Background: The vaginal microbiome is closely associated with the onset and recurrence of bacterial vaginosis (BV). In the present study, the state of vaginal microbiota during the onset and post-treatment asymptomatic stages of BV were compared to that of a healthy population to evaluate the changes in different characteristic bacteria during the onset, progression, and remission of BV. Methods: A case–control study was performed to explore these changes. Women with clinical symptoms of BV were divided into the disease group (M) and case–control group (C) based on the Nugent score. Subjects in the disease group whose symptoms were resolved after the treatment were assigned to the treated group (T) and healthy subjects were recruited into the normal control (N) group. The V3–V4 hypervariable regions of bacterial 16S rRNA genes were sequenced on the Illumina MiSeq platform. Results: The N harbored the highest number of detected species and a higher abundance of microbiota; they had a significantly higher abundance of Lactobacillus and different bacterial community composition compared to the other three groups. In group M, Gardnerella vaginalis was the dominant species, whereas Lactobacillus iners was predominant in the other three groups. While Lactobacillus was more commonly present in Group C compared to group M. it was significantly increased in group T. Alpha diversity analysis of bacterial communities revealed significant differences in community richness and diversity among all four groups (p < 0.05). Significant differences in the distribution of various bacterial communities among the different groups were also observed (p < 0.05). Specifically, the abundance of eight bacterial taxa (Megasphaera, Aerococcus christensenii, Clostridiales, Gardnerella, Peptostreptococcus, Veillonellaceae, Akkermansia, Coriobacteriales) differed significantly among the four groups (p < 0.05). Conclusion: Significant differences in the composition and alpha diversity of the vaginal microbiota at different stages of BV and the distribution of bacterial communities were observed among the investigated groups. In addition to Gardnerella, Sneathia sanguinegens and Prevotella timonensis play an important role in the pathogenesis of BV. The appearance of BV-like clinical symptoms was closely associated with the decrease in Prevotella and Atopobium vaginae populations.

Background With the gradual severe bacterial resistance and slow development of antibiotics, drug-resistant bacterial strains are widely distributed and have become a serious public health problem. Group B Streptococcus (GBS) which cause Group B strep-related disease is the major cause of severe infection in newborns. However, Clindamycin resistance of GBS induced by Erythromycin is emerging and become important clinical concerns today. Methods A retrospective study was conducted on the drug resistance analysis of GBS strains isolated from Obstetrics and Gynecology Hospital from Jan 2016 to Dec 2017. The clinical and microbiological data including patient demographics, antimicrobial susceptibility testing, relative distribution drug resistance-associated genes mefA & ermB to Erythromycin, and multilocus sequence typing (MLST typing) were collected and analyzed. The Kirby-Bauer and VITEK2-compact were used to perform the susceptibility testing. The double disk diffusion method (D-test) was used for the detection of inducible clindamycin resistance. MLST was employed to identify sequence types of these strains. Polymerase Chain Reaction (PCR) was conducted to detect the drug resistance genes mefA & ermB to Erythromycin. Results A total of 1021 strains were cultured and isolated from 31894 specimens. Erythromycin and clindamycin resistance was 53.6%（547/1021）and 50.1 % (512/1021), respectively, in which 74.4%（407/547）had harbored constitutive macrolide, lincosamide and streptogramin B resistance (cMLS B ), 45.0%（63/140）were inducible MLS B (iMLS B ). Additionally, MLST identified 12 different ST types including a new ST type ST1072 in 63 iMLS B GBS strains and the dominant STs were ST12 (30.1%) and ST19 (25.4%). The resistance ratio of ST19 to Levofloxacin (75.0%) was higher than that of other ST types. The relevance resistance ratio of mefA and ermB was respectively 27.0% and 41.3% among 63 GBS isolates. Conclusion Our study not only demonstrated a genetic diversity in iMLS B GBS in Shanghai through the analysis of MLST typing and resistance genes, but also found that there exist different distribution patterns of resistance and related resistance genes between different ST types. These findings would provide theoretical support for clinical prevention and treatment of resistant iMLS B GBS infection.

ObjectiveAutomation is increasingly being applied in clinical laboratories; however, preanalytical processing for microbiology tests and screening is still largely performed using manual methods owing to the complex procedures involved. To promote automation of clinical microbiology laboratories, it is important to assess the performance of automated systems for different specimen types separately. Therefore, the aim of this study was to explore the potential clinical application of the Copan Walk Away Specimen Processor (WASP) automated preanalytical microbiology processing system in the detection of pathogens in female reproductive tract specimens and its feasibility in optimizing diagnostic procedures.MethodsFemale reproductive tract specimens collected from pregnant women at their first obstetric check-up were inoculated into culture media using the Copan WASP automated specimen processing system and were also cultured using a conventional manual inoculation method. After 48 h of culture, the growth of colonies was observed, and the types of bacteria, number of colonies, and efficiency in isolating single colonies were compared between the automated and manual groups. The specimens collected from the WASP system using the Copan-ESwab sample collection tubes were further analyzed for the presence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Ureaplasmaurealyticum (UU) via fluorescence quantitative polymerase chain reaction (qPCR) and an immunochromatographic assay to investigate the feasibility of this method in optimizing detection of these common pathogens of the female reproductive tract.ResultsCompared with the manual culture method, the Copan WASP microbiology automation system detected fewer bacterial types (P&lt;0.001) and bacterial colonies (P&lt;0.001) but had a higher detection rate of single colonies (P&lt;0.001). There was no significant difference in the detection rates of common pathogens encountered in clinical obstetrics and gynecology, including group B Streptococcus (GBS) (P=0.575) and Candida (P=0.917), between the two methods. Specimens collected in the Copan-ESwab tubes could be used for screening of GBS and CT via fluorescence-based qPCR but not with immunochromatography. However, UU and NG were not detected in any sample with either method; thus, further validation is required to determine the feasibility of the Copan system for screening these pathogens.ConclusionThe Copan WASP microbiology automation system could facilitate the optimization of diagnostic procedures for detecting common pathogens of the female reproductive system, thereby reducing associated costs.