scholarly journals Diagnosing Bacterial Vaginosis with a Novel, Clinically-Actionable Molecular Diagnostic Tool

2018 ◽  
Author(s):  
Joseph P. Jarvis ◽  
Doug Rains ◽  
Steven J. Kradel ◽  
James Elliott ◽  
Evan E. Diamond ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Pathogenic Bacteria ◽  
Reproductive Age ◽  
Medical Decision ◽  
Molecular Diagnostic ◽  
Diagnostic Tools ◽  
Lactobacillus Species ◽  
Research Subjects ◽  
Asymptomatic Patients ◽  
Increased Risk

Abstract/SummaryBacterial vaginosis is a common condition among women of reproductive age and is associated with potentially serious side-effects, including an increased risk of preterm birth. Recent advancements in microbiome sequencing technologies have produced novel insights into the complicated mechanisms underlying bacterial vaginosis and have given rise to new methods of diagnosis. Here we report on the validation of a quantitative, molecular diagnostic algorithm based on the relative abundances of ten potentially pathogenic bacteria and four commensal Lactobacillus species in research subjects (n = 172) classified as symptomatic (n = 149) or asymptomatic (n = 23). We observe a clear and reinforcing pattern among patients diagnosed by the algorithm that is consistent with the current understanding of biological dynamics and dysregulation of the vaginal microbiome during infection. Using this enhanced assessment of the underlying biology of infection, we demonstrate improved diagnostic sensitivity (93%) and specificity (90%) relative to current diagnostic tools. Our algorithm also appears to provide enhanced diagnostic capabilities in ambiguous classes of patients for whom diagnosis and medical decision-making is complicated, including asymptomatic patients and those deemed “intermediate” by Nugent scoring. Ultimately, we establish CLS2.0q as a quantitative, sensitive, specific, accurate, robust, and flexible algorithm for the clinical diagnosis of bacterial vaginosis – importantly, one that is also ideal for the differential diagnosis of non-BV infections with clinically similar presentations.

scholarly journals Bacterial vaginosis.

1991 ◽  
Vol 4 (4) ◽  
pp. 485-502 ◽  
Author(s):  
C A Spiegel
Keyword(s):  
Urinary Tract ◽  
Bacterial Vaginosis ◽  
Urinary Tract Infections ◽  
Anaerobic Bacteria ◽  
Fetal Loss ◽  
Reproductive Age ◽  
Genital Tract Infection ◽  
Increased Risk ◽  
Tract Infections ◽  
Lactobacillus Spp

Bacterial vaginosis (BV) is the most common of the vaginitides affecting women of reproductive age. It appears to be due to an alteration in the vaginal ecology by which Lactobacillus spp., the predominant organisms in the healthy vagina, are replaced by a mixed flora including Prevotella bivia, Prevotella disiens, Porphyromonas spp., Mobiluncus spp., and Peptostreptococcus spp. All of these organisms except Mobiluncus spp. are also members of the endogenous vaginal flora. While evidence from treatment trials does not support the notion that BV is sexually transmitted, recent studies have shown an increased risk associated with multiple sexual partners. It has also been suggested that the pathogenesis of BV may be similar to that of urinary tract infections, with the rectum serving as a reservoir for some BV-associated flora. The organisms associated with BV have also been recognized as agents of female upper genital tract infection, including pelvic inflammatory disease, and the syndrome BV has been associated with adverse outcome of pregnancy, including premature rupture of membranes, chorioamnionitis, and fetal loss; postpartum endometritis; cuff cellulitis; and urinary tract infections. The mechanisms by which the BV-associated flora causes the signs of BV are not well understood, but a role for H2O2-producing Lactobacillus spp. in protecting against colonization by catalase-negative anaerobic bacteria has been recognized. These and other aspects of BV are reviewed.

scholarly journals Bacterial Vaginosis in Pregnant Women Receiving Care at Maxixe Health Centre

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Risk Factors ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Correct Diagnosis ◽  
Health Centre ◽  
Reproductive Age ◽  
African Countries ◽  
Multiple Partners ◽  
Increased Risk ◽  
Sub Saharan

