a point-of-care test for elevated sialidase identified a non-optimal vaginal environment, but these non-specific methods may miss important relationships that could be identified by characterizing individual vaginal bacteria and bacterial communities using molecular methods. In addition, results may be subject to residual confounding by condomless sex as this was reported for the prior month rather than for the fertile window during each cycle. WIDER IMPLICATIONS OF THE FINDINGS Given the high global prevalence of BV and infertility, an association between BV and reduced fecundability could have important implications for a large number of women who wish to conceive. Multi-omics approaches to studying the vaginal microbiota may provide key insights into this association and identify potential targets for intervention. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by a National Institutes of Health grant (NICHD R01 HD087346-R.S.M.). R.S.M. received additional support for mentoring (NICHD K24 HD88229). E.M.L. was supported by pre- and post-doctoral fellowships (NIAID T32 AI07140, NICHD F32 HD100202). Data collection and management were made possible using REDCap electronic data capture tools hosted at the University of Washington's Institute of Translational Health Science supported by grants from NCATS/NIH (UL1 TR002319). The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. R.S.M. receives research funding, paid to the University of Washington, from Hologic Corporation, and has received honoraria for consulting from Lupin Pharmaceuticals. L.E.M. receives research funding, paid to the University of Washington, from Hologic Corporation, and has received honoraria for service on scientific advisory boards from Hologic and Nabriva Therapeutics. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Erica M Lokken
- Department of Global Health, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Lisa E Manhart
- Department of Global Health, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - John Kinuthia
- Department of Obstetrics & Gynaecology, Kenyatta National Hospital, Nairobi, Kenya.,Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Clayton Jisuvei
- Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Khamis Mwinyikai
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Charles H Muller
- Department of Urology, University of Washington, Seattle, WA, USA
| | | | - Walter Jaoko
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - R Scott McClelland
- Department of Global Health, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA.,Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.,Department of Medicine, University of Washington, Seattle, WA, USA
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Luo L, Chen Q, Luo Q, Qin S, Liu Z, Li Q, Huang X, Xiao H, Xu N. Establishment and performance evaluation of multiplex PCR-dipstick DNA chromatography assay for simultaneous diagnosis of four sexually transmitted pathogens. J Microbiol Methods 2021; 186:106250. [PMID: 34029611 DOI: 10.1016/j.mimet.2021.106250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Rapid, sensitive, and specific diagnostic methods are indispensable for sexually transmitted infections (STIs). In this study, a multiplex PCR-dipstick DNA chromatography assay for diagnosis of four STI pathogens, namely Neisseria gonorrhoeae (N. gonorrhoeae), Mycoplasma hominis (M. hominis), Ureaplasma (U. urealyticum and U. parvum), and Chlamydia trachomatis (C. trachomatis), was established and evaluated. METHODS Based on the hybridization of probes and interaction between streptavidin and biotin, PCR products were visualized through hybridization of specific probes and enzymatic color generation. The sensitivity and specificity of all four pathogens were evaluated. Clinical performance of the test was evaluated using 295 specimens, and comparisons among results were determined via culture or colloidal gold assay. RESULTS No cross-reactions were observed, confirming the high specificity of this method. The limit of detection (LOD) of the four STI pathogens was 100 copies/μL. The sensitivity between PCR-dipstick DNA chromatography and culture or colloidal gold assay ranged from 84.6% to 100%. The specificity was between 93.5% and 96.6%, positive predictive value ranged from 53.6% to 86.7%, negative predictive value was over 98.3%, kappa value ranged from 0.676 to 0.864 (Cohen's kappa coefficient test), and the agreement rate was over 93.5%. CONCLUSION In conclusion, PCR-dipstick DNA chromatography serves as a rapid, sensitive, and specific method for simultaneous diagnosis of four STI pathogens.
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Affiliation(s)
- Li Luo
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qianming Chen
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qiang Luo
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Sheng Qin
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Zhenjie Liu
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Qiong Li
- Research and Development Department, Guangzhou Biotron Technology Co. Ltd, Room 204, Zone C, Science and Technology Innovation Base, No. 80, Lanyue Road, Science City, Guangzhou 510000, China
| | - Xianzhang Huang
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
| | - Hui Xiao
- Research and Development Department, Guangzhou Biotron Technology Co. Ltd, Room 204, Zone C, Science and Technology Innovation Base, No. 80, Lanyue Road, Science City, Guangzhou 510000, China.
| | - Ning Xu
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
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Szkodziak F, Krzyżanowski J, Szkodziak P. Psychological aspects of infertility. A systematic review. J Int Med Res 2021; 48:300060520932403. [PMID: 32600086 PMCID: PMC7328491 DOI: 10.1177/0300060520932403] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objective Fertility may be defined as a capacity to conceive and produce offspring. Infertility is characterized by failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. Infertility concerns an estimated 8–12% of the global population, and is associated with factors including time of unwanted non-conception, age of female partner and number of diseases impacting fertility. Unexplained infertility is described as idiopathic. This study aimed to analyse and evaluate the influence of mental disorders, often considered as reasons for idiopathic infertility, on female and male fertility, including stress, depression, sleep and eating disorders, and addictions. Methods This systematic review comprised a search of MEDLINE, Cochrane and PubMed databases for relevant articles that were analysed by two independent reviewers. Results A total of 106 articles published between 1955–2019 were included. Mental disorders modify endocrine gland and immune system functioning at both the tissue and cellular level, and are negatively associated with female and male fertility. Conclusion Mental disorders may negatively impact female and male fertility. Further studies are required to explain the exact role and contribution of mental disorders to fertility.
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Affiliation(s)
- Filip Szkodziak
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Jarosław Krzyżanowski
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Piotr Szkodziak
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
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Susilawati TN, Satria YAA. Genital Tract Infection during Pregnancy and its Association with Preterm Delivery. INDONESIAN JOURNAL OF TROPICAL AND INFECTIOUS DISEASE 2021. [DOI: 10.20473/ijtid.v8i3.11460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Genital tract infection (GTI) remains a significant health concern. It is estimated that in 2016, there were 370 million people who suffer from chlamydia, gonorrhea, and trichomoniasis; and 708 million others suffer from genital herpes and condyloma acuminatum. It has been reported that in pregnant women, GTI is associated with preterm delivery. The mechanisms of GTI-associated preterm delivery need to be further understood to prevent neonatal mortality and morbidity that could be the risk factor for neonates’ growth and development disorders. This article aims to describe various types of GTI and the associated pathogenesis causing preterm birth. A literature search was conducted to retrieve recent articles published in English from online databases including Pubmed, ScienceDirect, and Google Scholar. This literature study found that GTI evokes inflammatory responses that trigger several mechanisms leading to preterm delivery. The inflammatory responses in GTI include the production of proinflammatory cytokines and robust activation of neutrophils. The key mechanisms that stimulate preterm delivery in GTI include the events of early uterine contraction, preterm premature rupture of membranes, and induction of cervical ripening; which are under normal circumstances in a full-term pregnancy, those mechanisms are regulated by progesterone and prostaglandin levels along with suppression of the inflammatory responses. In conclusion, this paper has described the underlying mechanisms of preterm delivery in pregnant women with ISG. However, such mechanisms remain unclear in candida and gonococcal infection; thus, prompting the need for further studies.
