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Peramuna T, Kim CM, Aguila LKT, Wendt KL, Wood GE, Cichewicz RH. Iron(III) Binding Properties of PF1140, a Fungal N-Hydroxypyridone, and Activity against Mycoplasma genitalium. JOURNAL OF NATURAL PRODUCTS 2024. [PMID: 38958274 DOI: 10.1021/acs.jnatprod.4c00209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Mycoplasma genitalium is a sexually transmitted bacterium associated with urogenital disease syndromes in the US and worldwide. The global rise in drug resistance in M. genitalium necessitates the development of novel drugs to treat this pathogen. To address this need, we have screened extracts from a library of fungal isolates assembled through the University of Oklahoma Citizen Science Soil Collection Program. Analysis of one of the bioactive extracts using bioassay-guided fractionation led to the purification of the compound PF1140 (1) along with a new and several other known pyridones. The N-hydroxy pyridones are generally regarded as siderophores with high binding affinity for iron(III) under physiological conditions. Results from UV-vis absorption spectroscopy-based titration experiments revealed that 1 complexes with Fe3+. As M. genitalium does not utilize iron, we propose that the PF1140-iron complex induces cytotoxicity by facilitating the cellular uptake of iron, which reacts with endogenous hydrogen peroxide to produce toxic hydroxyl radicals.
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Affiliation(s)
- Thilini Peramuna
- Natural Products Discovery Group, Institute for Natural Products Applications and Research Technologies, Department of Chemistry and Biochemistry, Stephenson Life Sciences Research Center, University of Oklahoma, Norman, Oklahoma 73019, United States
| | - Caroline M Kim
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington 98104, United States
| | - Laarni Kendra T Aguila
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington 98104, United States
| | - Karen L Wendt
- Natural Products Discovery Group, Institute for Natural Products Applications and Research Technologies, Department of Chemistry and Biochemistry, Stephenson Life Sciences Research Center, University of Oklahoma, Norman, Oklahoma 73019, United States
| | - Gwendolyn E Wood
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington 98104, United States
| | - Robert H Cichewicz
- Natural Products Discovery Group, Institute for Natural Products Applications and Research Technologies, Department of Chemistry and Biochemistry, Stephenson Life Sciences Research Center, University of Oklahoma, Norman, Oklahoma 73019, United States
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2
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Nelson SG, Liu CM. Penile microbiome: decoding its impact on HIV risk. Curr Opin HIV AIDS 2024:01222929-990000000-00098. [PMID: 38935058 DOI: 10.1097/coh.0000000000000865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
PURPOSE OF REVIEW The penile microbiome has been linked to local inflammation and increased risk for sexually transmitted infections, including HIV. This review explores recent studies of this emerging area of HIV research. RECENT FINDINGS The male urogenital tract supports multiple distinct niches, where their associated microbiome are shaped by abiotic (e.g., oxygen, moisture) and biotic (e.g., host immunity) environmental factors and host behaviors, particularly sexual activity. In addition, male circumcision is a significant drivers of male genital microbiome in both children and adults. Recent sexual partner studies provide new insight into the exchange of genital bacteria and concurrent local immune changes that may impact HIV risk. SUMMARY The male genital microbiome is shaped by the local microenvironment and host behaviors including sexual activity. Improving our understanding of the connection between the male genital microbiome, local inflammation, and HIV susceptibility, as well as how pro-inflammatory genital bacteria are transmitted between sexual partners may inform new strategies to prevent HIV transmission.
