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1.
BMC Infect Dis ; 20(1): 642, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-32873233

RESUMEN

BACKGROUND: Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of high risk HPV (hr-HPV). METHODS: From January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions. RESULTS: Among 310,545 female, 6067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p < 0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42-2.31). Co-infection with TV increased the risk of CIN 2-3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16-2.53). CONCLUSIONS: Co-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.


Asunto(s)
Neoplasia Intraepitelial Cervical/epidemiología , Coinfección/complicaciones , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecciones por Papillomavirus/complicaciones , Vaginitis por Trichomonas/complicaciones , Trichomonas vaginalis/aislamiento & purificación , Neoplasias del Cuello Uterino/epidemiología , Adulto , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/virología , China/epidemiología , Coinfección/diagnóstico , Colposcopía , Estudios Transversales , Citodiagnóstico , Detección Precoz del Cáncer/métodos , Femenino , Genotipo , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Factores de Riesgo , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/parasitología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología
2.
PLoS One ; 15(6): e0234704, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32544192

RESUMEN

OBJECTIVE: Trichomonas vaginalis (TV) infection is common, curable, and associated with significant reproductive morbidity and risk for HIV infection. This analysis updates estimates of the prevalence of asymptomatic TV infection, and its associated risk factors, in the non-institutionalized U.S. population. METHODS: We analyzed data from 4057 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 data collection cycle. Participant interviews ascertained demographic characteristics, self-reported tobacco use, and sexual history. Self-collected urine specimens from participants aged 18 to 59 years were tested for TV infection using the Gen-Probe Aptima TV assay. Cotinine was assayed from serum to provide a biomarker of recent tobacco exposure. Weighted percentages are provided to account for unequal selection probabilities among participants and adjustments for non-response. RESULTS: Our sample included 1942 men (49.2%, 95% Confidence Interval [CI] 48.0-50.5) and 2115 women (50.8%, 95%CI 49.5-52.0). The infection prevalence among men was 0.5% (n = 16; 95%CI 0.2-1.0) and 1.8% (n = 55; 95%CI 1.1-3.1) in women. After controlling for participant characteristics associated with TV infection, females had a 5.2-fold increased odds of being infected compared to men (adjusted odds ratio (aOR) 5.2, 95% CI 2.4-11.4). Non-Hispanic blacks were more likely to be infected compared to non-Hispanic whites (aOR 11.2, 95% CI 4.6-27.2). Individuals below the federal poverty level were more likely to be infected compared to those earning >3 times the federal poverty level (aOR 6.7, 95% CI 1.7-26.6), and active smokers were more likely to be infected compared to participants with no nicotine exposure (aOR 8.7, 95% CI 4.1-18.2). CONCLUSION: Trichomonas vaginalis infection continues to be relatively common, especially in women, smokers, non-Hispanic blacks, and in groups of lower socioeconomic status. Identifying the demographic characteristics of populations in the United States disproportionately affected by TV could impact screening and treatment of this infection in clinical practice. Further research on whether screening and treating for asymptomatic TV infection in high-risk populations improves risk for reproductive morbidity and HIV infection is warranted.


Asunto(s)
Tricomoniasis/diagnóstico , Trichomonas vaginalis/aislamiento & purificación , Adolescente , Adulto , Cotinina/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Oportunidad Relativa , Pobreza , Prevalencia , Factores de Riesgo , Conducta Sexual , Fumar , Tricomoniasis/epidemiología , Tricomoniasis/etnología , Tricomoniasis/parasitología , Estados Unidos/epidemiología , Adulto Joven
3.
BMC Infect Dis ; 20(1): 375, 2020 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-32460721

