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BMC Infectious Diseases Mar 2005Bacterial vaginosis (BV) - a syndrome characterised by a shift in vaginal flora - appears to be particularly common in sub-Saharan Africa, but little is known of the...
BACKGROUND
Bacterial vaginosis (BV) - a syndrome characterised by a shift in vaginal flora - appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS) in The Gambia, West Africa.
METHODS
We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for T vaginalis and vaginal flora microscopy, and for Lactobacillus spp, aerobic organisms, Candida spp and BV-associated bacteria (Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma spp) cultures; and cervical swabs were collected for N gonorrhoeae culture and C trachomatis PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire.
RESULTS
BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. Lactobacillus spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H202)-producing strains. Prevalence of BV-associated bacteria were: G vaginalis 44.4%; Bacteroides 16.7%; Prevotella 15.2%; Peptostretococcus 1.5%; Mobiluncus 0%; other anaerobes 3.1%; and Mycoplasma hominis 21.4%. BV was positively associated with isolation of G vaginalis (odds-ratio [OR] 19.42, 95%CI 7.91 - 47.6) and anaerobes (P = 0.001 [OR] could not be calculated), but not with M hominis. BV was negatively associated with presence of Lactobacillus (OR 0.07, 95%CI 0.03 - 0.15), and H2O2-producing lactobacilli (OR 0.12, 95% CI 0.05 - 0.28). Presence of H2O2-producing lactobacilli was associated with significantly lower prevalence of G vaginalis, anaerobes and C trachomatis. HIV prevalence was 12.8%. Overall, there was no association between BV and HIV, and among micro-organisms associated with BV, only Bacteroides spp. and Prevotella spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting).
CONCLUSION
In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics.
Topics: Adolescent; Adult; Bacteria, Aerobic; Bacteria, Anaerobic; Female; Gambia; HIV Infections; Humans; Hygiene; Middle Aged; Prevalence; Syndrome; Vagina; Vaginosis, Bacterial
PubMed: 15757510
DOI: 10.1186/1471-2334-5-12 -
Paediatric and Perinatal Epidemiology Mar 2014We evaluated the importance of measuring early vaginal levels of eight bacterial vaginosis (BV)-associated bacteria, at two points in pregnancy, and the risk of...
BACKGROUND
We evaluated the importance of measuring early vaginal levels of eight bacterial vaginosis (BV)-associated bacteria, at two points in pregnancy, and the risk of spontaneous preterm delivery (SPTD) among pregnant women and the subgroup of pregnant women with a history of preterm delivery (PTD).
METHODS
This prospective cohort study enrolled women at five urban obstetric practices at Temple University Hospital in Philadelphia PA. Women with singleton pregnancies less than 16 weeks gestation self-collected vaginal swabs at two points in pregnancy, prior to 16 weeks gestation and between 20-24 weeks gestation, to measure the presence and level of eight BV-associated bacteria. Women were followed-up for gestational age at delivery via medical records.
RESULTS
Among women reporting a prior PTD, women with higher levels of Leptotrichia/Sneathia species, BVAB1 and Mobiluncus spp., prior to 16 weeks gestation, were significantly more likely to experience a SPTD. In addition, pregnant women with a prior PTD and increasing levels of Leptotrichia/Sneathia species (aOR: 9.1, 95% CI 1.9, 42.9), BVAB1 (aOR: 16.4, 95% CI 4.3, 62.7) or Megasphaera phylotype 1 (aOR: 6.2, 95% CI 1.9, 20.6), through 24 weeks gestation, were significantly more likely to experience an SPTD. Among the overall group of pregnant women, the levels of BV-associated bacteria were not related to SPTD.
CONCLUSION
Among the group of women reporting a prior PTD, increasing levels of BVAB1, Leptotrichia/Sneathia species, and Megasphaera phylotype 1, through mid-pregnancy were related to an increased risk of SPTD.
Topics: Adult; Bacterial Typing Techniques; Colony Count, Microbial; DNA, Bacterial; DNA, Ribosomal; Female; Follow-Up Studies; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Leptotrichia; Mobiluncus; Obstetric Labor, Premature; Philadelphia; Predictive Value of Tests; Pregnancy; Premature Birth; Prospective Studies; Risk Factors; Vagina; Vaginosis, Bacterial
PubMed: 24405280
DOI: 10.1111/ppe.12106 -
Journal of Clinical Microbiology Jun 1988New and selective Rlk and SA media, combined with cold enrichment at 4 to 5 degrees C, allowed isolation of Mobiluncus species from patients with bacterial vaginosis at...