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Affiliation(s)
- Sydney G Nelson
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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Obafemi OA, Rowan SE, Nishiyama M, Wendel KA. Mycoplasma genitalium: Key Information for the Primary Care Clinician. Med Clin North Am 2024; 108:297-310. [PMID: 38331481 DOI: 10.1016/j.mcna.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Mycoplasma genitalium (MG) is an emerging sexually transmitted infection, which appears to be a cause of urethritis and cervicitis and has been associated with pelvic inflammatory disease (PID), epididymitis, proctitis, infertility, complications during pregnancy, and human immunodeficiency virus (HIV) transmission. Three Food and Drug Administration (FDA) approved tests are available. Testing should be focused to avoid inappropriate antibiotic use. The Center of Disease Control and Prevention (CDC) guidelines recommend testing for persistent male urethritis, cervicitis, and proctitis and state that testing should be considered in cases of PID. Testing is also recommended for sexual contacts of patients with MG. Testing is not recommended in asymptomatic patients, including pregnant patients, who do not have a history of MG exposure. Although resistance-guided therapy is recommended, there are currently no FDA approved tests for MG macrolide resistance, and tests are not widely available in the United States. The CDC recommends 2-step treatment with doxycycline followed by azithromycin or moxifloxacin. Moxifloxacin is recommended if resistance testing is unavailable or testing demonstrates macrolide resistance..
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Affiliation(s)
- Oluyomi A Obafemi
- Public Health Institute at Denver Health, 601 Broadway, 8th Floor, MC 2800, Denver, CO 80203-3407, USA; Department of Family Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Sarah E Rowan
- Public Health Institute at Denver Health, 601 Broadway, 8th Floor, MC 2800, Denver, CO 80203-3407, USA; Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Masayo Nishiyama
- Public Health Institute at Denver Health, 601 Broadway, 8th Floor, MC 2800, Denver, CO 80203-3407, USA
| | - Karen A Wendel
- Public Health Institute at Denver Health, 601 Broadway, 8th Floor, MC 2800, Denver, CO 80203-3407, USA; Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, CO, USA.
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Tieosapjaroen W, Ong JJ, Fairley CK, Saleem K, Phillips TR, Tran J, Bradshaw CS, Chen MY, Chow EPF. Trends and associated factors in HIV testing among heterosexual men and women in Melbourne, Australia, 2011-2020. Sex Health 2023; 20:411-423. [PMID: 37468130 DOI: 10.1071/sh22195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/27/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Despite the increase in the proportion of HIV notifications attributed to heterosexuals in Australia, little is known about their HIV testing behaviours. We investigated the trends and factors associated with HIV testing behaviours among heterosexuals. METHODS We analysed the trend and proportion of heterosexuals attending the centre for the first time between 2011 and 2020, who had ever tested and tested for HIV in the past 12months and the median number of months since their last HIV test. We identified factors associated with HIV testing behaviours using univariable and multivariable logistic regressions. RESULTS Of the 78652 heterosexuals included, 53.1% were men and 46.9% were women. Overall, the proportion of heterosexuals who had ever tested for HIV was 40.8%, with a declining testing trend from 40.2% in 2011 to 36.5% in 2020 (P trend <0.001). Overall, the proportion of heterosexuals tested for HIV in the past 12months was 15.7%, with no significant change from 15.3% in 2011 to 14.7% in 2020 (P trend =0.489). The median number of months since the last HIV test decreased from 18.0 (IQR 6.9-37.3) in 2011 to 15.0 (IQR 6.4-32.5) in 2020 (P trend <0.001). Individuals who had condomless sex with casual partners (aOR 0.92, 95% CI 0.88-0.96) and who were diagnosed with a sexually transmitted infection (aOR 0.88, 95% CI 0.84-0.93) were less likely to have ever tested for HIV. CONCLUSIONS HIV testing was low among heterosexuals, and individuals who engaged in condomless sex and had another sexually transmitted infection were less likely to be tested. To reduce HIV transmission, strategies to improve HIV testing among heterosexuals are needed.
