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1.
Int J Mol Sci ; 21(7)2020 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-32276519

RESUMO

Lactic acid bacteria can act as reservoirs of antibiotic resistance genes that can be ultimately transferred to pathogens. The present work reports on the minimum inhibitory concentration (MIC) of 16 antibiotics to 25 LAB isolates of five Lactobacillus and one Bifidobacterium species from the human vagina. Acquired resistances were detected to kanamycin, streptomycin, chloramphenicol, gentamicin, and ampicillin. A PCR analysis of lactobacilli failed to identify genetic determinants involved in any of these resistances. Surprisingly, a tet(W) gene was detected by PCR in two Bifidobacterium bifidum strains, although they proved to be tetracycline-susceptible. In agreement with the PCR results, no acquired genes were identified in the genome of any of the Lactobacillus spp. strains sequenced. A genome analysis of B. bifidum VA07-1AN showed an insertion of two guanines in the middle of tet(W) interrupting the open reading frame. By growing the strain in the presence of tetracycline, stable tetracycline-resistant variants were obtained. An amino acid substitution in the ribosomal protein S12 (K43R) was further identified as the most likely cause of VA07-1AN being streptomycin resistance. The results of this work expand our knowledge of the resistance profiles of vaginal LAB and provide evidence for the genetic basis of some acquired resistances.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Lactobacillales/fisiologia , Polimorfismo Genético , Vagina/microbiologia , Bifidobacterium bifidum/efeitos dos fármacos , Bifidobacterium bifidum/genética , Bifidobacterium bifidum/fisiologia , Feminino , Humanos , Lactobacillales/efeitos dos fármacos , Lactobacillales/genética , Lactobacillus/efeitos dos fármacos , Lactobacillus/genética , Lactobacillus/fisiologia , Tetraciclina/farmacologia
2.
BMC Infect Dis ; 20(1): 201, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32143598

RESUMO

BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy. CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood. CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.


Assuntos
Melioidose/diagnóstico , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Aborto Espontâneo , Adulto , Antibacterianos/uso terapêutico , Burkholderia pseudomallei/isolamento & purificação , Feminino , Humanos , Melioidose/tratamento farmacológico , Melioidose/microbiologia , Gravidez , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Vagina/microbiologia
3.
BMC Infect Dis ; 20(1): 98, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005177

RESUMO

BACKGROUND: Potentially pathogenic bacteria that colonise the lower genital tract of women in labour can be passed to the baby during birth. While many babies become colonised with these bacteria after delivery, a few develop neonatal infections. The lower genital tract is a reservoir for potential pathogens and a source of infection for neonates. We determined the prevalence of vaginal colonisation of potentially pathogenic bacteria among women in labour in Central Uganda and identified potential risk factors associated with this colonisation. METHODS: We conducted a cross sectional study at three primary health care facilities and collected vaginal swabs from HIV-1 negative women in labour. Specimens were cultured on different selective microbiological media, and biochemical tests were used to classify bacterial isolates on the species level. Multivariable logistic regression analyses were used to estimate the association between relevant exposures and colonisation with potentially pathogenic bacteria. RESULTS: We recruited 1472 women in labour whose mean age was 24.6 years (standard deviation [SD] 4.9). Of these, 955 (64.9%; 95% Confidence Interval [CI] 62.4, 67%) were vaginally colonised with at least one potentially pathogenic bacterial species. The most commonly isolated species were Escherichia coli (n = 508; 34.5%), Klebsiella pneumoniae (n = 144; 9.8%) and Staphylococcus aureus (n = 121; 8.2%). Results from exploratory multivariable regression analyses indicated that having had ≥5 previous pregnancies (adjusted odds ratio [aOR] 0.59; 95% CI 0.35, 0.97) or being ≥30 years old (aOR 1.52; 95% CI 1.03, 2.23) could be associated with vaginal colonisation with any potentially pathogenic bacteria, as well as with vaginal colonisation with S. aureus (aOR 0.33; 95% CI 0.12, 0.88, and aOR 2.17; 95% CI 1.17, 4.00, respectively). Possession of domestic animals in a household (aOR 0.57; 95% CI 0.35, 0.92) could be associated with vaginal colonisation with E. coli. CONCLUSIONS: Two-thirds of HIV-1 negative women in labour were vaginally colonised by potentially pathogenic bacteria, mainly E. coli, K. pneumoniae, and S. aureus.