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Lazenby GB, Savage AH, Horner G, Richmond J, Peterman TA. Declining Chlamydia and Gonorrhea Diagnoses Among Pregnant Women in South Carolina, 2008 to 2018. Sex Transm Dis 2021; 48:141-144. [PMID: 32956241 DOI: 10.1097/olq.0000000000001297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reported US cases of chlamydia and gonorrhea have increased since 2000, whereas studies in select populations suggest that the prevalence of these diseases has decreased. We sought to determine if these diagnoses are increasing among pregnant women delivering at our center. METHODS This is a retrospective study of women delivering at least 1 infant >18 weeks of gestation at the Medical University of South Carolina for 11 years (2008-2018). Using the perinatal information system, we collected maternal race, age, insurer, and chlamydia and gonorrhea screening results during the pregnancy of record. Cochran-Armitage trend analyses were performed to evaluate trends in these diagnoses by delivery year for all women and for age/race subgroups. RESULTS During the study period, there were 24,807 deliveries. The median age of women was 28 years (interquartile range, 23-32 years). Five percent (5.0%) of women were diagnosed with chlamydia and 1.2% with gonorrhea. The percent of women diagnosed decreased for both chlamydia (9.6%-3.4%) and gonorrhea (2.5%-1.1%; P < 0.001, trend analyses for both). A higher percentage of Black women had chlamydia and gonorrhea, and both diagnoses declined over time: 17.4% to 6.9% (P < 0.0001) for chlamydia and 5.8% to 2.1% (P < 0.0001) for gonorrhea. In a subanalysis of race and age, Black women younger than 25 years experienced the most significant decline in chlamydia diagnoses (P < 0.0001). CONCLUSIONS We observed declining diagnoses of chlamydia and gonorrhea among pregnant women in our center. Although Black women delivering were more likely to have either diagnoses, they experienced a significant decline in both chlamydia and gonorrhea over time.
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Affiliation(s)
- Gweneth B Lazenby
- From the Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - Ashlyn H Savage
- From the Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - Gwynneth Horner
- From the Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - Joshua Richmond
- From the Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - Thomas A Peterman
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Ravel J, Moreno I, Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am J Obstet Gynecol 2021; 224:251-257. [PMID: 33091407 DOI: 10.1016/j.ajog.2020.10.019] [Citation(s) in RCA: 119] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/09/2020] [Accepted: 10/15/2020] [Indexed: 11/29/2022]
Abstract
Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including infertility. Bacterial vaginosis is characterized by a lower prevalence of lactobacilli and a higher prevalence of anaerobic bacteria, including Gardnerella vaginalis, Megasphaera spp., and Atopobium vaginae. Endometritis and pelvic inflammatory disease are caused by the ascension of pathogenic bacteria to the uterus, although the mechanisms by which they do so are unclear. Bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease have been linked to infertility in retrospective and prospective trials. Similarly, the causes of bacterial vaginosis and endometritis-related infertility are likely multifactorial and stem from inflammation, immune targeting of sperm antigens, the presence of bacterial toxins, and increased risk of sexually transmitted infections. Diagnosis and treatment of bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease before attempting conception may be important components of preconceptional care for symptomatic women to improve outcomes of natural and assisted reproduction.
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Affiliation(s)
- Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD.
| | - Inmaculada Moreno
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico (INCLIVA), Valencia, Spain; Research and Development Department, Igenomix-Ferring Preconceptional InnoHub, Boston, MA
| | - Carlos Simón
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico (INCLIVA), Valencia, Spain; Research and Development Department, Igenomix-Ferring Preconceptional InnoHub, Boston, MA; Department of Pediatrics, Obstetrics and Gynaecology, School of Medicine, University of Valencia, Valencia, Spain; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
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Aggarwal S, Singh AK, Balaji S, Ambalkar D. Sexually transmitted infections (STIs) and its changing scenario: A scoping review. Comb Chem High Throughput Screen 2021; 25:1630-1638. [PMID: 33645477 DOI: 10.2174/1386207324666210301093001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/28/2021] [Accepted: 02/18/2021] [Indexed: 11/22/2022]
Abstract
Sexually transmitted infections (STIs) and reproductive tract infections (RTIs) have existed worldwide since ancient time, causing significant morbidity and mortality. To maintain healthy sexual and reproductive life, it is highly essential to prevent STIs, RTIs and related illnesses. STIs are transmitted by swapping body fluids among people during sexual intercourse. The etiological agents for STIs are bacteria, virus and parasites for most cases, but proportions by different aetiology are changing. Various studies have shown that STIs are increasing, and its primary aetiology is changing worldwide. That should be considered seriously and needs necessary actions. Several factors related to hosts and disease-causing agents have identified to influence STIs' current strategies in the prevention and control program. The present assessment attempts to review the history, changing aetiology and antimicrobial resistance in STIs. This review has also highlighted the prevalence of STIs at the global level and their past and present trends in India, emphasising its future challenges and perspectives for making effective public health policies to prevent and control STIs.
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Affiliation(s)
- Sumit Aggarwal
- Epidemiology and Communicable Diseases Division, Indian Council of Medical Research-Headquarters, Ansari Nagar, New Delhi-110029. India
| | - Amit Kumar Singh
- ICMR-National JALMA Institute for Leprosy and other Mycobacterial diseases, Tajgani, Agra-282004. India
| | - Sivaraman Balaji
- Epidemiology and Communicable Diseases Division, Indian Council of Medical Research-Headquarters, Ansari Nagar, New Delhi-110029. India
| | - Deepti Ambalkar
- Department of lab medicine, Max Super speciality hospital, Saket Delhi -110017. India
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Aldakak L, Huber VM, Rühli F, Bender N. Sex difference in the immunogenicity of the quadrivalent Human Papilloma Virus vaccine: Systematic review and meta-analysis. Vaccine 2021; 39:1680-1686. [PMID: 33637386 DOI: 10.1016/j.vaccine.2021.02.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 12/02/2020] [Accepted: 02/09/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Immunological differences between males and females in response to viral vaccines are well known. This the first review to examine them for the Human Papilloma Virus. METHODS We conducted a systematic review and meta-analysis of the immunogenicity of the Quadrivalent Human Papilloma Virus Vaccine qHPVV. We searched Medline, Embase, and CENTRAL for trials published until September 17, 2019. Inclusion criteria were 3-doses and reporting geometric mean titers (GMTs). We performed random-effects meta-analyses and meta-regression separated by age group and sex. RESULTS Our search yielded 1809 unique studies. 334 full texts were screened and data from 18 studies were extracted. Females had higher pooled geometric mean titers than males in all age groups. Log transformed GMTs in male children (<16) years were: against HPV6: 6·62 (95% CI 6·29-6·94; I2 = 86·0%), against HPV11: 7·07 (95% CI 6·90-7·23; I2 = 63.1%), against HPV16: 8·53 (95% CI 8·28-8·78; I2 = 73·0%), and against HPV18 7·21 (95% CI 7·08-7·34; I2 = 26·4%). In females: against HPV6 7·10 (95% CI 6·79-7·41; I2 = 96·6%), HPV11: 7·32 (95% CI 7·15-7·50; I2 = 90·6%), HPV16: 8·71 (95% CI 8·52-8·91; I2 = 90·2%), and HPV18 7·35 (95% CI 7·11-7·58; I2 = 92·7%). In the meta-regression, the sexual difference was significant for HPV6 (p = 0·022) with a similar tendency for HPV11 (p = 0·066) and HPV18 (p = 0·079). Immunogenicity was significantly higher in children (<16) than in adults (p < 0·001). CONCLUSION Females have higher antibody titers against HPV after receiving the qHPVV than do males. The difference is bigger in low-risk HPV strains. Adjusting the doses and schedules for each sex should be explored further.
