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Li X, Xiang F, Liu T, Chen Z, Zhang M, Li J, Kang X, Wu R. Leveraging existing 16S rRNA gene surveys to decipher microbial signatures and dysbiosis in cervical carcinogenesis. Sci Rep 2024; 14:11532. [PMID: 38773342 PMCID: PMC11109339 DOI: 10.1038/s41598-024-62531-z] [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: 11/03/2023] [Accepted: 05/17/2024] [Indexed: 05/23/2024] Open
Abstract
The presence of dysbiotic cervicovaginal microbiota has been observed to be linked to the persistent development of cervical carcinogenesis mediated by the human papillomavirus (HPV). Nevertheless, the characteristics of the cervical microbiome in individuals diagnosed with cervical cancer (CC) are still not well understood. Comprehensive analysis was conducted by re-analyzing the cervical 16S rRNA sequencing datasets of a total of 507 samples from six previously published studies. We observed significant alpha and beta diversity differences in between CC, cervical intraepithelial neoplasia (CIN) and normal controls (NC), but not between HPV and NC in the combined dataset. Meta-analysis revealed that opportunistic pernicious microbes Streptococcus, Fusobacterium, Pseudomonas and Anaerococcus were enriched in CC, while Lactobacillus was depleted compared to NC. Members of Gardnerella, Sneathia, Pseudomonas, and Fannyhessea have significantly increased relative abundance compared to other bacteria in the CIN group. Five newly identified bacterial genera were found to differentiate CC from NC, with an area under the curve (AUC) of 0.8947. Moreover, co-occurrence network analysis showed that the most commonly encountered Lactobacillus was strongly negatively correlated with Prevotella. Overall, our study identified a set of potential biomarkers for CC from samples across different geographic regions. Our meta-analysis provided significant insights into the characteristics of dysbiotic cervicovaginal microbiota undergoing CC, which may lead to the development of noninvasive CC diagnostic tools and therapeutic interventions.
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Affiliation(s)
- Xiaoxiao Li
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China
| | - Fenfen Xiang
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China
| | - Tong Liu
- Department of Molecular Science, Uppsala Biocenter, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Zixi Chen
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China
| | - Mengzhe Zhang
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China
| | - Jinpeng Li
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China
| | - Xiangdong Kang
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China.
| | - Rong Wu
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 Lanxi Road, Shanghai, 200062, China.
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Prasanchit P, Pongchaikul P, Lertsittichai P, Tantitham C, Manonai J. Vaginal microbiomes of breast cancer survivors treated with aromatase inhibitors with and without vulvovaginal symptoms. Sci Rep 2024; 14:7417. [PMID: 38548910 PMCID: PMC10978846 DOI: 10.1038/s41598-024-58118-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
Genitourinary syndrome of menopause (GSM) is the leading cause of vaginal symptoms in breast cancer survivors treated with aromatase inhibitors. However, there are currently no effective treatment options available for women with a history of breast cancer. Recent research has established that changes in the vaginal microbiome may be linked to GSM. Most studies have assessed the microbiome without accounting for the estrogen status. It remains unknown whether the vaginal microbiome differ among patients with a low estrogenic state with and without vulvovaginal symptoms. To address such research questions, our study compares the vaginal microbiomes among breast cancer survivors treated with aromatase inhibitors with and without vulvovaginal symptoms. A total of 50 breast cancer survivors treated with aromatase inhibitors were recruited, among whom 25 had vulvovaginal symptoms and 25 had no vulvovaginal symptoms. Vaginal swabs were collected. DNA extraction, followed by sequencing of the V3-V4 regions of the 16S ribosomal RNA gene, were performed. Differential abundance analysis was conducted by linear discriminant analysis effect size. Taxonomy assignment, alpha diversity and beta diversity were examined. The relative abundance of genus Sneathia and genus Gardnerella was significantly increased in vulvovaginal symptoms group with no differences in bacterial diversity and richness.
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Affiliation(s)
- Pimpun Prasanchit
- Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Rd., Bangkok, 10400, Thailand
| | - Pisut Pongchaikul
- Ramathibodi Medical School, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 111, Suwannabhumi Canal Rd., Samut Prakan, 10540, Thailand
- Integrative Computational BioScience Center, Mahidol University, Nakhon Pathom, Thailand
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Panuwat Lertsittichai
- Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Rd., Bangkok, 10400, Thailand
| | - Chananya Tantitham
- Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Rd., Bangkok, 10400, Thailand
| | - Jittima Manonai
- Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Rd., Bangkok, 10400, Thailand.
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3
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Srinivasan S, Austin MN, Fiedler TL, Strenk SM, Agnew KJ, Gowda GAN, Raftery D, Beamer MA, Achilles SL, Wiesenfeld HC, Fredricks DN, Hillier SL. Amygdalobacter indicium gen. nov., sp. nov., and Amygdalobacter nucleatus sp. nov., gen. nov.: novel bacteria from the family Oscillospiraceae isolated from the female genital tract. Int J Syst Evol Microbiol 2023; 73. [PMID: 37787404 DOI: 10.1099/ijsem.0.006017] [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: 10/04/2023] Open
Abstract
Four obligately anaerobic Gram-positive bacteria representing one novel genus and two novel species were isolated from the female genital tract. Both novel species, designated UPII 610-JT and KA00274T, and an additional isolate of each species were characterized utilizing biochemical, genotypic and phylogenetic analyses. All strains were non-motile and non-spore forming, asaccharolytic, non-cellulolytic and indole-negative coccobacilli. Fatty acid methyl ester analysis for UPII 610-JT and KA00274T and additional isolates revealed C16 : 0, C18 : 0, C18:1ω9c and C18:2ω6,9c to be the major fatty acids for both species. UPII 610-JT had a 16S rRNA gene sequence similarity of 99.4 % to an uncultured clone sequence (AY724740) designated as Bacterial Vaginosis Associated Bacterium 2 (BVAB2). KA00274T had a 16S rRNA gene sequence similarity of 96.5 % to UPII 610-JT. Whole genomic DNA mol% G+C content was 42.2 and 39.3 % for UPII 610-JT and KA00274T, respectively. Phylogenetic analyses indicate these isolates represent a novel genus and two novel species within the Oscillospiraceae family. We propose the names Amygdalobacter indicium gen. nov., sp. nov., for UPII 610-JT representing the type strain of this species (=DSM 112989T, =ATCC TSD-274T) and Amygdalobacter nucleatus gen. nov., sp. nov., for KA00274T representing the type strain of this species (=DSM 112988T, =ATCC TSD-275T).
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Affiliation(s)
- Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - Tina L Fiedler
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Susan M Strenk
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kathy J Agnew
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Washington Medical Center, Seattle, WA, USA
| | - G A Nagana Gowda
- Northwest Metabolomics Research Center and Mitochondrial and Metabolism Center, Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Daniel Raftery
- Northwest Metabolomics Research Center and Mitochondrial and Metabolism Center, Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - May A Beamer
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Sharon L Achilles
- Magee-Womens Research Institute, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh PA, USA
| | - Harold C Wiesenfeld
- Magee-Womens Research Institute, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh PA, USA
| | - David N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sharon L Hillier
- Magee-Womens Research Institute, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh PA, USA
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4
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Hu J, Wu Y, Quan L, Yang W, Lang J, Tian G, Meng B. Research of cervical microbiota alterations with human papillomavirus infection status and women age in Sanmenxia area of China. Front Microbiol 2022; 13:1004664. [PMID: 36312946 PMCID: PMC9608786 DOI: 10.3389/fmicb.2022.1004664] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is the leading cause of cervical cancer. More and more studies discovered that cervical microbiota (CM) composition correlated with HPV infection and the development of cervical cancer. However, more studies need to be implemented to clarify the complex interaction between microbiota and the mechanism of disease development, especially in a specific area of China. Materials and methods In this study, 16S rDNA sequencing was applied on 276 Thin-prep Cytologic Test (TCT) samples of patients from the Sanmenxia area. Systematical analysis of the microbiota structure, diversity, group, and functional differences between different HPV infection groups and age groups, and co-occurrence relationships of the microbiota was carried out. Results The major microbiota compositions of all patients include Lactobacillus iners, Escherichia coli, Enterococcus faecalis, and Atopobium vaginae at species level, and Staphylococcus, Lactobacillus, Gardnerella, Bosea, Streptococcus, and Sneathia in genus level. Microbiota diversity was found significantly different between HPV-positive (Chao1 index: 98.8869, p < 0.01), unique-268 infected (infections with one of the HPV genotype 52, 56, or 58, 107.3885, p < 0.01), multi-268 infected (infections with two or more of HPV genotype 52, 56, and 58, 97.5337, p = 0.1012), other1 (94.9619, p < 0.05) groups and HPV-negative group (83.5299). Women older than 60 years old have higher microbiota diversity (108.8851, p < 0.01, n = 255) than younger women (87.0171, n = 21). The abundance of Gardnerella and Atopobium vaginae was significantly higher in the HPV-positive group than in the HPV-negative group, while Burkholderiaceae and Mycoplasma were more abundant in the unique-268 group compared to the negative group. Gamma-proteobacteria and Pseudomonas were found more abundant in older than 60 patients than younger groups. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Clusters of Orthologous Groups (COG) analysis revealed the effects on metabolism by microbiota that the metabolism of cells, proteins, and genetic information-related pathways significantly differed between HPV-negative and positive groups. In contrast, lipid metabolism, signal transduction, and cell cycle metabolism pathway significantly differed between multi-268 and negative groups. Conclusion The HPV infection status and age of women were related to CM’s diversity and function pathways. The complex CM co-occurrent relationships and their mechanism in disease development need to be further investigated.
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Affiliation(s)
- Jintao Hu
- Faculty of Engineering and Information Technology, The University of Melbourne, Parkville, VIC, Australia
- Genesis (Beijing) Co., Ltd., Beijing, China
| | - Yuhan Wu
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Lili Quan
- Department of Gynecology, Sanmenxia Central Hospital of Henan University of Science and Technology, Sanmenxia, Henan, China
| | | | | | - Geng Tian
- Genesis (Beijing) Co., Ltd., Beijing, China
- Geng Tian,
| | - Bo Meng
- Genesis (Beijing) Co., Ltd., Beijing, China
- *Correspondence: Bo Meng,
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5
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Hughes SM, Levy CN, Calienes FL, Martinez KA, Selke S, Tapia K, Chohan BH, Oluoch L, Kiptinness C, Wald A, Ghosh M, Hardy L, Ngure K, Mugo NR, Hladik F, Roxby AC. Starting to have sexual intercourse is associated with increases in cervicovaginal immune mediators in young women: a prospective study and meta-analysis. eLife 2022; 11:78565. [PMID: 36281966 PMCID: PMC9596159 DOI: 10.7554/elife.78565] [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: 03/11/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Adolescent girls and young women (AGYW) are at high risk of sexually transmitted infections (STIs). It is unknown whether beginning to have sexual intercourse results in changes to immune mediators in the cervicovaginal tract that contribute to this risk. Methods: We collected cervicovaginal lavages from Kenyan AGYW in the months before and after first penile-vaginal sexual intercourse and measured the concentrations of 20 immune mediators. We compared concentrations pre- and post-first sex using mixed effect models. We additionally performed a systematic review to identify similar studies and combined them with our results by meta-analysis of individual participant data. Results: We included 180 samples from 95 AGYW, with 44% providing only pre-first sex samples, 35% matched pre and post, and 21% only post. We consistently detected 19/20 immune mediators, all of which increased post-first sex (p<0.05 for 13/19; Holm-Bonferroni-adjusted p<0.05 for IL-1β, IL-2, and CXCL8). Effects remained similar after excluding samples with STIs and high Nugent scores. Concentrations increased cumulatively over time after date of first sex, with an estimated doubling time of about 5 months. Our systematic review identified two eligible studies, one of 93 Belgian participants, and the other of 18 American participants. Nine immune mediators were measured in at least two-thirds of studies. Meta-analysis confirmed higher levels post-first sex for 8/9 immune mediators (p<0.05 for six mediators, most prominently IL-1α, IL-1β, and CXCL8). Conclusions: Cervicovaginal immune mediator concentrations were higher in women who reported that they started sexual activity. Results were consistent across three studies conducted on three different continents. Funding: This research was funded by R01 HD091996-01 (ACR), by P01 AI 030731-25 (Project 1) (AW), R01 AI116292 (FH), R03 AI154366 (FH) and by the Center for AIDS Research (CFAR) of the University of Washington/Fred Hutchinson Cancer Research Center AI027757.