Assuntos
Infecções por Escherichia coli/epidemiologia , Infecções por Klebsiella/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Infecções Estafilocócicas/epidemiologia , Vagina/microbiologia , Adulto , Estudos Transversais , Feminino , Soropositividade para HIV/epidemiologia , Humanos , Trabalho de Parto , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Atenção Primária à Saúde , Fatores de Risco , Uganda/epidemiologia , Adulto Jovem
4.
Life Sci ; 246: 117413, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32035929

RESUMO

Cervical cancer is the second common cancer and the third leading cause of cancer deaths among women in less developed countries. It has been indicated that changes in vaginal microbiome play an important role in the occurrence and development of cervical cancer. However, studies have shown that probiotics play an effective role in fighting cancer by affecting pathogenic bacteria, inducing cancer cells apoptosis, and other anticancer activities. Therefore, the purpose of the present study is reviewing the anticancer effect of cervicovaginal bacteria and their potential for cervical cancer treatment.


Assuntos
Bactérias , Neoplasias do Colo do Útero/terapia , Toxinas Bacterianas/uso terapêutico , Feminino , Humanos , Imunoterapia/métodos , Microbiota , Probióticos , Vagina/microbiologia
5.
Nat Rev Urol ; 17(4): 232-250, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32071434

RESUMO

The female reproductive tract (FRT), similar to other mucosal sites, harbours a site-specific microbiome, which has an essential role in maintaining health and homeostasis. In the majority of women of reproductive age, the microbiota of the lower FRT (vagina and cervix) microenvironment is dominated by Lactobacillus species, which benefit the host through symbiotic relationships. By contrast, the upper FRT (uterus, Fallopian tubes and ovaries) might be sterile in healthy individuals or contain a low-biomass microbiome with a diverse mixture of microorganisms. When dysbiosis occurs, altered immune and metabolic signalling can affect hallmarks of cancer, including chronic inflammation, epithelial barrier breach, changes in cellular proliferation and apoptosis, genome instability, angiogenesis and metabolic dysregulation. These pathophysiological changes might lead to gynaecological cancer. Emerging evidence shows that genital dysbiosis and/or specific bacteria might have an active role in the development and/or progression and metastasis of gynaecological malignancies, such as cervical, endometrial and ovarian cancers, through direct and indirect mechanisms, including modulation of oestrogen metabolism. Cancer therapies might also alter microbiota at sites throughout the body. Reciprocally, microbiota composition can influence the efficacy and toxic effects of cancer therapies, as well as quality of life following cancer treatment. Modulation of the microbiome via probiotics or microbiota transplant might prove useful in improving responsiveness to cancer treatment and quality of life. Elucidating these complex host-microbiome interactions, including the crosstalk between distal and local sites, will translate into interventions for prevention, therapeutic efficacy and toxic effects to enhance health outcomes for women with gynaecological cancers.


Assuntos
Carcinogênese , Disbiose/microbiologia , Neoplasias dos Genitais Femininos/microbiologia , Genitália Feminina/microbiologia , Microbiota/fisiologia , Anti-Infecciosos/uso terapêutico , Bactérias Anaeróbias , Colo do Útero/microbiologia , Disbiose/metabolismo , Estrogênios/metabolismo , Tubas Uterinas/microbiologia , Feminino , Microbioma Gastrointestinal , Neoplasias dos Genitais Femininos/metabolismo , Neoplasias dos Genitais Femininos/prevenção & controle , Neoplasias dos Genitais Femininos/terapia , Genitália Feminina/metabolismo , Humanos , Lactobacillus , Ovário/microbiologia , Probióticos/uso terapêutico , Útero/microbiologia , Vagina/microbiologia
6.
Life Sci ; 248: 117444, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32084433

RESUMO

AIMS: Nonhuman primates have been used to investigate pathogenic mechanisms and evaluate immune responses following Chlamydia trachomatis inoculation. This study aimed to systemically profile antibody responses to C. trachomatis infection in nonhuman primates. MATERIALS AND METHODS: Sera were obtained from 4 pig-tailed and 8 long-tailed macaques which were intravaginally or ocularly infected with live C. trachomatis organisms, and analyzed by C. trachomatis proteome array of antigens. KEY FINDINGS: The sera from 12 macaques recognized total 172 C. trachomatis antigens. While 84 antigens were recognized by pig-tailed macaques intravaginally infected with serovar D strain, 125 antigens were recognized by long-tailed macaques ocularly infected with serovar A, and 37 antigens were recognized by both. Ocular inoculation with virulent A2497 strain induced antibodies to more antigens. Among the antigens uniquely recognized by A2497 strain infected macaques, outer membrane complex B antigen (OmcB) induced robust antibody response. Although macaques infected by less virulent A/HAR-13 strain failed to develop antibodies to OmcB, reinfection by A2497 strain induced high levels of antibodies to OmcB. SIGNIFICANCE: Proteome array has revealed a correlation of chlamydial infection invasiveness with chlamydial antigen immunogenicity, and identified antibody responses to OmcB potentially as biomarkers for invasive infection with C. trachomatis.