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Affiliation(s)
- Lafi Aldakak
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
| | - Vera Maria Huber
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
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Smolarczyk K, Mlynarczyk-Bonikowska B, Rudnicka E, Szukiewicz D, Meczekalski B, Smolarczyk R, Pieta W. The Impact of Selected Bacterial Sexually Transmitted Diseases on Pregnancy and Female Fertility. Int J Mol Sci 2021; 22:2170. [PMID: 33671616 PMCID: PMC7926516 DOI: 10.3390/ijms22042170] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 12/17/2022] Open
Abstract
Sexually transmitted infections (STIs) caused by Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium are a common cause of pelvic inflammatory disease (PID) which can lead to tubal factor infertility (TFI). TFI is one of the most common causes of infertility, accounting for 30% of female fertility problems. STIs can also have an impact on pregnancy, leading to adverse pregnancy outcomes. Escalating antibiotic resistance in Neisseria gonorrhoeae and Mycoplasma genitalium represents a significant problem and can be therapeutically challenging. We present a comprehensive review of the current treatment options, as well as the molecular approach to this subject. We have given special attention to molecular epidemiology, molecular diagnostics, current and new treatments, and drug resistance.
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MESH Headings
- Anti-Bacterial Agents/pharmacology
- Anti-Bacterial Agents/therapeutic use
- Chlamydia Infections/drug therapy
- Chlamydia Infections/etiology
- Chlamydia Infections/microbiology
- Drug Resistance, Bacterial/drug effects
- Fallopian Tubes/microbiology
- Fallopian Tubes/pathology
- Female
- Gonorrhea/drug therapy
- Gonorrhea/etiology
- Humans
- Infertility, Female/microbiology
- Molecular Diagnostic Techniques
- Molecular Epidemiology/methods
- Mycoplasma Infections/drug therapy
- Mycoplasma Infections/etiology
- Mycoplasma genitalium/pathogenicity
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/drug therapy
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/etiology
- Sexually Transmitted Diseases, Bacterial/complications
- Sexually Transmitted Diseases, Bacterial/diagnosis
- Sexually Transmitted Diseases, Bacterial/drug therapy
- Sexually Transmitted Diseases, Bacterial/epidemiology
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Affiliation(s)
- Katarzyna Smolarczyk
- Department of Dermatology and Venereology, Medical University of Warsaw, 02-008 Warsaw, Poland; (K.S.); (B.M.-B.)
| | - Beata Mlynarczyk-Bonikowska
- Department of Dermatology and Venereology, Medical University of Warsaw, 02-008 Warsaw, Poland; (K.S.); (B.M.-B.)
| | - Ewa Rudnicka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Dariusz Szukiewicz
- Department of General and Experimental Pathology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Blazej Meczekalski
- Department of Gynaecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland;
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Wojciech Pieta
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 02-091 Warsaw, Poland;
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130
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Wesselink AK. Multigenerational effects of environmental exposures. Hum Reprod 2021; 36:539-542. [PMID: 33377484 DOI: 10.1093/humrep/deaa361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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131
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Marston M, Gregson S. Human Immunodeficiency Virus, Antiretroviral Therapy, and Fertility in Sub-Saharan Africa: Pieces Still Missing in the Jigsaw Puzzle. J Infect Dis 2021; 221:1919-1921. [PMID: 31332439 DOI: 10.1093/infdis/jiz363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Milly Marston
- Department of Population Health, London School of Hygiene and Tropical Medicine, Imperial College London, United Kingdom
| | - Simon Gregson
- Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom.,Biomedical Research and Training Institute, Harare, Zimbabwe
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132
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Álvarez-Díaz JA. Embryo donation among Latin-Americans who have attended assisted reproduction techniques: a first empirical approach. JBRA Assist Reprod 2021; 25:81-89. [PMID: 32870624 PMCID: PMC7863107 DOI: 10.5935/1518-0557.20200055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 07/30/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To determine whether Latin Americans who have undergone assisted reproduction techniques would donate embryos. METHODS This is a multinational cross-sectional study, involving 602 patients. We invited the Latin American Network of Assisted Reproduction centers. Those who accepted received the instrument distributed among the patients who agreed by signing the informed consent form. In total, 261 men and 341 women participated from seven countries. RESULTS Patients would donate their embryos as follows: treatment with embryonic stem cells (73.6%), heterosexual couples (63.8%), Assisted Reproduction Techniques (ART) research (57%), scientific or basic research (55.3%), research with embryonic stem cells (55.2%), premenopausal women (53.8%), single women (45.1%), people with disabilities (25.4%), lesbians (25.3%), menopausal women (25.2%), lesbian couples (24.6%), gay couples (19.6%), senile women (15.1%). CONCLUSIONS The results favor embryos donation for research purposes, and a little less for clinical purposes, contrary to what was thought in qualitative studies conducted among Latin American populations.
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133
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Infection Prevalence and Antibiotic Resistance Levels in Ureaplasma urealyticum and Mycoplasma hominis in Gynecological Outpatients of a Tertiary Hospital in China from 2015 to 2018. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:8842267. [PMID: 33520043 PMCID: PMC7817312 DOI: 10.1155/2021/8842267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to estimate the Ureaplasma urealyticum and Mycoplasma hominis infection prevalence and antibiotic resistance levels in gynecological outpatients. Clinical characteristics and laboratory data of gynecological outpatients of the Fourth People's Hospital of Chongqing from 2015 to 2018 were retrospectively analyzed. Antibiotic resistance levels in U. urealyticum and M. hominis were defined by a commercial Mycoplasma kit for antibiotic susceptibility testing. Univariate analysis and multivariate logistic regression analysis were performed to evaluate risk factors associated with Mycoplasma isolation. Comparisons of yearly distributions and resistance rates were assessed by chi-square tests. Fifty-six percent of gynecological outpatients were positive for U. urealyticum, and 11.02% were positive for M. hominis. In the univariate analysis, women aged 30–39 years or with a history of pregnancy or gynecological diseases had an increased risk for Mycoplasma isolation, while women who were postmenopausal or had an education level of undergraduate degree or above had a decreased risk of Mycoplasma isolation. In the multivariate logistic regression model, an independent risk factor for Mycoplasma isolation was a history of gynecological diseases, while a bachelor's degree, master's degree, or above were protective factors against Mycoplasma isolation. There were distinctly gradual increases in the positivity rates of U. urealyticum and M. hominis from 2015 to 2018 and an overall increasing trend of resistance to ten antibiotics among U. urealyticum and M. hominis. The top three antibiotics associated with resistance were ofloxacin, sparfloxacin, and levofloxacin. Doxycycline, josamycin, and minocycline were preferred because they had the lowest levels of resistance. Increases in the prevalence of infection and antibiotic resistance in U. urealyticum and M. hominis were observed from 2015 to 2018, clearly confirming the necessity to monitor the standardized administration of antibiotics.