New and selective Rlk and SA media, combined with cold enrichment at 4 to 5 degrees C, allowed isolation of Mobiluncus species from patients with bacterial vaginosis at higher rates than with conventional cultivation methods. Rlk medium consists of Columbia CNA agar supplemented with peptone, yeast extract, 5% laked rabbit or sheep blood, nalidixic acid, and tinidazole. SA medium consists of Columbia CNA agar supplemented with 2% rabbit serum, 1.6% laked rabbit or sheep blood, nalidixic acid, and tinidazole. Use of these selective media plus the cold enrichment technique permitted Mobiluncus species to propagate at rates similar to those of other anaerobic members of the vaginal flora.
Topics: Bacteria, Anaerobic; Cold Temperature; Culture Media; Female; Humans
PubMed: 3384924
DOI: 10.1128/jcm.26.6.1134-1137.1988 -
Infectious Diseases in Obstetrics and... 2001To determine the prevalence of Gardnerella vaginalis, anaerobic bacteria and Mycoplasma hominis in vaginal specimens of women with and without bacterial vaginosis (BV)...
OBJECTIVE
To determine the prevalence of Gardnerella vaginalis, anaerobic bacteria and Mycoplasma hominis in vaginal specimens of women with and without bacterial vaginosis (BV) as well as to determine the sensitivity and specificity of the direct sialidase assay of vaginal fluid as a rapid test for diagnosing this syndrome.
METHODS
Vaginal cultures were obtained from 109 nonpregnant women (mean age 33 +/- 7.1 years), 47 of them with clinical signs of BV (BV+) and 62 of them without BV (BV-). In addition, we determined the vaginal sialidase activity in both groups, which may serve as a feature of this syndrome.
RESULTS
Anaerobic bacteria were isolated in 91% and 18% of the BV+ and BV- groups, respectively (p < 0.001). Peptostreptococcus spp., Prevotella bivia and Porphyromonas spp. were strongly associated with BV. P. bivia and Prevotella spp. represented 44% of all the anaerobes isolated in the BV+ group. All the isolated P. bivia strains presented sialidase activity. G. vaginalis and M. hominis were isolated in 76% and 42% of the BV+ and 1% and 0% of the BV- women, respectively (p < 0.001). Mobiluncus morphotypes were observed in 34% of the BV+ and 0% of BV- women. Sensitivity, specificity, positive predictive value and negative predictive value of sialidase activity were 81%, 94%, 90% and 86%, respectively.
CONCLUSIONS
Our data demonstrate a strong association between G. vaginalis, M. hominis, and P. bivia and BV. Sialidase activity and Gram stain of vaginal fluid represent accurate methods for diagnosing BV.
Topics: Adult; Bacteria, Anaerobic; Female; Gardnerella vaginalis; Humans; Mycoplasma Infections; Mycoplasma hominis; Neuraminidase; Vagina; Vaginosis, Bacterial
PubMed: 11368254
DOI: 10.1155/S1064744901000047 -
Infectious Diseases of Poverty Jun 2017The usefulness of C-reactive protein (CRP) as a non-specific marker of inflammation during pregnancy and lactation is unclear in impoverished populations where...
BACKGROUND
The usefulness of C-reactive protein (CRP) as a non-specific marker of inflammation during pregnancy and lactation is unclear in impoverished populations where co-existing infections and vitamin deficiencies are common.
METHODS
This cross-sectional study in Panama recruited 120 pregnant and 99 lactating Ngäbe-Buglé women from 14 communities in rural Panama. Obstetric history, indoor wood smoke exposure, fieldwork, BMI, vitamins A, B, D, and folic acid, and inflammation markers (CRP, neutrophil/lymphocyte ratio (NLR), plateletcrit and cytokines) were measured. Multiple regressions explored both associations of CRP with other inflammatory markers and associations of CRP and elevated CRP based on trimester-specific cut-offs with maternal factors, infections and vitamin deficiencies.