Assuntos
Anticorpos Antibacterianos/biossíntese , Antígenos de Bactérias/sangue , Infecções por Chlamydia/imunologia , Chlamydia trachomatis/imunologia , Infecções do Sistema Genital/imunologia , Tracoma/imunologia , Animais , Anticorpos Antibacterianos/classificação , Antígenos de Bactérias/classificação , Proteínas da Membrana Bacteriana Externa/sangue , Infecções por Chlamydia/sangue , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/patogenicidade , Olho/imunologia , Olho/microbiologia , Feminino , Soros Imunes/química , Macaca fascicularis , Macaca nemestrina , Masculino , Análise Serial de Proteínas , Proteoma/química , Proteoma/imunologia , Infecções do Sistema Genital/sangue , Infecções do Sistema Genital/microbiologia , Tracoma/sangue , Tracoma/microbiologia , Vagina/imunologia , Vagina/microbiologia
7.
Nat Commun ; 11(1): 940, 2020 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-32103005

RESUMO

Analysis of metagenomic and metatranscriptomic data is complicated and typically requires extensive computational resources. Leveraging a curated reference database of genes encoded by members of the target microbiome can make these analyses more tractable. In this study, we assemble a comprehensive human vaginal non-redundant gene catalog (VIRGO) that includes 0.95 million non-redundant genes. The gene catalog is functionally and taxonomically annotated. We also construct a vaginal orthologous groups (VOG) from VIRGO. The gene-centric design of VIRGO and VOG provides an easily accessible tool to comprehensively characterize the structure and function of vaginal metagenome and metatranscriptome datasets. To highlight the utility of VIRGO, we analyze 1,507 additional vaginal metagenomes, and identify a high degree of intraspecies diversity within and across vaginal microbiota. VIRGO offers a convenient reference database and toolkit that will facilitate a more in-depth understanding of the role of vaginal microorganisms in women's health and reproductive outcomes.


Assuntos
Bactérias/classificação , Bactérias/genética , Microbiota/genética , Transcriptoma/genética , Vagina/microbiologia , Bactérias/isolamento & purificação , Feminino , Perfilação da Expressão Gênica , Biblioteca Gênica , Humanos , Metagenoma/genética , RNA Ribossômico 16S/genética
8.
BMC Infect Dis ; 20(1): 35, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31931732

RESUMO

BACKGROUND: Streptococcus agalctiae (Group B Streptococcus, GBS) is a perinatal pathogen and a leading cause of neonatal infections worldwide. Serotype, sequence type, clonality, antibiotic resistance genes and surface protein profiles of GBS are scarce in Ethiopia, a reason that this study was planned to investigate. . METHODS: Sixteen colonizing GBS isolates obtained from recto-vaginal swabs of pregnant women and body surfaces of newborns were further analyzed. Minimum inhibitory concentration (MIC) test, and whole genome sequence (WGS) methods were done for antibiotic susceptibility test, and molecular characterization of the isolates. RESULTS: All the GBS isolates analyzed were belonged to four capsular serotypes: II, 11/16(68.8%), V, 3/16(18.8%), Ia and VI each with 1/16(6.3%) and five sequence type (ST-2, ST-10, ST-14, ST-569 and ST-933). Sequence type-10 was the most predominant ST followed by ST-569. The five STs were grouped into the four clonal complexes (CC - 1, CC-10, CC-19, and CC-23). Different surface proteins and pili families such as ALP1, ALPHA, ALP23, PI-1 / PI-2A1, PI-1 / PI-2B, and Srr1 were detected from WGS data. All isolates were found to be susceptible to the tested antibiotics except for tetracycline in MIC and WGS test methods used. Tetracycline resistant determinant genes such as TETM and TETL / TETM combination were identified. CONCLUSION: Further studies on serotype and molecular epidemiology will provide a comprehensive data of the GBS capsular serotype and clones available in Ethiopia.