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134
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Van Der Pol B, Torres-Chavolla E, Kodsi S, Cooper CK, Davis TE, Fife KH, Taylor SN, Augenbraun MH, Gaydos CA. Clinical Performance of the BD CTGCTV2 Assay for the BD MAX System for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis Infections. Sex Transm Dis 2021; 48:134-140. [PMID: 33448727 PMCID: PMC7817187 DOI: 10.1097/olq.0000000000001280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Diagnostic options to combat the increasing rates of sexually transmitted infections recorded throughout the world increasingly include multiplex assays. Here we describe the estimated sensitivity and specificity of a triplex molecular assay that simultaneously detects Chlamydia trachomatis (CT), Neisseria gonorrhoeae (or gonococci [GC]), and Trichomonas vaginalis (TV). METHODS Participants (2547 women and 1159 men) were recruited from 12 clinics in the United States. BD CTGCTV2 for BD MAX System assay (CTGCTV2) results were obtained from vaginal and endocervical swabs, endocervical samples in cytology medium, and female and male urine. Results were compared with infection standards that were sample type and pathogen dependent. RESULTS Female specimen sensitivity estimates ranged from 92.7% to 98.4%, 92.9% to 100%, and 86.6% to 100% for CT, GC and TV, respectively. Male urine sensitivity estimates were 96.7%, 99.2%, and 97.9% for CT, GC, and TV, respectively. Specificity estimates were >98.7% for all sample types. CONCLUSIONS BD CTGCTV2 performed well using a variety of sample types. As a true triplex assay, performed using a benchtop instrument, BD CTGCTV2 may be useful in settings where no testing is currently performed and in settings, such as reference laboratories, where testing turnaround time may be several days. Use of this assay at local laboratories may result in greater access to testing and a shorter time to result, which are important steps for improving our ability to combat sexually transmitted infections.
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Affiliation(s)
- Barbara Van Der Pol
- From the Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | | | - Salma Kodsi
- Becton, Dickinson and Company, BD Life Sciences—Diagnostic Systems, Sparks, MD
| | - Charles K. Cooper
- Becton, Dickinson and Company, BD Life Sciences—Diagnostic Systems, Sparks, MD
| | | | | | - Stephanie N. Taylor
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Charlotte A. Gaydos
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
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135
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Tantengco OAG, de Castro Silva M, Velayo CL. The role of genital mycoplasma infection in female infertility: A systematic review and meta-analysis. Am J Reprod Immunol 2021; 85:e13390. [PMID: 33417733 DOI: 10.1111/aji.13390] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/05/2021] [Indexed: 12/26/2022] Open
Abstract
PROBLEM Recent studies show that lower genital tract infection with genital mycoplasma may be associated with the pathology of female infertility. However, this association remains controversial due to the variable prevalence, sample sizes, and different methods used to diagnose genital mycoplasma infection. The aim of the present meta-analysis was to gain better understanding of the specific impact of genital mycoplasma on female infertility. METHOD OF STUDY A systematic review of literature on the association of genital mycoplasma (Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum) infection and female infertility was performed using three electronic databases: PubMed, Scopus, and CINAHL, from January 2000 to January 2020. Pooled odds ratio (OR) and 95% confidence intervals for genital mycoplasma infection and female infertility were derived from a fixed effects model. RESULTS This meta-analysis included eight studies conducted in six countries. Based on the results, women with infertility had a statistically higher odds of having any genital mycoplasma infection (p < .0001) compared to the control group. The pooled OR of all the included studies was 3.82 (95% CI: 2.55, 5.72). There was an unremarkable heterogeneity in all the studies included in this meta-analysis (I2 = 0%, p = .48). A subgroup analysis also showed that M. genitalium, M. hominis, and U. urealyticum infections are significantly associated with female infertility. CONCLUSION Our meta-analysis showed a significant association between M. genitalium, M. hominis, and U. urealyticum infections and female infertility. This evidence supports the development of guidelines for the diagnosis and treatment of genital mycoplasma infections to prevent female infertility.
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Affiliation(s)
| | - Mariana de Castro Silva
- Department of Pathology, Botucatu Medical School, Universidade Estadual Paulista, UNESP, Botucatu, SP, Brazil
| | - Clarissa L Velayo
- Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
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136
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Zhang F, Dai J, Chen T. Role of Lactobacillus in Female Infertility Via Modulating Sperm Agglutination and Immobilization. Front Cell Infect Microbiol 2021; 10:620529. [PMID: 33569356 PMCID: PMC7868545 DOI: 10.3389/fcimb.2020.620529] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022] Open
Abstract
Infertility has become a common problem in recent decades. The pathogenesis of infertility is variable, but microbiological factors account for a large proportion of it. Dysbiosis of vaginal microbiota is reportedly associated with female infertility, but the influence of normal vaginal microbiota on infertility is unclear. In this review, we summarize the physiological characteristics of the vaginal tract and vaginal microbiota communities. We mainly focus on the bacterial adherence of vaginal Lactobacillus species. Given that the adherent effect plays a crucial role in the colonization of bacteria, we hypothesize that the adherent effect of vaginal Lactobacillus may also influence the fertility of the host. We also analyze the agglutination and immobilization effects of other bacteria, especially Escherichia coli, on ejaculated spermatozoa, and speculate on the possible effects of normal vaginal microbiota on female fertility.
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Affiliation(s)
- Fenghao Zhang
- Institute of Translational Medicine & School of Life Sciences, Nanchang University, Nanchang, China
| | - Jie Dai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Renal Cancer and Melanoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Tingtao Chen
- Institute of Translational Medicine & School of Life Sciences, Nanchang University, Nanchang, China
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137
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Caruso G, Giammanco A, Virruso R, Fasciana T. Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1038. [PMID: 33503917 PMCID: PMC7908473 DOI: 10.3390/ijerph18031038] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/18/2022]
Abstract
Sexually transmitted infections (STIs) continue to exert a considerable public health and social burden globally, particularly for developing countries. Due to the high prevalence of asymptomatic infections and the limitations of symptom-based (syndromic) diagnosis, confirmation of infection using laboratory tools is essential to choose the most appropriate course of treatment and to screen at-risk groups. Numerous laboratory tests and platforms have been developed for gonorrhea, chlamydia, syphilis, trichomoniasis, genital mycoplasmas, herpesviruses, and human papillomavirus. Point-of-care testing is now a possibility, and microfluidic and high-throughput omics technologies promise to revolutionize the diagnosis of STIs. The scope of this paper is to provide an updated overview of the current laboratory diagnostic tools for these infections, highlighting their advantages, limitations, and point-of-care adaptability. The diagnostic applicability of the latest molecular and biochemical approaches is also discussed.
