scholarly journals Gardnerella Vaginalis in Recurrent Urinary Tract Infection is Associated with Dysbiosis of the Bladder Microbiome

Author(s):  
Jeong-Ju Yoo ◽  
Ju Sun Song ◽  
Woong Bin Kim ◽  
Jina Yun ◽  
Hee Bong Shin ◽  
...  

Abstract Background: Recent studies on the urine microbiome have highlighted the importance of the gut-vagina-bladder axis in recurrent cystitis (RC). In particular, the role of Gardnerella as a covert pathogen that activates E. coli in animal experiments has been reported. Herein, we conducted a human bladder microbiome study to investigate the effect of Gardnerella on RC. Methods: Urine 16S ribosomal RNA gene sequencing via transurethral catheterization was conducted in the normal control group (NC) (n=18) and RC group (n=78). Results: The positive detection rate of Gardnerella species did not differ between the NC and RC groups (22.2% vs. 18.0%, p = 0.677). In addition, the Gardnerella-positive NC and Gardnerella-positive RC groups showed similar levels of microbiome diversity. The Gardnerella-positive group was categorized into three subgroups: Escherichia-dominant group, Gardnerella-dominant group, and Lactobacillus-dominant group, respectively. All of the Escherichia-dominant groups were associated with RC. Gardnerella-dominant or Lactobacillus-dominant groups expressed RC with symptoms when risk factors such as degree of Gardnerella proliferation or causative agents of bacterial vaginosis were present.Conclusion: Gardnerella can act as a covert pathogen of RC depending on other risk factors, and Gardnerella infection should be considered in patients with RC. New guideline recommendations regarding antibiotics selection based on a novel method to detect the cause of RC may be required to reduce antibiotics resistance.

2021 ◽  
Author(s):  
Yihunalem Addis ◽  
Sirak Biset ◽  
Mucheye Gizachew

Abstract In low-income countries, asymptomatic bacteriuria (ASB) during pregnancy is a major cause for both maternal and foetal health risks. Rapid emergence of antimicrobial resistance also needs continuous monitoring of susceptibility profiles of uropathogens. We conducted a hospital-based cross-sectional study to deterimne prevalence, antimicrobial susceptibility, and associated risk factors of ASB among pregnant women. Socio-demographic and clinical data were collected by interview and extracted from women's medical records. Identification of bacteria from urine, and their susceptibility tests were done by using recommended methods. Logistic regression analyses were done by SPSS versions 20. The p-value <0.05 at 95% CI was considered as statistically significant. Of the 172 study participants, 24 (14%) had ASB. Among 24 isolates, 13 (54.2%) were gram-negative, and of these, E. coli (8; 61.5%) was predominant followed by K. pneumoniae (4; 30.8%). Previous UTI and antibiotic use were significantly associated risk factors for ASB. E .coli, S. areus and CoNS were resistant to tetracycline (87.5%), cotrimoxazole (83.3%), and gentamycin (80%), respectively. Prevalence of ASB was lower than many previous reports in the country. Commonly used antibiotic susceptibility profiles of isolates were known. Hence, hard work ought to assume to decline the consequence of ASB and antibiotics resistance.


Author(s):  
Mohammad Masoud Emami Meybodi ◽  
Abbas Rahimi Foroushani ◽  
Masoome Zolfaghari ◽  
Alireza Abdollahi ◽  
Abbas Alipour ◽  
...  