Assuntos
Epidemiologia Molecular/métodos , Complicações Infecciosas na Gravidez/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/genética , Streptococcus agalactiae/isolamento & purificação , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/genética , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Hospitais Universitários , Humanos , Recém-Nascido , Testes de Sensibilidade Microbiana , Filogenia , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Prevalência , Reto/microbiologia , Sorogrupo , Infecções Estreptocócicas/tratamento farmacológico , Tetraciclina/uso terapêutico , Vagina/microbiologia , Sequenciamento Completo do Genoma
9.
PLoS Pathog ; 16(1): e1008236, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31971984

RESUMO

Bacterial vaginosis (BV), a condition in which the vaginal microbiota consists of community of obligate and facultative anaerobes rather than dominated by a single species of Lactobacillus, affects ~30% of women in the US. Women with BV are at 60% increased risk for HIV acquisition and are 3-times more likely to transmit HIV to an uninfected partner. As cervicovaginal mucus (CVM) is the first line of defense against mucosal pathogens and the home of the resident vaginal microbiota, we hypothesized the barrier function of CVM to HIV may be diminished in BV. Here, we characterized CVM properties including pH, lactic acid content, and Nugent score to correlate with the microbiota community composition, which was confirmed by 16S rDNA sequencing on a subset of samples. We then quantified the mobility of fluorescently-labeled HIV virions and nanoparticles to characterize the structural and adhesive barrier properties of CVM. Our analyses included women with Nugent scores categorized as intermediate (4-6) and BV (7-10), women that were either symptomatic or asymptomatic, and a small group of women before and after antibiotic treatment for symptomatic BV. Overall, we found that HIV virions had significantly increased mobility in CVM from women with BV compared to CVM from women with Lactobacillus crispatus-dominant microbiota, regardless of whether symptoms were present. We confirmed using nanoparticles and scanning electron microscopy that the impaired barrier function was due to reduced adhesive barrier properties without an obvious degradation of the physical CVM pore structure. We further confirmed a similar increase in HIV mobility in CVM from women with Lactobacillus iners-dominant microbiota, the species most associated with transitions to BV and that persists after antibiotic treatment for BV. Our findings advance the understanding of the protective role of mucus and highlight the interplay between vaginal microbiota and the innate barrier function mucus.


Assuntos
Colo do Útero/microbiologia , Colo do Útero/virologia , Infecções por HIV/virologia , Vagina/microbiologia , Vagina/virologia , Vaginose Bacteriana/microbiologia , Adulto , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Coinfecção/microbiologia , Coinfecção/virologia , Feminino , HIV-1/fisiologia , Humanos , Microbiota , Pessoa de Meia-Idade , Muco/microbiologia , Muco/virologia , Adulto Jovem
10.
PLoS One ; 15(1): e0224359, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31914129

RESUMO

Sexually transmitted infections (STIs) and vaginal dysbiosis (disturbed resident microbiota presenting with abnormal Nugent score or candidiasis) have been associated with mucosal inflammation and risk of HIV-1 infection, cancer and poor reproductive outcomes. To date, the temporal relationships between aberrant cervical innate immunity and the clinical onset of microbial disturbance have not been studied in a large population of reproductive age women. We examined data from a longitudinal cohort of 934 Ugandan and Zimbabwean women contributing 3,274 HIV-negative visits who had complete laboratory, clinical and demographic data. Among those, 207 women later acquired HIV, and 584 women were intermittently diagnosed with C. trachomatis (CT), N. gonorrhoeae (NG), genital herpes (HSV-2), T. vaginalis (TV), candidiasis, and abnormal intermediate (4-6) or high (7-10) Nugent score, i.e. bacterial vaginosis (BV). Immune biomarker concentrations in cervical swabs were analyzed by generalized linear and mixed effect models adjusting for site, age, hormonal contraceptive use (HC), pregnancy, breastfeeding, genital practices, unprotected sex and overlapping infections. High likelihood ratios (1.5-4.9) denoted the values of cervical immune biomarkers to predict onset of abnormal Nugent score and candidiasis at the next visits. When controlling for covariates, higher levels of ß-defensin-2 were antecedent to BV, CT and HSV-2, lower anti-inflammatory ratio IL-1RA:IL-1ß-to intermediate Nugent scores and candida, lower levels of the serine protease inhibitor SLPI-to candida, lower levels of the adhesion molecule ICAM-1 -to TV, and lower levels of the oxidative stress mitigator and endothelial activation marker VEGF-to NG. Changes in innate immunity following onset of dysbiosis and infections were dependent on HC use when controlling for all other covariates. In conclusion, imminent female genital tract dysbiosis or infection can be predicted by distinct patterns of innate immunity. Future research should characterize biotic and abiotic determinants of this pre-existing innate immunity state.


