Transport media should preserve the viability and stability of microorganisms in clinical specimens. In this study, the Port-A-Cul transport system and the Copan transport system without charcoal, both designed to preserve anaerobes, were evaluated. Dacron swabs were inoculated with two combinations of facultative and anaerobic organisms typically found in vaginal swab samples. Combination I contained Candida albicans, Escherichia coli, Enterococcus spp., group B streptococci, Lactobacillus crispatus, and Staphylococcus aureus. Combination II contained Lactobacillus iners, Peptoniphilus asaccharolyticus, Mycoplasma hominis, Prevotella bivia, Prevotella corporis, Porphyromonas asaccharolytica, Mobiluncus curtisii, Peptostreptococcus anaerobius, and Gardnerella vaginalis. Duplicate swabs were placed into the two transporters and held for 24, 48, 72, and 96 h at 4 and 24°C. Both transporters maintained the viability of organisms better at 4°C than at 24°C. Prevotella bivia and Prevotella corporis had a loss of viability in both transporters at both temperatures. However, at 24°C, there was a significantly greater loss of viability for Mycoplasma hominis, Prevotella bivia, Prevotella corporis, and Peptoniphilus asaccharolyticus when the organisms were stored in Copan transport medium than when they were stored in Port-A-Cul transport medium for 96 h (P < 0.002). Some organisms proliferated in the transport media, but when transporters were held at 24°C for 96 h, a significantly greater increase in the concentrations of group B streptococci and Candida albicans, Escherichia coli, and Enterococcus spp. organisms in Copan medium than in Port-A-Cul medium was observed (P < 0.002). At room temperature, the Port-A-Cul system is superior to the Copan system with respect to the preservation of fastidious microorganisms and the prevention of the proliferation of facultative organisms.The ecosystem of the vagina is a complex mixture of fastidious anaerobes, nonfastidious aerobes, and genital mycoplasmas (1, 5-7, 9, 14, 16). Therefore, vaginal swab samples are also microbiologically complex. Due to the increased utilization of centralized laboratories, specimens may be in transit for time periods greater than 24 h, and during that time they may be exposed to various temperature conditions. Factors which may influence organism survival include deviations in temperature, interactions among microbes in the transport medium, prolonged transport time, and the type of transport medium that is used. It has been reported previously that there is a loss of viability observed during transport, with the degree of loss dependent on the microorganism, the transport system, and the temperature (2-4, 8, 10, 15, 18, 19, 21-23). An ideal transport system maintains the viability of fastidious organisms during transport without allowing the overgrowth of bacteria such as coliforms. Few studies have evaluated the survival of fastidious organisms in mixtures or clinical samples (2, 3, 4), and few have evaluated transport times greater than 24 h (3...

Streptococcus pseudoporcinus, a beta-hemolytic microorganism first isolated from the female gastrourinary tract in 2006, cross-reacts with serogrouping kits for group B Streptococcus (GBS) and could be misidentified in the laboratory. The epidemiologic characteristics of this species have not been reported previously, but this organism is thought to be rare. Paired vaginal and rectal samples were collected from 663 nonpregnant women enrolled in a phase II clinical vaccine trial of a GBS type III capsular polysaccharide-protein conjugate vaccine, and isolates initially identified as S. pseudoporcinus were collected for further testing. A total of 120 isolates of S. pseudoporcinus were recovered from 36 unique individuals with 5.4% of 663 women having this organism recovered at least once during follow-up. All of these isolates cross-reacted with a commercially available GBS serogrouping kit. Women colonized with isolates confirmed as S. pseudoporcinus by genotypic and phenotypic methodologies were compared to women who were not colonized to determine whether there were any significant factors associated with acquisition of S. pseudoporcinus. Acquisition of S. pseudoporcinus vaginally and/or rectally was 36 per 846.0 women-years of follow-up for an annual incidence of 4 per 100 woman-years of follow-up. Acquisition of S. pseudoporcinus was independently associated with black women, being 30 to 40 years of age, recent Trichomonas vaginalis infection, primary or recurrent genital herpes, having bacterial vaginosis by Nugent criteria, and having had two or more male sexual partners since the last visit. This study suggests that S. pseudoporcinus is not rare, especially among black women, and could be misidentified as GBS.Streptococcus pseudoporcinus is a facultative Gram-positive cocci usually characterized by a large zone of beta-hemolysis. It was initially thought to be Streptococcus porcinus, an organism in serological groups E, P, U, and V and found in the upper respiratory and genital tracts of swine (3), but in 2005, Duarte et al. demonstrated that strains of S. porcinus isolated from humans had unique pulsed-field gel electrophoresis profiles of the chromosomal DNA compared to the nonhuman strains and the majority of the human isolates belonged to serogroup NG1 (5). In 2006, Bekal et al. using 16S rRNA gene sequencing demonstrated that the organism found in humans had biochemical characteristics similar to those of S. porcinus but were genetically unique and proposed the name Streptococcus pseudoporcinus (1). Thompson and Facklam from the Centers for Disease Control and Prevention tested human strains of S. porcinus (serogroup NG1) with the group B reagents of 12 commercial Streptococcus test kits and reported that all of the kits evaluated cross-reacted with one or more of the isolates (17). Because S. pseudoporcinus cross-reacts with serogrouping kits for group B Streptococcus (GBS), S. pseudoporcinus may be misidentified as GBS in clinical settings.S. pseudoporcinus has been isolated from multiple specimen ...