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Affiliation(s)
- Giorgia Caruso
- U.O.C. of Microbiology and Virology, ARNAS “Civico, Di Cristina and Benfratelli”, 90127 Palermo, Italy
| | - Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.G.); (T.F.)
| | - Roberta Virruso
- U.O.C. of Microbiology, Virology and Parassitology, A.O.U.P. “Paolo Giaccone”, 90127 Palermo, Italy;
| | - Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.G.); (T.F.)
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138
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Henriquez FL, Mooney R, Bandel T, Giammarini E, Zeroual M, Fiori PL, Margarita V, Rappelli P, Dessì D. Paradigms of Protist/Bacteria Symbioses Affecting Human Health: Acanthamoeba species and Trichomonas vaginalis. Front Microbiol 2021; 11:616213. [PMID: 33488560 PMCID: PMC7817646 DOI: 10.3389/fmicb.2020.616213] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022] Open
Abstract
Ever since the publication of the seminal paper by Lynn Margulis in 1967 proposing the theory of the endosymbiotic origin of organelles, the study of the symbiotic relationships between unicellular eukaryotes and prokaryotes has received ever-growing attention by microbiologists and evolutionists alike. While the evolutionary significance of the endosymbiotic associations within protists has emerged and is intensively studied, the impact of these relationships on human health has been seldom taken into account. Microbial endosymbioses involving human eukaryotic pathogens are not common, and the sexually transmitted obligate parasite Trichomonas vaginalis and the free-living opportunistic pathogen Acanthamoeba represent two unique cases in this regard, to date. The reasons of this peculiarity for T. vaginalis and Acanthamoeba may be due to their lifestyles, characterized by bacteria-rich environments. However, this characteristic does not fully explain the reason why no bacterial endosymbiont has yet been detected in unicellular eukaryotic human pathogens other than in T. vaginalis and Acanthamoeba, albeit sparse and poorly investigated examples of morphological identification of bacteria-like microorganisms associated with Giardia and Entamoeba were reported in the past. In this review article we will present the body of experimental evidences revealing the profound effects of these examples of protist/bacteria symbiosis on the pathogenesis of the microbial species involved, and ultimately their impact on human health.
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Affiliation(s)
- Fiona L Henriquez
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom
| | - Ronnie Mooney
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom
| | - Timothy Bandel
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom
| | - Elisa Giammarini
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom
| | - Mohammed Zeroual
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom.,Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy
| | - Pier Luigi Fiori
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy.,Mediterrenean Center for Disease Control, Sassari, Italy
| | - Valentina Margarita
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy
| | - Paola Rappelli
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy.,Mediterrenean Center for Disease Control, Sassari, Italy
| | - Daniele Dessì
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy.,Mediterrenean Center for Disease Control, Sassari, Italy
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139
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Mueller SM, Menzi S, Kind AB, Blaich A, Bayer M, Navarini A, Itin P, Brandt O. Sexually transmitted coinfections in patients with anogenital warts - a retrospective analysis of 196 patients. J Dtsch Dermatol Ges 2020; 18:325-332. [PMID: 32291912 DOI: 10.1111/ddg.14060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/23/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Anogenital warts (AGWs) are most commonly caused by low-risk human papillomavirus (HPV) types, and although they are the most frequent viral sexually transmitted infections (STIs), little is known about STI coinfections in affected patients. We therefore sought to assess STI coinfection rates in patients with AGW, specify STI coinfections and calculate the number needed to screen (NNS) for each STI. METHODS A retrospective cross-sectional study analyzing data sets from AGW patients treated in our clinic between 2008-2016. RESULTS 142/196 (72 %) patients had been variably screened for infections with HIV, HBV and HCV, Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and HSV. The STI coinfection rate in all tested patients was 24.6 %, yielding an NNS of 4.1 to detect any STI. Of note, the coinfection rate did not differ significantly between heterosexual men, homosexual men and women, respectively. The NNS for syphilis was 8.4, for HIV 14.0, for HCV 28.5 and for HBV 39.0. The NNS for asymptomatic patients tested for HSV, Chlamydia trachomatis and Mycoplasma genitalium were 1.4, 5.3 and 12.0, respectively. CONCLUSION Due to the high prevalence of STI coinfections, AGW patients should be screened for other STIs.
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Affiliation(s)
- Simon M Mueller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Sheryl Menzi
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - André B Kind
- Colposcopy Unit, Department of Gynecology, University Hospital Basel, Basel, Switzerland
| | - Annette Blaich
- Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - Michael Bayer
- Department of Dermatology, University Hospital Basel, Basel, Switzerland.,Medici Aerztezentrum, Zell, Switzerland
| | - Alexander Navarini
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Peter Itin
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Oliver Brandt
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Kömürcü Karuserci Ö, Sucu S. Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:800-804. [PMID: 33348396 PMCID: PMC10309192 DOI: 10.1055/s-0040-1718444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE In recent years, there has been an increase in the incidence of ectopic pregnancies; therefore, it is important for tertiary centers to report their approaches and outcomes to expand and improve treatment modalities. The aim of the present study was to evaluate the general characteristics, treatment and outcomes of cases diagnosed with ectopic pregnancy. METHODS In total, 432 patients treated for ectopic pregnancy between February 2016 and June 2019 were retrospectively evaluated. RESULTS Overall, 370 patients had tubal pregnancy, 32 had cesarean scar pregnancy, 18 had pregnancy of unknown location, 6 had cervical pregnancy, and 6 had interstitial pregnancy. The most important risk factors were advanced age (> 35 years; prevalence: 31.2%) and smoking (prevalence: 27.1%). Thirty patients who did not have any symptoms of rupture and whose human chorionic gonadotropin (β-hCG) levels were ≤ 200 mIU/ml were followed-up with expectant management, while 316 patients whose β-hCG levels were between 1,500 mIU/ml and 5,000 mIU/ml did not have an intrauterine gestational sac on the transvaginal or abdominal ultrasound, did not demonstrate findings of rupture, and were treated with a systemic multi-dose methotrexate treatment protocol. In total, 24 patients who did not respond to the medical treatment, 20 patients whose β-hCG levels were > 5,000 mIU/ml, 16 patients who had shown symptoms of rupture at the initial presentation, and 6 patients diagnosed with interstitial pregnancy underwent surgery. Patients with cervical and scar pregnancies underwent ultrasound-guided curettage, and no additional treatment was needed. CONCLUSION The fertility status of the patients, the clinical and laboratory findings, and the levels of β-hCG are the factors that must be considered in planning the appropriate treatment.
