Gardnerella vaginalis Clade Distribution Is Associated With Behavioral Practices and Nugent Score in Women Who Have Sex With Women

2019 ◽  
Author(s):  
Erica L Plummer ◽  
Lenka A Vodstrcil ◽  
Gerald L Murray ◽  
Christopher K Fairley ◽  
Jennifer A Danielewski ◽  
...  
Keyword(s):  
Gardnerella Vaginalis ◽  
Relative Risk Ratio ◽  
Multinomial Regression ◽  
Nugent Score ◽  
Factors Associated ◽  
Female Partners ◽  
Vaginal Sex ◽  
Clade 1 ◽  
Species Specific ◽  
Sex Toys

Abstract Background Gardnerella vaginalis is detected in women with and without bacterial vaginosis (BV). Identification of 4 G. vaginalis clades raised the possibility that pathogenic and commensal clades exist. We investigated the association of behavioral practices and Nugent Score with G. vaginalis clade distribution in women who have sex with women (WSW). Methods Longitudinal self-collected vaginal specimens were analyzed using established G. vaginalis species-specific and clade-typing polymerase chain reaction assays. Logistic regression assessed factors associated with detection of G. vaginalis clades, and multinomial regression assessed factors associated with number of clades. Results Clades 1, 2, and 3 and multiclade communities (<2 clades) were associated with Nugent-BV. Clade 1 (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.65–6.84) and multiclade communities (relative risk ratio [RRR], 9.51; 95% CI, 4.36–20.73) were also associated with Lactobacillus-deficient vaginal microbiota. Clade 4 was neither associated with Nugent-BV nor Lactobacillus-deficient microbiota (OR, 1.49; 95% CI, 0.67–3.33). Specific clades were associated with differing behavioral practices. Clade 1 was associated with increasing number of recent sexual partners and smoking, whereas clade 2 was associated with penile-vaginal sex and sharing of sex toys with female partners. Conclusions Our results suggest that G. vaginalis clades have varying levels of pathogenicity in WSW, with acquisition occurring through sexual activity. These findings suggest that partner treatment may be an appropriate strategy to improve BV cure.

Identification, quantification and subtyping of Gardnerella vaginalis in noncultured clinical vaginal samples by quantitative PCR

2014 ◽  
Vol 63 (2) ◽  
pp. 162-175 ◽  
Author(s):  
Sergey V. Balashov ◽  
Eli Mordechai ◽  
Martin E. Adelson ◽  
Scott E. Gygax
Keyword(s):  
Quantitative Pcr ◽  
Positive Association ◽  
Vaginal Swab ◽  
Gardnerella Vaginalis ◽  
Vaginal Microflora ◽  
Single Clade ◽  
Pathogen Prevalence ◽  
Clade 1 ◽  
Species Specific ◽  
Very High

Gardnerella vaginalis is an important component of the human vaginal microflora. It is proposed to play a key role in the pathogenesis of bacterial vaginosis (BV), the most common vaginal condition. Here we describe the development, validation and comparative analysis of a novel molecular approach capable of G. vaginalis identification, quantification and subtyping in noncultured vaginal specimens. Using two quantitative PCR (qPCR) assays, we analysed G. vaginalis bacterial loads and clade distribution in 60 clinical vaginal-swab samples. A very high pathogen prevalence was revealed by species-specific qPCR not only among BV patients (100 %), but also in healthy women (97 %), although the G. vaginalis concentration was significantly lower in non-BV samples. G. vaginalis clades identified in vaginal specimens by subtyping multiplex qPCR, which targets four clade-specific genetic markers, had frequencies of 53 % for clade 1, 25 % for clade 2, 32 % for clade 3 and 83 % for clade 4. Multiple clades were found in 70 % of samples. Single G. vaginalis clades were represented by clade 1 and clade 4 in 28 % of specimens. A positive association with BV was shown for clade 1 and clade 3, while clade 2 was positively associated with intermediate vaginal microflora, but not with BV. Clade 4 demonstrated no correlation with the disorder. The presence of multiple clades had a high positive association with BV, whereas G. vaginalis identified as a single clade was negatively linked with the condition. Polyclonal G. vaginalis infection may be a risk factor for BV.

scholarly journals Sequence Comparison of Vaginolysin from Different Gardnerella Species

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 86
Author(s):  
Erin M. Garcia ◽  
Myrna G. Serrano ◽  
Laahirie Edupuganti ◽  
David J. Edwards ◽  
Gregory A. Buck ◽  
...  
Keyword(s):  
Amino Acid ◽  
Human Microbiome ◽  
Human Microbiome Project ◽  
Distinct Species ◽  
Vaginal Swab ◽  
Metagenomic Data ◽  
Gardnerella Vaginalis ◽  
Vaginal Epithelial Cells ◽  
Species Specific