Objective The primary target cells for HIV infection in the genital tract are CD4 T-cells expressing CCR5 on the surface. Alterations in genital tract T-cells expressing CCR5 could impact human immunodeficiency virus (HIV) acquisition risk. We hypothesized that when compared to baseline, use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a non-hormonal IUD. Study Design Thirty-four healthy, HIV negative women age 18-40 seeking an IUD for contraception were randomized to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women not needing contraception was also enrolled. Genital tract mucosal immune cell populations collected by cervical cytobrush and endometrial biopsy before and two months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent expressing receptors from baseline to follow-up were evaluated using paired Student’s t-tests. Results Neither IUD altered the number of T-cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T-cells expressing the HIV co-receptor CCR5 in the endometrium and cervix after two months of use compared with baseline. There was a decrease in activated endometrial T-cells in levonorgestrel IUD users and a decrease in activated cervical T-cells in copper IUD users after two months of IUD use compared with baseline. Conclusions Women using IUDs have reduced expression of the CCR5 HIV co-receptor on T-cells in the endometrium and cervix compared to expression prior to IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.

The impact of transport time and temperature on survival of group B streptococci (GBS) in Amies transport medium was evaluated. Viability of 10 or more CFU of GBS was maintained for 4 days at 24 or 3°C. However, there was a significant decrease in viability for GBS held at 30°C for 4 days

Problem Contraceptive hormones are systemically active, potent, and likely to invoke biological responses other than known fertility regulation impacts. We hypothesized that initiation of depot medroxyprogesterone acetate (DMPA) would increase genital HIV‐target‐cells and soluble immune mediators compared with baseline and initiation of other contraceptive methods. Method of Study We collected cervical cytobrushes and cervicovaginal fluid from healthy Zimbabwean women aged 18‐34 to assess immune cell populations, cytokines, and innate anti‐HIV activity at baseline and after 30, 90, and 180 days use of DMPA (n = 38), norethisterone enanthate (n = 41), medroxyprogesterone acetate/estradiol cypionate (n = 36), levonorgestrel implant (n = 43), etonogestrel implant (n = 47), or copper intrauterine device (Cu‐IUD) (n = 45). Cells were quantified by flow cytometry, cytokines were detected by multiplex assays, and innate anti‐HIV activity was assessed by in vitro HIV challenge. Results Compared to baseline, the number of cervical HIV target cells (#CD4 cells P < .04 and #CD11c cells P < .04), the concentration of the inflammatory cytokine IL‐1β ( P < .01), and the innate in vitro anti‐HIV activity ( P < .001) significantly decreased following DMPA initiation. In Cu‐IUD users, genital HIV target cells increased (#CD4 cells P < .001, #CD4CCR5 cells P = .02, #CD4CD69 cells P < .001, #CD8CD69 P = .01, and #CD11c cells P = .003) at day 30 and resolved by day 180. IFN‐γ ( P < .001), IL‐1β ( P < .001), IL‐6 ( P < .001), IL‐8 ( P < .001), IL‐10 ( P < .01), and RANTES ( P < .001) were also significantly increased at day 30. Minimal alterations were observed following initiation of subdermal implantable contraceptives. Conclusions This head‐to‐head study compared six contraceptives and found increased HIV target cells and cervical inflammation temporally associated with Cu‐IUD initiation. Use of hormonal contraception, including DMPA, did not increase cervical HIV target cells or inflammation. Clinical Trial Number: NCT02038335