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Affiliation(s)
- Sean M Hughes
- Department of Obstetrics and Gynecology, University of WashingtonSeattleUnited States
| | - Claire N Levy
- Department of Obstetrics and Gynecology, University of WashingtonSeattleUnited States
| | - Fernanda L Calienes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States
| | - Katie A Martinez
- Department of Obstetrics and Gynecology, University of WashingtonSeattleUnited States
| | - Stacy Selke
- Department of Laboratory Medicine & Pathology, University of WashingtonSeattleUnited States
| | - Kenneth Tapia
- Department of Global Health, University of WashingtonSeattleUnited States
| | - Bhavna H Chohan
- Department of Global Health, University of WashingtonSeattleUnited States,Centre for Virus Research, Kenya Medical Research InstituteNairobiKenya
| | - Lynda Oluoch
- Centre for Clinical Research, Kenya Medical Research InstituteNairobiKenya
| | | | - Anna Wald
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States,Department of Laboratory Medicine & Pathology, University of WashingtonSeattleUnited States,Department of Medicine, University of WashingtonSeattleUnited States,Department of Epidemiology, University of WashingtonSeattleUnited States
| | - Mimi Ghosh
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington UniversityWashingtonUnited States
| | - Liselotte Hardy
- Department of Clinical Sciences, Unit of Tropical Bacteriology, Institute of Tropical MedicineAntwerpBelgium
| | - Kenneth Ngure
- Department of Global Health, University of WashingtonSeattleUnited States,Department of Community Health, Jomo Kenyatta University of Agriculture and TechnologyNairobiKenya
| | - Nelly R Mugo
- Department of Global Health, University of WashingtonSeattleUnited States,Centre for Clinical Research, Kenya Medical Research InstituteNairobiKenya
| | - Florian Hladik
- Department of Obstetrics and Gynecology, University of WashingtonSeattleUnited States,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States,Department of Medicine, University of WashingtonSeattleUnited States
| | - Alison C Roxby
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States,Department of Global Health, University of WashingtonSeattleUnited States,Department of Medicine, University of WashingtonSeattleUnited States,Department of Epidemiology, University of WashingtonSeattleUnited States
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6
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Glascock AL, Jimenez NR, Boundy S, Koparde VN, Brooks JP, Edwards DJ, Strauss Iii JF, Jefferson KK, Serrano MG, Buck GA, Fettweis JM. Unique roles of vaginal Megasphaera phylotypes in reproductive health. Microb Genom 2021; 7. [PMID: 34898422 PMCID: PMC8767330 DOI: 10.1099/mgen.0.000526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The composition of the human vaginal microbiome has been extensively studied and is known to influence reproductive health. However, the functional roles of individual taxa and their contributions to negative health outcomes have yet to be well characterized. Here, we examine two vaginal bacterial taxa grouped within the genus Megasphaera that have been previously associated with bacterial vaginosis (BV) and pregnancy complications. Phylogenetic analyses support the classification of these taxa as two distinct species. These two phylotypes, Megasphaera phylotype 1 (MP1) and Megasphaera phylotype 2 (MP2), differ in genomic structure and metabolic potential, suggestive of differential roles within the vaginal environment. Further, these vaginal taxa show evidence of genome reduction and changes in DNA base composition, which may be common features of host dependence and/or adaptation to the vaginal environment. In a cohort of 3870 women, we observed that MP1 has a stronger positive association with bacterial vaginosis whereas MP2 was positively associated with trichomoniasis. MP1, in contrast to MP2 and other common BV-associated organisms, was not significantly excluded in pregnancy. In a cohort of 52 pregnant women, MP1 was both present and transcriptionally active in 75.4 % of vaginal samples. Conversely, MP2 was largely absent in the pregnant cohort. This study provides insight into the evolutionary history, genomic potential and predicted functional role of two clinically relevant vaginal microbial taxa.
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Affiliation(s)
| | - Nicole R Jimenez
- Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA, USA.,Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA
| | - Sam Boundy
- Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA, USA
| | - Vishal N Koparde
- Life Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - J Paul Brooks
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.,Department of Supply Chain Management and Analytics, Virginia Commonwealth University, Richmond, VA, USA
| | - David J Edwards
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.,Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, VA, USA
| | - Jerome F Strauss Iii
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kimberly K Jefferson
- Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA, USA.,Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
| | - Myrna G Serrano
- Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA, USA.,Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA
| | - Gregory A Buck
- Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA, USA.,Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.,Department of Computer Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennifer M Fettweis
- Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA, USA.,Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
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7
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 737] [Impact Index Per Article: 245.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
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Theis KR, Florova V, Romero R, Borisov AB, Winters AD, Galaz J, Gomez-Lopez N. Sneathia: an emerging pathogen in female reproductive disease and adverse perinatal outcomes. Crit Rev Microbiol 2021; 47:517-542. [PMID: 33823747 DOI: 10.1080/1040841x.2021.1905606] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sneathia is an emerging pathogen implicated in adverse reproductive and perinatal outcomes. Although scarce, recent data suggest that vaginally residing Sneathia becomes pathogenic following its ascension into the upper urogenital tract, amniotic fluid, placenta, and foetal membranes. The role of Sneathia in women's health and disease is generally underappreciated because the cultivation of these bacteria is limited by their complex nutritional requirements, slow growth patterns, and anaerobic nature. For this reason, molecular methods are typically required for the detection and differential diagnosis of Sneathia infections. Here, we review the laboratory methods used for the diagnosis of Sneathia infections, the molecular mechanisms underlying its virulence, and its sensitivity to antibiotics. We further review the evidence of Sneathia's contributions to the pathogenesis of bacterial vaginosis, chorioamnionitis, preterm prelabour rupture of membranes, spontaneous preterm labour, stillbirth, maternal and neonatal sepsis, HIV infection, and cervical cancer. Collectively, growing evidence indicates that Sneathia represents an important yet underappreciated pathogen affecting the development and progression of several adverse clinical conditions diagnosed in pregnant women and their neonates, as well as in non-pregnant women.
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Affiliation(s)
- Kevin R Theis
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Violetta Florova
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.,Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.,Detroit Medical Center, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Florida International University, Miami, FL, USA
| | - Andrei B Borisov
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Andrew D Winters
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jose Galaz
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, USA.,Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
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9
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Sobel JD, Sobel R. Current and emerging pharmacotherapy for recurrent bacterial vaginosis. Expert Opin Pharmacother 2021; 22:1593-1600. [PMID: 33750246 DOI: 10.1080/14656566.2021.1904890] [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] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Given the frequency of recurrent bacterial vaginosis (RBV), enhancing treatment and preventing recurrence have become the central target of pharmacotherapy today. Antimicrobial failure is occurring at a time when knowledge of pathogenesis of bacterial vaginosis (BV) and RBV is incomplete, limiting rational treatment modification. AREAS COVERED The current manuscript reviews pathogenesis of RBV and the performance of available antimicrobials as well as attempts employed to enhance activity and pharmacologic strategies to reduce BV recurrence and refractory vaginal disease. The authors also provide their expert perspectives on the subject area, including their outlook for the future. EXPERT OPINION In the face of an empty pipeline of new antibiotics, strategies have emerged to enhance existing antibiotic efficacy, which include modifying drug dose, treatment duration, long-term prophylactic regimens, and use of biofilm disrupting agents. It is likely that future effective therapy will include several simultaneous and consecutive treatment components, including combinations of antibiotics, antibiofilm agents, and probiotics. Measures to prevent sexual transmission and reinfection are also essential.
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Affiliation(s)
- Jack D Sobel
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, United States
| | - Ryan Sobel
- Department of Obstetrics and Gynecology, Jefferson Medical College, Philadelphia, United States
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10
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Farr Zuend C, Noël-Romas L, Hoger S, McCorriser S, Westmacott G, Marrazzo J, Hillier SL, Dezzutti C, Squires K, Bunge KE, Burgener A. Influence of dapivirine vaginal ring use on cervicovaginal immunity and functional microbiome in adolescent girls. AIDS 2021; 35:369-380. [PMID: 33181534 PMCID: PMC7924934 DOI: 10.1097/qad.0000000000002751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The antiretroviral-based dapivirine vaginal ring reduced HIV risk among women in phase III clinical trials. However, limited data exists on the impact of dapivirine on the vaginal microenvironment in adolescents. DESIGN A comprehensive metaproteomics approach was used to assess host proteome and microbiome changes in cervicovaginal mucus with dapivirine ring use in adolescents enrolled in the MTN-023/IPM 030 (MTN-023) trial. METHODS Participants were randomized 3 : 1 to use dapivirine or placebo vaginal rings monthly for 6 months. Cervicovaginal samples from a subset of 35 participants (8 placebo, 27 dapivirine) were analyzed. RESULTS Mass spectrometry analysis identified 405 human and 2467 bacterial proteins belonging to 15 unique genera. The host proteome belonged to many functional pathways primarily related to inflammation. When stratified by study treatment arm, 18 (4.4%) and 28 (6.9%) human proteins were differentially abundant (adjusted P < 0.05) between baseline and follow-up in the placebo and dapivirine arms, respectively. The vaginal microbiome was predominantly composed of Lactobacillus, Gardnerella, and Prevotella. Although bacterial taxa did not differ by arm or change significantly, Lactobacillus crispatus increased (P < 0.001) and Lactobacillus iners decreased (P < 0.001) during the 6-month follow-up. There were no significant differences in bacterial functions by arm or time in the trial. Protected vaginal sex significantly associated with decreased neutrophil inflammatory biomarkers and may be associated with changes in bacterial taxa and metabolism. CONCLUSION Condom use may associate with differences to inflammation and bacterial function but dapivirine ring use does not, thereby supporting the mucosal safety profile of this vaginal ring for adolescents.