Gardnerella vaginalis has recently been split into 13 distinct species. In this study, we tested the hypotheses that species-specific variations in the vaginolysin (VLY) amino acid sequence could influence the interaction between the toxin and vaginal epithelial cells and that VLY variation may be one factor that distinguishes less virulent or commensal strains from more virulent strains. This was assessed by bioinformatic analyses of publicly available Gardnerella spp. sequences and quantification of cytotoxicity and cytokine production from purified, recombinantly produced versions of VLY. After identifying conserved differences that could distinguish distinct VLY types, we analyzed metagenomic data from a cohort of female subjects from the Vaginal Human Microbiome Project to investigate whether these different VLY types exhibited any significant associations with symptoms or Gardnerella spp.-relative abundance in vaginal swab samples. While Type 1 VLY was most prevalent among the subjects and may be associated with increased reports of symptoms, subjects with Type 2 VLY dominant profiles exhibited increased relative Gardnerella spp. abundance. Our findings suggest that amino acid differences alter the interaction of VLY with vaginal keratinocytes, which may potentiate differences in bacterial vaginosis (BV) immunopathology in vivo.

scholarly journals Factors Associated with COVID-19 Vaccine Hesitancy

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 300
Author(s):  
Patricia Soares ◽  
João Victor Rocha ◽  
Marta Moniz ◽  
Ana Gama ◽  
Pedro Almeida Laires ◽  
...  
Keyword(s):  
Health Status ◽  
Vaccine Hesitancy ◽  
Multinomial Regression ◽  
Community Based ◽  
Safety And Efficacy ◽  
Perceived Safety ◽  
Factors Associated ◽  
Health Authorities ◽  
Flu Vaccine ◽  
Release Of Information

It is critical to develop tailored strategies to increase acceptability of the COVID-19 vaccine and decrease hesitancy. Hence, this study aims to assess and identify factors associated with COVID-19 vaccine hesitancy in Portugal. We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes data regarding intention to take COVID-19 vaccines, health status, and risk perception in Portugal from September 2020 to January 2021. We used multinomial regression to identify factors associated with intention to delay or refuse to take COVID-19 vaccines. COVID-19 vaccine hesitancy in Portugal was high: 56% would wait and 9% refuse. Several factors were associated with both refusal and delay: being younger, loss of income during the pandemic, no intention of taking the flu vaccine, low confidence in the COVID-19 vaccine and the health service response during the pandemic, worse perception of government measures, perception of the information provided as inconsistent and contradictory, and answering the questionnaire before the release of information regarding the safety and efficacy of COVID-19 vaccines. It is crucial to build confidence in the COVID-19 vaccine as its perceived safety and efficacy were strongly associated with intention to take the vaccine. Governments and health authorities should improve communication and increase trust.

scholarly journals Exploration of COVID-19-Based Changes to Caregiver Burden and Caregiving Intensity among Informal Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 945-945
Author(s):  
Steven Cohen ◽  
Zachary Kunicki ◽  
Megan Drohan ◽  
Mary Greaney
Keyword(s):  
Caregiver Burden ◽  
Informal Caregivers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multinomial Regression ◽  
Chi Square ◽  
Cross Sectional ◽  
Unpaid Care ◽  
Factors Associated ◽  
Amazon's Mechanical Turk

Abstract Individuals providing unpaid care of assistance to family members and friends (e.g. informal caregivers), may have been uniquely impacted by the COVID-19 pandemic. Research is needed to examine the pandemic’s effect on informal caregivers’ caregiving intensity and burden. Therefore, this cross-sectional study was conducted to explore self-reported changes in caregiver intensity (CI) and caregiver burden (CB) due to the pandemic to identify factors associated with changes in responsibilities and burdens. In June 2020, informal caregivers providing care to someone aged 50+ (n=835) reported their current and pre-pandemic caregiving intensity and burden. Data were collected via Amazon’s Mechanical Turk. Chi-square tests were used to examine bivariate associations between pandemic time (pre vs. post) differences in CI and CB. Multinomial regression was used to assess multivariate predictors of changes to CI and CB due to COVID-19. Results showed a significant U-shaped association between initial CB and CB change due to COVID-19. Higher levels of initial CB were associated with both a significant decrease in CB during COVID-19 (OR 1.33, 95%CI 1.06-1.67), and a significant increase in CB during COVID-19 (OR 1.22, 95%CI 1.05-1.43). There were no significant associations between initial CB and changes in CI due to COVID-19, although older caregivers were more likely to experience a decrease in CB due to caregiving (OR 1.02, 95%CI 1.00-1.05). These mixed results suggest that caregivers with high initial CB experienced the most extreme changes to CB due to COVID-19. Future planned analyses will focus on understanding the potential drivers behind these unexpected results.

