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Journal of Clinical Microbiology Jul 2012We report the first case of spontaneous intrapartum Atopobium vaginae bacteremia identified by 16S rRNA gene sequencing. The bacterium was misidentified by RapID ANA II,...
We report the first case of spontaneous intrapartum Atopobium vaginae bacteremia identified by 16S rRNA gene sequencing. The bacterium was misidentified by RapID ANA II, API Rapid ID 32A, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The likely source of bacteremia was the female genital tract. In invasive infections caused by A. vaginae, β-lactams and clindamycin are the antibiotics of choice, as most strains are resistant to metronidazole.
Topics: Actinobacteria; Adult; Anti-Bacterial Agents; Bacteremia; Clindamycin; DNA, Bacterial; DNA, Ribosomal; Drug Resistance, Bacterial; Female; Gram-Positive Bacterial Infections; Humans; Molecular Sequence Data; Pregnancy; Pregnancy Complications, Infectious; RNA, Ribosomal, 16S; Sequence Analysis, DNA; beta-Lactams
PubMed: 22573590
DOI: 10.1128/JCM.00212-12 -
Journal of Reproductive Immunology Jun 2023There have been few studies concerning an association between unexplained recurrent pregnancy loss (RPL) and the microbiome. A recent study including 67 patients...
There have been few studies concerning an association between unexplained recurrent pregnancy loss (RPL) and the microbiome. A recent study including 67 patients demonstrated that an increase in Ureaplasma species in the endometrium raised the risk of miscarriage with an euploid karyotype. While endometrial sampling is invasive, cervicovaginal sampling is not. We compared vaginal and cervical microbiomes with a 16 S ribosomal RNA sequence between 88 patients with unexplained RPL and 17 healthy women with no history of miscarriage. We prospectively assessed risk factors for maternal colonization at a subsequent miscarriage without an aneuploid karyotype in patients. Cervicovaginal bacteria were dominated by Lactobacillus iners, Gardnerella vaginalis, Atopobium vaginae and Bifidobacterium breve in Japanese population. The proportions of Delftia and unknown bacteria in the cervix were significantly higher in patients with RPL than in controls. Streptococcus, Microbacterium, Delftia, Anaerobacillus and Chloroplast in the cervix were significantly higher in patients with a history of chorioamnionitis compared to the controls. The abundance of Cutibacterium and Anaerobacillus in the cervix was significantly higher in patients who had subsequently miscarried compared to those who gave birth. The miscarriage rate in patients with higher proportions of both Cutibacterium and Anaerobacillus (66.7%, 2/3) was significantly greater than that of patients who lacked these bacteria (9.2%, 6/65, adjusted odds ratio 16.90, 95% confidence interval 1.27-225.47, p = 0.032). The presence of certain bacteria could be a predictor of subsequent miscarriage without an aneuploid karyotype. The cervicovaginal microbiome might be useful for investigating a possible cause of RPL.
Topics: Pregnancy; Humans; Female; Vagina; Cervix Uteri; Abortion, Habitual; Aneuploidy; Microbiota
PubMed: 37060795
DOI: 10.1016/j.jri.2023.103944 -
Biochimie Jun 2022Gynecological cancers that affect female reproductive tract, remain at the top of the global cancer burden list with high relapse rate and mortality. Notwithstanding... (Review)
Review
Gynecological cancers that affect female reproductive tract, remain at the top of the global cancer burden list with high relapse rate and mortality. Notwithstanding development of several novel therapeutic interventions including poly-ADP-ribose polymerase inhibitors, this family of malignancies remain deadly. The human microbiome project demonstrated that dysbiosis of health resident microflora is associated with several pathologies including malignancies of the female reproductive tract and detailed characterization of species variation and host-microbe interaction could provide clues for identification of early diagnostic biomarker, preventive and therapeutic interventions. Emerging evidence suggests that several microbial signatures are significantly associated with gynecological cancers. An increased population of Proteobacteria and Firmicutes followed by significantly reduced Lactobacilli are associated with lethal epithelial ovarian cancer. Similarly, a constant association of elevated level of Atopobium vaginae, Porphyromonas somerae, Micrococci and Gardnerella vaginalis are observed in endometrial and cervical cancers. Moreover, human papilloma virus infection significantly augments colonization of pathogenic microbes including Sneathia sanguinegens, Anaerococcus tetradius, and Peptostreptococcus anaerobius and drives carcinoma of the cervix. Interestingly, microbial dysbiosis in female reproductive tract modulates expression of several microbial and immune-responsive genes such as TLR-4, TLR-5, TLR-6 and NOD-1. Therefore, stringent investigation into the microbial dysbiosis and its underlying mechanism could provide valuable cues for identification of early diagnostic biomarker, preventive and therapeutic interventions against rogue gynecological malignancies.
