scholarly journals Vaginosis Bacteriana – Actualización y novedad terapéutica

Author(s):  
Jose Pablo Salas Morgan ◽  
Luis Carlos Angulo Moya ◽  
Erik Garita Mendez

La vaginosis bacteriana es la causa del flujo vaginal anormal más común en mujeres en edad reproductiva. Esta patología se presenta en la mayoría de los casos de forma asintomática y cuenta con una alta tasa de recurrencia. Desde la perspectiva fisiopatológica, la vaginosis bacteriana se causa por un desequilibrio bacteriano vaginal. Este desequilibro genera un desplazamiento de la flora vaginal normal y como consecuencia ésta se coloniza principalmente por bacterias anaerobias como: Gardenerella vaginalis, Prevotella, Peptostreptoccocus, Ureaplasma urealyticum, porphyromonas y mycoplasma hominis. Las pacientes pueden presentar clínicamente un flujo blanquecino o grisáceo, en ocasiones espumoso que puede ser mal oliente. Estas pacientes aparte de la clínica o sintomatología genital también podrían presentar un estrés psicológico que podría llevar al desarrollo de patologías de índole psiquiátrica. El tratamiento de la patología se realiza con antibióticos, de primera elección, dentro de los cuales se encuentra el metronidazol o clindamicina vaginal u oral y como segunda línea se utiliza el tinidazol o el secnidazol, ambos por vía oral. De igual forma, recientemente se han desarrollado nuevas terapias que ayudan a evitar el alto porcentaje de recurrencia de la patología, como colonias de Lactobaciillus depositadas directamente en la vagina.

2010 ◽  
Vol 63 (1-2) ◽  
pp. 47-50
Author(s):  
Sonja Vesic ◽  
Jelica Vukicevic ◽  
Eleonora Gvozdenovic ◽  
Dusan Skiljevic ◽  
Slobodanka Janosevic ◽  
...  

Introduction. Nongonococcal urethritis is the most common sexually transmitted infection in men, with vast majority of the etiological agents such as Chlamydia trachomatis, followed by urogenital mycoplasmas. The aim of this study was to determine the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in nongonococcal urethritis in men, and to examine infections associated with these agents. Material and methods. 299 sexually active, heterosexual men with nongonococcal urethritis were included into the study. Urethral samples were taken with a dacron swab placed into the urethra up to 2-3 cm. The Direct immunojluorescence tehnique was performed for identification of Chlamydia trachomatis. Ureaplasma urealyticum and Mycoplasma hominis were detected with Mycoplasma 1ST assay. Results. Chlamydia trachomatis was detected in 22.75%, Uraeplasma urealyticum in 21.08% and Mycoplasma hominis in 8.02% cases. We found no significant differences in prevalence between Chlamydia trachomatis and Ureaplasma urealyticym (p>0.05). Monoinjections were found in 51.85% with significantly higher rate (p<0.01) than associated infections (11.70%). Among associated infections, coinfection of Chlamydia trahomatis and Ureaplasma urealyticum was predominant. Association of Chlamydia trachomatis with urogenital mycoplasmas was significantly higher (p<0.05) than the one between Ureaplasma urealyticum and Mycoplasma hominis. In 36.45% patients no patogenic microorganisms were detected. Conclusion. These results confirmed the etiological role of Chlamydia trachomatis and urogenital mycoplasmas in nongonococcal urethritis with prevalence of 51.85% in monoinfections and 11.70% in associated infections. In 36.45% of cases the etiology of urethritis was not elucidated. These results suggest that more sensitive diagnostic tool should be applied when searching for the detailed etiology of nongonococcal urethritis.


1986 ◽  
Vol 13 (2) ◽  
pp. 67-70 ◽  
Author(s):  
WILLIAM M. MCCORMACK ◽  
BERNARD ROSNER ◽  
SUSAN ALPERT ◽  
JOHN R. EVRARD ◽  
VICKI ANN CROCKETT ◽  
...  

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 250-252
Author(s):  
K. B. Waites ◽  
M. B. Brown ◽  
S. Stagno ◽  
J. Schachter ◽  
S. Greenberg ◽  
...  

A 10-year-old girl with a 1-year history of lower genitourinary tract symptoms suggestive of bacterial infection but with numerous negative urine cultures was referred to the University of Alabama urology clinic after empirical treatment with multiple antibiotics failed to resolve her symptoms. An extensive urologic evaluation revealed no structural or physiologic abnormalities, but an exudative vaginitis was noted and large numbers of Ureaplasma urealyticum and Mycoplasma hominis were isolated from the lower genital tract. Cultures for Chlamydia, viruses, and routine bacterial pathogens were negative. After initiation of tetracycline therapy, symptoms resolved and subsequent cultures for mycoplasmas were negative. In addition, a seroconversion was noted for M hominis but not for U urealyticum. Chlamydia serology was negative. It was later learned that the patient had been sexually molested just prior to the onset of symptoms. This case illustrates the necessity of early consideration of a mycoplasmal etiology in the patient with persistent genitourinary symptoms and no obvious bacterial pathogen, or in the patient whose condition is refractory to routine antibiotic therapy.