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Affiliation(s)
- Christina Farr Zuend
- Center for Global health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
| | - Laura Noël-Romas
- Center for Global health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
- Departments of Obstetrics and Gynecology and Medical Microbiology, University of Manitoba
| | - Sarah Hoger
- Departments of Obstetrics and Gynecology and Medical Microbiology, University of Manitoba
| | - Stuart McCorriser
- Mass Spectrometry and Proteomics Core Facility, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Garrett Westmacott
- Mass Spectrometry and Proteomics Core Facility, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jeanne Marrazzo
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Sharon L. Hillier
- University of Pittsburgh School of Medicine
- Magee-Women's Research Institute, Pittsburgh
| | - Charlene Dezzutti
- University of Pittsburgh School of Medicine
- Magee-Women's Research Institute, Pittsburgh
| | - Kathleen Squires
- Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Katherine E. Bunge
- University of Pittsburgh School of Medicine
- Magee-Women's Research Institute, Pittsburgh
| | - Adam Burgener
- Center for Global health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
- Departments of Obstetrics and Gynecology and Medical Microbiology, University of Manitoba
- Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
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11
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Srinivasan S, Beamer MA, Fiedler TL, Austin MN, Sizova MV, Strenk SM, Agnew KJ, Gowda GAN, Raftery D, Epstein SS, Fredricks DN, Hillier SL. Megasphaera lornae sp. nov., Megasphaera hutchinsoni sp. nov., and Megasphaera vaginalis sp. nov.: novel bacteria isolated from the female genital tract. Int J Syst Evol Microbiol 2021; 71. [PMID: 33616513 DOI: 10.1099/ijsem.0.004702] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Six strictly anaerobic Gram-negative bacteria representing three novel species were isolated from the female reproductive tract. The proposed type strains for each species were designated UPII 199-6T, KA00182T and BV3C16-1T. Phylogenetic analyses based on 16S rRNA gene sequencing indicated that the bacterial isolates were members of the genus Megasphaera. UPII 199-6T and KA00182T had 16S rRNA gene sequence identities of 99.9 % with 16S rRNA clone sequences previously amplified from the human vagina designated as Megasphaera type 1 and Megasphaera type 2, members of the human vaginal microbiota associated with bacterial vaginosis, preterm birth and HIV acquisition. UPII 199-6T exhibited sequence identities ranging from 92.9 to 93.6 % with validly named Megasphaera isolates and KA00182T had 16S rRNA gene sequence identities ranging from 92.6-94.2 %. BV3C16-1T was most closely related to Megasphaera cerevisiae with a 16S rRNA gene sequence identity of 95.4 %. Cells were coccoid or diplococcoid, non-motile and did not form spores. Genital tract isolates metabolized organic acids but were asaccharolytic. The isolates also metabolized amino acids. The DNA G+C content for the genome sequences of UPII 199-6T, KA00182T and BV3C16-1T were 46.4, 38.9 and 49.8 mol%, respectively. Digital DNA-DNA hybridization and average nucleotide identity between the genital tract isolates and other validly named Megasphaera species suggest that each isolate type represents a new species. The major fatty acid methyl esters include the following: C12 : 0, C16 : 0, C16 : 0 dimethyl acetal (DMA) and summed feature 5 (C15 : 0 DMA and/or C14 : 0 3-OH) in UPII 199-6T; C16 : 0 and C16 : 1 cis 9 in KA00182T; C12 : 0; C14 : 0 3-OH; and summed feature 5 in BV3C16-1T. The isolates produced butyrate, isobutyrate, and isovalerate but there were specific differences including production of formate and propionate. Together, these data indicate that UPII 199-6T, KA00182T and BV3C16-1T represent novel species within the genus Megasphaera. We propose the following names: Megasphaera lornae sp. nov. for UPII 199-6T representing the type strain of this species (=DSM 111201T=ATCC TSD-205T), Megasphaera hutchinsoni sp. nov. for KA00182T representing the type strain of this species (=DSM 111202T=ATCC TSD-206T) and Megasphaera vaginalis sp. nov. for BV3C16-1T representing the type strain of this species (=DSM 111203T=ATCC TSD-207T).
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Affiliation(s)
- Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - May A Beamer
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Tina L Fiedler
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Maria V Sizova
- Present address: Evelo Biosciences, 620 Memorial Drive, Cambridge, MA, USA.,Department of Biology, Northeastern University, Boston, MA, USA
| | - Susan M Strenk
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kathy J Agnew
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Washington Medical Center, Seattle, WA, USA
| | - G A Nagana Gowda
- Northwest Metabolomics Research Center and Mitochondrial and Metabolism Center, Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Daniel Raftery
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Northwest Metabolomics Research Center and Mitochondrial and Metabolism Center, Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Slava S Epstein
- Department of Biology, Northeastern University, Boston, MA, USA
| | - David N Fredricks
- Department of Medicine, University of Washington, Seattle, WA, USA.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sharon L Hillier
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh, PA, USA.,Magee-Womens Research Institute, Pittsburgh, PA, USA
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12
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Tuddenham S, Ravel J, Marrazzo JM. Protection and Risk: Male and Female Genital Microbiota and Sexually Transmitted Infections. J Infect Dis 2021; 223:S222-S235. [PMID: 33576776 DOI: 10.1093/infdis/jiaa762] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Unique compositional and functional features of the cervicovaginal microbiota have been associated with protection against and risk for sexually transmitted infections (STI). In men, our knowledge of the interaction between the penile microbiota and STI is less developed. The current state of our understanding of these microbiota and their role in select STIs is briefly reviewed, along with strategies that leverage existing findings to manipulate genital microbiota and optimize protection against STIs. Finally, we focus on major research gaps and present a framework for future studies.
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Affiliation(s)
- Susan Tuddenham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jeanne M Marrazzo
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
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13
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Wei ZT, Chen HL, Wang CF, Yang GL, Han SM, Zhang SL. Depiction of Vaginal Microbiota in Women With High-Risk Human Papillomavirus Infection. Front Public Health 2021; 8:587298. [PMID: 33490017 PMCID: PMC7820762 DOI: 10.3389/fpubh.2020.587298] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/08/2020] [Indexed: 01/14/2023] Open
Abstract
Persistent infection with the carcinogenic human papillomavirus (HPV) is a prerequisite for the progression of cervical lesions and cancer. A growing body of research has focused on the functional role of the vaginal microbiota in the persistence of HPV infection. Understanding the microbial composition and structure in women with high-risk (hr)-HPV infection may help reveal associations between the vaginal microbiota and HPV infection, and identify potential biomarkers. Our study investigated the vaginal microbial community in women with and without hr-HPV infection, by using 16s rRNA gene sequencing. We found that microbial perturbations occurred in the early phase of hr-HPV infection. Lactobacillus and Sporolactobacillus were decreased, while bacteria related to bacterial vaginosis (BV), such as Gardnerella, Prevotella, Dialister, Slackia, Actinomyces, Porphyromonas, Peptoniphilus, Anaerococcus, Peptostreptococcus, Streptococcus, Ureaplasma, Megasphaera, and Mycoplasma were increased. Our results could offer insights into the correlations between hr-HPV and the vaginal microbiota in the early infection period, and provide indications that the predominance of some BV-associated bacteria during hr-HPV infection may increase the risk for cervical neoplasia.
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Affiliation(s)
- Zhen-Tong Wei
- Department of Oncologic Gynecology, The First Hospital of Jilin University, Changchun, China
| | - Hong-Liang Chen
- College of Veterinary Medicine, Jilin Provincial Engineering Research Center of Animal Probiotics, Jilin Agricultural University, Changchun, China
| | - Chun-Feng Wang
- College of Veterinary Medicine, Jilin Provincial Engineering Research Center of Animal Probiotics, Jilin Agricultural University, Changchun, China
| | - Gui-Lian Yang
- College of Veterinary Medicine, Jilin Provincial Engineering Research Center of Animal Probiotics, Jilin Agricultural University, Changchun, China
| | - Shu-Mei Han
- Medical Department, The First Hospital of Jilin University, Changchun, China
| | - Song-Ling Zhang
- Department of Oncologic Gynecology, The First Hospital of Jilin University, Changchun, China
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14
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Probiotic therapy in couples with infertility: A systematic review. Eur J Obstet Gynecol Reprod Biol 2020; 256:95-100. [PMID: 33188995 DOI: 10.1016/j.ejogrb.2020.10.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022]
Abstract
The reproductive microbiome is becoming increasingly recognised for its influence on fertility. While there has been much work to investigate the treatment of bacterial vaginosis and disordered microbiomes in optimizing outcomes in Assisted Reproductive Technology (ART), the role of routinely prescribed probiotics is yet to be established. The therapeutic potential of probiotic therapy remains an exciting opportunity in ART and this review endeavours to summarise its evidence to date. A systematic review of MEDLINE (Pubmed), Allied Health Literature (CINAHL), EMBASE, Web of Science and the Cochrane database was performed on 7th May 2019, and repeated on 26th August 2019. The search was built using the terms 'subfertility;' 'probiotic therapy;' 'clinical pregnancy rate' and 'assisted reproductive outcomes.' The primary outcome was change in clinical pregnancy rate. Secondary outcomes included improvements in male and female fertility parameters and microbial assessment. The initial search found 882 articles, of which 26 full manuscripts were reviewed. Four articles were eligible for inclusion. Of the two studies that reported the primary outcome, only one study found probiotics increased the clinical pregnancy rate non-significantly (48.0%-58.8%, p = 0.47). It also found higher miscarriage rate (30 % vs 16.6 %, p = 0.47) in the group treated with probiotics. Both studies on males with oral probiotic found significantly improved sperm motility. While benefit in sperm motility has been observed with male probiotic therapy, there is conflicting evidence on the efficacy of probiotic therapy for women undergoing assisted reproduction. High quality randomized studies are needed to definitively examine probiotic therapy and establish its benefit for couples undergoing assisted reproduction.
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15
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Plummer EL, Vodstrcil LA, Murray GL, Fairley CK, Danielewski JA, Garland SM, Chow EPF, Bulach DM, Fethers KA, Hocking JS, Bradshaw CS. Gardnerella vaginalis Clade Distribution Is Associated With Behavioral Practices and Nugent Score in Women Who Have Sex With Women. J Infect Dis 2020; 221:454-463. [PMID: 31544206 DOI: 10.1093/infdis/jiz474] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/11/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Gardnerella vaginalis is detected in women with and without bacterial vaginosis (BV). Identification of 4 G. vaginalis clades raised the possibility that pathogenic and commensal clades exist. We investigated the association of behavioral practices and Nugent Score with G. vaginalis clade distribution in women who have sex with women (WSW). METHODS Longitudinal self-collected vaginal specimens were analyzed using established G. vaginalis species-specific and clade-typing polymerase chain reaction assays. Logistic regression assessed factors associated with detection of G. vaginalis clades, and multinomial regression assessed factors associated with number of clades. RESULTS Clades 1, 2, and 3 and multiclade communities (<2 clades) were associated with Nugent-BV. Clade 1 (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.65-6.84) and multiclade communities (relative risk ratio [RRR], 9.51; 95% CI, 4.36-20.73) were also associated with Lactobacillus-deficient vaginal microbiota. Clade 4 was neither associated with Nugent-BV nor Lactobacillus-deficient microbiota (OR, 1.49; 95% CI, 0.67-3.33). Specific clades were associated with differing behavioral practices. Clade 1 was associated with increasing number of recent sexual partners and smoking, whereas clade 2 was associated with penile-vaginal sex and sharing of sex toys with female partners. CONCLUSIONS Our results suggest that G. vaginalis clades have varying levels of pathogenicity in WSW, with acquisition occurring through sexual activity. These findings suggest that partner treatment may be an appropriate strategy to improve BV cure.
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Affiliation(s)
- Erica L Plummer
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Lenka A Vodstrcil
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Gerald L Murray
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
| | - Christopher K Fairley
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Jennifer A Danielewski
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Suzanne M Garland
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
| | - Eric P F Chow
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Dieter M Bulach
- Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Bioinformatics, The University of Melbourne, Carlton, Victoria, Australia
| | | | - Jane S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Catriona S Bradshaw
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
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16
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Redelinghuys MJ, Geldenhuys J, Jung H, Kock MM. Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities. Front Cell Infect Microbiol 2020; 10:354. [PMID: 32850469 PMCID: PMC7431474 DOI: 10.3389/fcimb.2020.00354] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/09/2020] [Indexed: 12/16/2022] Open
Abstract
A healthy female genital tract harbors a microbiome dominated by lactic acid and hydrogen peroxide producing bacteria, which provide protection against infections by maintaining a low pH. Changes in the bacterial compositions of the vaginal microbiome can lead to bacterial vaginosis (BV), which is often associated with vaginal inflammation. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STIs) like human immunodeficiency virus (HIV) and affects women's reproductive health negatively. In pregnant women, BV can lead to chorioamnionitis and adverse pregnancy outcomes, including preterm premature rupture of the membranes and preterm birth. In order to manage BV effectively, good diagnostic procedures are required. Traditionally clinical and microscopic methods have been used to diagnose BV; however, these methods require skilled staff and time and suffer from reduced sensitivity and specificity. New diagnostics, including highly sensitive and specific point-of-care (POC) tests, treatment modalities and vaccines can be developed based on the identification of biomarkers from the growing pool of vaginal microbiome and vaginal metabolome data. In this review the current and future diagnostic avenues will be discussed.
