RESUMO
Vaginal infection is a gynecological problem in women of reproductive age with multiple health outcomes. The most common forms of infection include bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and aerobic vaginitis (AV). Our main goals were to evaluate different types of vaginal infections in Ecuadorian women in a large urban area (Quito) and to characterize the vaginal microbiota colonization by opportunistic species. We collected vaginal swabs and epidemiological surveys from 414 women from June 2016 to July of 2017. We analyzed vaginal samples for the presence of any vaginal infection. The microbiological examination was done through Gram-stain, wet mount smears, and polymerase chain reaction (PCR) assays using primers for target genes, such as 16S rRNA (Atopobium vaginae, Mobiluncus mulieris, and Gardnerella species), ddl (Enterococcus faecalis), adk (Escherichia coli) and KER1 (Candida albicans) genes. Most women showed a healthy vaginal microbiota (66.7%). Nearly one-tenth (10.4%) of the participants had intermediate microbiota, and the remaining women (22.9%) had a single vaginal infection (BV, AV, or VC) or coinfections. From the 95 participants that had an infection, AV was the main diagnosed vaginal infection (51.6%), followed by BV (24.2%) and finally VC (7.4%). The remaining women (16.8%) showed coinfections, being BV and AV the most common coinfection. Using univariable logistic regression analyses we found an increased odds of healthy microbiota in women with a sexual partner (P = 0.02, OR = 1.64). Also, women in a free union relationship (P = 0.000, OR = 16.65) had an increased odds of having coinfections. On the other hand, the use of birth control (condom OR = 0.388 or other contraceptive method OR = 0.363) was associated with significantly lower odds of intermediate microbiota (P ≤ 0.05). We found no statistically significant differences between women with infection and a particular group age. Using multivariate logistic regression analyses we initially found an increased odds of having BV in women with M. mulieris (P = 0.020, OR = 4.98) and Gardnerella species (P = 0.010, OR = 4.16). Women with E. coli showed an increased odds of having AV (P = 0.009, OR = 2.81). The presence of C. albicans in women showed an increased odds of having VC (P = 0.007, OR = 17.94). Finally, women with M. mulieris showed a reverse odds of having healthy microbiota (P = 0.008, OR = 0.06). We found no statistically significant differences between women with symptomatic and asymptomatic infections or the presence of Enterococcus faecalis. We found using logistic regression analyses that M. mulieris was the most prevalent opportunistic pathogen among women with vaginal infection. Further studies should evaluate the possibility to use M. mulieris as a potential key predictor for vaginal infections.
Assuntos
Microbiota , Vagina/microbiologia , Doenças Vaginais/microbiologia , Adulto , Fatores Etários , Candidíase Vulvovaginal/epidemiologia , Candidíase Vulvovaginal/microbiologia , Equador/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Doenças Vaginais/epidemiologia , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/microbiologia , Adulto JovemRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Argentinean medicinal plants such as Larrea divaricata Cav., Larrea cuneifolia Cav., Larrea nitida Cav., Zuccagnia punctata Cav. and Tetraglochin andina Ciald. are used alone and in combination in traditional medicine by inhabitants from northwestern Argentina to solve mycosis, vaginal infections, gastrointestinal, respiratory, and inflammatory processes. AIM OF THE STUDY: To assess the effect of interactions between hydroalcoholic extracts of these five species of medicinal plants against yeast strains isolated from vaginal infections, select the most active mixtures and evaluate anti-inflammatory and antioxidant activities. MATERIAL AND METHODS: Synergy between the plant extracts was studied by using a broth microdilution assay by means of the checkerboard method against Saccharomyces cerevisiae, Candida albicans, and non albicans strains. The inhibitory effect on lipoxygenase and the antioxidant capacity in cell-free and cell systems were studied. The chemical profile was evaluated by qualitative and quantitative screening, whereas chemical markers were quantified by HPLC-DAD. RESULTS: A synergistic antifungal effect was observed in some binary combinations. Z. punctata/L. divaricata, Z. punctata/L. cuneifolia, and Z. punctata/L. nitida were the most active mixtures. Nordihydroguaiaretic acid and 2',4'-dihydroxychalcone, two antifungal compounds, present in these extracts, were identified and quantified by HPLC-DAD. Both single extracts and bi-herbal mixtures showed antioxidant activity (in cellular and in cell-free systems) and were active on pro-inflammatory enzymes (LOX). CONCLUSIONS: Our results indicated that the most active combinations of these species extracts could be useful in the treatment of vaginal infectious diseases caused by Saccharomyces cerevisiae and Candida spp. strains and in associated oxidative and inflammatory processes, supporting its traditional use. In addition, the results highlighted the phyto-therapeutic potential of total phytochemical compounds present in these medicinal plants.
