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Bacterial vaginosis and Mycoplasma infections in reproductive-age women: Clarifying the association with risk factors. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2022.100769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Cox C, Watt AP, McKenna JP, Coyle PV. Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2016; 35:481-7. [PMID: 26796553 DOI: 10.1007/s10096-015-2564-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 12/21/2015] [Indexed: 11/24/2022]
Abstract
Gardnerella vaginalis plays an important role in bacterial vaginosis (BV,) while the role of genital Mollicutes is less obvious. The diagnosis of BV by use of the current Gram stain Nugent score is also suboptimal for defining the role of Mollicutes that lack a cell wall. Since bacterial load and diversity is an important prerequisite for BV, real-time quantitative polymerase chain reaction (qPCR) assays enable these to be assessed. The purpose of this study was to define the role of genital Mollicutes and potential patterns of synergy with G. vaginalis in women with BV. Vaginal swabs from 130 women categorised by Nugent score as BV (n = 28), intermediate (n = 22) and non-BV (n = 80) were tested against four qPCR TaqMan assays targeting G. vaginalis, Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum and U. parvum. Statistical analyses were used to compare bacterial prevalence and load between the three groups of women. Mycoplasma hominis and G. vaginalis co-infection was significantly more common in BV (60.7 %) compared to intermediate (36.4 %) and non-BV (8.8 %) Nugent scores (p < 0.001). Significantly higher loads of M. hominis (p = 0.001) and G. vaginalis (p < 0.001) were detected in women with BV and the respective loads in M. hominis and G. vaginalis co-infections displayed a significant positive correlation (p < 0.001; r = 0.60). No significant associations were seen with the other Mollicutes. The findings strengthen the evidence of a role for M. hominis in BV and a potential synergy with G. vaginalis. This synergy could be an important trigger of the condition and sexual contact the conduit for the transmission of an otherwise commensal bacterium that could initiate it.
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Affiliation(s)
- C Cox
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK. .,Centre for Infection and Immunity, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - A P Watt
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - J P McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - P V Coyle
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
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Lima TM, Teles LMR, de Oliveira AS, Campos FC, Barbosa RDCC, Pinheiro AKB, Damasceno AKDC. [Vaginal discharge in pregnant women: comparison between syndromic approach and examination of clinical nursing practice]. Rev Esc Enferm USP 2014; 47:1265-71. [PMID: 24626373 DOI: 10.1590/s0080-623420130000600002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 09/02/2013] [Indexed: 11/21/2022] Open
Abstract
This is a study for assessment of a quantitative approach in pregnant women (N=104), in which findings of vaginal infection were compared. The findings were obtained by two means, flowchart of vaginal discharge, and typical examinations in the clinical nursing practice. Data were collected from January to July 2011 through interviews and gynecological examinations. The flowchart showed no efficacy to identify candidiasis and trichomoniasis. Furthermore, it showed low sensitivity (0.0%; 50%) and positive predictive value (0.0%; 3.6%) for both infections, and low specificity for trichomoniasis (46%). The flowchart was shown to be satisfactory for bacterial vaginosis, with high sensitivity (100%), negative predictive value (100%), and accuracy (74%). We conclude that use of the flowchart should be reassessed, as it was not able to identify important infections in pregnant women. A continuous effort must be directed for development of effective tests in order to prevent the spread of infection and reduce the number of unnecessary treatments.