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Affiliation(s)
- Mathys J. Redelinghuys
- School of Clinical Medicine, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Janri Geldenhuys
- UP-Ampath Translational Genomics Initiative, Department of Biochemistry, Genetics and Microbiology, Faculty of Health Sciences and Faculty of Natural and Agricultural Sciences, Division of Genetics, University of Pretoria, Pretoria, South Africa
| | - Hyunsul Jung
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | - Marleen M. Kock
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
- Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
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17
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Francis SC, Crucitti T, Smekens T, Hansen CH, Andreasen A, Jespers V, Hardy L, Irani J, Changalucha J, Baisley K, Hayes R, Watson-Jones D, Buvé A. The Vaginal Microbiota Among Adolescent Girls in Tanzania Around the Time of Sexual Debut. Front Cell Infect Microbiol 2020; 10:305. [PMID: 32670894 PMCID: PMC7330010 DOI: 10.3389/fcimb.2020.00305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/20/2020] [Indexed: 12/28/2022] Open
Abstract
The aetiology of bacterial vaginosis (BV) is not well-understood, and prevalence appears to be higher among women living in sub-Saharan Africa. A recent conceptual model implicates three main bacteria (Gardnerella vaginalis; Atopobium vaginae; and Prevotella bivia), sexual activity, sialidase activity, and biofilm formation in the pathogenesis of BV. We describe the vaginal microbiota, presence of the putative sialidase A gene of G. vaginalis, and biofilm among 386 adolescent girls aged 17 and 18 years in a cross-sectional study in Mwanza, Tanzania around the time of expected sexual debut. Vaginal swabs were collected and tested by quantitative polymerase chain reaction (qPCR) for five Lactobacillus species, G. vaginalis, A. vaginae, P. bivia, the sialidase A gene of G. vaginalis, and by fluorescence in situ hybridisation (FISH) for evidence of G. vaginalis and A. vaginae biofilm. We conducted a risk factor analysis of G. vaginalis, A. vaginae and P. bivia, and explored the associations between biofilm, the presence of the sialidase A gene, and non-optimal vaginal microbiota (Nugent 4-7). L. crispatus and L. iners were detected in 69 and 82% of girls, respectively. The prevalence of L. crispatus was higher than previously reported in earlier studies among East and Southern African women. G. vaginalis, A. vaginae, P. bivia were independently associated with reported penile-vaginal sex. Samples with all three BV-associated bacteria made up the highest proportion of samples with Nugent-BV compared to samples with each bacterium alone or together in pairs. Of the 238 girls with G. vaginalis, 63% had the sialidase A gene detected, though there was no difference by reported sexual activity (p = 0.197). Of the 191 girls with results for sialidase A gene and FISH, there was strong evidence for an increased presence of sialidase A gene among those with evidence of a biofilm (p < 0.001). There was a strong association between biofilm and non-optimal microbiota (aOR67.00; 95% CI 26.72-190.53). These results support several of the steps outlined in the conceptual model, although the role of sexual activity is less clear. We recommend longitudinal studies to better understand changes in vaginal microbiota and biofilm formation around the time of sexual debut.
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Affiliation(s)
- Suzanna Carter Francis
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tania Crucitti
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tom Smekens
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christian Holm Hansen
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Aura Andreasen
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Vicky Jespers
- Belgian Health Care Knowledge Centre, Brussels, Belgium
| | - Liselotte Hardy
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Julia Irani
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | | | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Richard Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anne Buvé
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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18
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Gondwe T, Ness R, Totten PA, Astete S, Tang G, Gold MA, Martin D, Haggerty CL. Novel bacterial vaginosis-associated organisms mediate the relationship between vaginal douching and pelvic inflammatory disease. Sex Transm Infect 2019; 96:439-444. [PMID: 31810995 PMCID: PMC7476288 DOI: 10.1136/sextrans-2019-054191] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/27/2019] [Accepted: 11/07/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives We sought to determine whether the relationship between a history of vaginal douching and pelvic inflammatory disease (PID) is mediated by endometrial infection with one or more novel bacterial vaginosis (BV)-associated organisms among Atopobium vaginae, the BV-associated bacterium 1 (BVAB1), neathia (Leptotrichia) amnionii and Sneathia sanguinegens. Methods We first conducted log-binomial regression analyses to identify risk factors for endometrial infection in 535 adolescent and adult women with clinically suspected PID in the PID Evaluation and Clinical Health (PEACH) study. We then examined whether endometrial infection by the BV-associated organisms mediated the association between a history of vaginal douching and histologically confirmed PID using inverse probability weighted marginal structural models. Results Vaginal douching was significantly associated with endometrial infection with one or more of the targeted BV-associated organisms (relative risk (RR) 1.21, 95% CI: 1.08 to 1.35). The total effect estimate suggested that vaginal douching increased the risk of endometritis by 24% (RR 1.24, 95% CI: 1.03 to 1.49). The controlled direct effect of this association was attenuated with endometrial infection by one or more BV-associated organisms (adjusted RR (aRR) 1.00, 95% CI: 0.57 to 1.74) and endometrial infection by all four BV-associated organisms (aRR 0.95, 95% CI: 0.53 to 1.70) as intermediate variables. Conclusions Endometrial infection with one or more of the novel BV-associated organisms partially mediated the relationship between vaginal douching and histologically confirmed endometritis in the PEACH study. Frequent vaginal douching may confer risk for endometritis through increasing the risk of endometrial infection by novel-BV-associated organisms. Other potential pathways should be explored.
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Affiliation(s)
- Tamala Gondwe
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Roberta Ness
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas School of Public Health, Houston, Texas, USA
| | - Patricia A Totten
- Department of Medicine, Division of Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Sabina Astete
- Department of Medicine, Division of Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Gong Tang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Melanie A Gold
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center and Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - David Martin
- Department of Medicine, Louisiana State University, New Orleans, Louisiana, USA
| | - Catherine L Haggerty
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA .,Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
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19
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Van Der Pol WJ, Kumar R, Morrow CD, Blanchard EE, Taylor CM, Martin DH, Lefkowitz EJ, Muzny CA. In Silico and Experimental Evaluation of Primer Sets for Species-Level Resolution of the Vaginal Microbiota Using 16S Ribosomal RNA Gene Sequencing. J Infect Dis 2019; 219:305-314. [PMID: 30535155 DOI: 10.1093/infdis/jiy508] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/20/2018] [Indexed: 12/12/2022] Open
Abstract
Background Identification of bacteria in human vaginal specimens is commonly performed using 16S ribosomal RNA (rRNA) gene sequences. However, studies utilize different 16S primer sets, sequence databases, and parameters for sample and database clustering. Our goal was to assess the ability of these methods to detect common species of vaginal bacteria. Methods We performed an in silico analysis of 16S rRNA gene primer sets, targeting different hypervariable regions. Using vaginal samples from women with bacterial vaginosis, we sequenced 16S genes using the V1-V3, V3-V4, and V4 primer sets. For analysis, we used an extended Greengenes database including 16S gene sequences from vaginal bacteria not already present. We compared results with those obtained using the SILVA 16S database. Using multiple database and sample clustering parameters, each primer set's ability to detect common vaginal bacteria at the species level was determined. We also compared these methods to the use of DADA2 for denoising and clustering of sequence reads. Results V4 sequence reads clustered at 99% identity and using the 99% clustered, extended Greengenes database provided optimal species-level identification of vaginal bacteria. Conclusions This study is a first step toward standardizing methods for 16S rRNA gene sequencing and bioinformatics analysis of vaginal microbiome data.
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Affiliation(s)
- William J Van Der Pol
- Biomedical Informatics, Center for Clinical and Translational Sciences, University of Alabama at Birmingham
| | - Ranjit Kumar
- Biomedical Informatics, Center for Clinical and Translational Sciences, University of Alabama at Birmingham
| | - Casey D Morrow
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham
| | - Eugene E Blanchard
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans
| | - Christopher M Taylor
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans
| | - David H Martin
- Department of Epidemiology, Tulane University School of Public Health, New Orleans.,Departments of Medicine and Microbiology, Louisiana State University Health Sciences Center, New Orleans
| | - Elliot J Lefkowitz
- Biomedical Informatics, Center for Clinical and Translational Sciences, University of Alabama at Birmingham.,Department of Microbiology, University of Alabama at Birmingham
| | - Christina A Muzny
- Division of Infectious Diseases, University of Alabama at Birmingham
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20
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Muzny CA, Blanchard E, Taylor CM, Aaron KJ, Talluri R, Griswold ME, Redden DT, Luo M, Welsh DA, Van Der Pol WJ, Lefkowitz EJ, Martin DH, Schwebke JR. Identification of Key Bacteria Involved in the Induction of Incident Bacterial Vaginosis: A Prospective Study. J Infect Dis 2019; 218:966-978. [PMID: 29718358 DOI: 10.1093/infdis/jiy243] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/23/2018] [Indexed: 12/23/2022] Open
Abstract
Background The sequence of events preceding incident bacterial vaginosis (iBV) is unclear. Methods African American women who have sex with women, who had no Amsel criteria and Nugent scores of 0-3, were followed for 90 days to detect iBV (defined as a Nugent score of 7-10 on at least 2-3 consecutive days), using self-collected vaginal swab specimens. For women with iBV (cases) and women maintaining normal vaginal flora (healthy women), 16S ribosomal RNA gene sequencing targeting V4 was performed. Longitudinal vaginal microbiome data were analyzed. Results Of 204 women screened, 42 enrolled; of these, 45% developed iBV. Sequencing was performed on 448 specimens from 14 cases and 8 healthy women. Among healthy women, Lactobacillus crispatus dominated the vaginal microbiota in 75%. In contrast, prior to iBV, the vaginal microbiota in 79% of cases was dominated by Lactobacillus iners and/or Lactobacillus jensenii/Lactobacillus gasseri. The mean relative abundance of Prevotella bivia, Gardnerella vaginalis, Atopobium vaginae, and Megasphaera type I became significantly higher in cases 4 days before (P. bivia), 3 days before (G. vaginalis), and on the day of (A. vaginae and Megasphaera type I) iBV onset. The mean relative abundance of Sneathia sanguinegens, Finegoldia magna, BV-associated bacteria 1-3, and L. iners was not significantly different between groups before onset of iBV. Conclusion G. vaginalis, P. bivia, A. vaginae, and Megasphaera type I may play significant roles in iBV.