Assuntos
Disbiose/imunologia , Imunidade Inata/genética , Doenças Sexualmente Transmissíveis/imunologia , Vaginose Bacteriana/imunologia , Adolescente , Adulto , Biomarcadores/metabolismo , Colo do Útero/imunologia , Colo do Útero/microbiologia , Colo do Útero/patologia , Disbiose/epidemiologia , Disbiose/microbiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Molécula 1 de Adesão Intercelular/imunologia , Molécula 1 de Adesão Intercelular/metabolismo , Proteína Antagonista do Receptor de Interleucina 1/imunologia , Proteína Antagonista do Receptor de Interleucina 1/metabolismo , Interleucina-1beta/imunologia , Interleucina-1beta/metabolismo , Estresse Oxidativo/imunologia , Gravidez , Infecções do Sistema Genital/epidemiologia , Infecções do Sistema Genital/imunologia , Inibidor Secretado de Peptidases Leucocitárias/imunologia , Inibidor Secretado de Peptidases Leucocitárias/metabolismo , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/microbiologia , Uganda/epidemiologia , Vagina/imunologia , Vagina/microbiologia , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/microbiologia , Fator A de Crescimento do Endotélio Vascular/imunologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Zimbábue/epidemiologia
11.
Ann Clin Microbiol Antimicrob ; 19(1): 5, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992328

RESUMO

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.


Assuntos
Candidíase Vulvovaginal , Microbiota , Vaginite por Trichomonas , Vagina/microbiologia , Vaginose Bacteriana , Biofilmes/crescimento & desenvolvimento , Candida/isolamento & purificação , Candida/metabolismo , Candida albicans/isolamento & purificação , Candida albicans/metabolismo , Candidíase Vulvovaginal/microbiologia , Candidíase Vulvovaginal/patologia , Candidíase Vulvovaginal/transmissão , Coinfecção/microbiologia , Coinfecção/parasitologia , Feminino , Gardnerella vaginalis/isolamento & purificação , Interações entre Hospedeiro e Microrganismos , Humanos , Lactobacillus/isolamento & purificação , Lactobacillus/metabolismo , Interações Microbianas , Microbiota/fisiologia , Recidiva , Vaginite por Trichomonas/parasitologia , Vaginite por Trichomonas/patologia , Vaginite por Trichomonas/transmissão , Trichomonas vaginalis/isolamento & purificação , Trichomonas vaginalis/metabolismo , Vagina/parasitologia , Vaginose Bacteriana/microbiologia , Vaginose Bacteriana/patologia , Vaginose Bacteriana/transmissão , Fatores de Virulência/metabolismo
12.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(1): 60-66, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-31950791

RESUMO

Objective: To optimize the preparation parameters of the new silk birth-canal microecology transporter (BMT) for transferring the symbiotic bacteria of the birth canal efficiently. Methods: Birth canal microbial samples of 30 full term pregnant women at admission were collected as the control group (NC, n=30). The experimental group included 18 pregnant women terminated by Cesarean section, who were divided into 6 sub-groups (M1-M6, n=3) to complete the transfer tests of the birth-canal microecology. The new silk BMT was processed in the sterile liquid of the different osmotic pressure with the different immersion depth, and was placed in the vagina of the pregnant women for 1 h before sealed. All extracted DNA specimens were amplified in the V3-V4 region of the 16S rDNA, and were sequenced by Illumina Hiseq2500. Microbial diversity analysis was performed by Mothur, QIIME, Lefse and Metastat. Welch's t-test and Anosim nonparametric test were used to compare the difference between groups. Results: The new silk BMT with 70% immersion depth could be fully covered by the solution, and had good solution preserving and adhesion. The subjects had no foreign body sensation with satisfied experience. Both of the microbes on the new BMT and the control group were lactobacillus as the dominant bacteria genus. The microbial diversity and bacteria constitution in the new BMT was similar to the control group in the condition of 0.45% NaCl solution and 70% immersion depth, and there was no significant difference between the two groups ( P>0.05). Conclusion: The new silk BMT can transfer the symbiotic microbes of the birth canal efficiently, and the optimal preparation parameters were 0.45% hypotonic saline solution and 70% immersion depth.