Bacterial Vaginosis is a vaginal infection that occurs when there is a change in the balance of the vaginal flora with vaginal discharge, which may or may not have a characteristic smell, a decrease in vaginal pH, and it is one of the most common public health problems in Sub-Saharan African countries in women in reproductive age. Premature birth, underweight newborns and increased risk of HIV infection are some of its consequences. In Sub-Saharan countries like Mozambique, the real prevalence of this infection is almost unknown. Thus, this study was developed with the aim of analyzing the prevalence of bacterial vaginosis in pregnant women receiving care in the Maxixe City Health Centre (CSM) and identifying the risk factors associated with it. 253 samples of pregnant women attending prenatal external consultations at CSM were used in this study. Samples of vaginal exudate were obtained, stained by the Gram method and observed microscopically using the Nugent method to identify the bacterial vaginosis. The prevalence of bacterial vaginosis was 12, 3%, and the highest prevalence was recorded in the age group of 15-24. In this population, the inconsistent use of condom in sexual intercourse and multiple partners may be the risk factors in acquiring this infection. Therefore, it is concluded that the knowledge of etiology, correct diagnosis and appropriate treatment of bacterial vaginosis may contribute to a more comprehensive prenatal examination, aiming to reduce the rates of bacterial vaginosis and its consequences in pregnancy

scholarly journals Reducing the risk of tuberculosis transmission for HCWs in high incidence settings

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ana Paleckyte ◽  
Oshani Dissanayake ◽  
Stella Mpagama ◽  
Marc C. Lipman ◽  
Timothy D. McHugh
Keyword(s):  
Low Income ◽  
World Health ◽  
Infection Prevention And Control ◽  
Molecular Diagnostic ◽  
Diagnostic Tools ◽  
Respiratory Protection ◽  
Drug Resistant ◽  
Major Barrier ◽  
Environmental Controls ◽  
Increased Risk

AbstractGlobally, tuberculosis (TB) is a leading cause of death from a single infectious agent. Healthcare workers (HCWs) are at increased risk of hospital-acquired TB infection due to persistent exposure to Mycobacterium tuberculosis (Mtb) in healthcare settings. The World Health Organization (WHO) has developed an international system of infection prevention and control (IPC) interventions to interrupt the cycle of nosocomial TB transmission. The guidelines on TB IPC have proposed a comprehensive hierarchy of three core practices, comprising: administrative controls, environmental controls, and personal respiratory protection. However, the implementation of most recommendations goes beyond minimal physical and organisational requirements and thus cannot be appropriately introduced in resource-constrained settings and areas of high TB incidence. In many low- and middle-income countries (LMICs) the lack of knowledge, expertise and practice on TB IPC is a major barrier to the implementation of essential interventions. HCWs often underestimate the risk of airborne Mtb dissemination during tidal breathing. The lack of required expertise and funding to design, install and maintain the environmental control systems can lead to inadequate dilution of infectious particles in the air, and in turn, increase the risk of TB dissemination. Insufficient supply of particulate respirators and lack of direction on the re-use of respiratory protection is associated with unsafe working practices and increased risk of TB transmission between patients and HCWs. Delayed diagnosis and initiation of treatment are commonly influenced by the effectiveness of healthcare systems to identify TB patients, and the availability of rapid molecular diagnostic tools. Failure to recognise resistance to first-line drugs contributes to the emergence of drug-resistant Mtb strains, including multidrug-resistant and extensively drug-resistant Mtb. Future guideline development must consider the social, economic, cultural and climatic conditions to ensure that recommended control measures can be implemented in not only high-income countries, but more importantly low-income, high TB burden settings. Urgent action and more ambitious investments are needed at both regional and national levels to get back on track to reach the global TB targets, especially in the context of the COVID-19 pandemic.

scholarly journals Longitudinal profiling of the macaque vaginal microbiome reveals similarities to diverse human vaginal communities: implications for use as a pre-clinical model for bacterial vaginosis