Background and Objectives: Antimicrobial resistance (AMR) is an increasing threat for efficient treatment of infections. Determining the epidemiology of healthcare-associated infections and causative agents in various hospital wards helps appropriate selection of antimicrobial agents. Materials and Methods: This retrospective study was performed by analyzing antibiograms from March 2017 to March 2018 among patients admitted to the different wards of Imam Khomeini Hospital Complex in Tehran, Iran. Results: Among 2440 hospital acquired infections, 59.3% were Gram-negative bacilli: E. coli (n = 469, 22.2%), K. pneumoniae (n = 457, 21.7%), Acinetobacter spp. (n = 282, 13.4%), P. aeruginosa (n = 139, 6.6%) and important Gram-positive bacteria were Enterococcus spp. (n = 216, 10.2%), S. aureus (n = 148, 7%), S. epidermidis (n = 118, 5.6). Generally, there was a high antimicrobial resistance in bacterial isolates in this study. Methicillin resistant Staphylococcus aureus (MRSA) was 56.3 % and MRSE 62.9 %. Vancomycin resistant enterococci (VRE) was 60.7%. K. pneumoniae- ESBL was 79.6% and its resistance to carbapenem was 38.4%. E. coli-ESBL was 42% and its resistance to carbapenems was 2.3%. P. aeruginosa resistance to ceftazidime was 74.4%, to fluroquinolones 63.3%, to aminoglycosides 64.8%, to piperacillin tazobactam 47.6% and to carbapenems 62.1%. Acinetobacter baumannii resistance to ceftazidime was 98.7%, to fluroquinolones 97%, to aminoglycosides 95.9%, to ampicillin sulbactam 84%, to carbapenems 96.4% and to colistin 4%. Conclusion: The study revealed an alarming rate of resistance to the commonly used antimicrobial agents used in treating HAIs. Also the relationship between AMR and some risk factors and thus taking steps towards controlling them have been shown.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 177-183
Author(s):  
Irina N. Kononova ◽  
Yuliya E. Dobrokhotova ◽  
Elena N. Kareva ◽  
Olga E. Semioshina ◽  
Nadezhda A. Shmakova

Background. Biological pathomorphosis of the leading pathogens of the vaginal microecological system with the occurrence of vulvovaginitis in human papillomavirus (HPV)-associated cervical intraepithelial neoplasia (CIN) is a fundamental prerequisite for optimizing the complex treatment of this disease. Aim. Optimization of treatment of vulvovaginitis based on the study of the pathomorphism of their pathogens in patients with HPV-associated CIN. Materials and methods. A two-stage examination of 211 patients with HPV-associated CIN I was carried out from 2013 to 2020. To study the pathomorphosis of the disease, the patients were divided into 2 groups, the 1st group was examined in 20132016, the 2nd in 20172020. The study of microbiocenosis was carried out by RT-PCR using Femoflor-16 reagents. At the second stage, a study of the clinical efficacy of treatment of vulvovaginitis with the complex drug nifuratel 500 mg + nystatin 200 thousand IU (Macmiror Complex) in comparison with metronidazole 500 mg. Results and discussion. It was revealed that patients with HPV-associated CIN I over the last 8 years have a pathomorphosis of pathogens. In particular, the change in the dominance of anaerobic dysbiosis with the highest bacterial replication of Gardnerella vaginalis in association with Clostridium, Megasphaera spp. and Fusobacterium on the mixed nature of microflora, manifested in the form of vulvaginitis with the dominance of Atopobium vaginae in association with G. vaginalis, Ureaplasma (urealyticum + parvum) and the addition of the intestinal group Enterobacteriaceae spp. and Escherichia coli. The use of the complex drug nifuratel 500 mg + nystatin 200 thousand IU (Macmiror Complex) demonstrated a higher (4 times) clinical efficacy, a 12-fold decrease in the recurrence of the inflammatory process compared with metronidazole in the treatment of vulvovaginitis in patients with CIN I. Conclusions. 1. The structure of the cervico-vaginal microbiota in HPV-associated CIN I degree is characterized by dysbiotic disorders in 68.3% of cases. During the last 8 years, there was a pathomorphosis of the microecological status from the dominant anaerobic (in 74.2% of cases, =9.39 at p=0.001) to the dominant mixed (in 60.8% of cases, =8.54 at p=0.001 ) with the addition of the intestinal group Enterobacteriaceae spp. and E. coli in 60.8% of patients (=9.59 at p=0.001), which indicated a change in the dominant causative agents of vulvovaginitis in CIN I. 2. Comparative analysis of the clinical efficacy of complex drugs has demonstrated an increase in clinical efficacy when using the drug nifuratel 500 mg + nystatin 200 thousand IU by 4 times, a decrease in the recurrence of the inflammatory process by 12 times, compared with standard therapy with metronidazole, which allows us to recommend inclusion of the drug nifuratel 500 mg + nystatin 200 thousand IU in the therapy of vulvovaginitis in patients with CIN I.