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Affiliation(s)
| | - Eugene Blanchard
- Department of Microbiology, Immunology, and Parasitology, New Orleans, Louisiana.,BusPatrol America, Salt Lake City, Utah
| | - Christopher M Taylor
- Department of Microbiology, Immunology, and Parasitology, New Orleans, Louisiana.,Microbial Genomics Resource Group, School of Medicine, New Orleans, Louisiana
| | | | - Rajesh Talluri
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson
| | - Michael E Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson
| | - David T Redden
- Department of Biostatistics, School of Public Health, New Orleans, Louisiana
| | - Meng Luo
- Department of Microbiology, Immunology, and Parasitology, New Orleans, Louisiana.,Microbial Genomics Resource Group, School of Medicine, New Orleans, Louisiana
| | - David A Welsh
- Microbial Genomics Resource Group, School of Medicine, New Orleans, Louisiana.,Section of Pulmonary, Critical Care, Allergy/Immunology, New Orleans, Louisiana
| | | | - Elliot J Lefkowitz
- Department of Microbiology, University of Alabama at Birmingham, New Orleans, Louisiana
| | - David H Martin
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center.,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
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21
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Hamlin AA, Sheeder J, Muffly TM. Brief versus Thong Hygiene in Obstetrics and Gynecology (B-THONG): A survey study. J Obstet Gynaecol Res 2019; 45:1190-1196. [PMID: 30916426 DOI: 10.1111/jog.13958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/01/2019] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to evaluate if thong use is associated with a higher report of urogenital infections, including urinary tract infections, yeast vaginitis and bacterial vaginosis. METHODS A cross-sectional survey regarding underwear preferences and infectious history was designed and distributed to women via a crowdsourcing service. All survey questions related to the last 12 months. Parametric and nonparametric statistical methods were used to compare responses between thong wearers and nonthong wearers. Thong wearers were defined as women who wore a thong equal to or more than 50 % of the time. RESULTS Nine hundred and eighty-six respondents met inclusion criteria and completed the survey; 186 (18.9%) were defined as thong wearers and 800 (81.1%) were defined as nonthong wearers in the last 12 months. Reported rates of urogenital infections in the last 12 months were not significantly different for thong wearers versus nonthong wearers. Thong use was not an independent predictor of any urogenital infection in this study. CONCLUSION In this large cross-sectional study we found that oral sex was the only independent predictor of urinary tract infection and bacterial vaginosis, and that wearing noncotton crotch underwear was associated with yeast vaginitis. Wearing thong underwear was not associated with any urogenital infections. Medical providers should discuss sexual practices and underwear fabric, rather than style, with their patients when there is concern for urogenital infection.
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Affiliation(s)
- Alyssa A Hamlin
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jeanelle Sheeder
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Tyler M Muffly
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Obstetrics and Gynecology, Denver Health and Hospital Authority, Denver, Colorado, USA
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22
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Interaction of Gardnerella vaginalis and Vaginolysin with the Apical versus Basolateral Face of a Three-Dimensional Model of Vaginal Epithelium. Infect Immun 2019; 87:IAI.00646-18. [PMID: 30692180 DOI: 10.1128/iai.00646-18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 01/21/2019] [Indexed: 12/17/2022] Open
Abstract
Studies have implicated Gardnerella vaginalis as an important etiological agent in bacterial vaginosis (BV). It produces a cholesterol-dependent cytolysin, vaginolysin (VLY). In this study, we sought to characterize the interaction between vaginal epithelium, G. vaginalis, and VLY using EpiVaginal tissues from MatTek. These tissues are three-dimensional and have distinct apical and basolateral sides, enabling comparison of the effects of G. vaginalis and VLY following exposure to either side. We measured cytotoxicity, cytokine production, and bacterial growth, following apical versus basolateral exposure. G. vaginalis exhibited more-rapid growth in coculture with the tissue model when it was exposed to the apical side. VLY permeabilized cells on the basolateral side of the tissues but failed to permeabilize apical epithelial cells. Cytokine secretion in response to VLY and G. vaginalis also depended on the polarity of exposure. VLY did not cause significant changes in cytokine levels when exposed apically. Apical tissue challenge by G. vaginalis appeared to dampen the inflammatory response, as decreases in granulocyte-macrophage colony-stimulating factor (GM-CSF) (6.6-fold), RANTES (14.8-fold), and interferon gamma inducible protein 10 kDa (IP-10) (53-fold) and an increase in interleukin-1 receptor antagonist (IL-1ra) (5-fold) were observed. In vivo, G. vaginalis normally colonizes the apical face of the vaginal epithelium. Results from this study suggest that while G. vaginalis may grow on the apical face of the vaginal epithelium, its VLY toxin does not target these cells in this model. This phenomenon could have important implications regarding colonization of the vagina by G. vaginalis and may suggest an explanation for the lack of an overt immune response to this organism.
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23
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Damke E, Kurscheidt FA, Irie MM, Gimenes F, Consolaro MEL. Male Partners of Infertile Couples With Seminal Positivity for Markers of Bacterial Vaginosis Have Impaired Fertility. Am J Mens Health 2018; 12:2104-2115. [PMID: 30132409 PMCID: PMC6199420 DOI: 10.1177/1557988318794522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/12/2018] [Accepted: 07/22/2018] [Indexed: 11/16/2022] Open
Abstract
To access the possibility that key markers of bacterial vaginosis (KM-BV) could affect seminal parameters and thus fertility a prospective cohort study was designed (a) to develop rapid and sensitive multiplex polymerase chain reaction (M-PCR) assays to screen 13 key markers of bacterial vaginosis (KM-BV) in semen specimens, (b) to determine the prevalence of KM-BV in semen from randomized male partners of couples seeking fertility evaluation. A total of 229 semen samples were included in the study from males who visited the Sperm Analysis Section of Brazil between October 2015 and March 2016. Eligible men were 18 years or older and had a semen analysis due fertility evaluation (after failing to conceive with their partner after 1 year of unprotected intercourse). Basic seminal parameters were analyzed, and KM-BV was detected by M-PCR assays. M-PCR assays clearly distinguished 13 KM-BV in 146 semen samples (63.8%), mainly Gardnerella vaginalis (50.7%). Some important associations occurred between the presence of KM-BV in semen and changes in seminal parameters. KM-BV is commonly present in the semen of males seeking fertility evaluation and could potentially play significant roles in male subfertility and/or infertility.
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Affiliation(s)
- Edilson Damke
- State University of Maringá, Maringá, Paraná, Brazil
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24
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Eribe ERK, Olsen I. Leptotrichia species in human infections II. J Oral Microbiol 2017; 9:1368848. [PMID: 29081911 PMCID: PMC5646626 DOI: 10.1080/20002297.2017.1368848] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/15/2017] [Indexed: 12/19/2022] Open
Abstract
Leptotrichia species are non-motile facultative anaerobic/anaerobic bacteria that are found mostly in the oral cavity and some other parts of the human body, in animals, and even in ocean sediments. Valid species include L. buccalis, L. goodfellowii, L. hofstadii, L. honkongensis, L. shahii, L. trevisanii, and L. wadei. Some species require serum or blood for growth. All species ferment carbohydrates and produce lactic acid that may be involved with tooth decay. Acting as opportunistic pathogens, they are involved in a variety of diseases, and have been isolated from immunocompromised but also immunocompetent individuals. Mucositis, oral lesions, wounds, and abscesses may predispose to Leptotrichia septicemia. Because identification of Leptotrichia species by phenotypic features occasionally lead to misidentification, genetic techniques such as 16S rRNA gene sequencing is recommended. Early diagnosis and treatment of leptotrichia infections is important for positive outcomes. Over the last years, Leptotrichia species have been associated with several changes in taxonomy and new associations with clinical diseases. Such changes are reported in this updated review.
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Affiliation(s)
- Emenike R K Eribe
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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25
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Vaginal Microbiome and Its Relationship to Behavior, Sexual Health, and Sexually Transmitted Diseases. Obstet Gynecol 2017; 129:643-654. [PMID: 28277350 DOI: 10.1097/aog.0000000000001932] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The vaginal microbiota has great significance in maintaining vaginal health and protecting the host from disease. Recent advances in molecular techniques and informatics allow researchers to explore microbial composition in detail and to compare the structure of vaginal microbial communities with behavior and health outcomes, particularly acquisition and transmission of sexually transmitted diseases (STDs) and poor birth outcomes. Vaginal flora have been found to cluster into a limited number of communities, although community structure is dynamic. Certain community types are more associated with poor reproductive outcomes and STDs; communities dominated by Lactobacillus species, particularly Lactobacillus crispatus, are most associated with vaginal health. Modifiable and nonmodifiable factors are strongly associated with community composition, including behavior, race or ethnicity, and hygiene. In this review, we describe the state of the science on the vaginal microbiome and its relationship to behavior, sexual health, and STDs, including determinants of the microbiome that go beyond an individual level.
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26
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Abstract
OBJECTIVE To investigate the association of sexual debut and vaginal, anorectal, and oral microbiota and vaginal inflammatory markers in female adolescents. METHODS We conducted a school-based study in adolescents in Antwerp, Belgium. During three visits over 8 months, participants answered questionnaires and self-collected vaginal, anorectal, and oral swabs. Five Lactobacillus species, Lactobacillus genus, Gardnerella vaginalis, and Atopobium vaginae were quantified; and seven inflammatory markers were measured in the vaginal specimens. In the oral and anorectal specimens, Lactobacillus genus, G vaginalis, and A vaginae were ascertained. RESULTS Of the 93 adolescents (mean age 16.2 years) at the first visit, 41 (44.1%) had passed sexual debut (penile-vaginal intercourse) and five (5.4%) had sexual experience without passing sexual debut. Having sexual experience at the first visit was not found to be associated with species presence or concentrations (acknowledging an underpowered study because the required sample size was not attained). Modeling the longitudinal data on all girls showed that sexual debut was associated with increased odds of vaginal and anorectal G vaginalis (P=.021; P=.030) and A vaginae (P=.041; P=.012) with increments of interleukins (interleukin [IL]-1α P<.001, IL-1β P=.046, IL-8 P=.033) and chemokines (regulated on activation, normal T cell expressed and secreted P<.001; macrophage inflammatory protein-1β P=.040), whereas no difference was seen when modeling (before-after) the girls initiating and girls staying without sexual intercourse. The association of sexual intercourse with IL-1α (P<.001), IL-1β (P=.030), and IL-8 (P=.002) at the first visit was (greater than 70%) mediated by vaginal G vaginalis and A vaginae concentrations. CONCLUSION Sexual debut in adolescents is associated with an inflammatory vaginal reaction and with the presence of bacterial vaginosis-related species. Strategies preventing the colonization of bacterial vaginosis-related organisms during early sexual debut are urgently needed and may prevent acquisition of sexually transmitted infections including human immunodeficiency virus in early life.
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27
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Massad LS, Evans CT, Kang R, Hotton A, Greenblatt R, Minkoff H, Murphy K, Colie C, Weber KM. Correlates of Bacterial Vaginosis Over Long-Term Follow-Up: Impact of HIV Infection. AIDS Res Hum Retroviruses 2017; 33:432-439. [PMID: 27841674 DOI: 10.1089/aid.2016.0213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Correlates of bacterial vaginosis (BV) are poorly understood, especially in HIV infection. In a cohort study, HIV-seropositive and comparison seronegative women were assessed every 6 months during 1994-2015. BV was considered present when three of four Amsel criteria were met. Behavioral characteristics were assessed using structured interviews. Multivariable logistic regression used generalized estimating equation models to determine factors associated with BV. Cumulative incidence of BV over time was assessed using the log-rank test. Among 3,730 women (964 HIV seronegative and 2,766 HIV seropositive) contributing 70,970 visits, BV was diagnosed at 2,586 (14.0%) visits by HIV-seronegative women and 6,224 (11.9%) visits by HIV-seropositive women (p < .0001). The cumulative incidence of BV was 530/964 (55.0%) in HIV-seronegative women and 1,287/2,766 (46.5%) in seropositive women (p < .0001). In adjusted analyses, factors associated with BV were younger age, ethnicity, lower income, less education, recruitment site, recruitment in the 2001-2002 cohort, heavier drinking, current smoking, depression, and sex with a male partner; both hormonal contraception and menopause were negatively associated with BV. Of 533 women with prevalent BV, 228 (42.8%) recurred within a year, while persistent BV was found in 12.8% of participants; neither proportion differed by HIV serostatus. Time trends in the proportion of women with BV at any single visit were not identified. BV is common among women with and at risk for HIV, but HIV infection does not predispose to BV, which is associated instead with behavioral and cultural factors.
