Vulvovaginitis and their correction in patients with cervical HPV-associated diseases in the light of the doctrine of pathomorphosis

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
Keyword(s):  
Clinical Efficacy ◽  
Inflammatory Process ◽  
Ureaplasma Urealyticum ◽  
Intraepithelial Neoplasia ◽  
Gardnerella Vaginalis ◽  
E Coli ◽  
Causative Agents ◽  
Bacterial Replication ◽  
Mixed Nature ◽  
Complex Drug

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.

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

2021 ◽  
Author(s):  
Jeong-Ju Yoo ◽  
Ju Sun Song ◽  
Woong Bin Kim ◽  
Jina Yun ◽  
Hee Bong Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Animal Experiments ◽  
Gardnerella Vaginalis ◽  
Antibiotics Resistance ◽  
Control Group ◽  
Dominant Group ◽  
E Coli ◽  
Microbiome Diversity ◽  
Causative Agents ◽  
Novel Method

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.

Chlamydia trachomatis : probable cause of prostatitis

1998 ◽  
Vol 9 (6) ◽  
pp. 350-353 ◽  
Author(s):  
Iwona Ostaszewska ◽  
Bozena Zdrodowska-Stefanow ◽  
Jerzy Badyda ◽  
Katarzyna Pucilo ◽  
Jadwiga Trybula ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Trichomonas Vaginalis ◽  
Ureaplasma Urealyticum ◽  
Mycoplasma Hominis ◽  
Gardnerella Vaginalis ◽  
Igg Antibodies ◽  
Gram Positive Bacteria ◽  
Group I ◽  
Causative Agents ◽  
Group Ii

Summary: Seventy-eight men with symptoms of chronic or subacute prostatitis were enrolled. Investigations for the presence of Chlamydia trachomatis in urethral swabs were carried out. The expressed prostatic secretions were additionally examined for Mycoplasma hominis , Ureaplasma urealyticum , Gardnerella vaginalis , other Gram-negative and Gram-positive bacteria, Trichomonas vaginalis , yeast-like fungi and leucocyte count. Furthermore, all patients were evaluated for the presence of serum anti-chlamydial IgG antibodies. Signs of inflammation on the basis of the count of leucocytes per hpf in the prostatic secretions were detected in 42 patients (group I). Prostatodynia was found in the remaining 36 men (group II). In group I, chlamydial antigen was detected in the urethra and expressed prostatic secretions (EPS) in 6 (14.3%) and 9 (21.4%) patients, respectively. No evidence of current chlamydial infection was found in group II. The presence of serum anti-chlamydial IgG antibodies was demonstrated in 13/42 (30.9%) patients with prostatitis and in 3/36 (8.3%) patients with prostatodynia ( P 0.01). The results suggest that chlamydia may be one of the causative agents of chronic prostatitis. <

scholarly journals Characterization of Anti-Bacterial Effect of the Two New Phages against Uropathogenic Escherichia coli

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1348
Author(s):  
Lívia Slobodníková ◽  
Barbora Markusková ◽  
Michal Kajsík ◽  
Michal Andrezál ◽  
Marek Straka ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Therapeutic Potential ◽  
Medical Intervention ◽  
Uropathogenic Escherichia Coli ◽  
E Coli ◽  
Phage Cocktail ◽  
Causative Agents ◽  
Tract Infections

Urinary tract infections (UTIs) are among the events that most frequently need medical intervention. Uropathogenic Escherichia coli are frequently their causative agents and the infections are sometimes complicated by the presence of polyresistant nosocomial strains. Phage therapy is a tool that has good prospects for the treatment of these infections. In the present study, we isolated and characterized two bacteriophages with broad host specificity against a panel of local uropathogenic E. coli strains and combined them into a phage cocktail. According to genome sequencing, these phages were closely related and belonged to the Tequatrovirus genus. The newly isolated phages showed very good activity on a panel of local clinical E. coli strains from urinary tract infections. In the form of a two-phage cocktail, they were active on E. coli strains belonging to phylogroups B2 and D, with relatively lower activity in B1 and no response in phylogroup A. Our study is a preliminary step toward the establishment of a national phage bank containing local, well-characterized phages with therapeutic potential for patients in Slovakia.

scholarly journals EVALUATION OF THE MICROBIAL PROFILE AND ANTIBIOTIC RESISTANCE OF BACTERIA CAUSING URINARY TRACT INFECTION IN THE CHILDREN OF KYIV REGION

2016 ◽  
pp. 43-49
Author(s):  
О. Lavrenchuk ◽  
І. Bagdasarova
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acquired Resistance ◽  
High Sensitivity ◽  
E Coli ◽  
Microbial Profile ◽  
Number Of Patients ◽  
Causative Agents ◽  
Resistance To Penicillin