RESUMEN

BACKGROUND: Sexually transmitted infections (STIs) cause a major public health problem that affect both men and women in developing and developed countries. The aim of the study was to estimate the prevalence of 11 STIs among women who voluntarily participated in the study, while seeking gynecological checkup. The existence of an association between the presence of pathogens and symptoms and various sociodemographic risk factors was assessed. METHODS: A total of 505 vaginal and cervical specimens were collected from women above 18 years of age, with or without symptoms related to gynecological infections. Nucleic acid was extracted and samples were tested by real-time PCR for the following pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Ureaplasma urealyticum, Urealplasma parvum, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma girerdii, Gardnerella vaginalis, Candida albicans and Human Papillomavirus (HPV). Positive HPV samples underwent genotyping using a microarray system. RESULTS: Of the 505 samples, 312 (62%) were screened positive for at least one pathogen. Of these, 36% were positive for Gardnerella vaginalis, 35% for Ureaplasma parvum, 8% for Candida albicans, 6.7% for HPV, 4.6% for Ureaplasma urealyticum, 3.6% for Mycoplasma hominis, 2% for Trichomonas vaginalis, 0.8% for Chlamydia trachomatis, 0.4% for Mycoplasma girerdii, 0.2% for Mycoplasma genitalium and 0.2% for Neisseria gonorrhoeae. Lack of symptoms was reported in 187 women (37%), among whom 61% were infected. Thirty-four samples were HPV positive, with 17 high risk HPV genotypes (HR-HPV); the highest rates being recorded for types 16 (38%), 18 (21%) and 51 (18%). Out of the 34 HPV positives, 29 participants had HR-HPV. Association with various risk factors were reported. CONCLUSIONS: This is the first study that presents data about the presence of STIs among women in Lebanon and the MENA region by simultaneous detection of 11 pathogens. In the absence of systematic STI surveillance in Lebanon, concurrent screening for HPV and PAP smear is warranted.


Asunto(s)
Enfermedades de Transmisión Sexual/epidemiología , Adulto , Cuello del Útero/microbiología , Cuello del Útero/parasitología , Cuello del Útero/virología , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Estudios Transversales , Femenino , Gardnerella vaginalis/genética , Gardnerella vaginalis/aislamiento & purificación , Humanos , Líbano/epidemiología , Masculino , Epidemiología Molecular , Infecciones por Mycoplasma/epidemiología , Mycoplasma genitalium/genética , Mycoplasma genitalium/aislamiento & purificación , Mycoplasma hominis/genética , Mycoplasma hominis/aislamiento & purificación , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Factores de Riesgo , Enfermedades de Transmisión Sexual/microbiología , Enfermedades de Transmisión Sexual/parasitología , Enfermedades de Transmisión Sexual/virología , Trichomonas vaginalis/genética , Trichomonas vaginalis/aislamiento & purificación , Ureaplasma/genética , Ureaplasma/aislamiento & purificación , Vagina/microbiología , Vagina/parasitología , Vagina/virología , Frotis Vaginal , Adulto Joven
7.
Int J STD AIDS ; 31(3): 221-229, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31996095
8.
Ann Clin Microbiol Antimicrob ; 19(1): 5, 2020 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992328

RESUMEN

Recurrent vulvovaginal infections (RVVI) has not only become an epidemiological and clinical problem but also include large social and psychological consequences. Understanding the mechanisms of both commensalism and pathogenesis are necessary for the development of efficient diagnosis and treatment strategies for these enigmatic vaginal infections. Through this review, an attempt has been made to analyze vaginal microbiota (VMB) from scratch and to provide an update on its current understanding in relation to health and common RVVI i.e. bacterial vaginosis, vulvovaginal candidiaisis and Trichomoniasis, making the present review first of its kind. For this, potentially relevant studies were retrieved from data sources and critical analysis of the literature was made. Though, culture-independent methods have greatly unfolded the mystery regarding vaginal bacterial microbiome, there are only a few studies regarding the composition and diversity of vaginal mycobiome and different Trichomonas vaginalis strains. This scenario suggests a need of further studies based on comparative genomics of RVVI pathogens to improve our perceptive of RVVI pathogenesis that is still not clear (Fig. 5). Besides this, the review details the rationale for Lactobacilli dominance and changes that occur in healthy VMB throughout a women's life. Moreover, the list of possible agents continues to expand and new species recognised in both health and VVI are updated in this review. The review concludes with the controversies challenging the widely accepted dogma i.e. "VMB dominated with Lactobacilli is healthier than a diverse VMB". These controversies, over the past decade, have complicated the definition of vaginal health and vaginal infections with no definite conclusion. Thus, further studies on newly recognised microbial agents may reveal answers to these controversies. Conversely, VMB of women could be an answer but it is not enough to just look at the microbiology. We have to look at the woman itself, as VMB which is fine for one woman may be troublesome for others. These differences in women's response to the same VMB may be determined by a permutation of behavioural, cultural, genetic and various other anonymous factors, exploration of which may lead to proper definition of vaginal health and disease.