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Affiliation(s)
- Leslie S. Massad
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Charlesnika T. Evans
- Department of Preventive Medicine, Center for Healthcare Studies, Northwestern University, Chicago, Illinois
| | - Raymond Kang
- Center for Healthcare Studies, Northwestern University, Chicago, Illinois
| | - Anna Hotton
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, Illinois
| | - Ruth Greenblatt
- Department of Clinical Pharmacy, University of California, San Francisco, California
- Department of Medicine, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Howard Minkoff
- Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
| | - Kerry Murphy
- Department of Medicine, Albert Einstein School of Medicine/Montefiore Medical Center, Bronx, New York
| | - Christine Colie
- Department of Obstetrics and Gynecology, Georgetown University, Washington, District of Columbia
| | - Kathleen M. Weber
- The CORE Center at John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
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28
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Jung HS, Ehlers MM, Lombaard H, Redelinghuys MJ, Kock MM. Etiology of bacterial vaginosis and polymicrobial biofilm formation. Crit Rev Microbiol 2017; 43:651-667. [PMID: 28358585 DOI: 10.1080/1040841x.2017.1291579] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Microorganisms in nature rarely exist in a planktonic form, but in the form of biofilms. Biofilms have been identified as the cause of many chronic and persistent infections and have been implicated in the etiology of bacterial vaginosis (BV). Bacterial vaginosis is the most common form of vaginal infection in women of reproductive age. Similar to other biofilm infections, BV biofilms protect the BV-related bacteria against antibiotics and cause recurrent BV. In this review, an overview of BV-related bacteria, conceptual models and the stages involved in the polymicrobial BV biofilm formation will be discussed.
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Affiliation(s)
- Hyun-Sul Jung
- a Department of Medical Microbiology, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa
| | - Marthie M Ehlers
- a Department of Medical Microbiology, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa.,b Department of Medical Microbiology, Tshwane Academic Division , National Health Laboratory Service (NHLS) , Pretoria , South Africa
| | - Hennie Lombaard
- c Gauteng Department of Health, Rahima Moosa Mother and Child Hospital, Wits Obstetrics and Gynaecology Clinical Research Division, Department of Obstetrics and Gynaecology , University of Witwatersrand , Johannesburg , South Africa
| | - Mathys J Redelinghuys
- a Department of Medical Microbiology, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa
| | - Marleen M Kock
- a Department of Medical Microbiology, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa.,b Department of Medical Microbiology, Tshwane Academic Division , National Health Laboratory Service (NHLS) , Pretoria , South Africa
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29
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Vodstrcil LA, Twin J, Garland SM, Fairley CK, Hocking JS, Law MG, Plummer EL, Fethers KA, Chow EPF, Tabrizi SN, Bradshaw CS. The influence of sexual activity on the vaginal microbiota and Gardnerella vaginalis clade diversity in young women. PLoS One 2017; 12:e0171856. [PMID: 28234976 PMCID: PMC5325229 DOI: 10.1371/journal.pone.0171856] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/26/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To examine the influence of sexual activity on the composition and consistency of the vaginal microbiota over time, and distribution of Gardnerella vaginalis clades in young women. METHODS Fifty-two participants from a university cohort were selected. Vaginal swabs were self-collected every 3-months for up to 12 months with 184 specimens analysed. The vaginal microbiota was characterised using Roche 454 V3/4 region 16S rRNA sequencing, and G.vaginalis clade typing by qPCR. RESULTS A Lactobacillus crispatus dominated vaginal microbiota was associated with Caucasian ethnicity (adjusted relative risk ratio[ARRR] = 7.28, 95%CI:1.37,38.57,p = 0.020). An L.iners (ARRR = 17.51, 95%CI:2.18,140.33,p = 0.007) or G.vaginalis (ARRR = 14.03, 95%CI:1.22,160.69, p = 0.034) dominated microbiota was associated with engaging in penile-vaginal sex. Microbiota dominated by L.crispatus, L.iners or other lactobacilli exhibited greater longitudinal consistency of the bacterial communities present compared to ones dominated by heterogeneous non-lactobacilli (p<0.030); sexual activity did not influence consistency. Women who developed BV were more likely to have clade GV4 compared to those reporting no sex/practiced non-coital activities (OR = 11.82, 95%CI:1.87,74.82,p = 0.009). Specimens were more likely to contain multiple G.vaginalis clades rather than a single clade if women engaged in penile-vaginal sex (RRR = 9.55, 95%CI:1.33,68.38,p = 0.025) or were diagnosed with BV (RRR = 31.5, 95%CI:1.69,586.87,p = 0.021). CONCLUSIONS Sexual activity and ethnicity influenced the composition of the vaginal microbiota of these young, relatively sexually inexperienced women. Women had consistent vaginal microbiota over time if lactobacilli were the dominant spp. present. Penile-vaginal sex did not alter the consistency of microbial communities but increased G.vaginalis clade diversity in young women with and without BV, suggesting sexual transmission of commensal and potentially pathogenic clades.
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Affiliation(s)
- Lenka A. Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria
- Department of Molecular Microbiology, Murdoch Children’s Research Institute, Melbourne, Australia
- * E-mail:
| | - Jimmy Twin
- Department of Molecular Microbiology, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Melbourne, Australia
| | - Suzanne M. Garland
- Department of Molecular Microbiology, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Jane S. Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria
| | - Matthew G. Law
- The Kirby Institute, University of New South Wales, Darlinghurst, Australia
| | - Erica L. Plummer
- Department of Molecular Microbiology, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Melbourne, Australia
| | | | - Eric P. F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Sepehr N. Tabrizi
- Department of Molecular Microbiology, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Melbourne, Australia
- Department of Microbiology, The Royal Children’s Hospital, Melbourne, Australia
| | - Catriona S. Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria
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30
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Plummer EL, Garland SM, Bradshaw CS, Law MG, Vodstrcil LA, Hocking JS, Fairley CK, Tabrizi SN. Molecular diagnosis of bacterial vaginosis: Does adjustment for total bacterial load or human cellular content improve diagnostic performance? J Microbiol Methods 2016; 133:66-68. [PMID: 28042056 DOI: 10.1016/j.mimet.2016.12.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/28/2016] [Accepted: 12/29/2016] [Indexed: 11/19/2022]
Abstract
We investigated the utility of quantitative PCR assays for diagnosis of bacterial vaginosis and found that while the best model utilized bacterial copy number adjusted for total bacterial load (sensitivity=98%, specificity=93%, AUC=0.95[95%CI=0.93,0.97]), adjusting for total bacterial or human cell load did not consistently increase the diagnostic performance of the assays.
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Affiliation(s)
- E L Plummer
- Department of Molecular Microbiology, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia.
| | - S M Garland
- Department of Molecular Microbiology, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - C S Bradshaw
- Melbourne Sexual Health Centre, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - M G Law
- The Kirby Institute, University of New South Wales, Darlinghurst, Australia
| | - L A Vodstrcil
- Department of Molecular Microbiology, Murdoch Childrens Research Institute, Melbourne, Australia; Melbourne Sexual Health Centre, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - J S Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - C K Fairley
- Melbourne Sexual Health Centre, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - S N Tabrizi
- Department of Molecular Microbiology, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia; Department of Microbiology, The Royal Children's Hospital, Melbourne, Australia
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Abstract
Bacterial vaginosis (BV) is the most commonly reported microbiological syndrome among women of childbearing age. BV is characterized by a shift in the vaginal flora from the dominant Lactobacillus to a polymicrobial flora. BV has been associated with a wide array of health issues, including preterm births, pelvic inflammatory disease, increased susceptibility to HIV infection, and other chronic health problems. A number of potential microbial pathogens, singly and in combinations, have been implicated in the disease process. The list of possible agents continues to expand and includes members of a number of genera, including Gardnerella, Atopobium, Prevotella, Peptostreptococcus, Mobiluncus, Sneathia, Leptotrichia, Mycoplasma, and BV-associated bacterium 1 (BVAB1) to BVAB3. Efforts to characterize BV using epidemiological, microscopic, microbiological culture, and sequenced-based methods have all failed to reveal an etiology that can be consistently documented in all women with BV. A careful analysis of the available data suggests that what we term BV is, in fact, a set of common clinical signs and symptoms that can be provoked by a plethora of bacterial species with proinflammatory characteristics, coupled to an immune response driven by variability in host immune function.
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Farr A, Kiss H, Hagmann M, Holzer I, Kueronya V, Husslein PW, Petricevic L. Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study. BMC Pregnancy Childbirth 2016; 16:206. [PMID: 27495167 PMCID: PMC4974689 DOI: 10.1186/s12884-016-1003-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 08/03/2016] [Indexed: 01/31/2023] Open
Abstract
Background Vaginal infections are a risk factor for preterm delivery. In this study, we sought to evaluate the vaginal flora of pregnant women receiving opioid maintenance therapy (OMT) in comparison to non-dependent, non-maintained controls. Methods A total of 3763 women with singleton pregnancies who underwent routine screening for asymptomatic vaginal infections between 10 + 0 and 16 + 0 gestational weeks were examined. Vaginal smears were Gram-stained, and microscopically evaluated for bacterial vaginosis, candidiasis, and trichomoniasis. In a retrospective manner, data of 132 women receiving OMT (cases) were matched for age, ethnicity, parity, education, previous preterm delivery, and smoking status to the data of 3631 controls. The vaginal flora at antenatal screening served as the primary outcome measure. Secondary outcome measures were gestational age and birth weight. Results In the OMT group, 62/132 (47 %) pregnant women received methadone, 39/132 (29.5 %) buprenorphine, and 31/132 (23.5 %) slow-release oral morphine. Normal or intermediate flora was found in 72/132 OMT women (54.5 %) and 2865/3631 controls [78.9 %; OR 0.49 (95 % CI, 0.33–0.71); p < 0.001]. Candidiasis occurred more frequently in OMT women than in controls [OR 2.11 (95 % CI, 1.26–3.27); p < 0.001]. Findings were inconclusive regarding bacterial vaginosis (± candidiasis) and trichomoniasis. Compared to infants of the control group, those of women with OMT had a lower mean birth weight [MD −165.3 g (95 % CI, −283.6 to −46.9); p = 0.006]. Conclusions Pregnant women with OMT are at risk for asymptomatic vaginal infections. As recurrent candidiasis is associated with preterm delivery, the vulnerability of this patient population should lead to consequent antenatal infection screening at early gestation. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1003-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alex Farr
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Herbert Kiss
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Michael Hagmann
- Section for Medical Statistics, Centre of Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Iris Holzer
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Verena Kueronya
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Peter W Husslein
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Ljubomir Petricevic
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
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33
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Schlabritz-Loutsevitch N, Gygax SE, Dick E, Smith WL, Snider C, Hubbard G, Ventolini G. Vaginal Dysbiosis from an Evolutionary Perspective. Sci Rep 2016; 6:26817. [PMID: 27226349 PMCID: PMC4880931 DOI: 10.1038/srep26817] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/09/2016] [Indexed: 12/11/2022] Open
Abstract
Evolutionary approaches are powerful tools for understanding human disorders. The composition of vaginal microbiome is important for reproductive success and has not yet been characterized in the contexts of social structure and vaginal pathology in non-human primates (NHPs). We investigated vaginal size, vulvovaginal pathology and the presence of the main human subtypes of Lactobacillus spp./ BV-related species in the vaginal microflora of baboons (Papio spp.). We performed morphometric measurements of external and internal genitalia (group I, n = 47), analyzed pathology records of animals from 1999–2015 (group II, n = 64 from a total of 12,776), and evaluated vaginal swabs using polymerase chain reaction (PCR) (group III, n = 14). A total of 68 lesions were identified in 64 baboons. Lactobacillus iners, Gardnerella vaginalis, Atopobium vaginae, Megasphaera I, and Megasphaera II were not detected. L. jensenii, L. crispatus, and L. gasseri were detected in 2/14 (14.2%), 1/14 (7.1%), and 1/14 (7.1%) samples, respectively. BVAB2 was detected in 5/14 (35.7%) samples. The differences in the vaginal milieu between NHP and humans might be the factor associated with human-specific pattern of placental development and should be taken in consideration in NHP models of human pharmacology and microbiology.