The rapid growth of the acquired resistance of bacteria to antibacterial agents requires a revision of the selection ofempirical antimicrobial therapy in children with urinary tract infection (UTI). The aim of this work was to investigate the etiological structure of uropathogen flora and its sensitivity to nitrofurantoin and antibacterial drugs ofother classes in children with UTI in Kyiv and region. Materials and methods. Were examined in 95 children aged 3 to 17years in the aediatric Nephrology Department of, Institute of Nephrology NAMS of Ukraine” on the basis of clinical hospital №7 Kyiv city in 2015-2016. The disease duration ofthepatients rangedfrom 3 months to 4years. Results.The microbial spectrum of the urine depended on theform of pyelonephritis, but all patients were dominated by enterobacteria E. coli and Kl. pneumoniae. The greatest number of patients was resistant to ampicillin, co-trimoxazol and cefuroxime – 10.5% of patients with acute and 17.2% with chronic pyelonephritis. The highest sensitivity was preserved in all patients before medications meronem and gentamicin – 100% and 94.7%, respectively. Most children in Kyiv and Kyiv region showed a high sensitivity to nitrofurantoin:furamag – 78.9-75.8%,furagin - 63.8-65.5%. Comparative analysis of therapeutic efficiency of drugsfuramag and co-trimoxazol, demonstrated greater therapeutic efficacy of nitro- furans in the absence of recurrences, compared with co-trimoxazol (Oto 1.68withp=0.021). Conclusions. Among the causative agents of UTI in children of the city of Kyiv and Kyiv region was dominated by gram-negativeflora - E. coli and Kl. pneumoniae. High sensitivity to nitrofurantoin drugs, especiallyfuramag, cephalosporins, and gentamicin and meronem was documented. High rates of resistance to penicillin and co-trimoxazol was revealed. The use of the drugfuramag contributed to a more rapid, complete andpersistent normalization ofclinical and laboratory parameters in children with UTI.

scholarly journals Age and sex trends of Gardnerella vaginalis infection in patients with sexually transmitted infections in Korea

2021 ◽  
Author(s):  
Young Sam Yuk ◽  
Jae Eun Choi ◽  
Jae Kyung Kim
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Clinical Laboratory ◽  
Gardnerella Vaginalis ◽  
High Tendency ◽  
Sexually Transmitted ◽  
Female Patients ◽  
Average Patient ◽  
Causative Agents ◽  
Age And Sex

Background and Objectives: Gardnerella vaginalis and Candida albicans are the most common causative agents of bac- terial vaginosis, and infections with these pathogens lead to inflammation, endometritis, and pruritus. The aim of this retro- spective study was to determine the trends of G. vaginalis infections based on real-time PCR data according to age and sex in patients with sexually transmitted diseases. Materials and Methods: A total of 59,381 specimens isolated at a clinical laboratory from September 2018 to December 2020 were subjected to real-time PCR for the detection of G. vaginalis DNA. Sample types included catheter, pus, tissue, swab, and urine samples. Results: Among 59,381 samples, 20,718 (34.8%) were positive for G. vaginalis. Of the positive samples, 13,186 (63.7%) were from male patients and 7,532 (36.3%) were from female patients. Average patient age was 39.1 years (the average age of male and female patients was 38.34 and 40.43 years, respectively). Female patients younger than 19 years exhibited the highest incidence of G. vaginalis, at 71.57%, followed by 68.46% incidence in those aged 20-29 years; the lowest incidence was in women aged 40-49 years. Further, among specimen types, the highest number of G. vaginalis-positive specimens was obtained by the swab sampling method. Conclusion: From 2018 to 2020 in Korea, the number of tests conducted for bacterial vaginosis has increased, while the incidence of G. vaginalis infections appears to have decreased. the finding that female adolescents have a high tendency to carry the pathogen is important. and for effective surveillance of BV, sampling by cotton swabs and detection by multiplex PCR might be a good approach.

scholarly journals Kinetics of Targeted Phage Rescue in a Mouse Model of SystemicEscherichia coliK1

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
György Schneider ◽  
Nikolett Szentes ◽  
Marianna Horváth ◽  
Ágnes Dorn ◽  
Alysia Cox ◽  
...  
Keyword(s):  
Capsular Polysaccharide ◽  
Protective Efficacy ◽  
Lytic Bacteriophage ◽  
E Coli ◽  
Causative Agents ◽  
High Level ◽  
Systemic Infections ◽  
Kinetics Of

Escherichia (E.) coliK1 strains remain common causative agents of neonatal sepsis and meningitis. We have isolated a lytic bacteriophage (ΦIK1) againstE. colistrain IHE3034 and tested its specificityin vitro, as well as distribution and protective efficacyin vivo. The phage was shown to be specific to the K1 capsular polysaccharide. In the lethal murine model, a high level of protection was afforded by the phage with strict kinetics. A single dose of 1 x 108phage particles administered 10 and 60 minutes following the bacterial challenge elicited 100 % and 95 % survival, respectively. No mice could be rescued if phage administration occurred 3 hours postinfection. Tissue distribution surveys in the surviving mice revealed that the spleen was the primary organ in which accumulation of active ΦIK1 phages could be detected two weeks after phage administration. These results suggest that bacteriophages have potential as therapeutic agents in the control of systemic infections.