Asunto(s)
Candidiasis Vulvovaginal , Microbiota , Vaginitis por Trichomonas , Vagina/microbiología , Vaginosis Bacteriana , Biopelículas/crecimiento & desarrollo , Candida/aislamiento & purificación , Candida/metabolismo , Candida albicans/aislamiento & purificación , Candida albicans/metabolismo , Candidiasis Vulvovaginal/microbiología , Candidiasis Vulvovaginal/patología , Candidiasis Vulvovaginal/transmisión , Coinfección/microbiología , Coinfección/parasitología , Femenino , Gardnerella vaginalis/aislamiento & purificación , Interacciones Microbiota-Huesped , Humanos , Lactobacillus/aislamiento & purificación , Lactobacillus/metabolismo , Interacciones Microbianas , Microbiota/fisiología , Recurrencia , Vaginitis por Trichomonas/parasitología , Vaginitis por Trichomonas/patología , Vaginitis por Trichomonas/transmisión , Trichomonas vaginalis/aislamiento & purificación , Trichomonas vaginalis/metabolismo , Vagina/parasitología , Vaginosis Bacteriana/microbiología , Vaginosis Bacteriana/patología , Vaginosis Bacteriana/transmisión , Factores de Virulencia/metabolismo
9.
Int J Infect Dis ; 90: 234-236, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31726227

RESUMEN

We report the unusual diagnosis of trichomoniasis in an 18year old patient suffering from salpingitis. Chlamydiae, Mycoplasma and Gardnerella vaginalis were diagnosed using classic laboratory procedures. However, T. vaginalis infection was assessed fortuitously by Polymerase Chain Reaction (PCR) followed by sequencing using panfungal primers (NL1/NL4) on a vaginal swab. This cross-reactivity of panfungal primers was further confirmed using a specific T. vaginalis PCR as well as a reference strain of T. vaginalis isolated in culture. Such cross-reactivity of panfungal primers has been previously reported with non-fungal eukaryotes (Taenia solium, Strongyloides stercoralis or Toxoplasma gondii DNA). This case highlights the usefulness of broad range molecular tools that can take advantage of this cross-reactivity in order to diagnose unsuspected pathogens. In particular settings (e.g. immunosuppression, infection without etiology) it should be used to detect pathogens across kingdoms. Thus, such tools would help direct care providers toward appropriate treatment regimens and better management of unsuspected infection etiologies.


Asunto(s)
Cartilla de ADN/genética , Tricomoniasis/diagnóstico , Trichomonas vaginalis/aislamiento & purificación , Adolescente , Femenino , Humanos , Reacción en Cadena de la Polimerasa/métodos , Tricomoniasis/parasitología , Trichomonas vaginalis/clasificación , Trichomonas vaginalis/genética , Trichomonas vaginalis/fisiología , Vagina/parasitología
10.
Lett Appl Microbiol ; 70(3): 196-202, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31808556

RESUMEN

Trichomonas vaginalis is one of the most common curable sexually transmitted pathogens infecting both men and women worldwide. Unlike traditional methods such as microscopy and culture, nucleic acid amplification tests rapidly detect this agent, assisting in treatment. Conventional polymerase chain reaction (PCR), the loop-mediated isothermal amplification (LAMP), and the Xpert TV assay were evaluated using 28 microscopy positive T. vaginalis samples and 125 microscopy negative samples from symptomatic females of reproductive age. The sensitivity of all tests was 100% and the specificity was 100%, 100%, and 99·2% for PCR, Xpert TV, and LAMP, respectively. The inter-rater reliability was excellent for PCR: Xpert TV (kappa-coefficient = 1) and good for LAMP assay: Xpert TV/PCR (kappa-coefficient = 0·98) and conventional PCR: LAMP (kappa-coefficient = 0·98). The study highlights the importance of PCR for screening T. vaginalis in women, particularly in laboratories where the Xpert-TV assay is not available or not affordable. The LAMP assay showed a lower positive predictive value which merits further evaluation. SIGNIFICANCE AND IMPACT OF THE STUDY: Trichomonas vaginalis is a common sexually transmitted pathogen associated with considerable morbidity and risk of complications. Due to the limitations of traditional diagnostic modalities, three molecular assays were compared: conventional polymerase chain reaction (PCR), Xpert TV assay, and loop mediated isothermal amplification (LAMP) assay for detecting T. vaginalis in symptomatic females. All tests had a sensitivity of 100% and the inter-rater reliability was excellent for PCR: Xpert TV, and good for LAMP assay: Xpert TV/PCR. The translational impact of this study lies in the possible use of conventional PCR and LAMP in laboratories where the Xpert TV assay is not available or not affordable.


