Bacterial Vaginosis and the Risk of Trichomonas vaginalis Acquisition Among HIV-1–Negative Women

Balkus, Jennifer E.; Richardson, Barbra A.; Rabe, Lorna K.; Taha, Taha E.; Mgodi, Nyaradzo; Kasaro, Margaret P.; Ramjee, Gita; Hoffman, Irving; Karim, Salim Safurdeen. Abdool

doi:10.1097/olq.0000000000000075

Cited by 83 publications

(71 citation statements)

References 30 publications

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“…The increased risk of individuals with BV for pregnancy complications or sexually transmitted infection (STI) acquisition is present in both symptomatic and asymptomatic individuals (4)(5)(6). BV is associated with preterm labor in pregnant women (7), postoperative infections after hysterectomy (8) or surgical abortion (9), and acquisition of STIs, including HIV and Trichomonas vaginalis (5,10). Diagnosis of symptomatic BV is based upon the presence of Ն3 of the following clinical signs (Amsel's criteria): (i) elevated vaginal pH (Ͼ4.5), (ii) a homogenous thin gray-white vaginal discharge, (iii) the presence of clue cells (bacteria-covered exfoliated vaginal epithelial cells) by wet-mount microscopy of a vaginal smear, or (iv) a positive whiff test (fishy odor after addition of 10% KOH to a sample of vaginal discharge) (3).…”

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confidence: 99%

Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis

et al. 2016

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c Bacterial vaginosis (BV) is the most common gynecological infection in the United States. Diagnosis based on Amsel's criteria can be challenging and can be aided by laboratory-based testing. A standard method for diagnosis in research studies is enumeration of bacterial morphotypes of a Gram-stained vaginal smear (i.e., Nugent scoring). However, this technique is subjective, requires specialized training, and is not widely available. Therefore, a highly accurate molecular assay for the diagnosis of BV would be of great utility. We analyzed 385 vaginal specimens collected prospectively from subjects who were evaluated for BV by clinical signs and Nugent scoring. We analyzed quantitative real-time PCR (qPCR) assays on DNA extracted from these specimens to quantify nine organisms associated with vaginal health or disease: Gardnerella vaginalis, Atopobium vaginae, BV-associated bacteria 2 (BVAB2, an uncultured member of the order Clostridiales), Megasphaera phylotype 1 or 2, Lactobacillus iners, Lactobacillus crispatus, Lactobacillus gasseri, and Lactobacillus jensenii. We generated a logistic regression model that identified G. vaginalis, A. vaginae, and Megasphaera phylotypes 1 and 2 as the organisms for which quantification provided the most accurate diagnosis of symptomatic BV, as defined by Amsel's criteria and Nugent scoring, with 92% sensitivity, 95% specificity, 94% positive predictive value, and 94% negative predictive value. The inclusion of Lactobacillus spp. did not contribute sufficiently to the quantitative model for symptomatic BV detection. This molecular assay is a highly accurate laboratory tool to assist in the diagnosis of symptomatic BV.

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confidence: 99%

Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis

et al. 2016

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“…[22][23][24] For example, intestinal nematode infections are often positively associated with one another 25 and BV is often positively associated with other common vaginal pathogens. [26][27][28] Much less is understood about interactions among vaginal, intestinal, urinary tract, skin, and oral infections. Nematode parasites have been reported to influence the progression of microparasite infections.…”

Section: Introductionmentioning

confidence: 99%

Interactions Among Urogenital, Intestinal, Skin, and Oral Infections in Pregnant and Lactating Panamanian Ngäbe Women: A Neglected Public Health Challenge