Assuntos
Anti-Inflamatórios/farmacologia , Antifúngicos/farmacologia , Antioxidantes/farmacologia , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Anti-Inflamatórios/administração & dosagem , Antifúngicos/administração & dosagem , Antioxidantes/administração & dosagem , Argentina , Cromatografia Líquida de Alta Pressão , Sinergismo Farmacológico , Quimioterapia Combinada , Feminino , Fungos/efeitos dos fármacos , Humanos , Micoses/tratamento farmacológico , Micoses/microbiologia , Extratos Vegetais/administração & dosagem , Doenças Vaginais/tratamento farmacológico , Doenças Vaginais/microbiologiaRESUMO
BACKGROUND: In France, no previous studies have focused specifically on health problems among medical students during internships abroad including the clinical symptoms suggestive of infectious diseases and the acquisition of pathogen carriage. METHODS: Clinical follow up and qPCR based respiratory, gastrointestinal and vaginal pathogen carriage before and after travel were prospectively assessed in a cohort of medical students departing from Marseille, France. RESULTS: 134 students were included. 73.9%, 38.8% and 5.0% of students reported gastrointestinal, respiratory and vaginal symptoms, respectively. The acquisition rate of Enteroaggregative Escherichia coli (EAEC) and Enteropathogenic E. coli (EPEC) was 53% and 41%, respectively. The acquisition of respiratory viruses was low but associated with persisting symptoms, while bacterial acquisition ranged from 3.3% for Streptococcus pyogenes to 15.0% for Haemophilus influenzae. Gardnerella vaginalis and Atopobium vaginae acquisition rates were 7.7% and 14.3% respectively. Five students (5.1%) had molecular quantification criteria for bacterial vaginosis on return. CONCLUSION: This preliminary study demonstrates that besides the known risk of gastrointestinal and respiratory infections and associated changes in intestinal and respiratory microbiota, medical students abroad may also experience changes in vaginal microbiota leading, in some cases, to clinical symptoms or the acquisition of bacterial vaginosis, which may be asymptomatic.
Assuntos
Portador Sadio/microbiologia , Gastroenteropatias/microbiologia , Infecções Respiratórias/virologia , Viagem , Doenças Vaginais/microbiologia , Ásia , Feminino , França/epidemiologia , Gastroenteropatias/epidemiologia , Humanos , Masculino , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , América do Sul , Estudantes de Medicina , Doenças Vaginais/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Chlamydia trachomatis is the most prevalent bacteria causing sexually transmitted infections. In women, this infection can cause cervicitis and urethritis, although it's usually asymptomatic. The aim of this study was to investigate the prevalence of C. trachomatis in women attending the lab Instituto de Previsión Social and detect the genotypes. METHODS: Endocervical samples from 505 symptomatic and asymptomatic women were assayed. It was determined the presence of C. trachomatis by PCR through amplification of a fragment of the cryptic plasmid. Positive samples were genotyped by the partial amplification of the ompA gene and analyzed phylogenetically. RESULTS: Forty-three positive samples were detected to infection with C. trachomatis, obtaining a prevalence of 8.5% (IC 95%: 6.4-11.3%). The prevalence of C. trachomatis was higher in women with vaginal symptoms [11.3% (30/265) vs. 5.4% (13/240)] (p = 0.018), as well as in women under 26 year-old [11.5% (28/244) vs. 6.2% (15/246)] (p = 0.021). Based on phylogenetic analysis, it was observed that 62% of the samples were genotype E, 15% genotype J, 15% genotype D, and 8% genotype F. CONCLUSIONS: This work is the first contribution on the molecular epidemiology of C. trachomatis in the Misiones province, Argentina, which shows the rate of prevalence of this bacterium and offers information on circulating genotypes.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/genética , Adolescente , Adulto , Argentina , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Epidemiologia Molecular , Filogenia , Reação em Cadeia da Polimerase , Prevalência , Doenças Vaginais/microbiologia , Adulto JovemRESUMO
PURPOSE: Purulent or exudative genitourinary infections are a frequent cause of consultation in primary and specialized healthcare. The objectives of this study were: to determine the prevalence of Trichomonas vaginalis and co-infections with Candida spp. and Gardnerella vaginalis in vaginal secretion; and to use multilocus sequence typing (MLST) to analyse the genetic diversity of T. vaginalis strains. METHODOLOGY: The samples were submitted for analysis (n=5230) to a third-level hospital in Granada (Southern Spain) between 2011 and 2014; eight T. vaginalis strains isolated during 2015 were randomly selected for MLST analysis. Culture and nucleic acid hybridization techniques were used to detect microorganisms in the samples. RESULTS: The prevalence of T. vaginalis was 2.4â% between 2011 and 2014, being higher during the first few months of both 2011 and 2012. Among samples positive for T. vaginalis, co-infection with G. vaginalis was detected in 29 samples and co-infection with Candida spp. in 6, while co-infection with all three pathogens was observed in 3 samples. The only statistically significant between-year difference in co-infection rates was observed for T. vaginalis with G. vaginalis due to an elevated rate in 2011. MLST analysis results demonstrated a high genetic variability among strains circulating in our setting. CONCLUSION: These findings emphasize the need for the routine application of diagnostic procedures to avoid the spread of this sexually transmitted infection.