Asunto(s)
Técnicas de Amplificación de Ácido Nucleico/métodos , Reacción en Cadena de la Polimerasa/métodos , Enfermedades de Transmisión Sexual/diagnóstico , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/genética , Adulto , Bioensayo/métodos , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Enfermedades de Transmisión Sexual/parasitología , Trichomonas vaginalis/aislamiento & purificación , Frotis Vaginal/métodos
11.
Arch Microbiol ; 202(2): 323-327, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31659380

RESUMEN

Microbial changes in vaginal ecosystem may accelerate the process of cervical carcinogenesis. The developed cervical cancer can lead to changes in the vaginal microbiota. The aim of our study is to determine the vaginal microbiota changes at women with FIGO I stage cervical cancer. We conducted an open, single-site survey in the Department of Gynecology of the Military Medical Academy in Sofia, Bulgaria, from 2014 to 2019 year. The study included a total of 32 women aged 38-55 years with clinical and pathology established cervical cancer (FIGO I stage). The underlying vaginal DNA microbiological test indicated presence or absence of bacterial vaginosis, other vaginal infections or normal vaginal microbiota. Of 32 (100%) women enrolled in our study, 19 (59.4%) was with FIGO IA stage cervical cancer and 13 (40.6%) with IB stage. Disturbances of vaginal microbiota in we found at 23 (71.9%) of women with cervical cancer included in our study. At the rest of 9 (28.1%) women we found out normal vaginal microbiota. Bacterial vaginosis was determined clinically and microbiologically in 15 (46.9%) women enrolled in the study. Aerobic vaginitis caused by Streptococcus species we establish at 4 (12.5%) of women. Trichomonas vaginalis infection have 1 (3.1%) women and Candida Albicans the last one 1 (3.1%) from this group with disturbed vaginal microbial balance. Bacterial dysbacteriosis, characterized by a predominance of Gardnerella vaginalis alone or in complex with other anaerobic bacteria, aerobic vaginitis and other sexually transmitted vaginal pathogens from one side and a concomitant paucity of vaginal Lactobacillus species may be an HPV-dependent cofactor for cervical neoplasia development. Only with this single observation it is difficult to confirm that vaginal microbiota dysbiosis contributes to HPV infection and carcinogenesis.


Asunto(s)
Disbiosis/microbiología , Microbiota/fisiología , Neoplasias del Cuello Uterino/microbiología , Vagina/microbiología , Adulto , Bulgaria , Candida albicans/aislamiento & purificación , Femenino , Gardnerella vaginalis/aislamiento & purificación , Humanos , Lactobacillus/genética , Persona de Mediana Edad , Vaginitis por Trichomonas/parasitología , Trichomonas vaginalis/aislamiento & purificación , Neoplasias del Cuello Uterino/patología , Vaginosis Bacteriana/microbiología
12.
Sex Transm Infect ; 96(4): 306-311, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31515293