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Affiliation(s)
- Özge Kömürcü Karuserci
- Obstetrics and Gynecology Department, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Seyhun Sucu
- Obstetrics and Gynecology Department, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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141
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Yan L, Yang J, Long X, Zhou D. Epidemiological Characteristics of Human Papillomavirus (HPV) Infection in Different Groups of Women in Chongqing, China. Jpn J Infect Dis 2020; 74:369-372. [PMID: 33250490 DOI: 10.7883/yoken.jjid.2020.635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Persistent high-risk (HR) human papillomavirus (HPV) infection is an essential risk factor for cervical carcinoma and precancerous lesion. There are differences in HPV distribution among different countries, regions and ethnic groups. The aim of this research was to reveal the epidemiological characteristics of HPV in Chongqing, China. In this study, 13,788 women aged 18 to 78 were screened for 23 HPV genotypes by PCR-reverse dot blot hybridization. The total HPV-positive rate was 19.9% (2,745/13,788), while the positive rates for HR, and low-risk (LR) HPV were 17.3% (2,379/13,788), and 4.6% (638/13,788), respectively. In addition to cervical cancer (CC) and cervical intraepithelial neoplasia (CIN) patients, the HPV infection rates among infertile women and women with gynecological diseases were markedly higher than that among healthy women. The HPV and HR-HPV infection rates in the different age groups showed statistically significant differences, and the prevalence peaks were observed in women under 20 years and over 50 years of age. Overall, HPV-52, HPV-16 and HPV-58 ranked as the top 3 most common subtypes among women in Chongqing. The results of this research provide epidemiological information regarding HPV infection in Chongqing. These data constitute valuable evidence for the prevention and management of cervical carcinoma and development of HPV vaccines.
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Affiliation(s)
- Li Yan
- Cervical Diseases Diagnosis and Treatment Center, Chongqing Health Center for Women and Children, China
| | - Jun Yang
- Cervical Diseases Diagnosis and Treatment Center, Chongqing Health Center for Women and Children, China
| | - Xin Long
- Cervical Diseases Diagnosis and Treatment Center, Chongqing Health Center for Women and Children, China
| | - Deping Zhou
- Cervical Diseases Diagnosis and Treatment Center, Chongqing Health Center for Women and Children, China
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142
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Mansor N, Ahmad N, Rahman HA. Determinants of knowledge on sexually transmitted infections among students in public higher education institutions in Melaka state, Malaysia. PLoS One 2020; 15:e0240842. [PMID: 33119620 PMCID: PMC7595423 DOI: 10.1371/journal.pone.0240842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/04/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction The increasing trend of sexually transmitted infections (STIs) among the young population is a significant public health problem. This study aimed to determine the level of knowledge on STIs among students in higher education institutions and its predicting factors, in Melaka. Methodology A cross-sectional study was conducted among 600 students from higher education institutions in Melaka aged between 18 to 30 years old. Multistage sampling of the institutions was performed. Valid and reliable self-administered questionnaire in the national language, Bahasa Malaysia, was used as to collect data on sociodemographic, personal background, knowledge on STIs and sources of information for STIs. Univariate, bivariate and multivariate analyses were conducted using IBM SPSS software version 25. Results The response rate for this study was 88%. The mean knowledge score was 24.1 ±5.1 out of 38. HIV was the most known STIs while gonorrhoea, trichomoniasis and chlamydial infections were among the least known STIs. Oral intercourse was the least known sexual activity that could transmit STIs. Higher proportion of respondents had correct knowledge on control and preventive measures of STIs (between 78% and 95%) compared to correct knowledge on sign and symptoms of STIs (between 8.5% and 67.8%). More than 90% of the respondents were unaware that a person infected with STIs could be symptom free. Four variables were identified as the determinants of the knowledge on STIs, which were level of education, place of stay, history of sexual and reproductive health education and involvement in STIs awareness programs (F (4,445) = 11.405, p <0.001, R2 = 0.093). Conclusions The knowledge on STIs among students in higher education institutions was unsatisfactory. The existing sexual education programs can be strengthened by delivering more information on other STIs rather than focusing on HIV only. The future program should focus on students of diploma and/or skill certificate and staying off-campus.
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Affiliation(s)
- Norain Mansor
- Community Health Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Norliza Ahmad
- Community Health Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
| | - Hejar Abdul Rahman
- Community Health Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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143
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Farsimadan M, Motamedifar M. The effects of human immunodeficiency virus, human papillomavirus, herpes simplex virus-1 and -2, human herpesvirus-6 and -8, cytomegalovirus, and hepatitis B and C virus on female fertility and pregnancy. Br J Biomed Sci 2020; 78:1-11. [PMID: 32726192 DOI: 10.1080/09674845.2020.1803540] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Female infertility may be defined as a woman of reproductive age being unable to become pregnant after a year of regular unprotected sexual intercourse. Social, genetic, endocrine, physiological, and psychological factors as well as lifestyle habits (i.e., smoking and alcohol consumption), either alone or in combination with male factors, are major causes. However, approximately 15-30% of cases of female infertility remain unexplained. Numerous investigations have also indicated that microbiomes play an important role in human reproduction. All parts of the female reproductive system may be influenced by infectious and pathological agents, especially viruses, and these may interfere with reproductive function and so are risk factors for infertility, although in many cases an exact role is unclear. We present an overview of the impact of common viral infections on female reproduction, searching Medline, PubMed, Scopus, and Google scholar databases for potentially relevant studies of viruses known to have a potential effect. Human immunodeficiency virus (HIV), herpes simplex virus (HSV) and human herpesvirus (HHV) increase infertility rates whilst human papillomavirus (HPV), cytomegalovirus (CMV), and hepatitis B and C virus (HBV, HCV) infections mostly lead to higher abortion and miscarriage rates. Moreover, HPV infection is linked to increased tubal infertility, endometriosis, and pelvic inflammatory disease. HPV was the most frequently observed infection and with lower pregnancy rate and foetal death in women undergoing IVF treatments. Assisted reproductive treatment could be a safe and effective approach for HIV and HBV infected women.
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Affiliation(s)
- M Farsimadan
- Department of Biology, Faculty of Sciences, University of Guilan , Rasht, Iran
| | - M Motamedifar
- Department of Bacteriology and Virology, Shiraz Medical School, and Shiraz HIV/Aids Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz, Iran
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Song W, Yu Q, Wang LC, Stein DC. Adaptation of Neisseria gonorrhoeae to the Female Reproductive Tract. Microbiol Insights 2020; 13:1178636120947077. [PMID: 32848409 PMCID: PMC7425258 DOI: 10.1177/1178636120947077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/15/2022] Open
Abstract
Gonorrhea, caused by Neisseria gonorrhoeae, is a common sexually transmitted infection and an urgent public health problem. Humans are the exclusive host, and the genital tract with heterogeneous epithelia is the primary niche of this bacterium, creating unique challenges for understanding its pathogenesis. The cervical tissue explant model that we have developed enabled us to show that the properties of the epithelial cells in the female reproductive tract are the main factors driving gonococcal adaptation. Gonococcal variants that colonize strongly and penetrate poorly, thereby causing asymptomatic infection, survive better in the cervix. Gonococci adapt to different epithelial cell types by varying their surfaces and modulating distinct epithelial cell-cell adhesion complexes through manipulation of host cell signaling. These findings provide critical new insights on the mechanisms by which N. gonorrhoeae adapts to the human mucosal surface and causes asymptomatic infection.