1987 ◽  
Vol 98 (3) ◽  
pp. 353-359 ◽  
Author(s):  
Patricia M. Furr ◽  
D. Taylor-Robinson

SUMMARYUreaplasma urealyticum organisms (ureaplasmas) and Mycoplasma hominis organisms (mycoplasmas) were sought in mid-stream urines collected from 200 men and 200 women attending hospital with conditions of a non-venereal nature. In addition, the urines from 100 male and 100 female healthy volunteers were examined. Overall, ureaplasmas were isolated four times more often than mycoplasmas. In individuals less than 50 years of age, the organisms were found in about 20 % of men and about 40 % of women. In individuals 50 years or older, they were found about one-third to one-half as frequently. Centrifugation of urine and examination of the resuspended deposit did not increase the isolation rates. In men, the numbers of organisms in the urine were usually small (< 103 c.c.u./ml) with less than tenfold more in the urine of women. The occurrence of 51– > 1000 leucocytes per mm3 in some of the urines was not associated with either the presence or an increased number of ureaplasmas/mycoplasmas, whereas they were associated with the presence of 105 or more bacteria/ml. The significance of these findings in the context of defining the role of ureaplasmas/mycoplasmas in genital-tract disease is discussed.


2015 ◽  
Vol 143 (15) ◽  
pp. 3327-3334 ◽  
Author(s):  
L.-S. CHEN ◽  
J.-R. WU ◽  
B. WANG ◽  
T. YANG ◽  
R. YUAN ◽  
...  

SUMMARYMycoplasmainfections are most frequently associated with disease in the urogenital or respiratory tracts and, in most cases, mycoplasmas infect the host persistently. In HIV-infected individuals the prevalence and role of genital mycoplasmas has not been well studied. To investigate the six species ofMycoplasmaand the risk factors for infection in Jiangsu province, first-void urine and venous blood samples were collected and epidemiological questionnaires were administered after informed consent. A total of 1541 HIV/AIDS patients were recruited in this study. The overall infection rates of sixMycoplasmaspecies were:Ureaplasma urealyticum(26·7%),Mycoplasma hominis(25·3%),M. fermentans(5·1%),M. genitalium(20·1%),M. penetrans(1·6%) andM. pirum(15·4%). TheMycoplasmainfection rate in the unmarried group was lower than that of the married, divorced and widowed groups [adjusted odds ratio (aOR) 1·432, 95% confidence interval (CI) 1·077–1·904,P< 0·05]. The patients who refused highly active antiretroviral therapy (HAART) had a much higher risk ofMucoplasmainfection (aOR 1·357, 95% CI 1·097–1·679,P< 0·05). Otherwise, a high CD4+T cell count was a protective factor againstMycoplasmainfection (aOR 0·576, 95% CI 0·460–0·719,P< 0·05). Further research will be required to confirm a causal relationship and to identify risk factors forMycoplasmainfection in HIV/AIDS populations.


2021 ◽  
Vol 25 (4) ◽  
pp. 259-264
Author(s):  
Simona Žilinskienė ◽  
Arūnas Petkevičius

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.


2011 ◽  
Vol 152 (42) ◽  
pp. 1698-1702 ◽  
Author(s):  
Balázs Farkas ◽  
Eszter Ostorházi ◽  
Katinka Pónyai ◽  
Béla Tóth ◽  
Elmardi Adlan ◽  
...  

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.


2018 ◽  
Vol 33 (1) ◽  
Author(s):  
Richard Aschbacher ◽  
Francesca Romagnoli ◽  
Elisa Masi ◽  
Valentina Pasquetto ◽  
Franco Perino ◽  
...  

Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium are established or presumed as (??) STI pathogens. The present study aims  at ng describing the one-year molecular epidemiology of these seven pathogens in the Province of Bolzano, Northern Italy. From April 2016 to March 2017, a total of  2,949 patients, mainly females, were enrolled and 3,427 urine, vaginal, endocervical and/or urethral samples were subjected to simultaneous analysis of the seven pathogens by means of Real Time Polymerase Chain Reaction (AnyplexTM II STI-7 Detection Kit Seegene, Seoul, Korea). At least one of the seven microorganisms was detected in 40.7% of patients, with an uneven distribution: 43.1% in females (F) and 29.8% (p<0.001) in males (M). The prevalence of microorganisms was as follows: 30.3% U. parvum (F: 35.6%, M: 8.3%), 6.9% U. urealyticum (F: 6.8%, M: 7.0%), 4.9% M. hominis (F: 5.4%, M: 2.3%), 4.9% C. trachomatis (F: 3.4%, M: 11.4%), 1.1% M. genitalium (F: 1.0%, M: 1.2%), 1.2% N. gonorrhoeae (F: 0.17%, M: 5.6%) and 0.40% T. vaginalis (F: 0.38%, M: 0.53%). Mixed infections were detected in 7.4% of patients. The highest prevalence was observed for U. parvum, followed by U. urealyticum and M. hominis and a significant  presence of multi-pathogen infections was registered.


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