RESUMEN

OBJECTIVES: Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) cause the majority of non-gonococcal urethritis (NGU). The role of Ureaplasma urealyticum (UU) in NGU is unclear. Prior case-control studies that examined the association of UU and NGU may have been confounded by mixed infections and less stringent criteria for controls. The objective of this case-control study was to determine the prevalence and aetiology of mixed infections in men and assess if UU monoinfection is associated with NGU. METHODS: We identified 155 men with NGU and 103 controls. Behavioural and clinical information was obtained and men were tested for Neisseria gonorrhoeae and CT, MG, UU and Trichomonas vaginalis (TV). Men who were five-pathogen negative were classified as idiopathic urethritis (IU). RESULTS: Twelve per cent of NGU cases in which a pathogen was identified had mixed infections, mostly UU coinfections with MG or CT; 27% had IU. In monoinfected NGU cases, 34% had CT, 17% had MG, 11% had UU and 2% had TV. In controls, pathogens were rarely identified, except for UU, which was present in 20%. Comparing cases and controls, NGU was associated with CT and MG monoinfections and mixed infections. UU monoinfection was not associated with NGU and was almost twice as prevalent in controls. Men in both the case and control groups who were younger and who reported no prior NGU diagnosis were more likely to have UU (OR 0.97 per year of age, 95% CI 0.94 to 0.998 and OR 6.3, 95% CI 1.4 to 28.5, respectively). CONCLUSIONS: Mixed infections are common in men with NGU and most of these are UU coinfections with other pathogens that are well-established causes of NGU. UU monoinfections are not associated with NGU and are common in younger men and men who have never previously had NGU. Almost half of NGU cases are idiopathic.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Coinfección/epidemiología , Mycoplasma genitalium/aislamiento & purificación , Trichomonas vaginalis/aislamiento & purificación , Ureaplasma urealyticum/aislamiento & purificación , Uretritis/epidemiología , Adolescente , Adulto , Estudios de Casos y Controles , Coinfección/etiología , Humanos , Masculino , Persona de Mediana Edad , Neisseria gonorrhoeae/aislamiento & purificación , Prevalencia , Uretritis/etiología , Adulto Joven
13.
Infect Disord Drug Targets ; 20(1): 98-101, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30652653

RESUMEN

BACKGROUND: Trichomoniasis is known as a common venereal disease. It is estimated that 180 million people in the world are infected with this disease. The present study was conducted to estimate the prevalence of (Trichomonas vaginalis) T. vaginalis among women who were referred to the central laboratory in Ilam. METHODS: In this cross-sectional study, 481 women with suspicious symptoms of trichomoniasis were selected during the first six months of 2015 in the central laboratory and Shahid Mostafa laboratory in Ilam, Iran. All patients were referred to the labs by gynecologists. Sterile swabs were used to collect direct smears. The results and questionnaire data were entered into SPSS version 16 and were analyzed using chi-square test and Fisher's exact test. RESULTS: Direct smear of T. vaginalis demonstrated seven positive cases (1.5%). The highest and the lowest percentages of T. vaginalis infection in women were related to the 45-50 and 20-30 years age groups, respectively. Illiterate women had the highest percentage of infection. No significant relationship was found between the level of education and trichomoniasis infection in women (p = 0.085). The highest infection rate was associated with the use of ectopic contraceptive methods (condoms). CONCLUSION: The prevalence of T. vaginalis was low among women in Ilam but was high among women who have used tubal ligation and condom to prevent pregnancy. Therefore, more attention is required from healthcare centers for appropriate education to women about the proper use of protective equipment.


Asunto(s)
Tricomoniasis/epidemiología , Trichomonas vaginalis/aislamiento & purificación , Adulto , Distribución por Edad , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Irán/epidemiología , Persona de Mediana Edad , Prevalencia , Tricomoniasis/diagnóstico , Tricomoniasis/inmunología , Trichomonas vaginalis/inmunología , Adulto Joven
14.
Sex Transm Infect ; 96(1): 76-78, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-30992326

RESUMEN

OBJECTIVES: Using mathematical modelling, we have previously shown that the prevalence of infection with Trichomonas vaginalis (TV) is likely to increase in the general population in Australia with the transition from Pap smear-based cervical screening to human papillomavirus (HPV) DNA testing. Here we use the existing model to estimate the level of supplemental testing required to maintain TV control. METHODS: A compartmental mathematical model describing the transmission of TV in the general heterosexual population in Australia was used to evaluate the impact of a range of screening scenarios on TV prevalence over time following the transition to HPV DNA testing for cervical screening. Scenarios considered were the inclusion of a TV test with the HPV test and the addition of TV testing to routine chlamydia testing conducted in primary care. RESULTS: Our modelling suggests that with sufficient coverage, inclusion of TV testing with routine chlamydia screening in general practice, TV prevalence can be reduced over time, but at the current reported coverage will gradually increase following the transition to HPV testing. Inclusion of TV testing with HPV testing in the cervical screening programme is preferable to no supplemental testing but is considerably less effective in controlling TV. CONCLUSIONS: These findings support the inclusion of TV testing with routine chlamydia testing of young people.


Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/aislamiento & purificación , Adulto , Australia/epidemiología , Femenino , Pruebas de ADN del Papillomavirus Humano , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Prueba de Papanicolaou , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Vaginitis por Trichomonas/epidemiología , Vaginitis por Trichomonas/parasitología , Trichomonas vaginalis/genética , Adulto Joven
15.
PLoS One ; 14(12): e0225545, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31830061

RESUMEN

BACKGROUND: Although the significance of the human vaginal microbiome for health and disease is increasingly acknowledged, there is paucity of data on the differences in the composition of the vaginal microbiome upon infection with different sexually transmitted pathogens. METHOD: The composition of the vaginal bacterial community of women with Trichomonas vaginalis (TV, N = 18) was compared to that of women with Chlamydia trachomatis (CT, N = 14), and to that of controls (N = 21) (women negative for TV, CT and bacterial vaginosis). The vaginal bacterial composition was determined using high throughput sequencing with the Ion 16S metagenomics kit of the variable regions 2, 4 and 8 of the bacterial 16S ribosomal RNA gene from the vaginal swab DNA extract of the women. QIIME and R package "Phyloseq" were used to assess the α- and ß-diversity and absolute abundance of the 16S rRNA gene per sample in the three groups. Differences in taxa at various levels were determined using the independent T-test. RESULTS: A total of 545 operational taxonomic units (OTUs) were identified in all the three groups of which 488 occurred in all three groups (core OTUs). Bacterial α-diversity, by both Simpson's and Shannon's indices, was significantly higher, (p = 0.056) and (p = 0.001) respectively, among women with either TV or CT than among controls (mean α-diversity TV-infected > CT-infected > Controls). At the genus level, women infected with TV had a significantly (p < 0.01) higher abundance of Parvimonas and Prevotella species compared to both controls and CT-infected women, whereas women infected with CT had a significantly (p < 0.05) higher abundance of Anaerococcus, Collinsella, Corynebacterium and Dialister. CONCLUSION: The vaginal microbiomes of TV and CT-infected women were markedly different from each other and from women without TV and CT. Future studies should determine whether the altered microbiomes are merely markers of disease, or whether they actively contribute to the pathology of the two genital infections.


Asunto(s)
Infecciones por Chlamydia/microbiología , Microbiota/inmunología , Complicaciones Infecciosas del Embarazo/microbiología , Vaginitis por Trichomonas/microbiología , Vagina/microbiología , Adolescente , Adulto , Infecciones por Chlamydia/inmunología , Chlamydia trachomatis/genética , Chlamydia trachomatis/inmunología , Chlamydia trachomatis/aislamiento & purificación , ADN Bacteriano/aislamiento & purificación , Femenino , Humanos , Microbiota/genética , Embarazo , Complicaciones Infecciosas del Embarazo/inmunología , ARN Ribosómico 16S/genética , Vaginitis por Trichomonas/inmunología , Trichomonas vaginalis/genética , Trichomonas vaginalis/inmunología , Trichomonas vaginalis/aislamiento & purificación , Adulto Joven
16.
Rev Chilena Infectol ; 36(3): 292-298, 2019 Jun.
Artículo en Español | MEDLINE | ID: mdl-31859747