RESULTS
CRP was higher in pregnancy (51.4 ± 4.7 nmol/L) than lactation (27.8 ± 3.5 nmol/L) and was elevated above trimester specific cut-offs in 21% of pregnant and 30% of lactating women. Vitamin deficiencies were common (vitamin A 29.6%; vitamin D 68.5%; vitamin B 68%; folic acid 25.5%) and over 50% of women had two or more concurrent deficiencies as well as multiple infections. Multiple regression models highlighted differences in variables associated with CRP between pregnancy and lactation. In pregnancy, CRP was positively associated with greater indoor wood smoke exposure, caries and hookworm and negatively associated with Ascaris and vaginal Lactobacillus and Bacteroides/Gardnerella scores. Consistent with this, greater wood smoke exposure, caries as well as higher diplococcal infection score increased the odds of trimester-elevated CRP concentrations whereas longer gestational age lowered the likelihood of a trimester-elevated CRP. During lactation, folic acid deficiency was associated with higher CRP whereas parity, number of eosinophils and Mobiluncus score were associated with lower CRP. Also, a higher BMI and Trichomonas vaginalis score increased the likelihood of an elevated CRP whereas higher parity and number of eosinophils were associated with lower likelihood of an elevated CRP.
CONCLUSIONS
Infections both raise and lower CRP concentrations in pregnant and lactating mothers. Only folic acid deficiency during lactation was associated with higher CRP concentrations. Caution is required when interpreting CRP concentrations in pregnant and lactating women who have co-existing nutrient deficiencies and multiple infections.
Topics: Adolescent; Adult; Avitaminosis; C-Reactive Protein; Communicable Diseases; Cross-Sectional Studies; Female; Humans; Indians, Central American; Lactation; Panama; Pregnancy; Young Adult
PubMed: 28571565
DOI: 10.1186/s40249-017-0307-1 -
Frontiers in Microbiology 2020The high incidence of bacterial vaginosis recurrence is common after treatment with an antibiotic agent and suggests the need for new treatments to prevent this. We...
The high incidence of bacterial vaginosis recurrence is common after treatment with an antibiotic agent and suggests the need for new treatments to prevent this. We conducted a randomized trial to evaluate the ability of maltose gel to treat bacterial vaginosis. Eighteen female rhesus macaques were randomly assigned, in a 2:1 ratio, to receive maltose gel or placebo gel by syringe to the fornix of the vagina for five consecutive days. We used 16S rRNA sequencing data from 70 swab samples of vaginal secretions in two groups in total on days 0, 3, and 5 after medication initiation and days 3 and 5 after medication withdrawal for the study of microbiome composition. We found that, in the placebo control group, there was no significant change in the composition and abundance of vaginal microbiota during the follow-up period. In the maltose gel test group, the abundance of in the vagina microbiota increased gradually with the prolongation of the treatment time on Days 3 and 5 (ANOVA = 6.99e-5 < 0.01) but began to decrease after the withdrawal of maltose gel, which was different from that of the control group. Correspondingly, the diversity and abundance of BV-related bacteria, , , , , , and , decreased on Day 0 to Day 5 of medication and increased after drug withdrawal in the maltose gel test group. The study confirms that maltose gel can facilitate the proliferation of and promote the transition of the vaginal microbiota from BV-related bacteria dominant to dominant in the rhesus macaque.
PubMed: 33240248
DOI: 10.3389/fmicb.2020.594065 -
Antimicrobial Agents and Chemotherapy Nov 1986Clinical isolates of Gardnerella vaginalis, Streptococcus agalactiae, Bacteroides spp., and Mobiluncus spp. were screened for resistance to tetracycline and for the...
Clinical isolates of Gardnerella vaginalis, Streptococcus agalactiae, Bacteroides spp., and Mobiluncus spp. were screened for resistance to tetracycline and for the presence of the streptococcal tetM determinant. The S. agalactiae and G. vaginalis strains contained DNA sequences homologous to the tetM determinant, while strains of the other two genera did not.
Topics: Bacteria; DNA, Bacterial; Drug Resistance, Microbial; Humans; R Factors; Sequence Homology, Nucleic Acid; Tetracycline; Urogenital System
PubMed: 3800360
DOI: 10.1128/AAC.30.5.810 -
Journal of Endodontics Aug 2016The purpose of this study was to combine multiple displacement amplification and checkerboard DNA-DNA hybridization to qualitatively and quantitatively evaluate the...
INTRODUCTION
The purpose of this study was to combine multiple displacement amplification and checkerboard DNA-DNA hybridization to qualitatively and quantitatively evaluate the microbiota present in infections refractory to endodontic treatment.