Assuntos
Candida/classificação , Candidíase/complicações , Gardnerella vaginalis/isolamento & purificação , Variação Genética , Tricomoníase/microbiologia , Trichomonas vaginalis/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candidíase/epidemiologia , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/parasitologia , Feminino , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Pessoa de Meia-Idade , Espanha/epidemiologia , Tricomoníase/complicações , Tricomoníase/epidemiologia , Doenças Vaginais/epidemiologia , Doenças Vaginais/microbiologia , Doenças Vaginais/parasitologia , Adulto JovemRESUMO
OBJECTIVE: To assess the prevalence of genital Mycoplasma spp. among women with systemic lupus erythematosus (SLE) and to identify factors associated with such infection. METHODS: A cross-sectional study was conducted among patients with SLE and healthy women who attended a hospital in Puebla, Mexico, between July 29, 2014, and January 4, 2015. All participants were aged 18 years or older and sexually active. A structured interview assessed sociodemographic, obstetric, gynecologic, and clinical characteristics. Disease activity was evaluated using the Mexican SLE Disease Activity Index. Polymerase chain reaction was used to detect the presence of Mycoplasma spp. in genital samples. RESULTS: Ureaplasma urealyticum was the only genital mycoplasma detected; it was present in 32 (24.6%) of 130 patients with SLE and 12 (12.8%) of 94 healthy women. Patients with SLE had increased odds of infection (odds ratio 2.120, 95% confidence interval 1.046-4.296). Among patients with SLE, multiparity was more common in those with U. urealyticum infection (P=0.043). CONCLUSION: One-quarter of women with SLE had genital infection with U. urealyticum. An association was found between infection and multiparity among women with SLE.
Assuntos
Lúpus Eritematoso Sistêmico/epidemiologia , Infecções por Ureaplasma/epidemiologia , Ureaplasma urealyticum/isolamento & purificação , Doenças Vaginais/epidemiologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Paridade , Prevalência , Infecções por Ureaplasma/microbiologia , Doenças Vaginais/microbiologia , Adulto JovemRESUMO
Background: The prevalence of cervicovaginal infections during pregnancy has been associated with adverse perinatal outcomes however, the actual approach used for diagnosis is not effective. The aim of this study was to compare the diagnosis of vaginal infections in pregnant women using clinical, molecular diagnostic and traditional microbiological culture in a pilot study, to determine the prevalence and association with the development of preterm labor. Materials and methods: We performed a nested cross-sectional study composed by 54 women in a cohort of pregnant women in Mexico City. Cervicovaginal infections were evaluated by clinical methods, microbiology culture and a commercially available molecular biology test. Results: Prevalence of cervicovaginal infections during pregnancy was estimated between 28% and 50% according to methodologies. Considering the clinical diagnosis of preterm labor as the gold standard, all diagnostic tests were poor as predictors of preterm labor. Conclusion: Traditional approaches to establish the significance of cervicovaginal infection in pregnancy are exhausted, so be sought new ways to understand this complex relationship. Meanwhile it is recommended to continue to use traditional methods to identify infections during pregnancy in both knowledge of new methods aimed at understanding these relationships are sophisticated.
