Agents causing genital infections in routine cytological tests: frequency and characteristics of Papanicolaou smears

Urinary tract infections are responsible for most human infections, these are caused by bacteria, fungi, protozoa and associated microorganisms. The goal of this study was to determine the rate of vaginal infection-causing agents in routine cytological exams and also to evaluate the characteristics of positive tested Pap smears. A retrospective documental with descriptive aspect research was performed in a Clinical Pathology laboratory from Maceió-AL. The results of the Pap smears exams for Trichomonas vaginalis, Gardnerella vaginalis, Candida spp and HPV were arranged in a database as well as other data such as bacterial, protozoan, fungal and viral coinfections. The sample was composed by 18.645 women who have undergone Pap smear exams from 2013 to 2017. Of these analyzed exams, 27.4% in 2013, 10.9% in 2014, 10.6% in 2015, 15.2% in 2016 and 13.67% in 2017 were within normal range, however more than half of these exams presented some infections caused by unspecific or microbiological agents. By analyzing all the reports, 4.073 (21.84%) presented inflammations caused by some species of infectious agent with the following rate order: G. vaginalis and T. vaginalis. Furthermore, it was possible to confirm high rates of coinfection by and Candida spp. The rate of genital infections in this study highlights that there is a public health matter that must be controlled, which points a greater need for monitoring, guidance and actions towards greater awareness in order to prevent these problems.

Some Clinical and Inflammatory Aspects of Trichomonas vaginalis Infection among Women with Pelvic Inflammatory Diseases

Infection with Trichomonas vaginalis and its relation to some diseases have lately had much attention. The objective of this study was to assess the infection rate of T. vaginalis and its relation to pelvic inflammatory diseases, infertility, and vaginosis. The study also assessed some demographic, clinical, and immunological parameters in women infected with T. vaginalis. The study included 160 non-pregnant married women who attended some private clinics and public hospitals in Baghdad from October 2020 to February 2021. All participants had symptoms of vaginal discharge only or vaginal discharge with lower abdominal pain. The participants were divided into an infertility group (n = 61) and fertility group (n = 99). The participants were also divided into Pelvic Inflammatory Disease (PID) group (n=41) and non-PID group (n=119). All participants underwent vaginal examination. Vaginal swabs were taken from all participants for T. vaginalis, bacteria, yeast, clue cell, pH, and vaginal leukocyte examinations. Sera were also taken to measure both IL-1α and IL-8 using sandwich ELISA technique to compare them with apparently healthy control subjects who had no vaginal discharge. The study revealed that the total infection rate of T. vaginalis was 14.37%. The results showed no significant relations between T. vaginalis positive status and each of age, infertility, vaginosis, contraceptive use, and high BMI. While a significant relation (P=0.03) was noticed between T. vaginalis positive status and PID. Women with PID exhibited a higher infection rate with T. vaginalis (24.39%) versus non PID women (10.92%). High clue cells number was not significantly related to T. vaginalis positive status, only if both PID and vaginosis were considered in the statistical analysis. In addition, high leukocytes count was not related to T. vaginalis positive status. While abnormal vaginal pH was significantly (P=0.01) related to T. vaginalis positive status. Finally, the levels of both IL-1α and IL-8 were noticed to be declined in women who had T. vaginalis infection, although they were not declined significantly. This study gives an insight about some clinical aspects of T. vaginalis infection among PID women. T. vaginalis is highly predictable in women with PID. Consequently, attention and more investigation would be needed on this topic in Iraq.