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Affiliation(s)
- Warittha Tieosapjaroen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia; and Faculty of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Kanwal Saleem
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Tiffany R Phillips
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Julien Tran
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
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Dabee S, Balle C, Onono M, Innes S, Nair G, Palanee-Phillips T, Burgener AD, Bosinger SE, Passmore JAS, Heffron R, Jaspan H, Happel AU. Update on the Impact of Depot Medroxyprogesterone Acetate on Vaginal Mucosal Endpoints and Relevance to Sexually Transmitted Infections. Curr HIV/AIDS Rep 2023; 20:251-260. [PMID: 37341916 PMCID: PMC10403392 DOI: 10.1007/s11904-023-00662-0] [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] [Accepted: 05/29/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE OF REVIEW The long-acting reversible intramuscularly-injected contraceptive depot medroxyprogesterone acetate (DMPA-IM) is widely used by cisgender women in Africa. Although DMPA-IM provides reliable contraception, potential effects on the female genital tract (FGT) mucosa have raised concern, including risk of HIV infection. This review summarises and compares evidence from observational cohort studies and the randomised Evidence for Contraceptive Options in HIV Outcomes (ECHO) Trial. RECENT FINDINGS Although previous observational studies found women using DMPA-IM had higher abundance of bacterial vaginosis (BV)-associated bacteria, increased inflammation, increased cervicovaginal HIV target cell density, and epithelial barrier damage, sub-studies of the ECHO Trial found no adverse changes in vaginal microbiome, inflammation, proteome, transcriptome, and risk of viral and bacterial STIs, other than an increase in Th17-like cells. Randomised data suggest that DMPA-IM use does not adversely change mucosal endpoints associated with acquisition of infections. These findings support the safe use of DMPA-IM in women at high risk of acquiring STIs, including HIV.
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Affiliation(s)
- Smritee Dabee
- Center for Global Infectious Disease, Seattle Children’s Research Institute, 307 Westlake Ave. N, Seattle, WA 98109 USA
| | - Christina Balle
- Department of Pathology, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | | | - Steve Innes
- Desmond Tutu Health Foundation, 3 Woodlands Rd, Woodstock, Cape Town, 7915 South Africa
| | - Gonasagrie Nair
- Desmond Tutu Health Foundation, 3 Woodlands Rd, Woodstock, Cape Town, 7915 South Africa
| | - Thesla Palanee-Phillips
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Klein St & Esselen St, Hillbrow, Johannesburg 2001 South Africa
| | - Adam D. Burgener
- Center for Global Health and Diseases, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106 USA
- Department of Obstetrics and Gynecology, University of Manitoba, 66 Chancellors Cir, Winnipeg, MB R3T 2N2 Canada
- Unit of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institute, Karolinska University Hospital, Visionsgatan 18, L8, 171 76 Solna, Sweden
| | - Steven E. Bosinger
- ENPRC Genomics Core Laboratory, Emory National Primate Research Center, 954 Gatewood Rd NE, Atlanta, GA 30329 USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA 30307 USA
- Emory Vaccine Center, Emory University, 7 1st Ave, Atlanta, GA 30317 USA
| | - Jo-Ann S. Passmore
- Department of Pathology, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- National Health Laboratory Service, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Renee Heffron
- Department of Medicine, University of Alabama at Birmingham, 845 19th Street South, AL 35294-2170 Birmingham, USA
- Department of Global Health, University of Washington, 1510 San Juan Road NE, Seattle, WA 98195 USA
| | - Heather Jaspan
- Center for Global Infectious Disease, Seattle Children’s Research Institute, 307 Westlake Ave. N, Seattle, WA 98109 USA
- Department of Pathology, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Department of Pediatrics, University of Washington, 1959 NE Pacific St., Seattle, WA 98195 USA
- Department of Global Health, University of Washington, 1510 San Juan Road NE, Seattle, WA 98195 USA
| | - Anna-Ursula Happel
- Department of Pathology, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