scholarly journals Fatores associados às alterações cérvico-uterinas de mulheres atendidas em um município polo do oeste catarinense Factors associated to uterine-cervix changes in women assisted in a pole town in western Santa Catarina

2017 ◽  
Vol 9 (1) ◽  
pp. 167
Author(s):  
Rafaela Bedin ◽  
Vanessa Aparecida Gasparin ◽  
Érica De Brito Pitilin
Keyword(s):  
Uterine Cervix ◽  
Gardnerella Vaginalis ◽  
Santa Catarina ◽  
Factors Associated

Objetivo: Identificar as alterações cérvico-uterinas nos exames citopatológicos e seus fatores associados. Métodos: Estudo retrospectivo realizado pela análises dos exames citopatológicos registrados no Sistema de Informação do Câncer no sul do país em 2014. A amostra final resultou em 1.157 laudos. Para a análise dos dados foi utilizado o software SSPP. O estudo foi aprovado pelo Comitê de Ética e Pesquisa com seres humanos da Universidade Federal da Fronteira Sul sob CAAE nº 46421815.0.0000.5564. Resultados: Predominou nas amostras os lactobacilos como agentes microbiológicos e a Gardnerella vaginalis como agente infeccioso. O colo uterino alterado, a presença de células metaplásicas associado ao diagnóstico de metaplasia foi prevalente nas mulheres de 25 a 34 anos. As inflamações(18,9%), seguido dos achados citológicos(11,8%) foram as alterações mais frequentes. Conclusão: Associaram-se ao risco de ocorrência das alterações celulares idade entre 25 a 64 anos, uso da pílula anticoncepcional, Terapia de Reposição Hormonal e epitélio metaplásico.

Socio-demographic determinants of health-care seeking options and alternative management practices of childhood diarrhoeal illness: A household survey among mothers in Iraq

2019 ◽  
Author(s):  
Ihab Habib ◽  
Ali Harb ◽  
Sam Abraham ◽  
Mark O’Dea ◽  
Haidar Ali Hantosh ◽  
...  
Keyword(s):  
Health Care ◽  
Management Practices ◽  
Household Survey ◽  
University Education ◽  
Relative Risk Ratio ◽  
P Value ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Alternative Management ◽  
Factors Associated

Abstract Background Diarrhoea remains a significant cause of child morbidity and mortality in Iraq. The objective of this study was to examine the current practices of home-based management of diarrhoeal illnesses among Iraqi children. We surveyed mothers of children below five years of age in order to identify the socio-demographic factors associated with maternal health-care seeking practices. Methods A total of 500 mother-child pairs were interviewed in a cross-sectional household survey in Thi-Qar Governorate, south-eastern Iraq between March 2016 and February 2017. Logistic and multinomial regression models were utilized to infer socio-demographic predictors of the health-care seeking and alternative management practices adopted by the mothers. Results The interviewees reported that 35.2% of their children had diarrhoea in the two weeks prior to the survey. The least likelihood of reported occurrence of diarrhoea was among mother-child pairs where the mothers had received university education, as compared to mothers who were illiterate or received only primary or secondary education. Lower odds (OR=0.4, P-value <0.001) of reported childhood diarrhoea was revealed among mothers aged >25 years old compared to those younger. Self-ordered medicine from a pharmacy was the most preferred alternative management option in almost half (52.4% (262/500)) of the interviewed mothers in Thi-Qar. Interestingly, 69.6% (348/500) of the mothers reported supplying their children suffering from diarrhoea with antibiotics. Relative to mothers with university education, those with high school education had more likelihood of selecting medical center (relative risk ratio (rrr) = 2.4) and pharmacy (rrr = 3.7) as against no treatment. Conclusions Lower maternal educational level, mothers' age <25 and the district of residence were important factors associated with diarrhoea occurrence among under-five children. In light of the findings from this study, intervention aimed at improving health-care seeking for managing diarrhoea in Iraqi children should jointly consider the influence of mothers age, education, as well as the level of economic status of the communities in which mothers of these children resides. The results of this study indicate the need for enhancing public health education in order to improve the maternal management of diarrhoeal disease and the avoidance of unnecessary use of antimicrobials.

scholarly journals Risk and protective factors associated with BV chronicity among women in Rakai, Uganda