Assuntos
Técnicas Microbiológicas , Microbiota , Seda , Vagina , Bactérias/classificação , Biodiversidade , Cesárea , Feminino , Humanos , Lactobacillus/fisiologia , Técnicas Microbiológicas/métodos , Microbiota/fisiologia , Gravidez , Vagina/microbiologia
13.
Einstein (Sao Paulo) ; 18: eAO4920, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826077

RESUMO

OBJECTIVE: To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. METHODS: This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, minimal and maximal values. Parity and socioeconomic status were described by absolute frequency and percentages. We used logistic regression models in the software (SPSS) to analyze correlations of variables according to vaginal-rectal culture, considering a 95%CI and p-values. Variables were age, number of pregnancies, weight gain in pregnancy and gestational age at delivery. RESULTS: A total of 347 medical records were included, and after applying the exclusion criteria, 287 medical records composed the final sample. Patients' age ranged between 17 and 44 years. Mean age was 30.6 years, 67 patients had positive result for group B Streptococcus (prevalence of 23.3%; 95%CI: 18.7-28.5). CONCLUSION: Considering the high prevalence of group B Streptococcus in our service, the antibiotic prophylaxis strategy based on rectovaginal culture screening approach seems to be cost-effective.


Assuntos
Complicações Infecciosas na Gravidez/microbiologia , Reto/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Vagina/microbiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Idade Materna , Paridade , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal , Prevalência , Estudos Retrospectivos , Fatores Socioeconômicos , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/epidemiologia , Adulto Jovem
14.
Infect Immun ; 88(2)2020 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-31818965

RESUMO

The sialylatable lacto-N-neotetraose (LNnT; Gal-GlcNAc-Gal-Glc) moiety from heptose I (HepI) of the lipooligosaccharide (LOS) of Neisseria gonorrhoeae undergoes positive selection during human infection. Lactose (Gal-Glc) from HepII, although phase variable, is commonly expressed in humans; loss of HepII lactose compromises gonococcal fitness in mice. Anti-LOS monoclonal antibody (MAb) 2C7, a promising antigonococcal immunotherapeutic that elicits complement-dependent bactericidal activity and attenuates gonococcal colonization in mice, recognizes an epitope comprised of lactoses expressed simultaneously from HepI and HepII. Glycan extensions beyond lactose on HepI modulate binding and function of MAb 2C7 in vitro Here, four gonococcal LOS mutants, each with lactose from HepII but fixed (unable to phase-vary) LOS HepI glycans extended beyond the lactose substitution of HepI (lactose alone, Gal-lactose, LNnT, or GalNAc-LNnT), were used to define how HepI glycan extensions affect (i) mouse vaginal colonization and (ii) efficacy in vitro and in vivo of a human IgG1 chimeric derivative of MAb 2C7 (2C7-Ximab) with a complement-enhancing E-to-G Fc mutation at position 430 (2C7-Ximab-E430G). About 10-fold lower 2C7-Ximab-E430G concentrations achieved similar complement-dependent killing of three gonococcal mutants with glycan extensions beyond lactose-substituted HepI (lactose alone, LNnT, or GalNAc-LNnT) as 2C7-Ximab (unmodified Fc). The fourth mutant (Gal-lactose) resisted direct complement-dependent killing but was killed approximately 70% by 2C7-Ximab-E430G in the presence of polymorphonuclear leukocytes and complement. Only mutants with (sialylatable) LNnT from HepI colonized mice for >3 days, reiterating the importance of LNnT sialylation for infection. 2C7-Ximab-E430G significantly attenuated colonization caused by the virulent mutants.


Assuntos
Anticorpos Antibacterianos/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Gonorreia/terapia , Lipopolissacarídeos/imunologia , Neisseria gonorrhoeae/imunologia , Animais , Modelos Animais de Doenças , Feminino , Camundongos Endogâmicos BALB C , Resultado do Tratamento , Vagina/microbiologia
15.
BJOG ; 127(2): 287-299, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31299136

RESUMO

BACKGROUND: Vaginal probiotics claiming to cure and/or prevent bacterial and/or fungal vaginal dysbiosis are available on the market but, until recently, did not have to be approved as drugs for human use. OBJECTIVES: We evaluated the impact of vaginal probiotics on bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) cure and/or recurrence, as well as vaginal microbiota (VMB) composition and vaginal detection of probiotic strains. SEARCH STRATEGY: We performed a systematic literature search in MEDLINE and Embase up to 15 January 2019. SELECTION CRITERIA: There were no restrictions in probiotic strains/formulations, study populations, and designs. BV had to be diagnosed by Nugent or Ison-Hay Gram stain scoring, VVC by culture, wet mount or PCR, and VMB composition/detection by molecular techniques. DATA COLLECTION AND ANALYSIS: The authors independently extracted data. MAIN RESULTS: All 22 vaginal probiotics evaluated in the 34 eligible studies contained Lactobacillus strains, and some contained additional active ingredients. The probiotics hold promise for BV cure and prevention, but much less so for VVC cure and prevention. No major safety concerns were reported in any of the studies. Vaginal detection of probiotic strains never lasted long beyond the dosing period, suggesting that they did not colonise the vagina. However, findings are not definitive because heterogeneity was high and the quality of most studies suboptimal. CONCLUSIONS: Availability of vaginal probiotics for vaginal health indications will likely decline in 2020 because of regulatory changes. We urge the field to invest in clinical evidence-based product development and to conduct future trials more rigorously. TWEETABLE ABSTRACT: Lactobacilli-containing vaginal probiotics hold promise for bacterial vaginosis cure and prevention, but not for vulvovaginal candidiasis.