Negonorėjiniai uretritai: etiopatogenezė, klinikos, diagnostikos ir gydymo savitumai

2021 ◽  
Vol 25 (4) ◽  
pp. 259-264
Author(s):  
Simona Žilinskienė ◽  
Arūnas Petkevičius
Keyword(s):  
Chlamydia Trachomatis ◽  
Ureaplasma Urealyticum ◽  
Mycoplasma Hominis ◽  
Mycoplasma Genitalium ◽  
Gardnerella Vaginalis ◽  
Ureaplasma Parvum

Negonorėjinis uretritas (NGU) yra dažniausia vyrų lytinių takų liga. Mokslinių tyrimų rezultatais pagrįsta, kad pagrindiniai sukėlėjai yra Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum. Įdiegus pažangius molekulinės diagnostikos metodus, dažnai šlaplės mikrofloroje randama Mycoplasma hominis, Ureaplasma parvum, Gardnerella vaginalis ir kitų saprofitinių mikroorganizmų, kurių svarba uretritų etiopatogenezėje yra prieštaringa ir iki galo neišaiškinta. Negydytas vyrų uretritas gali sukelti sutrikimų, susijusių su reprodukcine bei lytine funkcija, ir yra viena iš pagrindinių nevaisingumo priežasčių. Šio straipsnio tikslas yra, apžvelgus mokslinę literatūrą, išanalizuoti vyrų NGU epidemiologiją, priežastis, diagnostikos ir gydymo galimybes.

Infection With Chlamydia trachomatis Increases the Risk of High-grade Anal Intraepithelial Neoplasia in People Living With Human Immunodeficiency Virus

2019 ◽  
Vol 70 (10) ◽  
pp. 2161-2167 ◽  
Author(s):  
Mar Masiá ◽  
Marta Fernández-González ◽  
José A García ◽  
Sergio Padilla ◽  
Elena García-Payá ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Chlamydia Trachomatis ◽  
Ureaplasma Urealyticum ◽  
Univariate Analysis ◽  
Intraepithelial Neoplasia ◽  
Anal Intraepithelial Neoplasia ◽  
High Grade ◽  
Chain Reactions ◽  
Immunodeficiency Virus ◽  
Hpv Genotypes

Abstract Background We aimed to assess the relationship between sexually transmitted infections (STIs)—including a large panel of human papillomavirus (HPV) genotypes—and high-grade anal intraepithelial neoplasia (HGAIN) in men who have sex with men (MSM) who were living with human immunodeficiency virus (HIV). Methods In a prospective study in an HIV cohort, participants underwent high-resolution anoscopy (HRA) for anorectal swabs collection to investigate STIs and for anal biopsy. Multiplex real-time polymerase chain reactions were performed, detecting several STIs and 28 HPV genotypes. Univariate and multivariate generalized linear models were used to analyze the relationships of variables of interest with HGAIN. Results There were 145 participants included; in 49, 2 HRAs were performed. Ureaplasma urealyticum (UU) was detected in 25 (17.2%) participants, Chlamydia trachomatis (CT) in 13 (9.0%), Mycoplasma genitalium (MG) in 4 (2.8%), HPV16 in 38 (26.2%), HPV52 in 29 (20%), and HPV53 and HPV42 in 28 (19.3%) participants each. There were 35 (24.1%) subjects diagnosed with HGAIN. In the univariate analysis, HGAIN was associated with CT, UU, MG, HPV16, HPV53, HPV68, and HPV70, and significant interactions were found between CT and HPV16 (odds ratio [OR] 31.0 95% confidence interval [CI] 4.3–221.7) and between UU and HPV16 (OR 8.8, 95% CI 2.1–37.5). In the adjusted model, CT, HPV16, HPV53, HPV70, the CD4+/CD8+ ratio, and the interaction between CT and HPV16 remained independent predictors of HGAIN. HPV16, HPV53, and HPV70 persisted in the second HRA in all the participants with recurrent HGAIN. Conclusions Coinfection with CT may potentiate the oncogenic capability of HPV16 and increase the risk of HGAIN in people with HIV. HPV53 and HPV70 should be considered among the genotypes associated with HGAIN.