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Affiliation(s)
- Wenxia Song
- Department of Cell Biology & Molecular Genetics, University of Maryland, College Park, MD, USA
- Wenxia Song, Department of Cell Biology & Molecular Genetics, University of Maryland, College Park, MD 20742, USA.
| | - Qian Yu
- Department of Cell Biology & Molecular Genetics, University of Maryland, College Park, MD, USA
| | - Liang-Chun Wang
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung
| | - Daniel C Stein
- Department of Cell Biology & Molecular Genetics, University of Maryland, College Park, MD, USA
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145
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Ye X, Li Y, Wang L, Fang X, Kong J. All-in-one microfluidic nucleic acid diagnosis system for multiplex detection of sexually transmitted pathogens directly from genitourinary secretions. Talanta 2020; 221:121462. [PMID: 33076082 DOI: 10.1016/j.talanta.2020.121462] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 12/23/2022]
Abstract
Sexually transmitted infections are a serious public health concern worldwide, especially in young people. More than 30 pathogens can cause sexually transmitted diseases and co-infection often occurs. Therefore, the development of fast, low-cost and easy-to-use diagnostic screening methods is urgently needed for disease prevention and control. Herein, we established an all-in-one microfluidic nucleic acid diagnosis system, which could simultaneously detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis and Ureaplasma urealyticum directly from genitourinary secretions with minimal manual manipulations. This system integrated nucleic acid extraction, amplification, and detection on a single microfluidic chip and could be automatically performed in an integrated detection device. This novel diagnosis tool showed good detection limits, stability (coefficient of variation <6%), specificity (no cross-reaction with 23 other pathogens for each target) and resistance to interference by other substances and the diagnostic efficacy was similar to that of PCR. The turn-around time was reduced to 50 min from sample to answer with automated testing steps. This novel diagnosis tool has the advantages of highly integrated, automated, sample-to-answer detection, and could thus replace the traditional method. This could significantly improve the prevention and control of sexually transmitted diseases.
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Affiliation(s)
- Xin Ye
- Department of Chemistry and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200433, PR China
| | - Yang Li
- Shanghai Suxin Biotechnology Co. Ltd and Suchuang Diagnostic Products Co., Ltd, Shanghai, 201318, PR China
| | - Lijuan Wang
- Shanghai Suxin Biotechnology Co. Ltd and Suchuang Diagnostic Products Co., Ltd, Shanghai, 201318, PR China
| | - Xueen Fang
- Department of Chemistry and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200433, PR China.
| | - Jilie Kong
- Department of Chemistry and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200433, PR China.
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146
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Zauner G, Girardi G. Potential causes of male and female infertility in Qatar. J Reprod Immunol 2020; 141:103173. [PMID: 32652349 DOI: 10.1016/j.jri.2020.103173] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/14/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022]
Abstract
A steady decline in the fertility rate has been observed in Qatar during the past fifty years. Therefore, infertility is considered a national priority in Qatar, a pronatalist society. This review article summarises the potential causes of infertility that are particularly prevalent in the Qatari population. The high rate of consanguinity leading to genetic abnormalities, the high incidence of metabolic disease, environmental contamination due to the rapid urbanization and oil and natural gas extraction procedures are discussed. In addition, the particular lifestyle of the Qatari population and the influence of religion and culture on sexual and reproductive behavior in an Arab/Islamic society are considered. The active response of the state of Qatar in implementing ways to mitigate the effects of these factors to protect fertility are also presented.
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Affiliation(s)
- Gerhild Zauner
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar
| | - Guillermina Girardi
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar.
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147
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Hong X, Ma J, Yin J, Fang S, Geng J, Zhao H, Zhu M, Ye M, Zhu X, Xuan Y, Wang B. The association between vaginal microbiota and female infertility: a systematic review and meta-analysis. Arch Gynecol Obstet 2020; 302:569-578. [PMID: 32638096 DOI: 10.1007/s00404-020-05675-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/08/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE This study aimed to explore the association between vaginal microbiota and infertility. METHODS We searched a range of electronic databases for appropriate articles, including PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), and Wanfang, from inception to 8th September 2019. Identified articles were then screened using strict inclusion and exclusion criteria. By referring to Tamarelle's method, we divided vaginal microbiota into two categories: low-Lactobacillus vaginal microbiota (LL-VMB) and high-Lactobacillus vaginal microbiota (HL-VMB). Patients were defined as HL-VMB if they had a Nugent score of 0-3, a negative Amesel/Spiegel's test, or if the vaginal community status was dominated by either L. crispatus, L. iners, L. gasseri and L. jensenii via 16S rRNA sequencing. Otherwise, cases were regarded as LL-VMB. Statistical analyses were performed with STATA 13.0 statistical software. Effect estimates are presented as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Fifteen articles were included in our final analysis. The HL-VMB was negatively related to infertility; a fixed model showed that the pooled OR was 0.83 (95% CI 0.77-0.90). There was no significant publication bias, as determined by Begg's test (P = 0.488) and Egger's test (P = 0.652). Using a random effect model, the pooled OR for intermediate bacterial vaginitis (BV) and infertility was 1.39 (95% CI 1.10-1.76) and the pooled OR for positive BV was 1.72 (95% CI 1.10-2.69). Subgroup and sensitivity analyses further demonstrated that the associations identified were stable. However, the acquired evidence was not sufficient to make inferences with regards to the mechanisms underlying these relationships. CONCLUSION This systematic review and meta-analysis identified a negative correlation between HL-VMB and female infertility. However, due to a variety of limitations, the evidence acquired does not allow us to identify the specific mechanisms underlying this association. Further high-quality studies are needed to verify the causal relationship and explore the molecular mechanisms involved.
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Affiliation(s)
- Xiang Hong
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Jun Ma
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Jiechen Yin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | | | - Jia Geng
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Hongxia Zhao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Mengwen Zhu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Meng Ye
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Xiaoyue Zhu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Yan Xuan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China
| | - Bei Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 dingjiaqiao road, gulou district, Nanjing, 210009, Jiangsu, China.
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148
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Hong X, Qin P, Huang K, Ding X, Ma J, Xuan Y, Zhu X, Peng D, Wang B. Association between polycystic ovary syndrome and the vaginal microbiome: A case-control study. Clin Endocrinol (Oxf) 2020; 93:52-60. [PMID: 32311120 DOI: 10.1111/cen.14198] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. Some evidence suggests that dysbiosis of the gut microbiota could be associated with PCOS clinical parameters, but little is known for the association between vaginal microbiome and PCOS. OBJECTIVE To determine differences in the vaginal microbiome between women with PCOS and healthy control women. RESEARCH DESIGN AND METHODS In this case-control study, the women with newly diagnosed PCOS (n = 39) and healthy controls (n = 40) were included from the hospital and maternal and child health centre, respectively. The vaginal swabs were collected, and microbiome structures were identified by 16S rRNA gene sequencing. The screening values for potential bacteria biomarker for PCOS were assessed by receiver operating characteristic (ROC) curve method. RESULTS There was significant difference in vaginal bacterial structures between PCOS and healthy control women. The vaginal bacterial species in the PCOS group were more diverse than the control group (Simpson index for PCOS group vs. control group: median 0.49 vs. 0.80, P = .008; Shannon index: median 1.07 vs. 0.44, P = .003; Chao1 index: median 85.12 vs. 66.13, P < .001). The relative abundance of Lactobacillus crispatus in the PCOS group was significantly lower than controls (P = .001), and the relative abundance of Mycoplasma and Prevotella was higher than controls (P < .001, P = .002, respectively). The Mycoplasma genus could be a potential biomarker for PCOS screening, as ROC analysis showed that the area under the curve (AUC) for the relative abundance of Mycoplasma was 0.958 (95% CI: 0.901-0.999). Subgroup analyses also showed these associations would not change among the women with the same BMI level and vagina cleanliness grading. CONCLUSIONS In the vaginal microbiome, the Mycoplasma genus was associated with PCOS. Further research is required to explore causal correlations between PCOS and the vaginal microbiome.