Topics: Biomarkers; Dysbiosis; Female; Genital Neoplasms, Female; Humans; Lactobacillus; Microbiota
PubMed: 35176353
DOI: 10.1016/j.biochi.2022.02.005 -
Journal of Medical Microbiology Aug 2017Cervicovaginal Atopobium vaginae and Gardnerella vaginalis are strongly associated with bacterial vaginosis (BV) and are the main components of vaginal biofilms. The low...
PURPOSE
Cervicovaginal Atopobium vaginae and Gardnerella vaginalis are strongly associated with bacterial vaginosis (BV) and are the main components of vaginal biofilms. The low efficacy of BV treatment with metronidazole may be due to the presence of such biofilms. Thus, the aim of this study was to compare the pretreatment cervicovaginal loads of A. vaginae and G. vaginalis for women who restored normal flora and those who persisted with BV after a full course of oral metronidazole.
METHODOLOGY
In this cross-sectional study, 309 reproductive-aged women were recruited in a primary health care service in Botucatu, Brazil. Cervicovaginal samples were tested for genital tract infections, microscopic classification of local microbiota and molecular quantification of A. vaginae and G. vaginalis.
RESULTS
All the participants with concurrent cervicovaginal infections (n=64) were excluded. A total of 84 out of 245 (34.3 %) women had BV at enrolment and 43 (51.2 %) of them completed the treatment and returned for follow-up. Evaluation of the vaginal microbiota at follow-up showed that 29 (67.4 %) women restored normal vaginal flora, while 14 (32.6 %) still had BV. The pretreatment loads of G. vaginalis were lower in women with treatment failure (P=0.001) compared to those who successfully restored normal flora. The loads of A. vaginae did not differ between the groups.
CONCLUSION
Although G. vaginalis produces several virulence factors and its loads correlate positively with those of A. vaginae, higher cervicovaginal quantities of these bacteria are not associated with treatment failure of BV after oral metronidazole.
Topics: Actinobacteria; Adolescent; Adult; Bacterial Load; Brazil; Female; Gardnerella vaginalis; Humans; Middle Aged; Treatment Failure; Vagina; Vaginosis, Bacterial; Young Adult
PubMed: 28792372
DOI: 10.1099/jmm.0.000561 -
Journal of Clinical Microbiology Apr 2011Infectious complications after chorionic villus sampling (CVS) are rare (<0.1%) but can lead to maternal sepsis and spontaneous abortion. We report the first bacteremia...
Infectious complications after chorionic villus sampling (CVS) are rare (<0.1%) but can lead to maternal sepsis and spontaneous abortion. We report the first bacteremia with Atopobium vaginae and suggest A. vaginae to be a pathogenic microorganism that can lead to intrauterine infection and fetal death following CVS.