Assuntos
Técnicas de Diagnóstico Molecular/métodos , Complicações Infecciosas na Gravidez/diagnóstico , Doenças do Colo do Útero/diagnóstico , Doenças Vaginais/diagnóstico , Adolescente , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , México , Trabalho de Parto Prematuro/epidemiologia , Projetos Piloto , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Resultado da Gravidez , Doenças do Colo do Útero/microbiologia , Doenças Vaginais/microbiologia , Adulto JovemRESUMO
AIMS: To assess the preventive effect of different intravaginal (i.va.) doses of Lactobacillus reuteri CRL1324 against vaginal colonization by Group B Streptococcus (GBS) in a murine experimental model. METHODS AND RESULTS: The major virulence factors of four vaginal GBS clinical isolates were determined to select the most virulent strain and set up a murine model of streptococcal vaginal colonization. Later, the effect of four and seven doses of 10(8) viable cells of Lact. reuteri CRL1324 i.va. administered, prior to the GBS challenge was studied. Seven doses of lactobacilli were able to significantly reduce the number of viable GBS cells, while four doses showed no preventive effect. Both doses reduced the leucocyte influx induced by GBS. Seven doses caused a slight increase in the Lact. reuteri CRL1324 vaginal colonization compared with four doses and reduced murine vaginal pH compared to control mice. CONCLUSIONS: Lactobacillus reuteri CRL1324 evidenced a preventive effect on GBS vaginal colonization in an experimental mouse model. SIGNIFICANCE AND IMPACTS OF THE STUDY: Maternal GBS colonization is one of the most important risk factors for developing disease in newborns. Lactobacillus reuteri CRL1324 could be considered as a new biological agent to reduce infections caused by this micro-organism.
Assuntos
Limosilactobacillus reuteri , Probióticos , Infecções Estreptocócicas/prevenção & controle , Streptococcus agalactiae , Vagina/microbiologia , Doenças Vaginais/prevenção & controle , Animais , Modelos Animais de Doenças , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Microbiota , Streptococcus agalactiae/crescimento & desenvolvimento , Streptococcus agalactiae/isolamento & purificação , Streptococcus agalactiae/patogenicidade , Doenças Vaginais/microbiologia , Fatores de VirulênciaRESUMO
BACKGROUND: In the United States 19 million people acquire a sexually transmitted disease every year. Sexually transmitted diseases impact in gynecological terms because they may cause sterility, infertility and ectopic pregnancy. OBJECTIVE: To compare the effectiveness of two combinations of three oral antimicrobial drugs in the treatment of mixed cervical-vaginal infections, included those caused by Mycoplasma and Chlamydia trachomatis. MATERIAL AND METHOD: Aclinical, random, comparative, double-blind study included 50 patients assisting to infectology consult with diagnosis of mixed cervical-vaginal infection. Patients were divided into two groups: Group A (n = 25): fluconazole 37.5 mg, tinidazole 500 mg and azithromycin 250 mg; group B (n = 25): fluconazole 37.5 mg, tinidazole 500 mg and clindamycin 312.5 mg. Patients of both groups received two tablets twice p.o. for one day. Cultures were performed to corroborate the diagnosis and then to demonstrate effectiveness of the schemes studied. For the analysis of the data we used measures of central tendency, dispersion and inferential statistics for comparison of proportions by c2 and Fisher's exact tests with a significance level of p < 0.05. RESULTS: All patient got clinical cure; however, regarding the microbiologic eradication a positive case was identified in group A, requiring rescue treatment. The compliance in both groups was of 100%. In both groups, statistical analysis did not show significant differences. Three patients in group A had mild adverse effects. Patients mean age was 33.4 +/- 5.3 years. CONCLUSIONS: Both treatments showed similar effectiveness against mixed cervical-vaginal infections. Microbiological efficacy was of 96% and 100% in group A and B, respectively, besides, scheme of group B was better tolerated.
Assuntos
Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Antitricômonas/uso terapêutico , Azitromicina/uso terapêutico , Clindamicina/uso terapêutico , Fluconazol/uso terapêutico , Infecções por Mycoplasma/tratamento farmacológico , Tinidazol/uso terapêutico , Doenças do Colo do Útero/tratamento farmacológico , Doenças do Colo do Útero/microbiologia , Doenças Vaginais/tratamento farmacológico , Doenças Vaginais/microbiologia , Adulto , Infecções por Chlamydia/tratamento farmacológico , Método Duplo-Cego , Quimioterapia Combinada , Feminino , HumanosRESUMO
Diseases related to the urogenital system in both males and females, are common in clinical routine of smallanimal and represents important causes of morbidity and mortality in dogs and cats. Pyocolpos is a cysticdilatation of the vagina due to the accumulation of pus resulting from the genital tract obstruction. The maincause of obstruction is imperforate hymen, transverse vaginal membrane, or vaginal atresia.We present a caseof a three-year-old female Pinscher with a history of constipation for four days, even after administration oflaxatives and enema, and estrus for ten days without a report of cover. Physical examinations were performed,which revealed increased abdominal size. Ultrasound confirmed the presence of large amounts of vaginal fluid.Exploratory laparotomy was performed, which confirmed the diagnosis of pyocolpos. Although pyocolposis a rare congenital malformation in female domestic animals, this report of its existence underscores theimportance of more accurate clinical research when increased abdominal size is noted by veterinarians.