METHODS
The subjects of this study were 40 patients presenting with periapical lesions refractory to endodontic treatment. Samples were taken by scraping or filing root canal walls with a #10 K-type hand file. Sample DNA was amplified by multiple displacement amplification, and the levels of 107 bacterial taxa were analyzed by checkerboard DNA-DNA hybridization. The taxa were divided into 3 distinct microbial populations depending on their mean proportion in samples (% DNA probe counts ± standard error of the mean) as follows: dominant (≥3.0%), subdominant (>1.6%-3.0%), and residual (≤1.6%) populations. The significance of differences was determined using the Mann-Whitney test.
RESULTS
The taxa present with the highest mean proportions (constituting the dominant population) were Corynebacterium diphtheriae (8.03 ± 0.98), Porphyromonas gingivalis (5.42 ± 2.09), Streptococcus sobrinus (5.33 ± 0.69), and Stenotrophomonas maltophilia (4.72 ± 1.73). Among the subdominant population were Eubacterium saphenum (3.85 ± 1.06), Helicobacter pylori (3.16 ± 0.62), Dialister pneumosintes (3.12 ± 1.1), Clostridium difficile (2.74 ± 0.41), Enterobacter agglomerans (2.64 ± 0.54), Salmonella enterica (2.51 ± 0.52), Mobiluncus mulieris (2.44 ± 0.6), and Klebsiella oxytoca (2.32 ± 0.66). In the population of bacteria present at the lowest mean proportions (the residual population), Bacteroides ureolyticus (0.04 ± 0.01), Haemophilus influenzae (0.04 ± 0.02), and Prevotella oris (0.01 ± 0.01) were found at the lowest mean proportions. Enterococcus faecalis was detected in the residual population (0.52 ± 0.26).
CONCLUSIONS
The microbial climax community in teeth refractory to endodontic treatment not only harbors medically important species but also contains distinct microbial consortia present with different population levels.
Topics: Bacteria; DNA Probes; DNA, Bacterial; Dental Pulp Cavity; Dental Pulp Necrosis; Humans; Microbiota; Nucleic Acid Hybridization; Periapical Diseases; Root Canal Therapy
PubMed: 27377440
DOI: 10.1016/j.joen.2016.05.014 -
Microbiome Feb 2014This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial...
BACKGROUND
This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term.
RESULTS
A retrospective case-control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp.
CONCLUSION
We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the predominant members of the microbial community in normal pregnancy. These results can serve as the basis to study the relationship between the vaginal microbiome and adverse pregnancy outcomes.
PubMed: 24484853
DOI: 10.1186/2049-2618-2-4 -
Journal of Infection in Developing... Jun 2021This study aimed to determine the incidence of lower genital infections and related factors in preterm premature rupture of membranes (PPROM) and preterm labor.
INTRODUCTION
This study aimed to determine the incidence of lower genital infections and related factors in preterm premature rupture of membranes (PPROM) and preterm labor.
METHODOLOGY
A case-control study was conducted on pregnant women who were admitted to the Hospital of Hue University of Medicine and Pharmacy, Vietnam between November 2017 and May 2019. Cases from 22 to 36 gestational weeks were included as group 1 (patients with preterm labor and intact membranes) or as group 2 (those with PPROM). The control group included women with singleton pregnancies who were matched on gestational age and recruited concurrently with the study cases. Gram stain was perfomed to identify Lactobacillus, Gardnerella, mobiluncus, Candida, and leucocytes. Trichomonas vaginalis was detected by wet mount. Cultures of vaginal secretions and aminotic fluid were performed to identify aerobic bacteria.
RESULTS
Bacterial vaginosis was higher in group 1 (28.9%) compared to control (11.4%). The incidence of isolated aerobic bacteria was 44.1% in group 2, 11.1% in group 1, and 12.7% in the control group (p < 0.001). Fungal infection was not shown to be a risk factor for preterm labor (p = 0.990), whereas, bacterial vaginosis was (OR = 3.16; 95%CI = 1.23-8.15; p = 0.016). Isolated aerobic bacteria were associated with premature rupture of membranes (OR = 5.45; 95%CI = 2.11-14.05; p < 0.001).
CONCLUSIONS
Bacteria vaginosis increased the risk of preterm labor and preterm premature rupture of membranes. Isolated aerobic bacteria were related to PPROM, while fungal infection was not associated with preterm labor.
Topics: Adult; Case-Control Studies; Female; Fetal Membranes, Premature Rupture; Humans; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Infectious; Prenatal Diagnosis; Reproductive Tract Infections; Risk Factors; Vietnam; Young Adult
PubMed: 34242190
DOI: 10.3855/jidc.13244