ATUAÇÃO DA ENFERMEIRA NA INFECÇÃO POR TRICHOMONAS VAGINALIS

INTRODUÇÃO: A tricomoníase é uma doença sexualmente transmissível (DST) negligenciada no Brasil. Essa doença é uma das DSTs mais prevalentes mundialmente. Esse estudo teve como objetivo analisar a atuação da enfermeira na infecção por Trichomonas vaginalis. METODOLOGIA: consistiu em um estudo de revisão integrativa de literatura, através de pesquisa nas bases de dados literatura latino-americana e do Caribe Ciências da Saúde (LILACS), Medical Literatura Análise e Retrieval System on-line (MEDLINE), Public Medline (Pu- bMed) e as bibliotecas virtuais Scientific Electronic Library Online (SciELO), essas escolhidas por sua larga difusão acadêmica. RESULTADOS E DISCuSSÃO: A busca foi realizada pelo acesso on-line e a amostra final desta revisão integrativa contém artigos dos anos de 2010 a 2016. Os artigos incluídos trataram do diagnóstico das principais infecções do trato geniturinário, a tricomoníase aparecendo como uma das três principais; da importância do conhecimento sobre essas patologias no que se refere ao agente causal, sintomatologia, técnicas diagnósticas e tratamento correto para evitar complicações no curso crônico da infecção. CONSIDERAÇÕES FINAIS: Embora haja poucos trabalhos sobre a atuação dos enfermeiros frente a pacientes com tricomoníase, a presente revisão integrativa mostrou que os enfermeiros que atuam na área de saúde da mulher ou que receberem treinamento na área pode estar apto a diagnosticar e realizar os cuidados necessários para gerenciar/controlar as infecções do trato geniturinário, entre elas a tricomoníase, tanto em mulheres quanto em homens.

Proliferation of Mouse Prostate Cancer Cells Inflamed by Trichomonas vaginalis

Our objective was to investigate whether inflammatory microenvironment induced by Trichomonas vaginalis infection can stimulate proliferation of prostate cancer (PCa) cells in vitro and in vivo mouse experiments. The production of CXCL1 and CCL2 increased when cells of the mouse PCa cells (TRAMP-C2 cell line) were infected with live T. vaginalis. T. vaginalis-conditioned medium (TCM) prepared from co-culture of PCa cells and T. vaginalis increased PCa cells migration, proliferation and invasion. The cytokine receptors (CXCR2, CCR2, gp130) were expressed higher on the PCa cells treated with TCM. Pretreatment of PCa cells with antibodies to these cytokine receptors significantly reduced the proliferation, mobility and invasiveness of PCa cells, indicating that TCM has its effect through cytokine-cytokine receptor signaling. In C57BL/6 mice, the prostates injected with T. vaginalis mixed PCa cells were larger than those injected with PCa cells alone after 4 weeks. Expression of epithelial-mesenchymal transition markers and cyclin D1 in the prostate tissue injected with T. vaginalis mixed PCa cells increased than those of PCa cells alone. Collectively, it was suggested that inflammatory reactions by T. vaginalis-stimulated PCa cells increase the proliferation and invasion of PCa cells through cytokine-cytokine receptor signaling pathways.

Involvement of Macrophages in Proliferation of Prostate Cancer Cells Infected with Trichomonas vaginalis

Macrophages play a key role in chronic inflammation, and are the most abundant immune cells in the tumor microenvironment. We investigated whether an interaction between inflamed prostate cancer cells stimulated with Trichomonas vaginalis and macrophages stimulates the proliferation of the cancer cells. Conditioned medium was prepared from T. vaginalis-infected (TCM) and uninfected (CM) mouse prostate cancer (PCa) cell line (TRAMP-C2 cells). Thereafter conditioned medium was prepared from macrophages (J774A.1 cell line) after incubation with CM (MCM) or TCM (MTCM). When TRAMP-C2 cells were stimulated with T. vaginalis, protein and mRNA levels of CXCL1 and CCL2 increased, and migration of macrophages toward TCM was more extensive than towards CM. Macrophages stimulated with TCM produced higher levels of CCL2, IL-6, TNF-α, their mRNAs than macrophages stimulated with CM. MTCM stimulated the proliferation and invasiveness of TRAMP-C2 cells as well as the expression of cytokine receptors (CCR2, GP130, CXCR2). Importantly, blocking of each cytokine receptors with anti-cytokine receptor antibody significantly reduced the proliferation and invasiveness of TRAMP-C2 cells. We conclude that inflammatory mediators released by TRAMP-C2 cells in response to infection by T. vaginalis stimulate the migration and activation of macrophages and the activated macrophages stimulate the proliferation and invasiveness of the TRAMP-C2 cells via cytokine-cytokine receptor binding. Our results therefore suggested that macrophages contribute to the exacerbation of PCa due to inflammation of prostate cancer cells reacted with T. vaginalis.