Topics: Abortion, Septic; Actinobacteria; Adult; Anti-Bacterial Agents; Bacteremia; Chorionic Villi Sampling; DNA, Bacterial; DNA, Ribosomal; Female; Gram-Positive Bacterial Infections; Humans; Pregnancy; Pregnancy Complications, Infectious; RNA, Ribosomal, 16S; Sequence Analysis, DNA
PubMed: 21289141
DOI: 10.1128/JCM.01655-10 -
Journal of Gynecology Obstetrics and... Nov 2021Bacterial Vaginosis (BV) is the most common vaginal infection. A large amount of evidence shows that the anatomical scope of BV's pathogenic effect is far beyond the... (Review)
Review
Bacterial Vaginosis (BV) is the most common vaginal infection. A large amount of evidence shows that the anatomical scope of BV's pathogenic effect is far beyond the lower reproductive tract. BV is closely related to adverse reproductive outcomes, which may be due to the infection of the vaginal flora ascending to the upper genital tract. In addition, the incidence of BV is relatively high in infertile women. The vaginal microbiome also plays an important role in women's health and diseases. For most women, the normal vaginal microbiota is dominated by Lactobacillus, which can maintain a healthy vaginal environment by producing lactic acid, HO and bacteriocin, etc. BV is characterized by the imbalanced vaginal flora. It changes the acidic environment that is normally dominated by Lactobacillus, and causes an overgrowth of anaerobic and facultative anaerobic bacteria such as Gardnerella vaginalis and Atopobium vaginae. Studies have shown that bacterial infections in the vagina can spread to upper genital tract and cause adverse fertility outcome. Therefore, early diagnosis and therapeutics of symptomatic BV is helpful to improve the outcome of poor fertility.
Topics: Adult; Female; Humans; Reproductive Health; Treatment Outcome; Vagina; Vaginosis, Bacterial
PubMed: 34087449
DOI: 10.1016/j.jogoh.2021.102174 -
Microbial Pathogenesis Jul 2022Vaginosis is a condition experienced by most women at least once in their lifetime. This condition arises due to the imbalance in the microbiome of the vaginal... (Review)
Review
Vaginosis is a condition experienced by most women at least once in their lifetime. This condition arises due to the imbalance in the microbiome of the vaginal ecosystem. Most of the pathogens of this disease are organisms which are commonly found in a normal healthy vagina. The vaginal microbiome is important as they act as a primary defence against secondary infections and Sexually transmitted diseases and infections (STDs and STIs). The vagina is mostly dominated by Lactobacillus along with other microbes including Gardnerella vaginalis, Atopobium vaginae., Prevotella spp., Mobiluncus spp., etc. Vaginal microbiome also includes Candida albicans and other species of the genus. The ratio in which these species are present varies from person to person and the dominant species decides the whether a vagina is "normal" or not. Lactobacillus dominated vagina is considered normal and if dominated by Gardnerella and such it is considered to be Bacterial vaginosis (BV) and similarly for Vulvovaginal Candidiasis (VVC). The microbiome also undergoes changes during menstrual cycles and menopausal stages. Due to the dynamic nature of this microbiome, it is tough to perfectly restore the balance. But several treatments are currently available with antibiotics like Clindamycin and derivatives of 5-nitroimidazole drugs like Metronidazole. The extensive use and the non-adherence to the treatment regimen has led to drug resistance through biofilm formation, efflux pumps, single nucleotide polymorphisms and resulting recurrent episode of vaginosis in women. Alternative medicines, preparations from plant sources, anti-microbial peptides and nano formulations are also being explored. Most of these medicines tend to focus on reducing the pathogen load rather than restoring the balance of the ecosystem. Vaginal microbiome transplant, an effort to restore the normalcy in the vaginal environment is becoming a popular treatment. In this review we discuss about the types of vaginosis, available treatments, challenges in treating the condition and the new drugs that are under investigation.