2016 ◽  
Vol 10 (10) ◽  
pp. 1073-1080 ◽  
Author(s):  
Zorana M Djordjevic ◽  
Marko M Folic ◽  
Nevena D Folic ◽  
Nevena Gajovic ◽  
Olgica Gajovic ◽  
...  

Introduction: Acinetobacter baumannii is one of major causative agents of severe, life-threatening hospital infections (HIs), especially in intensive care units (ICUs). Our aim was to discover the risk factors associated with the emergence of HIs caused by carbapenem-resistant Acinetobacter baumannii (CRAB), as well as those associated with death in patients who suffer from such infections. Methodology: A prospective cohort study was conducted over a five-year period in the medical-surgical ICU of the Clinical Centre in Kragujevac, Serbia. The study group comprised patients who had HIs caused by CRAB, while the control group comprised patients infected with carbapenem-sensitive Acinetobacter baumannii. Results: In total, 137 patients developed HIs caused by Acinetobacter baumannii. The mean age of the patients was 59.65 ± 16.08 years, and 99 (72.26%) of them were males. In 95 patients (69.35%), the infection was caused by CRAB. There were six independent risk factors for CRAB infections: use of mechanical ventilation, previous stay in another department, stay in ICU for more than a month, and previous use of carbapenems, aminoglycosides, and metronidazole. Three independent risk factors were found for death in patients with HIs caused by CRAB: use of mechanical ventilation, previous stay in another department, and previous use of carbapenems. Conclusions: The results of this study can be helpful when identifying patients with risk of HIs caused by CRAB and in planning preventive measures. Modification of known risk factors and appropriate institutional policy of antibiotic utilization are important measures that may decrease the incidence and mortality of such infections.


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yuetian Yu ◽  
Hui Shen ◽  
Cheng Zhu ◽  
Ruru Guo ◽  
Yuan Gao ◽  
...  

Objective. To investigate the prevalence and risk factors of infections caused by Extended-Spectrum β-Lactamase (ESBL) producing Escherichia coli (E. coli) in systemic lupus erythematosus (SLE) patients and develop a predictive model. Methods. Three hundred and eighty-four consecutive SLE patients with E. coli infection were enrolled in this retrospective case control study from January 2012 to December 2017. Prevalence and antimicrobial susceptibility pattern of ESBL producing E. coli were analyzed. Multivariate analysis was performed to determine the risk factors. Sensitivity and specificity were obtained at various point cutoffs and area under the receiver operator characteristic curve (AuROC) was determined to confirm the prediction power of the model. Results. Of the total 384 E. coli strains tested, 212 (55.2%) produced ESBL. The majority of these isolates were from urine (44.3%). Carbapenems (>80%) and amikacin (89.6%) had good activity against ESBL producing E. coli. Eleven variables were identified as independent risk factors for ESBL producing E. coli infection including Enterobacteriaceae colonization or infection in preceding year (OR=8.15, 95%CI 5.12–21.71), daily prednisone dose > 30mg (OR=5.48, 95%CI 3.12–13.72), low C3 levels (OR=2.17, 95%CI 1.62–6.71), nosocomial acquired infection (OR=4.12, 95%CI 1.98–8.85), etc. The model developed to predict ESBL producing E. coli infection was effective, with the AuROC of 0.840 (95% CI 0.799-0.876). Conclusions. The prevalence of ESBL producing E. coli was increasing with high antibiotics resistance in patients with SLE. The model revealed excellent predictive performance and exhibited a good discrimination.


2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.


Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.


2014 ◽  
pp. 77-86
Author(s):  
Anh Tien Hoang ◽  
Thi Y Nhi Nguyen ◽  
Luu Trinh Nguyen ◽  
Thi Hong Diep Phan ◽  
Huu Cat Nguyen ◽  
...  