2020 ◽  
Author(s):  
Nicholas S Rhoades ◽  
Sara M Hendrickson ◽  
Danielle R Gerken ◽  
Kassandra Martinez ◽  
Ov D Slayden ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Rhesus Macaque ◽  
Rhesus Macaques ◽  
Adverse Outcomes ◽  
Reproductive Age ◽  
Lactobacillus Species ◽  
Vaginal Microbiome ◽  
Clinical Model ◽  
Sexually Transmitted ◽  
Increased Susceptibility

The vaginal microbiota plays an important role in women's reproductive and urogenital health. Disturbances in this microbial community can lead to several adverse outcomes including pelvic inflammatory disease, bacterial vaginosis (BV) as well as increased susceptibility to sexually transmitted infections, miscarriage, and pre-term births. It is now well accepted that while the microbiome of healthy women in the developed world is dominated by Lactobacillus species, vaginal communities in asymptomatic women, especially those in the developing world, can be comprised of a diverse set of micro-organisms. The presence of a diverse vaginal microbiome has been associated with increased susceptibility to HIV infection but their implications for women's health remain poorly understood. Rhesus macaques are an excellent translational animal model due to significant physiological and genetic homology with humans. In this study, we performed a longitudinal analysis of clinical and microbiome data from 16 reproductive age female rhesus macaques. Many animals showed hallmarks of BV, including Nugent scores above 7 and high vaginal pH. At both the taxonomic and functional level, the rhesus macaque vaginal microbiome was most similar to that of women who harbor a diverse vaginal community associated with asymptomatic/symptomatic bacterial vaginosis. Specifically, rhesus macaque vaginal microbiomes harbored a diverse set of anaerobic gram-negative bacteria, including; Snethia, Prevotella, Porphyromonas, and Mobilluncus. Interestingly, some animals were transiently colonized by Lactobacillus and some with Gardnerella. Our in-depth and comprehensive analysis highlights the importance of the model to test interventions for manipulating the vaginal microbiome.

scholarly journals Bacterial vaginosis and health-associated bacteria modulate the immunometabolic landscape in 3D model of human cervix

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Paweł Łaniewski ◽  
Melissa M. Herbst-Kralovetz
Keyword(s):  
Epithelial Cell ◽  
Bacterial Vaginosis ◽  
Pathogenic Bacteria ◽  
Cell Model ◽  
Female Reproductive Tract ◽  
Gardnerella Vaginalis ◽  
Obstetric Outcomes ◽  
Phenyllactic Acid ◽  
Increased Risk ◽  
Human Cervix

AbstractBacterial vaginosis (BV) is an enigmatic polymicrobial condition characterized by a depletion of health-associated Lactobacillus and an overgrowth of anaerobes. Importantly, BV is linked to adverse gynecologic and obstetric outcomes: an increased risk of sexually transmitted infections, preterm birth, and cancer. We hypothesized that members of the cervicovaginal microbiota distinctly contribute to immunometabolic changes in the human cervix, leading to these sequelae. Our 3D epithelial cell model that recapitulates the human cervical epithelium was infected with clinical isolates of cervicovaginal bacteria, alone or as a polymicrobial community. We used Lactobacillus crispatus as a representative health-associated commensal and four common BV-associated species: Gardnerella vaginalis, Prevotella bivia, Atopobium vaginae, and Sneathia amnii. The immunometabolic profiles of these microenvironments were analyzed using multiplex immunoassays and untargeted global metabolomics. A. vaginae and S. amnii exhibited the highest proinflammatory potential through induction of cytokines, iNOS, and oxidative stress-associated compounds. G. vaginalis, P. bivia, and S. amnii distinctly altered physicochemical barrier-related proteins and metabolites (mucins, sialic acid, polyamines), whereas L. crispatus produced an antimicrobial compound, phenyllactic acid. Alterations to the immunometabolic landscape correlate with symptoms and hallmarks of BV and connected BV with adverse women’s health outcomes. Overall, this study demonstrated that 3D cervical epithelial cell colonized with cervicovaginal microbiota faithfully reproduce the immunometabolic microenvironment previously observed in clinical studies and can successfully be used as a robust tool to evaluate host responses to commensal and pathogenic bacteria in the female reproductive tract.