RESUMEN

BACKGROUND: Pregnant woman is exposed to many sexual transmitted infections (STI). Many of these infections may produce diseases in the fetus and newborn, and also alteration in the normal course of the pregnancy. AIM: Screening of asymptomatic cervical infection in pregnant woman and its relationship with the vaginal microbiota. PATIENTS AND METHODS: 85 pregnant women without clinical cervicitis who consult in the routine pregnant control (47 patients) and women derived from STI service (38 patients). The samples were obtained from the vaginal fund sac and were analyzed with optic microscopy, cultures and PCR of Neisseria gonorrhoeae, Trichomonas vaginalis and Chlamydia trachomatis. RESULTS: 12,9% of the enrolled women were positive for C. trachomatis, 2,4% for T. vaginalis. In this study, we did not found N. gonorrhoeae. We observed 23,3% of patients with altered microbiota (bacterial vaginosis and intermediate microbiota) was positive for C. trachomatis. CONCLUSIONS: In this study, we found a high frequency of C. trachomatis infection, that correlates with the presence of altered microbiota. This high frequency would promote preventive strategies in the pregnant women routine controls.


Asunto(s)
Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/aislamiento & purificación , Enfermedades de Transmisión Sexual/diagnóstico , Tricomoniasis/microbiología , Trichomonas vaginalis/aislamiento & purificación , Vagina/microbiología , Adolescente , Adulto , Distribución por Edad , Infecciones Asintomáticas , Infecciones por Chlamydia/diagnóstico , Femenino , Humanos , Tamizaje Masivo , Microbiota , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/microbiología , Enfermedades de Transmisión Sexual/microbiología , Factores Socioeconómicos , Tricomoniasis/diagnóstico , Adulto Joven
17.
Bull Exp Biol Med ; 167(6): 795-800, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31656005

RESUMEN

We performed an electron microscopic study of samples of urethral polyps obtained from 90 women (mean age 52.5±4.9 years). According to PCR and culture studies, the most common infectious agent in patients with urethral polyps is U. urealyticum (100% cases). In 70% cases, this infectious agent was present as monoinfection, of these, clinically significant concentration (>106 CFU/ml) were found in 53.3% cases. In 30% cases, associations with C. trachomatis, T. vaginalis, and M. genitalium were found. We observed significant ultrastructural heterogeneity of the epithelial cells in urethral polyps, which manifested in a combination of hyperplastic and metaplastic changes and signs of cytodestruction. Detection of mycoplasma-like bodies in connective tissue mononuclear cells and viral particles in epithelial cells during ultrastructural study, including cases with negative PCR results, indicates the pathogenetic role of latent infection in the formation of urethral polyps.


Asunto(s)
Pólipos/complicaciones , Pólipos/patología , Neoplasias Uretrales/complicaciones , Neoplasias Uretrales/patología , Infecciones Urinarias/complicaciones , Urotelio/ultraestructura , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/patología , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/patología , Mycoplasma genitalium/genética , Mycoplasma genitalium/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Pólipos/epidemiología , Pólipos/ultraestructura , Tricomoniasis/epidemiología , Tricomoniasis/patología , Trichomonas vaginalis/genética , Trichomonas vaginalis/aislamiento & purificación , Infecciones por Ureaplasma/epidemiología , Infecciones por Ureaplasma/patología , Ureaplasma urealyticum/genética , Ureaplasma urealyticum/aislamiento & purificación , Enfermedades Uretrales/complicaciones , Enfermedades Uretrales/epidemiología , Enfermedades Uretrales/microbiología , Enfermedades Uretrales/patología , Neoplasias Uretrales/epidemiología , Neoplasias Uretrales/ultraestructura , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Urotelio/microbiología , Urotelio/patología
18.
J Microbiol Methods ; 165: 105719, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31513857

RESUMEN

Implementation of routine laboratory diagnostics is imperative to address the high burden of sexually transmitted infections (STI) in Sub-Saharan Africa. We demonstrate that logistical challenges of specimen storage, temperature and transport time are unlikely to impact on performance of routine STI diagnostics using the GeneXpert® platform implemented in these settings.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Neisseria gonorrhoeae/aislamiento & purificación , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Manejo de Especímenes/métodos , Trichomonas vaginalis/aislamiento & purificación , Orina/microbiología , África del Sur del Sahara , Femenino , Humanos , Temperatura
19.
PLoS One ; 14(7): e0220330, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31365550

