Genital infections and reproductive complications associated with Trichomonas vaginalis, Neisseria gonorrhoeae, and Streptococcus agalactiae in women of Qom, central Iran

Abstract

Background: Trichomonas vaginalis (T.vaginalis) and Neisseria gonorrhoeae (N.gonorrhoeae) are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran. Objective:Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran.Materials and Methods:Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler® real-time PCR (for N.gonorrhoeae) and ITS-PCR (for T.vaginalis). Results:Of 420 volunteers, 277 (65.9%) had genital signs/symptoms, including 38.3% malodorous discharge, 37.9% dyspareunia, and 54.8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens (1.2%) in Thayer-Martin culture and 17 (4.1%) in real-time PCR were identified as N.gonorrhoeae. Fifty-four specimens (12.9%) in wet mount, 64 (15.2%) in Dorset’s culture, and 81 (19.3%) in ITS-PCR showed positive results for T.vaginalis. Five mixed infections of T.vaginalis+ N.gonorrhoeae were found. The risk of T.vaginalis infection was increased in women with low-birth-weight (p=0.00; OR=43.29), history of abortion (p=0.00; OR=91.84), and premature rupture of membranes (PROM) (p=0.00; OR=21.75). The probability of finding nuclear leukocytes (p=0.00; OR=43.34) in vaginal smear was higher in T.vaginalis infection.Conclusion:The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women.

A multiplex assay of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae infections in genital specimens

“…In this study the frequency of T. vaginalis infection was 32.7% in the studied population. This is higher than our previous report on the general population of the same region [23]. One explanation might be that this study included women with genital complaints.…”

“…The conditions for N. gonorrhoeae PCR were as follows: initial denaturation of 94°C for 4 minutes, then 30 cycles of 94ºC for 60 seconds, 53.8ºC for 45 seconds, 72°C for 45 seconds, followed by final extension of 72ºC for 10 minutes. Positive results were further confirmed by real-time PCR assay targeting the porA pseudogene as previously described [23]. Sequences of primer pair NIS.F and NIS.R were shown in Table 1 (CinnaGene, Tehran, Iran).…”

“…Several reports have shown that coinfections of STIs are common in women [15,16]. We have recently reported the significant prevalence of STIs in genital samples of the women of Qom, central Iran [23]. Application of conventional PCR is a common strategy for detection of STIs, which is adopted by many laboratories in Iran.…”

“…Wet mount smears were examined for identification of motile flagellated trophozoite of T. vaginalis immediately after sampling. For molecular detection of T. vaginalis, TV.F/TV.R primer pair (CinnaGene, Tehran, Iran), which amplify ITS ribosomal RNA gene was used (Table 1) following the protocol as previously described [23]. For confirmation of the results, some T. vaginalis PCR products were submitted for sequencing.…”

Development of a convenient detection method for Trichomonas vaginalis based on loop-mediated isothermal amplification targeting adhesion protein 65

“…Clinical manifestations of the disease in women possibly contain vulvovaginal irritation, lower abdominal pain, dyspareunia, dysuria, malodorous vaginal discharge [2,14], although the infection is usually asymptomatic in men or in a few cases with the clinical manifestations of dysuria, irritation, urethral discharge [15,16]. In addition, pregnant women infected with T. vaginalis could cause decrease of birth weights, premature rupture of fetal membrane, premature delivery, abortion [17]. Recent studies have shown that T. vaginalis infection is also related to cervical cancer in women [18], prostate cancer in men and infertility [18,19].…”