Bacterial vaginosis in pregnancy: a current view on diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 30-34
Author(s):  
Tamara E Karapetyan ◽  
Natalya A Lomova ◽  
Valeria R Yusubova ◽  
Shota G Gvenetadze
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
African American Women ◽  
Premature Birth ◽  
Genital Tract ◽  
Clinical Symptoms ◽  
Reproductive Age ◽  
Obstetric Outcomes ◽  
Current View ◽  
Increased Risk

Bacterial vaginosis (BV) is the most prevalent lower genital tract disease in women of reproductive age (both pregnant and non-pregnant) and the most common cause of vaginal discharge and foul odor from the genital tract. To date, there is a lot of literature describing many different approaches to the diagnosis and treatment of BV during pregnancy. BV is common, and its precise prevalence varies widely depending on the patient population. Studies confirm that the prevalence of BV among pregnant women is the same as in the population of non-pregnant women, and ranges from 6 to 32%. The link between BV and a patient’s ethnicity, smoking, sexual behavior and douching was established. BV is more prevalent among African American women, smokers, sexually active women compared to virgins and those who use douching. Diagnosis of BV is based on clinical symptoms and the results of microbiological examination. Diagnostic criteria are the same for pregnant and non-pregnant women. If BV is confirmed, treat-ment is indicated. In most international guidelines on sexually transmitted infections, the use of either metronidazole 500 mg orally 2 times a day for 7 days, or clindamycin 300 mg orally 2 times a day for 7 days are recommended for the prevention of adverse obstetric outcomes. BV is considered as the risk factor for adverse obstetric outcomes, such as premature birth, premature rupture of membranes, spontaneous abortion, chorioamnionitis and postpartum infections, such as endometritis and infectious compli-cations in the area of the postoperative wound after cesarean section. Pregnant women with symptoms of BV are advised to be screened and treated to eliminate the symptoms. Treatment with oral or local antibiotics is acceptable to achieve recovery (cure) in pregnant women with a symptomatic course of BV and a low risk of adverse obstetric outcomes. Women without symptoms of BV and women without identified risk factors for preterm birth should not be routinely screened and treated for BV, while patients with an increased risk for premature birth may benefit from routine screening and treatment for BV.

scholarly journals Etiologic characterization of vulvovaginitis among females attending a tertiary care hospital: a one year study

2017 ◽  
Vol 6 (6) ◽  
pp. 2246
Author(s):  
Chembetei Kavitha Kiran ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Care Hospital ◽  
Age Group ◽  
Increased Risk ◽  
One Year

Background: Vulvovaginitis is one among the major pathologies encountered in reproductive age group. Etiologies are always multiple and candidiasis, bacterial vaginitis and trichomoniasis account for 90% of etiology. The incidence is dependable upon multiple factors like age group, ethnicity, socioeconomic status, geographical locale. Improperly treated and untreated vulvovaginitis is associated with long term complications like infertility, pelvic inflammatory disease in nulliparous females and preterm labour, miscarriage, ectopic pregnancy, chorioamnionitis among pregnant females and recurrent UTIs, cervicitis, endometritis, increased risk of acquiring STIs among normal females. The present study was undertaken with the objective of understanding the etiologies associated with vulvovaginitis among women attending Obstetrics clinic of a tertiary care hospital. The risk factors associated with the conditions, the features of the vaginal discharge and symptoms associated with each etiology were studied.Methods: A cross sectional study for a period of one year was conducted among 200 female patients attending the Department of gynecology for vaginitis and evaluated for etiology. Patient’s risk factors, clinical history, symptoms were collected by questionnaire and specimens were collected from all the cases and processed as per standard guidelines. Bacterial vaginosis was confirmed based on Neugent’s criteria, Trichomoniasis by wet mount examination and candidiasis by culture. The study was approved by the institutional ethical committee.Results: 137 cases of vulvovaginitis were diagnosed based on etiology. Vulvovaginitis was most common among 27-36 years and in multiparous women. Most common causative agent was Candida (59.12%) followed by bacterial vaginosis (22.63%) and Trichomoniasis (18.25%). Vaginal discharge was the commonest symptom (100%) followed by malodor and vulval irritation. Following unhygienic practices was the commonest risk factor associated with Vulvovaginitis.Conclusions: A regular evaluation is mandatory for all the females attending hospital for vaginitis. Successful management reduces the morbid conditions and it’s essential to treat the conditions during the pregnancy which prevents the complications associated like preterm birth, miscarriage etc. and adverse outcomes.

