Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis

Cox, Ciara; Watt, Alison; McKenna, James; Coyle, Peter

doi:10.1007/s10096-015-2564-x

Cited by 58 publications

(54 citation statements)

References 42 publications

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“…Specifically, UP and MH were more prevalent in women with BV than in women with non-BV type flora, while UU showed no such association. This greater prevalence of particular genital Mollicutes in BV-positive samples cannot be attributed solely to co-infection by G. vaginalis [42] because the latter was also common in the BV-negative samples. However, quantification of microbial loads in the vaginal samples might reveal a synergistic relationship between BV-associated bacteria and vaginal Mollicutes [42].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis

et al. 2017

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BackgroundBacterial vaginosis (BV) is one of the leading causes of vaginal complaints among women of childbearing age. The role of Gardnerella vaginalis remains controversial due to its presence in healthy and BV-type vaginal microflora. The phenotypic and genotypic heterogeneity of G. vaginalis suggested the existence of strain variants linked with different health conditions. We sought to analyze prevalence and distribution of G. vaginalis subgroups (clades) in BV-positive (n = 29), partial BV (n = 27), and BV-negative (n = 53) vaginal samples from Lithuanian women.MethodsVaginal samples were characterized by Amsel criteria and the Nugent method. Bacterial signatures characteristic of BV and concomitant infections were identified by culture and PCR. Using singleplex PCR assays, G. vaginalis subgroups were identified in 109 noncultured vaginal specimens by targeting clade-specific genes. Isolated G. vaginalis clinical strains were subtyped and the presence of the sialidase coding gene was detected by PCR. Data analysis was performed using GraphPad Prism statistical software.Results G. vaginalis was found in 87% of women without BV. Clade 4 was most frequently detected (79.4%), followed by clade 1 (63.7%), clade 2 (42.2%), and clade 3 (15.7%). Multi-clade G. vaginalis communities showed a positive association with Nugent score (NS) ≥ 4 (OR 3.64; 95% CI 1.48–8.91; p = 0.005). Clade 1 and clade 2 were statistically significantly more common in samples with NS 7–10 (OR 4.69; 95% CI 1.38–15.88; p = 0.01 and OR 6.26; 95% CI 2.20–17.81; p ≤ 0.001, respectively). Clade 3 and clade 4 showed no association with high NS (OR 0.88; 95% CI 0.26–3.04; p = 1.00 and OR 1.31; 95% CI 0.39–4.41; p = 0.767, respectively). The gene coding for sialidase was detected in all isolates of clade 1 and clade 2, but not in clade 4 isolates.ConclusionsWe showed an association between the microbial state of vaginal microflora and specific subgroups of G. vaginalis, the distribution of which may determine the clinical manifestation of BV. The frequent detection of clade 4 in the BV-negative samples might be due its lack of the gene coding for sialidase.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2501-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis

et al. 2017

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“…C. trachomatis and M. genitalium , and/or BV . The bacterial load of particularly M. hominis and to a lesser extent U. parvum and U. urealyticum can be significantly increased in the dysbiosis of BV . However, despite the association between particularly M. hominis and BV, M. hominis cannot be detected in approximately one‐third of women with BV and, accordingly, it is neither a sufficiently sensitive nor specific bacterial marker for diagnosis of BV .…”

Section: Womenmentioning

confidence: 99%

“…8,46,49,59 The bacterial load of particularly M. hominis and to a lesser extent U. parvum and U. urealyticum can be significantly increased in the dysbiosis of BV. 4,48,60 However, despite the association between particularly M. hominis and BV, M. hominis cannot be detected in approximately one-third of women with BV and, accordingly, it is neither a sufficiently sensitive nor specific bacterial marker for diagnosis of BV. 8,[61][62][63] Despite not being susceptible to metronidazole, eradication or a decrease in the M. hominis load after BV treatment has also been reported, [64][65][66] further indicating that M. hominis frequently belongs to the dysbiosis of BV.…”

Section: Male Infertilitymentioning

confidence: 99%

Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? – a position statement from the European STI Guidelines Editorial Board

Horner

Donders

Cusini

et al. 2018

Acad Dermatol Venereol

177

146

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At present, we have no evidence that we are doing more good than harm detecting and subsequently treating Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum colonizations/infections. Consequently, routine testing and treatment of asymptomatic or symptomatic men and women for M. hominis, U. urealyticum and U. parvum are not recommended. Asymptomatic carriage of these bacteria is common, and the majority of individuals do not develop any disease. Although U. urealyticum has been associated with urethritis in men, it is probably not causal unless a high load is present (likely carriage in 40-80% of detected cases). The extensive testing, detection and subsequent antimicrobial treatment of these bacteria performed in some settings may result in the selection of antimicrobial resistance, in these bacteria, 'true' STI agents, as well as in the general microbiota, and substantial economic cost for society and individuals, particularly women. The commercialization of many particularly multiplex PCR assays detecting traditional non-viral STIs together with M. hominis, U. parvum and/or U. urealyticum has worsened this situation. Thus, routine screening of asymptomatic men and women or routine testing of symptomatic individuals for M. hominis, U. urealyticum and U. parvum is not recommended. If testing of men with symptomatic urethritis is undertaken, traditional STI urethritis agents such as Neisseria gonorrhoeae, Chlamydia trachomatis, M. genitalium and, in settings where relevant, Trichomonas vaginalis should be excluded prior to U. urealyticum testing and quantitative species-specific molecular diagnostic tests should be used. Only men with high U. urealyticum load should be considered for treatment; however, appropriate evidence for effective treatment regimens is lacking. In symptomatic women, bacterial vaginosis (BV) should always be tested for and treated if detected.

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“…Although the composition of the bacterial microbiota in women with BV varies between individuals, Gardnerella , Atopobium , Prevotella , Megasphaera , Leptotrichia , Sneathia , Bifidobacterium , Dialister and three Clostridium species known as BV‐associated bacteria 1–3, are the most frequent microorganisms that have been identified . The mycoplasma, Mycoplasma hominis , is also a frequent isolate in BV‐positive women . Multiple studies have associated a diagnosis of BV with a wide range of reproductive tract disorders.…”

Section: Introductionmentioning

confidence: 99%

Bacterial vaginosis: a critical analysis of current knowledge

Nasioudis

Linhares

Ledger

et al. 2016

BJOG

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Bacterial vaginosis (BV), the change from a Lactobacillusdominant vaginal microbiota to an anaerobic and facultative bacterial dominance, is associated with pathological sequelae. In many BV-positive women their microbiota is in fact normal and unrelated to pathology. Whether or not the dominance of BVassociated bacteria persists depends upon interactions between host and bacterial factors. Inconsistencies in diagnosis and erroneous associations with pathology may be due to a failure to differentiate between sub-populations of women. It is only in those women with a BV diagnosis in which the identified bacteria are atypical and persist that BV may be a clinical problem requiring intervention.Tweetable abstract Improved diagnosis of bacterial vaginosis is needed to accurately determine its role in pathology.

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Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis

Cited by 58 publications

References 42 publications

Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis

Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis

Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? – a position statement from the European STI Guidelines Editorial Board

Bacterial vaginosis: a critical analysis of current knowledge

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