Assuntos
Candidíase Vulvovaginal , Disbiose/prevenção & controle , Disbiose/terapia , Lactobacillus , Microbiota , Probióticos/administração & dosagem , Vagina/microbiologia , Vaginose Bacteriana , Candidíase Vulvovaginal/microbiologia , Candidíase Vulvovaginal/prevenção & controle , Candidíase Vulvovaginal/terapia , Disbiose/microbiologia , Feminino , Humanos , Resultado do Tratamento , Vaginose Bacteriana/microbiologia , Vaginose Bacteriana/prevenção & controle , Vaginose Bacteriana/terapia
16.
BJOG ; 127(2): 182-192, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31749298

RESUMO

OBJECTIVE: Characterise the vaginal metabolome of cervical HPV-infected and uninfected women. DESIGN: Cross-sectional. SETTING: The Center for Health Behavior Research at the University of Maryland School of Public Health. SAMPLE: Thirty-nine participants, 13 categorised as HPV-negative and 26 as HPV-positive (any genotype; HPV+ ), 14 of whom were positive with at least one high-risk HPV strain (hrHPV). METHOD: Self-collected mid-vaginal swabs were profiled for bacterial composition by 16S rRNA gene amplicon sequencing, metabolites by both gas and liquid chromatography mass spectrometry, and 37 types of HPV DNA. MAIN OUTCOME MEASURES: Metabolite abundances. RESULTS: Vaginal microbiota clustered into Community State Type (CST) I (Lactobacillus crispatus-dominated), CST III (Lactobacillus iners-dominated), and CST IV (low-Lactobacillus, 'molecular-BV'). HPV+ women had higher biogenic amine and phospholipid concentrations compared with HPV- women after adjustment for CST and cigarette smoking. Metabolomic profiles of HPV+ and HPV- women differed in strata of CST. In CST III, there were higher concentrations of biogenic amines and glycogen-related metabolites in HPV+ women than in HPV- women. In CST IV, there were lower concentrations of glutathione, glycogen, and phospholipid-related metabolites in HPV+ participants than in HPV- participants. Across all CSTs, women with hrHPV strains had lower concentrations of amino acids, lipids, and peptides compared with women who had only low-risk HPV (lrHPV). CONCLUSIONS: The vaginal metabolome of HPV+ women differed from HPV- women in terms of several metabolites, including biogenic amines, glutathione, and lipid-related metabolites. If the temporal relation between increased levels of reduced glutathione and oxidised glutathione and HPV incidence/persistence is confirmed in future studies, anti-oxidant therapies may be considered as a non-surgical HPV control intervention. TWEETABLE ABSTRACT: Metabolomics study: Vaginal microenvironment of HPV+ women may be informative for non-surgical interventions.


Assuntos
Metaboloma , Microbiota , Infecções por Papillomavirus/microbiologia , Vagina/microbiologia , Adulto , Estudos Transversais , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Lactobacillus , Microbiota/genética , Infecções por Papillomavirus/genética , Infecções por Papillomavirus/virologia , RNA Ribossômico 16S/genética , Vagina/virologia
18.
Int J Infect Dis ; 91: 261-263, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31863877

RESUMO

Tick-borne relapsing fever (TBRF) borreliae are one of the main causes of fever in rural Africa and can cause miscarriages. This article reports Borrelia crocidurae as a probable cause of spontaneous miscarriage, which was detected through vaginal self-sampling. This appears to be the first such report.