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Affiliation(s)
- Xiang Hong
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Pengfei Qin
- Department of Obstetrics and Gynecology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Kaiping Huang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Xiaoling Ding
- Maternal and Child Health Center of Gulou District, Nanjing, China
| | - Jun Ma
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Yan Xuan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Xiaoyue Zhu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Danhong Peng
- Department of Obstetrics and Gynecology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Bei Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
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149
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Boiko I, Akimova V, Mazur L, Savchenko I, Kohut I, Krynytska I. The Clinico-Epidemiological Profile of Patients with Gonorrhoea and Challenges in the Management of Neisseria gonorrhoeae Infection in an STI clinic, Ternopil, Ukraine (2013-2018). J Med Life 2020; 13:75-81. [PMID: 32341705 PMCID: PMC7175438 DOI: 10.25122/jml-2019-0170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Gonorrhea is the second most common sexually transmitted infection spreading worldwide and a serious public health problem. However, further data are required to improve the management of gonorrhea. Our aim was to review the features of gonococcal infection and characterize the challenges of its management. A retrospective descriptive study of the medical records of 136 adult patients with gonorrhea that visited Ternopil Regional Sexually Transmitted Infections Clinic (Ukraine) in 2013-2018 was performed. The male-to-female ratio was 6.6:1. Homosexually-acquired gonorrhoea was 3.7%. Also, most patients acquired gonorrhea in Ukraine (98.4%). The mean infectious period lasted 2-16 days, including the incubation period of 1-9 days and the period from the onset of symptoms to the first visit of the clinic of 1-7 days. The probability of N. gonorrhoeae transmission within the frame of the epidemiologic sexual chain was 1:2.4. Concurrent T. vaginalis (39.7%) and C. trachomatis (2.2%) were detected. HIV and syphilis screening rates were 1.6% and 0.7%, respectively. The examining rate of sexual partners was 11%, testing extragenital specimens - 0.7%, screening coverage for HIV - 46.3%, compliance with follow-up visits - 41.9%. Part of patients (16.2%) received monotherapy with clarithromycin, doxycycline, benzylpenicillin, azithromycin, or ofloxacin. The management of N. gonorrhoeae infections was compromised by a low rate of examining sexual partners, females and testing extragenital specimens, screening for HIV, compliance to follow-up visits, access to nucleic acid amplification tests, and receiving questionable or even obsolete antimicrobial treatment. Therefore, more accurate and comprehensive management of gonorrhea is urgently needed in Ukraine.
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Affiliation(s)
- Iryna Boiko
- Department of Functional and Laboratory Diagnostics, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Viorika Akimova
- Department of Clinical Laboratory Diagnostic, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Lyudmyla Mazur
- Department of Clinical Immunology, Allergology and General Patients' Care, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Iryna Savchenko
- First Department of Internal Medicine, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Ihor Kohut
- Department of Infectious Diseases with Epidemiology, Skin and Sexually Transmitted Diseases, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Inna Krynytska
- Department of Functional and Laboratory Diagnostics, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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150
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Duncan SA, Sahu R, Dixit S, Singh SR, Dennis VA. Suppressors of Cytokine Signaling (SOCS)1 and SOCS3 Proteins Are Mediators of Interleukin-10 Modulation of Inflammatory Responses Induced by Chlamydia muridarum and Its Major Outer Membrane Protein (MOMP) in Mouse J774 Macrophages. Mediators Inflamm 2020; 2020:7461742. [PMID: 32684836 PMCID: PMC7333066 DOI: 10.1155/2020/7461742] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022] Open
Abstract
The immunopathology of chlamydial diseases is exacerbated by a broad-spectrum of inflammatory mediators, which we reported are inhibited by IL-10 in macrophages. However, the chlamydial protein moiety that induces the inflammatory mediators and the mechanisms by which IL-10 inhibits them are unknown. We hypothesized that Chlamydia major outer membrane protein (MOMP) mediates its disease pathogenesis, and the suppressor of cytokine signaling (SOCS)1 and SOCS3 proteins are mediators of the IL-10 inhibitory actions. Our hypothesis was tested by exposing mouse J774 macrophages to chlamydial stimulants (live Chlamydia muridarum and MOMP) with and without IL-10. MOMP significantly induced several inflammatory mediators (IL-6, IL-12p40, CCL5, CXCL10), which were dose-dependently inhibited by IL-10. Chlamydial stimulants induced the mRNA gene transcripts and protein expression of SOCS1 and SOCS3, with more SOCS3 expression. Notably, IL-10 reciprocally regulated their expression by reducing SOCS1 and increasing SOCS3. Specific inhibitions of MAPK pathways revealed that p38, JNK, and MEK1/2 are required for inducing inflammatory mediators as well as SOCS1 and SOCS3. Chlamydial stimulants triggered an M1 pro-inflammatory phenotype evidently by an enhanced nos2 (M1 marker) expression, which was skewed by IL-10 towards a more M2 anti-inflammatory phenotype by the increased expression of mrc1 and arg1 (M2 markers) and the reduced SOCS1/SOCS3 ratios. Neutralization of endogenously produced IL-10 augmented the secretion of inflammatory mediators, reduced SOCS3 expression, and skewed the chlamydial M1 to an M2 phenotype. Inhibition of proteasome degradation increased TNF but decreased IL-10, CCL5, and CXCL10 secretion by suppressing SOCS1 and SOCS3 expressions and dysregulating their STAT1 and STAT3 transcription factors. Our data show that SOCS1 and SOCS3 are regulators of IL-10 inhibitory actions, and underscore SOCS proteins as therapeutic targets for IL-10 control of inflammation for Chlamydia and other bacterial inflammatory diseases.
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Affiliation(s)
- Skyla A. Duncan
- Center for NanoBiotechnology Research (CNBR), Department of Biological Sciences, Alabama State University, 1627 Harris Way, Montgomery, AL 36104, USA
| | - Rajnish Sahu
- Center for NanoBiotechnology Research (CNBR), Department of Biological Sciences, Alabama State University, 1627 Harris Way, Montgomery, AL 36104, USA
| | - Saurabh Dixit
- Center for NanoBiotechnology Research (CNBR), Department of Biological Sciences, Alabama State University, 1627 Harris Way, Montgomery, AL 36104, USA
| | - Shree R. Singh
- Center for NanoBiotechnology Research (CNBR), Department of Biological Sciences, Alabama State University, 1627 Harris Way, Montgomery, AL 36104, USA
| | - Vida A. Dennis
- Center for NanoBiotechnology Research (CNBR), Department of Biological Sciences, Alabama State University, 1627 Harris Way, Montgomery, AL 36104, USA
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