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Kabaghe AN, Stephens R, Payne D, Theu J, Luhanga M, Chalira D, Arons MM, O'Malley G, Thomson KA, Nyangulu M, Nyirenda R, Patel P, Wadonda-Kabondo N. HIV Recent Infection and Past HIV Testing History Among Newly HIV-Diagnosed 15-24-Year-Olds in Malawi: An Analysis of 2019-2022 HIV Recent Infection Surveillance Data. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:4-19. [PMID: 37406145 DOI: 10.1521/aeap.2023.35.suppa.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Awareness of HIV status in Malawi is 88.3% and lowest among 15-24-year-olds (76.2%). There is a need to understand HIV testing history and transmission in this age group. We analyzed pooled HIV surveillance data to describe testing history and HIV recent infection among 8,389 HIV-positive 15-24-year-olds from 251 sites in Malawi between 2019 and 2022. Most HIV-positive 15-24-year-olds were female; aged 23-24 years; rural residents; and diagnosed at voluntary counseling and testing. No prior HIV testing was reported in 43.5% and 32.9% of 15-19-year-olds and males, respectively. Overall, 4.9% of HIV-positive diagnoses were classified as recent HIV infections, with the highest proportions among breastfeeding women (8.2%); persons tested at sexually transmitted infection clinics (9.0%); persons with a prior negative test within 6 months (13.0%); and 17-18-year-olds (7.3%). Tailored and innovative HIV prevention and testing strategies for young adolescents, young males, and pregnant and breastfeeding women are needed for HIV epidemic control.
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Affiliation(s)
| | - Reno Stephens
- U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Danielle Payne
- U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Joe Theu
- International Training and Education Center for Health (I-TECH), University of Washington, Lilongwe, Malawi
| | - Misheck Luhanga
- U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Davie Chalira
- International Training and Education Center for Health (I-TECH), University of Washington, Lilongwe, Malawi
| | - Melissa M Arons
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gabrielle O'Malley
- International Training and Education Center for Health (I-TECH), University of Washington, Seattle, Washington
| | - Kerry A Thomson
- International Training and Education Center for Health (I-TECH), University of Washington, Seattle, Washington
| | - Mtemwa Nyangulu
- U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi
| | | | - Pragna Patel
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Wood GE, Bradshaw CS, Manhart LE. Update in Epidemiology and Management of Mycoplasma genitalium Infections. Infect Dis Clin North Am 2023; 37:311-333. [PMID: 37105645 DOI: 10.1016/j.idc.2023.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Mycoplasma genitalium is a frequent cause of urogenital syndromes in men and women and is associated with adverse sequelae in women. M genitalium also infects the rectum, and may cause proctitis, but rarely infects the pharynx. Diagnosis requires nucleic acid amplification testing. Antibiotic resistance is widespread: more than half of infections are resistant to macrolides and fluoroquinolone resistance is increasing. Resistance-guided therapy is recommended for symptomatic patients, involving initial treatment with doxycycline to reduce organism load followed by azithromycin for macrolide-sensitive infections or moxifloxacin for macrolide-resistant infections. Neither screening nor tests of cure are recommended in asymptomatic persons.
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Affiliation(s)
- Gwendolyn E Wood
- Division of Infectious Diseases, University of Washington, Center for AIDS and STD, Box 359779, 325 9th Avenue, Seattle, WA 98104, USA.
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia; Central Clinical School, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Lisa E Manhart
- Department of Epidemiology, University of Washington, Center for AIDS and STD, Box 359931, 325 9th Avenue, Seattle, WA 98104, USA
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Abstract
Trichomoniasis is the most common nonviral sexually transmitted infection worldwide. It has been associated with a variety of adverse sexual and reproductive health outcomes for both men and women. In this review, the authors discuss updates in its epidemiology, pathophysiology, clinical significance, diagnosis, and treatment.