Topics: Candidiasis, Vulvovaginal; Female; Gardnerella vaginalis; Humans; Lactobacillus; Microbiota; Vagina; Vaginosis, Bacterial
PubMed: 35644292
DOI: 10.1016/j.micpath.2022.105606 -
BMJ Case Reports Sep 2018is an anaerobic gram-positive organism associated with genitourinary infections. Bacteraemia is rare, with only two cases reported in the literature. This case...
is an anaerobic gram-positive organism associated with genitourinary infections. Bacteraemia is rare, with only two cases reported in the literature. This case describes an 18-year-old type 1 diabetic, presenting with sepsis and haemoptysis, on a background of poor dental hygiene and recurrent hospital admissions. Blood cultures grew and echocardiogram revealed a large tricuspid valve lesion. Despite medical therapy, symptoms of pulmonary emboli continued and she therefore underwent surgical resection of the lesion. Histopathological findings were of a vegetation; culture of the lesion was negative but 16S ribosomal PCR was positive, detecting 16S rRNA of The patient was treated with 4 weeks of vancomycin and made a good recovery. To our knowledge, this represents the first report of infective endocarditis due to this organism. We also provide a review of the literature, including comparing published drug susceptibility data with consensus breakpoints for antimicrobial agents.
Topics: Actinobacteria; Adolescent; Anti-Bacterial Agents; Diabetes Mellitus, Type 1; Diagnosis, Differential; Echocardiography, Transesophageal; Endocarditis, Bacterial; Female; Gram-Positive Bacterial Infections; Humans; Pulmonary Embolism; Tomography, X-Ray Computed; Tricuspid Valve; Urinary Tract Infections; Vancomycin
PubMed: 30173134
DOI: 10.1136/bcr-2018-225871 -
Clinical Infectious Diseases : An... Jul 2008Bacterial vaginosis (BV) is a poorly detected public health problem that is associated with preterm delivery and for which no reliable diagnostic tool exists.
BACKGROUND
Bacterial vaginosis (BV) is a poorly detected public health problem that is associated with preterm delivery and for which no reliable diagnostic tool exists.
METHODS
Molecular analysis of 231 vaginal samples, classified by Gram stain-based Nugent score, was used to propose molecular criteria for BV; these criteria were prospectively applied to 56 new samples. A quantitative molecular tool targeting 8 BV-related microorganisms and a human gene was developed using a specific real-time polymerase chain reaction assay and serial dilutions of a plasmid suspension. The targeted microorganisms were Gardnerella vaginalis, Lactobacillus species, Mobiluncus curtisii, Mobiluncus mulieris, and Candida albicans (which can be identified by Gram staining), as well as Atopobium vaginae, Mycoplasma hominis, and Ureaplasma urealyticum (which cannot be detected by Gram staining).
RESULTS
With use of the Nugent score, 167 samples were classified as normal, 20 were classified as BV, and 44 were classified as intermediate. Except for U. urealyticum, M. mulieris, and Lactobacillus species, DNA of the tested bacteria was detected more frequently in samples demonstrating BV, but the predictive value of such detection was low. The molecular quantification of A. vaginae (DNA level, > or = 10(8) copies/mL) and G. vaginalis (DNA level, > or = 10(9) copies/mL) had the highest predictive value for the diagnosis of BV, with excellent sensitivity (95%), specificity (99%), and positive (95%) and negative (99%) predictive values; 25 (57%) of the samples demonstrating intermediate flora had a BV profile. When applied prospectively, our molecular criteria had total positive and negative predictive values of 96% and 99%, respectively.
CONCLUSIONS
We report a highly reproducible, quantitative tool to objectively analyze vaginal flora that uses cutoff values for the concentrations of A. vaginae and G. vaginalis to establish the molecular diagnosis of BV.
Topics: Actinobacteria; Candida albicans; Colony Count, Microbial; DNA Primers; Female; Gardnerella vaginalis; Humans; Lactobacillus; Mobiluncus; Mycoplasma hominis; Polymerase Chain Reaction; Predictive Value of Tests; Sensitivity and Specificity; Ureaplasma urealyticum; Vaginosis, Bacterial
PubMed: 18513147
DOI: 10.1086/588661 -
Trials Feb 2016
Erratum to: 'Screen-and-treat program by point-of-care of Atopobium vaginae and Gardnerella vaginalis in preventing preterm birth (AuTop trial): study protocol for a randomized controlled trial'.
PubMed: 26873474
DOI: 10.1186/s13063-016-1219-2