2019 ◽  
Vol 96 (5) ◽  
pp. 380-386
Author(s):  
Marie E Thoma ◽  
Rebecca M Brotman ◽  
Ronald H Gray ◽  
Nelson K Sewankambo ◽  
Maria J Wawer
Keyword(s):  
Protective Factors ◽  
Risk And Protective Factors ◽  
Consistent Condom ◽  
Nugent Score ◽  
Factors Associated ◽  
Vaginal Swabs ◽  
Adjustment Factors ◽  
Microbial Agents

ObjectivesTo assess risk and protective factors associated with bacterial vaginosis (BV) chronicity ascertained by Nugent score criteria.MethodsA longitudinal cohort study included 255 sexually experienced, postmenarcheal women who provided weekly self-collected vaginal swabs for up to 2 years. Vaginal swabs were scored using Nugent criteria and classified as normal (≤3), intermediate (4–6) and Nugent-BV (≥7). Detailed behavioural/health information were assessed every 6 months. A per-woman longitudinal summary measure of BV chronicity was defined as the percentage of each woman’s weekly vaginal assessments scored as Nugent-BV over a 6-month interval. Risk and protective factors associated with BV chronicity were assessed using multiple linear regression with generalised estimating equations.ResultsAverage BV chronicity was 39% across all follow-up periods. After adjustment, factors associated with BV chronicity included baseline Nugent-BV (β=35.3, 95% CI 28.6 to 42.0) compared with normal baseline Nugent scores and use of unprotected water for bathing (ie, rainwater, pond, lake/stream) (β=12.0, 95% CI 3.4 to 20.5) compared with protected water sources (ie, well, tap, borehole). Women had fewer BV occurrences if they were currently pregnant (β=−6.6, 95% CI −12.1 to 1.1), reported consistent condom use (β=−7.7, 95% CI −14.2 to 1.3) or their partner was circumcised (β=−5.8, 95% CI −11.3 to 0.3).ConclusionsFactors associated with higher and lower values of BV chronicity were multifactorial. Notably, higher values of BV chronicity were associated with potentially contaminated bathing water. Future studies should examine the role of waterborne microbial agents in the pathogenesis of BV.

scholarly journals Criteria for diagnosis of bacterial vaginosis using the test Femoflor-16

2017 ◽  
Vol 66 (4) ◽  
pp. 57-67 ◽  
Author(s):  
Veronika V. Nazarova ◽  
Elena V. Shipitsyna ◽  
Ekaterina N. Gerasimova ◽  
Alevtina M. Savicheva
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Bacterial Load ◽  
Anaerobic Bacteria ◽  
Microscopic Investigation ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Nugent Score ◽  
Adverse Pregnancy ◽  
Amsel Criteria

Background. Bacterial vaginosis is disturbance of the balance of the vaginal microflora, associated with a number of infectious diseases of the urogenital tract and adverse pregnancy outcomes. In this country, for the detection of vaginal dysbiotic conditions, the test Femoflor-16 (DNA-Technology, Moscow) is widely used, however interpretation algorithms of this test do not include the category of BV. Aim. The study aimed to elaborate diagnostic criteria for the detection of BV using Femoflor-16 test. Materials and methods. Women of reproductive age addressing a gynecologist with vaginal discharge were enrolled in the study. For clinical diagnosis of BV, the Amsel criteria were used, laboratory analysis for BV was performed via microscopic investigation of vaginal discharge using the Nugent score. Samples of vaginal discharge from all women were analyzed with the test Femoflor-16, intended for characterizing vaginal microbiocenosis using multiplex quantitative real-time PCR. Results. A total of 280 women were included in the study. BV was diagnosed in 86 women (31%) using the Amsel criteria, and in 81 women (29%) using the Nugent score. All groups of anaerobic bacteria included in Femoflor-16 test were shown to be associated with BV, with the exception of bacteria of the genus Mobiluncus, which are detected together with phylogenetically related but not BV-associated bacteria of the genus Corynebacterium. A low amount of lactobacilli (< 10% of total bacterial load) coupled with an elevated amount of Gardnerella vaginalis/Prevotella bivia/Porphyromonas (> 1%) and/or Eubacterium (> 2%) and/or Sneathia/Leptotrichia/Fusobacterium (> 0.1%) and/or Megasphaera/Veillonella/Dialister (> 0.1%) and/or Lachnobacterium/Clostridium (> 0.1%) and/or Peptostreptococcus (> 0.1%) and/or Atopobium vaginae (> 0.2%) detected BV with a sensitivity of 99% and specificity of 93%. Conclusions. Criteria for BV diagnosis using the test Femoflor-16 have been elaborated, which enable to detect BV or exclude it with a sensitivity of 99% and specificity of 93%. These criteria for BV and criteria of the test manufacturers for severe anaerobic dysbiosis determine to a large extent the same category of the vaginal microbiocenosis.

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