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Affiliation(s)
| | - Scott E Gygax
- Femeris Women's Health Research Center, Genesis Biotechnology Group - Hamilton, New Jersey, USA
| | - Edward Dick
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - William L Smith
- Femeris Women's Health Research Center, Genesis Biotechnology Group - Hamilton, New Jersey, USA
| | - Cathy Snider
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - Gene Hubbard
- University of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Gary Ventolini
- Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
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Zozaya M, Ferris MJ, Siren JD, Lillis R, Myers L, Nsuami MJ, Eren AM, Brown J, Taylor CM, Martin DH. Bacterial communities in penile skin, male urethra, and vaginas of heterosexual couples with and without bacterial vaginosis. MICROBIOME 2016; 4:16. [PMID: 27090518 PMCID: PMC4835890 DOI: 10.1186/s40168-016-0161-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/17/2016] [Indexed: 05/09/2023]
Abstract
BACKGROUND The epidemiology of bacterial vaginosis (BV) suggests it is sexually transmissible, yet no transmissible agent has been identified. It is probable that BV-associated bacterial communities are transferred from male to female partners during intercourse; however, the microbiota of sexual partners has not been well-studied. RESULTS Pyrosequencing analysis of PCR-amplified 16S rDNA was used to examine BV-associated bacteria in monogamous couples with and without BV using vaginal, male urethral, and penile skin specimens. The penile skin and urethral microbiota of male partners of women with BV was significantly more similar to the vaginal microbiota of their female partner compared to the vaginal microbiota of non-partner women with BV. This was not the case for male partners of women with normal vaginal microbiota. Specific BV-associated species were concordant in women with BV and their male partners. CONCLUSIONS In monogamous heterosexual couples in which the woman has BV, the significantly higher similarity between the vaginal microbiota and the penile skin and urethral microbiota of the male partner, supports the hypothesis that sexual exchange of BV-associated bacterial taxa is common.
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Affiliation(s)
- Marcela Zozaya
- />Children’s Hospital of New Orleans, 200 Henry Clay Ave., New Orleans, LA 70118 USA
| | - Michael J. Ferris
- />Children’s Hospital of New Orleans, 200 Henry Clay Ave., New Orleans, LA 70118 USA
- />Department of Pediatrics, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA 70112 USA
| | - Julia D. Siren
- />Department of Internal Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Ave., New Orleans, LA 70112 USA
| | - Rebecca Lillis
- />Department of Internal Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Ave., New Orleans, LA 70112 USA
| | - Leann Myers
- />Department of Biostatistics and Bioinformatics, Tulane School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112 USA
| | - M. Jacques Nsuami
- />Department of Internal Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Ave., New Orleans, LA 70112 USA
| | - A. Murat Eren
- />Marine Biological Laboratory, JBPC, 7 MBL St., Woods Hole, MA 02543 USA
| | - Jonathan Brown
- />Rally Software, 3333 Walnut St., Boulder, CO 80301 USA
| | - Christopher M. Taylor
- />Department of Microbiology Immunology and Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA 70112 USA
| | - David H. Martin
- />Department of Internal Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Ave., New Orleans, LA 70112 USA
- />Department of Microbiology Immunology and Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA 70112 USA
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35
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The Vaginal Microbiome. Mol Microbiol 2016. [DOI: 10.1128/9781555819071.ch12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Forcey DS, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, Bradshaw CS. Factors Associated with Bacterial Vaginosis among Women Who Have Sex with Women: A Systematic Review. PLoS One 2015; 10:e0141905. [PMID: 26675816 PMCID: PMC4682944 DOI: 10.1371/journal.pone.0141905] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/14/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Women who have sex with women (WSW) have a higher burden of bacterial vaginosis (BV) than heterosexual women; studies of risk factors specific to this population are limited. We summarised current knowledge regarding risk factors for BV among WSW by systematic review. METHODS This systematic review was conducted according to the PRISMA statement. PUBMED, EMBASE, Web of Science and The Cochrane Library were searched to 31st December, 2014. INCLUSION CRITERIA 1) WSW included in the study population; 2) accepted BV diagnostic method; 3) investigated or could extrapolate factors(s) associated with BV acquisition, persistence or transmission in WSW specifically by comparing BV positive to BV negative women. Search was limited to English-language publications. RESULTS A limited number of studies have investigated BV in WSW. Of 71 unique references, 18 full-text articles were assessed and 14 studies fulfilled inclusion criteria. BV was positively associated with higher numbers of female partners, both lifetime and in the three months prior to diagnosis, and confirmed BV in a female partner, but inconsistently associated with partners' BV history or symptoms. BV was not associated with ethnicity, vaginal douching or hormonal contraception. The impact of specific sexual activities, male sexual contact, smoking and the menstrual cycle varied considerably between study populations. CONCLUSION BV in WSW is associated with increased numbers of recent and past female partners and confirmed BV in a female partner. There are limited studies of BV in WSW populations, and research is needed to further elucidate risk factors for BV among WSW. However these data provide epidemiological evidence that BV risk in women is directly related to exposure to other female partners and a partner with BV, providing support for the concept that BV is likely to be transmitted between women. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42014009536 (PROSPERO).
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Affiliation(s)
- Dana S. Forcey
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia
- * E-mail: (DSF); (CSB)
| | - Lenka A. Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jane S. Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia
- Central Clinical School, Monash University, The Alfred Centre, 55 Commercial Road, Melbourne, 3004, Victoria, Australia
| | - Matthew Law
- The Kirby Institute, The University of New South Wales, 101 West Street, Darlinghurst, 2010, New South Wales, Australia
| | - Ruth P. McNair
- Department of General Practice, The University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Catriona S. Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia
- Central Clinical School, Monash University, The Alfred Centre, 55 Commercial Road, Melbourne, 3004, Victoria, Australia
- * E-mail: (DSF); (CSB)
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37
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Accuracy of Self-Report of Sexual Activity among Adolescent Girls: Implications for Interpretation of Vaginal Flora Patterns. mBio 2015; 6:e00819. [PMID: 26106081 PMCID: PMC4479702 DOI: 10.1128/mbio.00819-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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38
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Reply to "Accuracy of Self-Report of Sexual Activity among Adolescent Girls: Implications for Interpretation of Vaginal Flora Patterns". mBio 2015; 6:e00890. [PMID: 26106083 PMCID: PMC4479700 DOI: 10.1128/mbio.00890-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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39
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Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64:1-137. [PMID: 26042815 PMCID: PMC5885289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.
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Affiliation(s)
- Kimberly A. Workowski
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
- Emory University, Atlanta, Georgia
| | - Gail A. Bolan
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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40
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Sensitive Detection of Thirteen Bacterial Vaginosis-Associated Agents Using Multiplex Polymerase Chain Reaction. BIOMED RESEARCH INTERNATIONAL 2015; 2015:645853. [PMID: 26078959 PMCID: PMC4452834 DOI: 10.1155/2015/645853] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/28/2015] [Indexed: 11/24/2022]
Abstract
Bacterial vaginosis (BV) is characterized by a polymicrobial proliferation of anaerobic bacteria and depletion of lactobacilli, which are components of natural vaginal microbiota. Currently, there are limited conventional methods for BV diagnosis, and these methods are time-consuming, expensive, and rarely allow for the detection of more than one agent simultaneously. Therefore, we conceived and validated a multiplex polymerase chain reaction (M-PCR) assay for the simultaneous screening of thirteen bacterial vaginosis-associated agents (BV-AAs) related to symptomatic BV: Gardnerella vaginalis, Mobiluncus curtisii, Mobiluncus mulieris, Bacteroides fragilis, Mycoplasma hominis, Atopobium vaginae, Ureaplasma urealyticum, Megasphaera type I, Clostridia-like bacteria vaginosis-associated bacteria (BVABs) 1, 2, and 3, Sneathia sanguinegens, and Mycoplasma genitalium. The overall validation parameters of M-PCR compared to single PCR (sPCR) were extremely high, including agreement of 99.1% and sensitivity, specificity, and positive predictive values of 100.0%, negative predictive value of 97.0%, accuracy of 99.3%, and agreement with Nugent results of 100.0%. The prevalence of BV-AAs was very high (72.6%), and simultaneous agents were detected in 53.0%, which demonstrates the effectiveness of the M-PCR assay. Therefore, the M-PCR assay has great potential to impact BV diagnostic methods in vaginal samples and diminish associated complications in the near future.
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41
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Hickey RJ, Zhou X, Settles ML, Erb J, Malone K, Hansmann MA, Shew ML, Van Der Pol B, Fortenberry JD, Forney LJ. Vaginal microbiota of adolescent girls prior to the onset of menarche resemble those of reproductive-age women. mBio 2015; 6:e00097-15. [PMID: 25805726 PMCID: PMC4453513 DOI: 10.1128/mbio.00097-15] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/18/2015] [Indexed: 01/02/2023] Open
Abstract
UNLABELLED Puberty is an important developmental stage wherein hormonal shifts mediate the physical and physiological changes that lead to menarche, but until now, the bacterial composition of vaginal microbiota during this period has been poorly characterized. We performed a prospective longitudinal study of perimenarcheal girls to gain insight into the timing and sequence of changes that occur in the vaginal and vulvar microbiota during puberty. The study enrolled 31 healthy, premenarcheal girls between the ages of 10 and 12 years and collected vaginal and vulvar swabs quarterly for up to 3 years. Bacterial composition was characterized by Roche 454 pyrosequencing and classification of regions V1 to V3 of 16S rRNA genes. Contrary to expectations, lactic acid bacteria, primarily Lactobacillus spp., were dominant in the microbiota of most girls well before the onset of menarche in the early to middle stages of puberty. Gardnerella vaginalis was detected at appreciable levels in approximately one-third of subjects, a notable finding considering that this organism is commonly associated with bacterial vaginosis in adults. Vulvar microbiota closely resembled vaginal microbiota but often exhibited additional taxa typically associated with skin microbiota. Our findings suggest that the vaginal microbiota of girls begin to resemble those of adults well before the onset of menarche. IMPORTANCE This study addresses longitudinal changes in vaginal and vulvar microbial communities prior to and immediately following menarche. The research is significant because microbial ecology of the vagina is an integral aspect of health, including resistance to infections. The physiologic changes of puberty and initiation of cyclic menstruation are likely to have profound effects on vaginal microbiota, but almost nothing is known about changes that normally occur during this time. Our understanding has been especially hampered by the lack of thorough characterization of microbial communities using techniques that do not rely on the cultivation of fastidious bacteria, as well as a dearth of studies on girls in the early to middle stages of puberty. This study improves our understanding of the normal development of vaginal microbiota during puberty and onset of menarche and may better inform clinical approaches to vulvovaginal care of adolescent girls.
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Affiliation(s)
| | - Xia Zhou
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, USA
| | | | - Julie Erb
- FemCare Division, Procter & Gamble, Cincinnati, Ohio, USA
| | - Kristin Malone
- FemCare Division, Procter & Gamble, Cincinnati, Ohio, USA
| | | | - Marcia L Shew
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Barbara Van Der Pol
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Austin MN, Rabe LK, Srinivasan S, Fredricks DN, Wiesenfeld HC, Hillier SL. Mageeibacillus indolicus gen. nov., sp. nov.: a novel bacterium isolated from the female genital tract. Anaerobe 2014; 32:37-42. [PMID: 25482717 DOI: 10.1016/j.anaerobe.2014.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 01/22/2023]
Abstract
Three isolates of a bacterium recovered from human endometrium using conventional culture methods were characterized biochemically and subjected to 16S rRNA gene sequencing and phylogenetic analysis. Isolates were non-motile, obligately anaerobic, non-spore forming, asaccharolytic, non-cellulolytic, indole positive, Gram positive rods. Cell wall fatty acid profiling revealed C14:0, C16:0, C18:2 ω6, 9c, C18:1 ω9c and C18:0 to be the major fatty acid composition. The DNA mol % G+C was determined to be 44.2%. 16S rRNA gene sequence analysis revealed only 91% sequence similarity with the closest cultivated bacterial isolate, Saccharofermentans acetigenes. Based on genotypic and phenotypic data, all three isolates are considered to be members of the same species and data suggest it represents a novel genus and species in the order Clostridiales with an association with Clostridium rRNA cluster III within the family Ruminococcaceae. We propose the name, Mageeibacillus indolicus gen. nov., sp. nov. The type strain is BAA-2120(T) and CCUG 59143(T).