Background : Sleep Apnea Syndrome (SAS) is a cause of hypertension, increasingcardiovascular risk and cardiovascular disease such as stroke, coronary artery disease, myocardial infarction, arrhythmias, heart failure, increasing the risk of death in patients with heart disease, independent of other causative factors. So far, in Vietnam there are very few studies on Obstructive Sleep Apnea Syndrome (OSAS) and cardiovascular risk factors . Self-making SASD07 is trustly for detecting OSAS with statistical significiant in comparision with StarDustII (gold criteria). Subjects and Methods: Cross sectional study, comparision with control group: 136 peoples (68 in disease group and 68 in control group). Patients were parallelly measured with StarDustII and SASD07 to detect OSAS and find the corellation with cardiovascular risk factors. Results: There is a positive correlation between SBP with the severity of OSAS (r = 0.459, p < 0.001), positive correlation between DBP with the severity of OSAS (r = 0.352, p < 0.003). No statistically significant differences between severe OSAS and fasting blood glucose, cholesterol, HDL Cholesterol, Non - HDL Cholesterol, LDL Cholesterol and TG median (p > 0.05). There is a positive correlation between AHI and neck circumference (r = 0.511, p < 0.001), waist circumference (r = 0.585, p < 0.001), BMI (r = 0.380, p < 0.01). SASD07 diagnostic value of detecting OSAS compared with StarDustII have Kappa = 0.72, (standard error 0.06, p <0.001). Conclusion: The risk factors related to OSAS in our study is neck circumference, waist circumference, systolic blood pressure, diastolic blood pressure. SASD07 have a good value in diagnosing of OSAS compared with polysomnography StarDustII. Key words: Sleep Apnea Syndrome, cardiovascular risk factor, SASD07.


2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.


This study presents the results of effect of a combination of bismuth subnitrate teat canal sealant (Boviseal® -Bimeda® Animal Health, Ireland) and the antibiotic Ampicillin & Cloxacillin (Bovaclox® DC-Norbrook Laboratories Ltd-UK) when used during the dry period on occurrence of mastitis 100 days post-calving. The objectives of this study were: to determine the effect of Boviseal® teat canal sealant in combination with Bovaclox® DC in control of dairy cow mastitis 100 days after calving; to determine bacterial pathogens causing mastitis in the selected farms and to determine risk factors for occurrence of dairy mastitis in the selected farms. This controlled field trial was carried out in two Kenyan dairy farms: Chemusian Farm in Nakuru County and Gicheha Farm in Kiambu County. 156 dairy cows were used in the study. Healthy cows with no history of mastitis in their current lactation were recruited. They were randomly placed into either of the two study groups: the control and the test group. The Control group received Bovaclox® DC while the Test group received the Bovaclox® DC followed by Boviseal®. The cows were followed during the entire dry period and 100 days post-calving monitoring for mastitis occurrence. Cows in the control group were more susceptible to mastitis 100 days post-calving compared to cows in the treatment group (P<0.001, RR=4.4, OR=17.7). Of the bacterial pathogens, coagulase negative Staphylococci (CNS) were the most common pathogens isolated from mastitic milk at 34.6 % followed by Micrococcus spp. (9.0%). Other bacteria isolated were Streptococcus agalactiae (3.8%), Staphylococcus aureus (1.9%); Escherichia coli (0.6%) and various bacterial mixtures. Results of logistic regressions at P≤0.05 showed that farm, position of the quarter, type of barn floor and type of treatment were significantly associated with occurrence of mastitis. Cows in Gicheha farm whose barn floor was earthen, those cows in the control group and hindquarters were risk factors for mastitis (RR=1.5, 4.4 and 1.18 respectively). The results of this study showed that Bovaclox® DC + Boviseal® teat canal sealant combination applied during the dry period is more effective in controlling bovine mastitis 100 days post-calving compared to the use of Bovaclox® DC alone. The study thus recommends the use of Bovaclox® DC + Boviseal® dry cow combination for control of bovine mastitis.


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