scholarly journals Frequency and antibiotic resistance of Ureaplasma urealyticum and Mycoplasma hominis in genital samples of sexually active individuals

2011 ◽  
Vol 152 (42) ◽  
pp. 1698-1702 ◽  
Author(s):  
Balázs Farkas ◽  
Eszter Ostorházi ◽  
Katinka Pónyai ◽  
Béla Tóth ◽  
Elmardi Adlan ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Sexually Transmitted Diseases ◽  
Ureaplasma Urealyticum ◽  
Antibiotic Sensitivity ◽  
Mycoplasma Hominis ◽  
High Rate ◽  
Sexually Active ◽  
Sexually Transmitted ◽  
Causative Agents ◽  
Resistant Strains

Ureaplasma urealyticum and Mycoplasma hominis have important role among the causative agents of sexually transmitted diseases. Aim: The aim of the study was to determine the frequency and antibiotic resistance of Ureaplasma urealyticum and Mycoplasma hominis in genital samples obtained from patients examined in the Sexually Transmitted Diseases Centre of the Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, Budapest between May 1, 2008 and July 31, 2010. Patients and methods: Samples were taken from the urethra in men and from the cervix and urethra in women by universal swab (Biolab®) into Urea-Myco DUO kit (Bio-Rad®) and were incubated for 48 hours at 37 C°. Antibiotic sensitivity of positive samples was determined in U9 bouillon using SIR Mycoplasma kit (Bio-Rad®). Results: Samples for 4154 patients aged 16-60 years were examined. In 247/4154 samples (6%) U. urealyticum and in 26/4154 samples (0.63%) M. hominis was isolated from the genital tract. Most U. urealyticum and M. hominis strains (75% and 77%, respectively) were cultured from cervix, while the remaining 25%, and 23% from the male and female urethra, respectively. U. urealyticum and M. hominis were most commonly detected in patients aged between 21 and 40 years. The majority of U. urealyticum strains were sensitive to tetracycline (94%), doxycycline (95%), azithromycin (88%) and josamycin (90%), but were resistant to ofloxacin (21%), erythromycin (85%) and clindamycin (79%). Seventy-seven percent of the U. urealyticum strains were simultaneously resistant to erythromycin and clindamycin, suggesting that ex iuvantibus therapies may select cross-resistant strains to both antibiotics. The resistance of M. hominis to clindamycin, doxycycline, ofloxacin and tetracycline varied between 4% and 12 %. Conclusions: Because none of the strains was sensitive to all examined antibiotics, the antibiotic sensitivity of U. urealyticum and M. hominis strains should be determined. The high rate of ofloxacin, erythromycin and clindamycin resistance should be considered in the therapy of U. urealyticum infections in Hungary. This is the firstsuch a clinical microbiological study in this topic in Hungary. Orv. Hetil., 2011, 152, 1698–1702.

Adherence of bacteria to mucus collected from different parts of the reproductive tract of heifers and cows

2013 ◽  
Vol 59 (11) ◽  
pp. 720-725 ◽  
Author(s):  
E. Styková ◽  
R. Nemcová ◽  
I. Valocký ◽  
F. Novotný ◽  
P. Guba
Keyword(s):  
Reproductive Tract ◽  
Fusobacterium Necrophorum ◽  
Gardnerella Vaginalis ◽  
Gastric Mucus ◽  
Strain Specificity ◽  
E Coli ◽  
Probiotic Strains ◽  
Lactobacillus Mucosae ◽  
Different Parts

In the present study, we examined the adherence of indigenous vaginal bacteria, probiotic strains, and metritis pathogens to mucus collected from different parts of the reproductive tracts of heifers and cows and compared their adherence with the bacterial adherence to mucus collected from the stomach and large intestine of pigs. Most of the vaginal strains adhered to mucus collected from different parts of the reproductive tract and strongly adhered to gastric mucus, with the exception of Lactobacillus buchneri 24S8. Only Lactobacillus mucosae 29S8, Enterococcus faecium E21, and E. faecium EAC adhered to colonic mucus. Probiotic strains adhered strongly to mucus collected from the reproductive tract and gastric mucus but did not adhere to colonic mucus. Pathogenic strains were adherent to vaginal, uterine horn, and gastric mucus, except Escherichia coli O8:K88ab:H9 (65), Fusobacterium necrophorum, and Gardnerella vaginalis, which adhered to uterine cervix mucus. Only Kocuria kristinae and G. vaginalis adhered to uterine body mucus; E. coli O149:K88ac (EC) adhered to colonic mucus. The strains did not exhibit host specificity but rather strain specificity. The ability to adhere to mucus was a characteristic unique to each strain. To our knowledge, this is the first report regarding in vitro adherence of GRAS (Generally Regarded As Safe) lactobacilli isolated from different sources to mucus collected from different parts of the reproductive tract.

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