Gonzalez‐Fernandez¹,

Koski²,

Sinisterra³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Interrelationships among bacteria, protozoa, helminths, and ectoparasites were explored in a cross-sectional survey of 213 pregnant and 99 lactating indigenous women. Prevalences in pregnancy and lactation, respectively, were: vaginitis (89.2%; 46.8%), vaginal trichomoniasis (75.3%; 91.1%), bacterial vaginosis (BV; 60.6%; 63.3%), hookworm (56.6%; 47.8%), asymptomatic bacteriuria/urinary tract infection (AB/UTI; 56.2%; 36.2%), cervicitis (33.3%; 6.3%), vaginal yeast (24.9%; 11.4%), Ascaris (32.5%; 17.4%), vaginal diplococci (20.4%; 31.6%), caries (19.7%; 18.2%), scabies (17.4%; 8.1%), and Trichuris (12.5%; 8.7%). Multiple regressions revealed positive associations during pregnancy (trichomoniasis and AB/UTI; diplococci and Ascaris) and lactation (yeast and scabies). Negative associations were detected in pregnancy (BV and trichomoniasis; hookworm and diplococci) and lactation (BV and yeast). Vaginal Lactobacillus reduced odds of diplococci in pregnancy and lactation, but increased Ascaris eggs per gram (epg) and odds of trichomoniasis in pregnancy and yeast in lactation. These associations raised a concern that treatment of one condition may increase the risk of another.

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“…Verskeie faktore is as oorsake van genitale inflammasie voorgestel, insluitend bakteriële vaginose (BV) -gekenmerk deur verhoogde vaginale mikrobiese diversiteit en 'n afname in die proporsie Lactobacilli -en seksueel oordraagbare infeksies (SOI's). Hierdie faktore blyk interafhanklik te wees, aangesien BV geassosieer word met 'n verhoogde risiko van SOI-besmetting (Balkus et al 2014;Gallo et al 2012;Wiesenfeld et al 2003), insluitend MIV (Atashili et al 2008;Myer et al 2005;Taha et al 1998), en ook omgekeerd (Gallo et al 2012). BV is meer algemeen in vroue van Afrika-afkoms in vergelyking met Europese vroue (Buvé et al 2014;Ravel et al 2010;Srinivasan et al 2012), met 'n uiters hoë BV-voorkomssyfer in SuidAfrika (34%-58%) in vergelyking met ander lande (Kenyon, Colebunders & Crucitti 2013).…”

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Hoë voorkomskoers van bakteriële vaginose en Chlamydia in ’n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

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Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hulle seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIVnegatiewe Suid-Afrikaanse vroue uit 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Vaginale mikrobiota is met behulp van 16S rRNA amplikon volgorde-bepaling geprofileer; bakteriese vaginose (BV) status is met behulp van 'n Nugent-telling vasgestel; en SOI's is deur middel van 'n multipleks polimerase kettingreaksie bepaal. SOI's was algemeen, met 55% van die vroue wat ten minste een SOI gehad het; 41% wat met hoë-risiko menslike papillomavirus (MPV) besmet was, en 'n verdere 28% wat met laerisiko-MPV besmet was; 44% van die vroue was met Chlamydia besmet waarvan 16% een of meer addisionele SOI gehad het. BV persentasies was ook baie hoog met 55% van die vroue wat as BV-positief (Nugent-telling ≥7) geklassifiseer is, 7% as BVintermediêr (Nugent-telling 3-6), en 38% as BV-negatief (Nugent-telling 0-2). Streptococcus (Streptococcus agalactiae), die grootste oorsaak van neonatale sepsis, was teenwoordig in 25% van die BV-positiewe vroue en 28% van die BV-negatiewe vroue, en was dus meer onder BV-negatiewe vroue. Chlamydia-infeksie sowel as BV kan reproduktiewe gesondheid nadelig beïnvloed en verhoog hierdie vroue se risiko vir die verkryging van MIV. Die voorkoms van veral Prevotella amnii kan die MIV-risiko verhoog as gevolg van sy inflammatoriese kapasiteit. Laboratoriumgebaseerde toetsing vir SOI's (veral Chlamydia en Gonorrhoeae) blyk in hierdie gemeenskap geregverdig te wees, tesame met verdere monitering en/of behandeling van BV. High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town. Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16-22-year-old, HIV-negative South African women from a low-income, high-population-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring; and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7); 7% as BV-intermediate (Nugent score 3-6) and 38% as BV-negative (Nugent 0-2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and ...

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Bacterial Vaginosis and the Risk of Trichomonas vaginalis Acquisition Among HIV-1–Negative Women

Cited by 83 publications

References 30 publications

Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis

Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis

Interactions Among Urogenital, Intestinal, Skin, and Oral Infections in Pregnant and Lactating Panamanian Ngäbe Women: A Neglected Public Health Challenge

Hoë voorkomskoers van bakteriële vaginose en Chlamydia in ’n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad

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