Assuntos
Aborto Espontâneo/microbiologia , Borrelia/isolamento & purificação , Febre Recorrente/microbiologia , Vagina/microbiologia , Adulto , Borrelia/classificação , Borrelia/genética , Feminino , Humanos , Gravidez , Febre Recorrente/diagnóstico , População Rural/estatística & dados numéricos , Senegal
19.
BJOG ; 127(2): 275-284, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30932317

RESUMO

OBJECTIVE: To determine the effects on the vaginal microbiota of an oral probiotic preparation administered from early pregnancy. DESIGN: Randomised, double blind, placebo-controlled trial. SETTING: Four maternity units in the UK. POPULATION: Women aged 16 years or older recruited at 9-14 weeks' gestation. METHODS: Participants were randomly allocated to receive oral capsules of probiotic containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 each at 2.5 × 109 colony-forming units (CFUs) or placebo once daily from recruitment until the end of pregnancy. MAIN OUTCOME MEASURE: Rates of bacterial vaginosis (BV, defined as Nugent score ≥7) at 18-20 weeks' gestation compared by logistic regression adjusted for possible confounders. RESULTS: The primary analysis included 78% (238/304) of participants who initially consented (probiotic group 123, placebo group 115). Of these participants, 95% (227/238) reported an intake of 93% or more of the required number of capsules. The rates of BV did not differ between groups at 18-20 weeks' gestation (15% (19/123) in the probiotic group vs. 9% (10/115) in the placebo group, adjusted odds ratio 1.82, 95% confidence interval 0.64-5.19). There were also no differences between the groups in the proportion of women colonised with the probiotic strains, Escherichia coli, group B streptococci or other vaginal microbiota. There were no differences in the alpha diversity or composition of the bacterial communities between or within the probiotic and placebo groups at 9-14 and 18-20 weeks' gestation. CONCLUSIONS: Oral probiotics taken from early pregnancy did not modify the vaginal microbiota. TWEETABLE ABSTRACT: The oral probiotic preparation used in this study does not prevent BV in pregnant women.


Assuntos
Microbiota/fisiologia , Complicações Infecciosas na Gravidez/microbiologia , Probióticos/uso terapêutico , Vagina/microbiologia , Adulto , Método Duplo-Cego , Feminino , Humanos , Lactobacillus reuteri/efeitos dos fármacos , Lactobacillus rhamnosus/efeitos dos fármacos , Gravidez , Primeiro Trimestre da Gravidez , Vaginose Bacteriana/complicações , Vaginose Bacteriana/tratamento farmacológico , Vaginose Bacteriana/microbiologia , Adulto Jovem
20.
BJOG ; 127(2): 264-274, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31573753

RESUMO

OBJECTIVE: To characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first and second trimester miscarriages. DESIGN: Nested case-control study. SETTING: Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London. POPULATION: 161 pregnancies: 64 resulting in first trimester miscarriage, 14 in second trimester miscarriage and 83 term pregnancies. METHODS: Prospective profiling and comparison of vaginal bacteria composition using 16S rRNA gene-based metataxonomics from 5 weeks' gestation in pregnancies ending in miscarriage or uncomplicated term deliveries matched for age, gestation and body mass index. MAIN OUTCOME MEASURES: Relative vaginal bacteria abundance, diversity and richness. Pregnancy outcomes defined as first or second trimester miscarriage, or uncomplicated term delivery. RESULTS: First trimester miscarriage associated with reduced prevalence of Lactobacillus spp.-dominated vaginal microbiota classified using hierarchical clustering analysis (65.6 versus 87.7%; P = 0.005), higher alpha diversity (mean Inverse Simpson Index 2.5 [95% confidence interval 1.8-3.0] versus 1.5 [1.3-1.7], P = 0.003) and higher richness 25.1 (18.5-31.7) versus 16.7 (13.4-20), P = 0.017), compared with viable pregnancies. This was independent of vaginal bleeding and observable before first trimester miscarriage diagnosis (P = 0.015). Incomplete/complete miscarriage associated with higher proportions of Lactobacillus spp.-depleted communities compared with missed miscarriage. Early pregnancy vaginal bacterial stability was similar between miscarriage and term pregnancies. CONCLUSIONS: These findings associate the bacterial component of vaginal microbiota with first trimester miscarriage and indicate suboptimal community composition is established in early pregnancy. While further studies are required to elucidate the mechanism, vaginal bacterial composition may represent a modifiable risk factor for first trimester miscarriage. TWEETABLE ABSTRACT: Vaginal bacterial composition in first trimester miscarriage is associated with reduced Lactobacillus spp. abundance and is independent of vaginal bleeding.


Assuntos
Aborto Espontâneo/microbiologia , Microbiota/fisiologia , Vagina/microbiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Londres , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Estudos Prospectivos , RNA Ribossômico 16S
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