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Affiliation(s)
- Thais Marques Lima
- Universidade Federal do Ceará, Brasil, FortalezaCE, Doutoranda em Enfermagem, Universidade Federal do Ceará , Fortaleza , CE , Brasil
| | - Liana Mara Rocha Teles
- Universidade Federal do Ceará, Brasil, FortalezaCE, Doutoranda em Enfermagem, Universidade Federal do Ceará , Fortaleza , CE , Brasil
| | - Amanda Souza de Oliveira
- Universidade Federal do Ceará, Brasil, FortalezaCE, Mestranda em Enfermagem, Universidade Federal do Ceará , Fortaleza , CE , Brasil
| | - Fernanda Câmara Campos
- Universidade Federal do Ceará, Brasil, FortalezaCE, Graduanda de Enfermagem, Universidade Federal do Ceará , Fortaleza , CE , Brasil
| | - Rita de Cássia Carvalho Barbosa
- Departamento de Farmácia, Universidade Federal do Ceará, Brasil, FortalezaCE, Professora Doutora, Departamento de Farmácia , Universidade Federal do Ceará , Fortaleza , CE , Brasil
| | - Ana Karina Bezerra Pinheiro
- Departamento de Enfermagem, Universidade Federal do Ceará, Brasil, FortalezaCE, Professora Adjunta, Departamento de Enfermagem , Universidade Federal do Ceará , Fortaleza , CE , Brasil
| | - Ana Kelve de Castro Damasceno
- Departamento de Enfermagem, Universidade Federal do Ceará, Brasil, FortalezaCE, Professora Adjunta, Departamento de Enfermagem , Universidade Federal do Ceará , Fortaleza , CE , Brasil
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Forces driving change in medical diagnostics. Clin Chim Acta 2013; 415:31-4. [PMID: 22982817 DOI: 10.1016/j.cca.2012.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 08/20/2012] [Accepted: 09/06/2012] [Indexed: 11/23/2022]
Abstract
This article reviews the external forces that affect and shape the future of medical diagnostics. A PESTELI model is retrospectively used to highlight the factors that drive change at an operational and management level. The author describes the future picture of clinical laboratory diagnostics and proposes ways to overcome current and pending challenges on clinical laboratories and university curriculum. An international committee with broad expertise in clinical laboratory diagnostics is proposed to examine these changes and provide guidance.
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Verstraelen H, Verhelst R, Vaneechoutte M, Temmerman M. The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC Infect Dis 2010; 10:81. [PMID: 20353563 PMCID: PMC3161362 DOI: 10.1186/1471-2334-10-81] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 03/30/2010] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Bacterial vaginosis (BV) has been most consistently linked to sexual behaviour, and the epidemiological profile of BV mirrors that of established sexually transmitted infections (STIs). It remains a matter of debate however whether BV pathogenesis does actually involve sexual transmission of pathogenic micro-organisms from men to women. We therefore made a critical appraisal of the literature on BV in relation to sexual behaviour. DISCUSSION G. vaginalis carriage and BV occurs rarely with children, but has been observed among adolescent, even sexually non-experienced girls, contradicting that sexual transmission is a necessary prerequisite to disease acquisition. G. vaginalis carriage is enhanced by penetrative sexual contact but also by non-penetrative digito-genital contact and oral sex, again indicating that sex per se, but not necessarily coital transmission is involved. Several observations also point at female-to-male rather than at male-to-female transmission of G. vaginalis, presumably explaining the high concordance rates of G. vaginalis carriage among couples. Male antibiotic treatment has not been found to protect against BV, condom use is slightly protective, whereas male circumcision might protect against BV. BV is also common among women-who-have-sex-with-women and this relates at least in part to non-coital sexual behaviours. Though male-to-female transmission cannot be ruled out, overall there is little evidence that BV acts as an STD. Rather, we suggest BV may be considered a sexually enhanced disease (SED), with frequency of intercourse being a critical factor. This may relate to two distinct pathogenetic mechanisms: (1) in case of unprotected intercourse alkalinisation of the vaginal niche enhances a shift from lactobacilli-dominated microflora to a BV-like type of microflora and (2) in case of unprotected and protected intercourse mechanical transfer of perineal enteric bacteria is enhanced by coitus. A similar mechanism of mechanical transfer may explain the consistent link between non-coital sexual acts and BV. Similar observations supporting the SED pathogenetic model have been made for vaginal candidiasis and for urinary tract infection. SUMMARY Though male-to-female transmission cannot be ruled out, overall there is incomplete evidence that BV acts as an STI. We believe however that BV may be considered a sexually enhanced disease, with frequency of intercourse being a critical factor.
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Affiliation(s)
- Hans Verstraelen
- Department of Obstetrics & Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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