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Affiliation(s)
- Michele N Austin
- Magee-Womens Research Institute, 204 Craft Avenue, Lab A530, Pittsburgh, PA, USA.
| | - Lorna K Rabe
- Magee-Womens Research Institute, 204 Craft Avenue, Lab A530, Pittsburgh, PA, USA
| | - Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Harold C Wiesenfeld
- Magee-Womens Research Institute, 204 Craft Avenue, Lab A530, Pittsburgh, PA, USA; University of Pittsburgh, Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, PA, USA
| | - Sharon L Hillier
- Magee-Womens Research Institute, 204 Craft Avenue, Lab A530, Pittsburgh, PA, USA; University of Pittsburgh, Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, PA, USA
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Africa CWJ, Nel J, Stemmet M. Anaerobes and bacterial vaginosis in pregnancy: virulence factors contributing to vaginal colonisation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:6979-7000. [PMID: 25014248 PMCID: PMC4113856 DOI: 10.3390/ijerph110706979] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/25/2014] [Accepted: 06/30/2014] [Indexed: 12/21/2022]
Abstract
The aetiology and pathogenesis of bacterial vaginosis (BV) is unclear but it appears to be associated with factors that disrupt the normal acidity of the vagina thus altering the equilibrium between the normal vaginal microbiota. BV has serious implications for female morbidity, including reports of pelvic inflammatory disease, adverse pregnancy outcomes, increased susceptibility to sexually transmitted infections and infertility. This paper reviewed new available information regarding possible factors contributing to the establishment of the BV vaginal biofilm, examined the proposed role of anaerobic microbial species recently detected by new culture-independent methods and discusses developments related to the effects of BV on human pregnancy. The literature search included Pubmed (NLM), LISTA (EBSCO), and Web of Science. Because of the complexity and diversity of population groups, diagnosis and methodology used, no meta-analysis was performed. Several anaerobic microbial species previously missed in the laboratory diagnosis of BV have been revealed while taking cognisance of newly proposed theories of infection, thereby improving our understanding and knowledge of the complex aetiology and pathogenesis of BV and its perceived role in adverse pregnancy outcomes.
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Affiliation(s)
- Charlene W J Africa
- Department of Medical Biosciences, University of the Western Cape, Private Bag X17, Bellville 7535, Cape Town, South Africa.
| | - Janske Nel
- Department of Medical Biosciences, University of the Western Cape, Private Bag X17, Bellville 7535, Cape Town, South Africa.
| | - Megan Stemmet
- Department of Medical Biosciences, University of the Western Cape, Private Bag X17, Bellville 7535, Cape Town, South Africa.
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44
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Affiliation(s)
| | | | - William E Josey
- Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia
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45
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Hickey RJ, Forney LJ. Gardnerella vaginalis does not always cause bacterial vaginosis. J Infect Dis 2014; 210:1682-3. [PMID: 24855684 DOI: 10.1093/infdis/jiu303] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Roxana J Hickey
- Department of Biological Sciences and Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow
| | - Larry J Forney
- Department of Biological Sciences and Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow
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46
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Wang B, Xiao BB, Shang CG, Wang K, Na RS, Nu XX, Liao Q. Molecular analysis of the relationship between specific vaginal bacteria and bacterial vaginosis metronidazole therapy failure. Eur J Clin Microbiol Infect Dis 2014; 33:1749-56. [PMID: 24816815 DOI: 10.1007/s10096-014-2128-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 04/17/2014] [Indexed: 11/24/2022]
Abstract
Bacterial vaginosis frequently persists, even after treatment. The role of some strains of bacteria associated with bacterial vaginosis treatment failure remains poorly defined. The aim of our study was to define the risk of bacterial vaginosis treatment failure, including pre-treatment detection of specific vaginal bacteria. Bacterial vaginosis is present when the Nugent score is ≥7 and the modified Amsel criteria is positive. Women with bacterial vaginosis were treated with intravaginal metronidazole gel nightly for 5 nights. The 454 pyrosequencing method was used to detect bacteria in vaginal fluid. By univariate analysis, a history of bacterial vaginosis, intrauterine device use and the presence of Facklamia, Corynebacterium and Veillonella were significantly associated with bacterial vaginosis treatment failure. Lactobacillus crispatus, Lactobacillus pentosus and Megasphaera were significantly associated with curing bacterial vaginosis. After logistic regression analysis and detection of these bacteria for test-of-cure, we found that women who had a history of bacterial vaginosis had a higher incidence of bacterial vaginosis treatment failure, whereas women with L. crispatus had a lower incidence of treatment failure. Post-treatment sexual activity was not associated with the treatment effect. Our data suggested that treatment failure may be not caused by drug resistance. Rather, it has a closer relationship with the failed restoration of lactobacilli.
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Affiliation(s)
- B Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China
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47
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Abstract
Female genital tract microbiota play a crucial role in maintaining health. Disequilibrium of the microbiota has been associated with increased risk of pelvic infections. In recent years, culture-independent molecular techniques have expanded understanding of the composition of genital microbiota and the dynamic nature of the microbiota. There is evidence that upper genital tract may not be sterile and may harbor microflora in the physiologic state. The isolation of bacterial vaginosis-associated organisms in women with genital infections establishes a link between pelvic infections and abnormal vaginal flora. With the understanding of the composition of the microbiota in healthy and diseased states, the next logical step is to identify the function of the newly identified microbes. This knowledge will further expand our understanding of the causation of pelvic infections, which may lead to more effective prevention and treatment strategies.
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Affiliation(s)
- Harsha Sharma
- Department of Obstetrics and Gynecology, Mt Sinai School of Medicine Jamaica Program, Queens Hospital Center, Queens, New York
| | - Reshef Tal
- Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
| | - Natalie A Clark
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
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Characterization of the vaginal microbiota among sexual risk behavior groups of women with bacterial vaginosis. PLoS One 2013; 8:e80254. [PMID: 24236175 PMCID: PMC3827412 DOI: 10.1371/journal.pone.0080254] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/01/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The pathogenesis of bacterial vaginosis (BV) remains elusive. BV may be more common among women who have sex with women (WSW). The objective of this study was to use 454 pyrosequencing to investigate the vaginal microbiome of WSW, women who have sex with women and men (WSWM), and women who have sex with men (WSM) with BV to determine if there are differences in organism composition between groups that may inform new hypotheses regarding the pathogenesis of BV. METHODS Vaginal swab specimens from eligible women with BV at the Mississippi State Department of Health STD Clinic were used. After DNA extraction, 454 pyrosequencing of PCR-amplified 16S rRNA gene sequences was performed. Sequence data was classified using the Ribosomal Database Program classifer. Complete linkage clustering analysis was performed to compare bacterial community composition among samples. Differences in operational taxonomic units with an abundance of ≥ 2% between risk behavior groups were determined. Alpha and beta diversity were measured using Shannon's Index implemented in QIIME and Unifrac analysis, respectively. RESULTS 33 WSW, 35 WSWM, and 44 WSM were included. The vaginal bacterial communities of all women clustered into four taxonomic groups with the dominant taxonomic group in each being Lactobacillus, Lachnospiraceae, Prevotella, and Sneathia. Regarding differences in organism composition between risk behavior groups, the abundance of Atopobium (relative ratio (RR)=0.24; 95%CI 0.11-0.54) and Parvimonas (RR=0.33; 95%CI 0.11-0.93) were significantly lower in WSW than WSM, the abundance of Prevotella was significantly higher in WSW than WSWM (RR=1.77; 95%CI 1.10-2.86), and the abundance of Atopobium (RR=0.41; 95%CI 0.18-0.88) was significantly lower in WSWM than WSM. Overall, WSM had the highest diversity of bacterial taxa. CONCLUSION The microbiology of BV among women in different risk behavior groups is heterogeneous. WSM in this study had the highest diversity of bacterial taxa. Additional studies are needed to better understand these differences.
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Silva D, Henriques A, Cereija T, Martinez-de-Oliveira J, Miranda M, Cerca N. Prevalence of Gardnerella vaginalis and Atopobium vaginae in Portuguese women and association with risk factors for bacterial vaginosis. Int J Gynaecol Obstet 2013; 124:178-9. [PMID: 24268352 DOI: 10.1016/j.ijgo.2013.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/27/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Debora Silva
- Institute for Biotechnology and Bioengineering, Centre for Biological Engineering, University of Minho, Braga, Portugal
| | - Ana Henriques
- Institute for Biotechnology and Bioengineering, Centre for Biological Engineering, University of Minho, Braga, Portugal
| | - Tatiana Cereija
- Institute for Biotechnology and Bioengineering, Centre for Biological Engineering, University of Minho, Braga, Portugal
| | | | - Manuela Miranda
- Famalicão Unit, Hospital Center of Medio Ave, Braga, Portugal
| | - Nuno Cerca
- Institute for Biotechnology and Bioengineering, Centre for Biological Engineering, University of Minho, Braga, Portugal.
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Datcu R, Gesink D, Mulvad G, Montgomery-Andersen R, Rink E, Koch A, Ahrens P, Jensen JS. Vaginal microbiome in women from Greenland assessed by microscopy and quantitative PCR. BMC Infect Dis 2013; 13:480. [PMID: 24131550 PMCID: PMC3853076 DOI: 10.1186/1471-2334-13-480] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacterial vaginosis (BV) is a common condition, although its aetiology remains unexplained. The aim of this study was to analyse the composition of vaginal microbiota in women from Greenland to provide a quantitative description and improve the understanding of BV. METHODS Self-collected vaginal smears and swabs were obtained from 177 women. The vaginal smears were graded for BV according to Nugent's criteria. The vaginal swab samples were analysed by 19 quantitative PCRs (qPCRs) for selected vaginal bacteria and by PCR for four sexually transmitted infections (STIs). RESULTS STIs were common: Mycoplasma genitalium 12%, Chlamydia trachomatis 7%, Neisseria gonorrhoeae 1%, and Trichomonas vaginalis 0.5%. BV was found in 45% of women, but was not associated with individual STIs. Seven of the 19 vaginal bacteria (Atopobium vaginae, Prevotella spp., Gardnerella vaginalis, BVAB2, Eggerthella-like bacterium, Leptotrichia amnionii, and Megasphaera type 1) had areas under the receiver operating characteristic (ROC) curve > 85%, suggesting they are good predictors of BV according to Nugent. Prevotella spp. had the highest odds ratio for BV (OR 437; 95% CI 82-2779) in univariate analysis considering only specimens with a bacterial load above the threshold determined by ROC curve analysis as positive, as well as the highest adjusted odds ratio in multivariate logistic regression analysis (OR 4.4; 95% CI 1.4-13.5). BV could be subdivided into clusters dominated by a single or a few species together. CONCLUSIONS BV by Nugent score was highly prevalent. Two of seven key species (Prevotella spp. and A. vaginae) remained significantly associated with BV in a multivariate model after adjusting for other bacterial species. G. vaginalis and Prevotella spp. defined the majority of BV clusters.
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Affiliation(s)
| | | | | | | | | | | | | | - Jørgen Skov Jensen
- Microbiology and Infection Control, STI, Research and Development, Statens Serum Institut, Artillerivej 5, DK 2300, Copenhagen S, Denmark.
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