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Prodger JL, Galiwango RM, Tobian AAR, Park D, Liu CM, Kaul R. How Does Voluntary Medical Male Circumcision Reduce HIV Risk? Curr HIV/AIDS Rep 2022; 19:484-490. [PMID: 36308579 PMCID: PMC9617235 DOI: 10.1007/s11904-022-00634-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Voluntary medical male circumcision (VMMC) is a surgical procedure that reduces HIV acquisition risk by almost two-thirds. However, global implementation is lagging, in part due to VMMC hesitancy. A better understanding of the mechanism(s) by which this procedure protects against HIV may increase acceptance of VMMC as an HIV risk reduction approach among health care providers and their clients. RECENT FINDINGS HIV acquisition in the uncircumcised penis occurs preferentially across the inner foreskin tissues, due to increased susceptibility that is linked to elevated inflammatory cytokine levels in the sub-preputial space and an increased tissue density of HIV-susceptible CD4 + T cells. Inflammation can be caused by sexually transmitted infections, but is more commonly induced by specific anaerobic components of the penile microbiome. Circumcision protects by both directly removing the susceptible tissues of the inner foreskin, and by inducing a less inflammatory residual penile microbiome. VMMC reduces HIV susceptibility by removing susceptible penile tissues, and also through impacts on the penile immune and microbial milieu. Understanding these mechanisms may not only increase VMMC acceptability and reinvigorate global VMMC programs, but may also lead to non-surgical HIV prevention approaches focused on penile immunology and/or microbiota.
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Affiliation(s)
- Jessica L Prodger
- Departments of Microbiology and Immunology and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A 5C1, Canada
| | | | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Daniel Park
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Cindy M Liu
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
| | - Rupert Kaul
- Departments of Medicine and Immunology, University of Toronto, Medical Sciences Building Rm. 6356, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
- University Health Network, Toronto, ON, Canada.
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Li Q, Li Y, Bai Y, Zhang H, Zhao W. Development and validation of a predictive model for the risk of developing trichomonas vaginitis in women. Sci Rep 2022; 12:20182. [PMID: 36424393 PMCID: PMC9691695 DOI: 10.1038/s41598-022-24396-y] [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: 06/03/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
Trichomonas vaginitis (TV) is the most common non-viral sexually transmitted infection (STI) worldwide. The high prevalence of TV combined with mild or asymptomatic early symptoms leads to clinical vulnerability from delayed diagnosis. Latent infection can increase the incidence of pelvic infections, infertility, and adverse pregnancy complications. Data from 898 women who underwent vaginal flora testing from June 2014 to December 2014 were used to create a nomogram to assess the risk of TV in women in order to guide TV prevention and clinical intervention. The prediction model was evaluated in terms of identification, calibration, and clinical utility using the C-index, calibration plots, decision curve analysis, and internal validation. Predictors in the TV nomogram included age, occupation, yearly income, tea drinking, bathing frequency, menopause, spontaneous abortion, use of contraceptives, history of gynecological surgery, and HPV infection. The C-index of the TV risk prediction model was 0.732 (95% confidence interval: 0.695-0.768). It showed good discriminatory and predictive power. Decision curve analysis indicated that the nomogram had a good net benefit when the threshold probability of TV in women was 2-80%. The established TV prediction model easily, accurately, and quickly predicts the risk of TV onset.
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Affiliation(s)
- Qi Li
- grid.452845.a0000 0004 1799 2077Department of Obstetrics and Gynecology, the Second Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi China ,grid.263452.40000 0004 1798 4018Shanxi Medical University, Taiyuan, China
| | - Yaqin Li
- grid.452845.a0000 0004 1799 2077Department of Obstetrics and Gynecology, the Second Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi China ,grid.263452.40000 0004 1798 4018Shanxi Medical University, Taiyuan, China
| | - Ying Bai
- grid.452845.a0000 0004 1799 2077Department of Obstetrics and Gynecology, the Second Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi China ,grid.263452.40000 0004 1798 4018Shanxi Medical University, Taiyuan, China
| | - Honglei Zhang
- grid.263452.40000 0004 1798 4018Department of Pathology and Pathophysiology, Basic Medical College, Shanxi Medical University, Taiyuan, China
| | - Weihong Zhao
- grid.452845.a0000 0004 1799 2077Department of Obstetrics and Gynecology, the Second Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi China
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