RESUMEN

BACKGROUND: Cervicitis is one of the major health problems amongst women caused by infection of various pathogens including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) as well as human papillomavirus (HPV), and persistent cervical inflammation is one of the etiologic agents of cervical cancer. Toll-like receptors (TLRs) play an important role in the recognition and subsequent elimination of these pathogens. Variations in the Toll-like receptor genes influence susceptibility to pathogens as well as disease progression independently. METHODS: Ten single nucleotide polymorphisms, five each of TLR4 and TLR9 genes were analyzed among 130 cervicitis patients and 150 controls either using polymerase chain reaction-restriction fragment length polymorphism or allele specific-PCR. RESULTS: T. vaginalis infection was found at the highest frequency (30.7%) as compared to C. trachomatis (1.5%), N. gonorrhoeae (2.3%) and HPV (4.6%) infections in cervicitis patients. TLR4 rs11536889 CC (age-adjusted OR, 2.469 [95% CI, 1.499 to 4.065]; p < 0.001) and TLR9 rs187084 TC (age-adjusted OR, 2.165 [95% CI, 1.267-3.699]; p = 0.005) genotypes showed the higher distribution in cervicitis patients compared to controls. In addition, TLR4 rs11536889 C allele was shown to increase the risk of cervicitis (age-adjusted OR, 1.632 [95% CI, 1.132 to 2.352]; p = 0.009) compared to controls. The TLR4 haplotype GCA (OR, 0.6 [95% CI, 0.38-0.95]; p = 0.0272) and TLR9 haplotype GTA (OR, 1.99 [95% CI, 1.14-3.48]; p = 0.014) were found to be associated with decreased and increased risk of cervicitis respectively. CONCLUSIONS: TLR4 and TLR9 polymorphisms, as well as haplotypes were shown to modulate the cervicitis risk.


Asunto(s)
Receptor Toll-Like 4/genética , Receptor Toll-Like 9/genética , Cervicitis Uterina/diagnóstico , Alelos , Estudios de Casos y Controles , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Haplotipos , Humanos , Desequilibrio de Ligamiento , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Oportunidad Relativa , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Trichomonas vaginalis/genética , Trichomonas vaginalis/aislamiento & purificación , Cervicitis Uterina/genética , Cervicitis Uterina/microbiología , Cervicitis Uterina/virología
20.
J Infect Dis ; 220(9): 1503-1510, 2019 09 26.
Artículo en Inglés | MEDLINE | ID: mdl-31287879

RESUMEN

BACKGROUND: While bacterial vaginosis has been associated with an increased risk of Trichomonas vaginalis (TV) acquisition, it is unknown whether other characteristics of the vaginal microbiota, including the presence of key bacterial species, influence a woman's risk of TV acquisition. METHODS: The vaginal microbiota before 25 unique episodes of TV infection involving 18 women was compared to that of 50 controls who remained uninfected. TV was detected by transcription-mediated amplification. Vaginal microbiota were quantified using broad-range polymerase chain reaction analysis and taxon-specific quantitative PCR of the 16S ribosomal RNA gene. RESULTS: TV acquisition was significantly associated with the presence of Prevotella amnii (risk ratio [RR], 2.21; 95% confidence interval [CI], 1.12-4.38; P = .02) and Sneathia sanguinegens (RR, 2.58; 95% CI, 1.00-6.62; P = .049). When adjusted for menstrual phase, the association between P. amnii and TV acquisition remained similar (adjusted RR, 2.11; 95% CI, 1.03-4.33; P = .04), but the association between S. sanguinegens and TV acquisition was attenuated (adjusted RR, 2.31; 95% CI, .86-6.23; P = .10). CONCLUSIONS: Key vaginal bacterial species may contribute to the susceptibility to TV acquisition. Understanding how these bacterial species increase a woman's risk of TV acquisition could help to guide the development of novel strategies to reduce women's risk of TV infection.


Asunto(s)
Bacterias/aislamiento & purificación , Biota , Susceptibilidad a Enfermedades , Vaginitis por Trichomonas/epidemiología , Trichomonas vaginalis/aislamiento & purificación , Vagina/microbiología , Vagina/parasitología , Adulto , Bacterias/clasificación , ADN Bacteriano/genética , ADN Protozoario/genética , Femenino , Humanos , Persona de Mediana Edad , Técnicas de Amplificación de Ácido Nucleico , Estudios Prospectivos , Medición de Riesgo
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