scholarly journals Prevalence of bacterial vaginosis in females in the reproductive age group in Kadur, Karnataka, India

2017 ◽  
Vol 6 (11) ◽  
pp. 4863
Author(s):  
Akshita R. Seth ◽  
Chaitra S. ◽  
Vaishnavi S. ◽  
Sharath Chandra G. R.
Keyword(s):  
Risk Factors ◽  
Bacterial Vaginosis ◽  
Trichomonas Vaginalis ◽  
Reproductive Age ◽  
Vaginal Candidiasis ◽  
Lactobacillus Species ◽  
Age Group ◽  
Atypical Cell ◽  
Associated Risk Factors ◽  
Reproductive Age Group

Background: Bacterial vaginosis, well known as the nonspecific vaginitis is caused by the normal resident flora of the vagina, predominantly by the peroxides producing lactobacillus species, when there is a disparity in their proportion and replaced by Gardinerella vaginalis, Mycoplasm hominis, Mobilunceus species, Bacteroids species, Prevotela species, Fusobacterium species and Porphyromonus species, Peptostreptococcus species.Methods: A cross section study was performed to study the prevalence of bacterial vaginosis in the reproductive age group women and the associated risk factors. The diagnosis of the vaginosis was made from the smear and Amsle’s clinical criteria.Results: Out of 250 patients 112 (44.8%) were diagnosed to have BV, 20-29-year age group had the largest percentage of infection 69 (61.6%). IUCD users 36 (32.14%) are found to be suffering from BV. Vaginal candidiasis, trichomonas vaginalis and atypical cell of unknown significant was seen in 32 (28.5%), 9 (8.03%) and 17 (15.17%) women respectively.Conclusions: A routine high vaginal swab for smear and culture must be performed for every woman presenting with chronic white discharge and itching, to prevent misuse usage of antibiotic. Further studies are needed to study the associated risk factors for BV.

scholarly journals The Resilience and Stress on Bacterial Vaginosis among Reproductive Age Women in the Coastal area of Ampenan, Kota Mataram

Jurnal NERS ◽  
2016 ◽  
Vol 9 (2) ◽  
pp. 187
Author(s):  
Ika Nur Pratiwi ◽  
Elsi Dwi Hapsari ◽  
Nuring Pangastuti
Keyword(s):  
Bacterial Vaginosis ◽  
Anaerobic Bacteria ◽  
Reproductive Age ◽  
Influential Factor ◽  
Traumatic Experience ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Reproductive Age Women ◽  
Increased Risk ◽  
Self Reporting Questionnaire

Introduction: Bacterial Vaginosis (BV) is a common vaginal condition produced by overgrowth of anaerobic bacteria. Stress can alter women’s reproductive health in many ways; one of them is increasing the risk for bacterial vaginosis. In facing stressful life conditions, resilience plays an important role to maintain optimal function and prevent traumatic experience. Methods: This research was an analytical observational study with cross sectional design. Questionnaires were given to 104 women in reproductive age between November 2013 and January 2014. Resilience and stress were assessed using The Connor-Davidson Resilience Scale (CD-RISC) and Self Reporting Questionnaire respectively, and bacterial vaginosis status was diagnosed using Amsel’s criteria. Statistical analysis was performed using chi square test and multiple logistic regressions. Results: Bivariate analysis showed significant relations between resilience (p=0,005), stress (p=0,002), frequency of sexual intercourse within 1 week (p= 0,015) and the bacterial vaginosis incidence. Multivariate analysis showed stress was the most influential factor OR=3,9 (95% CI=1,478–10,562). Discussion: Resilience and stress were significantly with increased risk of having bacterial vaginosisKeywords: resilience, stress, bacterial vaginosis, reproductive age women

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