Cervical Infection Research Articles

The association of telomere maintenance and TERT expression with susceptibility to human papillomavirus infection in cervical epithelium.

The role of telomerase reverse transcriptase (TERT) induction and telomere maintenance in carcinogenesis including cervical cancer (CC) pathogenesis has been well established. However, it remains unclear whether they affect infection of high-risk human papillomavirus (hrHPV), an initiating event for CC development. Similarly, genetic variants at the TERT locus are shown to be associated with susceptibility to CC, but it is unclear whether these SNPs modify the risk for cervical HPV infection. Here we show that in CC-derived HeLa cells, TERT overexpression inhibits, while its depletion upregulates expression of Syndecan-1 (SDC-1), a key component for HPV entry receptors. The TCGA cohort of CC analyses reveals an inverse correlation between TERT and SDC-1 expression (R = -0.23, P = 0.001). We further recruited 1330 females (520 non-HPV and 810 hrHPV-infected) without CC or high-grade cervicalintraepithelial neoplasia to analyze telomeres in cervical epithelial cells and SNPs at rs2736098, rs2736100 and rs2736108, previously identified TERT SNPs for CC risk. Non-infected females exhibited age-related telomere shortening in cervical epithelial cells and their telomeres were significantly longer than those in hrHPV-infected group (1.31 ± 0.62 vs 1.19 ± 0.48, P < 0.001). There were no differences in rs2736098 and rs2736100 genotypes, but non-infected individuals had significantly a higher C-allele frequency (associated with higher TERT expression) while lower T-allele levels at rs2736108 compared with those in the hrHPV group (P = 0.020). Collectively, appropriate telomere maintenance and TERT expression in normal cervical cells may prevent CC by modulating hrHPV infection predisposition, although they are required for CC development and progression.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) or recurrent urinary tract infections: a case report

BackgroundFever is the most frequent reason for medical consultation in children, and makes up 15–25% of all consultations in primary care and emergency departments. In here we report a case of a 13 year-old girl who referred with an unusual presentation of fever and was misdiagnosed with recurrent urinary tract infection for 8 years.Case presentationThis is a Clinical Reasoning Cycle case study. A 13 year-old girl was referred with a chief complaint of recurrent fevers from 8 years. During her first febrile episode, she had a 5-day high-grade fever associated with loss of appetite. Her physical examination at that time was unremarkable. Blood tests showed leukocytosis with a shift to the left and urine examination was in favor of pyuria. The urine culture was positive for bacterial growth. The episodes of fever were repeated every 45 days. Accordingly, the patient was diagnosed as a case of recurrent urinary tract infection. In the intervals between her febrile episodes, the patient was healthy and laboratory tests were normal. Ultrasonography, voiding cystourethrogram and dimercaptosuccinic acid scans were normal. During her last visit, the patient mentioned difficulty in swallowing and on examination cervical lymph nodes, exudative tonsillitis and painful aphthous stomatitis were detected. All antibiotics were stopped and corticosteroids were started. The patient’s symptoms were relieved and the interval between her febrile episodes became longer.ConclusionsOur study shows that a patient should never be marked, particularly when the symptom and signs aren’t completely justifying a patient’s condition.

Head and neck infection, clinicopathological outline

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the antimicrobial drugs, a significant percentage of head and neck infection still can be recorded, this study try to identify the causes of recorded cases of head and neck infection in antibiotics era by focusing on the clinical presentation and the predisposing factors. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective study was conducted in the department of otolaryngology in university of Benghazi including 84 patients who were diagnosed as head and neck infection. Clinical data, risk factors and managements were discussed in this study. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; The 84 patients with deep cervical infection were studied. The mean age of our patients was 33 years, most of them were males. Some had other co-diseases. Their main complains was severe throat pain. The most common space involved was peritonsillar space and the most common source of infection was tonsillar infection. Only third of the cases showed positive culture results. The most common organism cultured was &lt;em&gt;Staphylococci&lt;/em&gt;. The range of hospital stay was 4-11 days. There was no mortality in our series of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Cervical infection is associated with high rate of morbidity and mortality specially in immune-compromised patients, therefore early detection of the disease followed by quick and appropriate management are life-saving measurements. All patients need early broad-spectrum intravenous antibiotics, and most of them need different surgical intervention. As bad oral hygiene, smoking and low immunity are the major risk factors for neck infection, education of the community, especially in rural area, is required.&lt;/p&gt;

Breaking Down the Barrier: The Role of Cervical Infection and Inflammation in Preterm Birth

Approximately 40% of cases of spontaneous preterm birth (sPTB) are associated with ascending intrauterine infections. The cervix serves as a physical and immunological gatekeeper, preventing the ascent of microorganisms from the vagina to the amniotic cavity. The cervix undergoes remodeling during pregnancy. It remains firm and closed from the start until the late third trimester of pregnancy and then dilates and effaces to accommodate the passage of the fetus during delivery. Remodeling proceeds appropriately and timely to maintain the pregnancy until term delivery. However, risk factors, such as acute and chronic infection and local inflammation in the cervix, may compromise cervical integrity and result in premature remodeling, predisposing to sPTB. Previous clinical studies have established bacterial (i.e., chlamydia, gonorrhea, mycoplasma, etc.) and viral infections (i.e., herpesviruses and human papillomaviruses) as risk factors of PTB. However, the exact mechanism leading to PTB is still unknown. This review focuses on: (1) the epidemiology of cervical infections in pregnant patients; (2) cellular mechanisms that may explain the association of cervical infections to premature cervical ripening and PTB; (3) endogenous defense mechanisms of the cervix that protect the uterine cavity from infection and inflammation; and (4) potential inflammatory biomarkers associated with cervical infection that can serve as prognostic markers for premature cervical ripening and PTB. This review will provide mechanistic insights on cervical functions to assist in managing cervical infections during pregnancy.

Prevalence of abnormal Pap smear results in inflammatory bowel disease: a prospective study.

Development of malignancy is a pending threat for patients with inflammatory bowel disease (IBD). Aim of this study was to analyze cervical dysplasia and infection with human papilloma virus (HPV) in patients with IBD. This was a prospective, single center cohort study in Germany. Consecutive IBD patients admitted to the Department of Gastroenterology were sent to Gynecology, where a questionnaire was answered and gynecological examinations including a smear for cytology and HPV were taken. Participants of a general screening program constituted controls. Descriptive statistics, 95% confidence intervals and odds ratios were calculated. A total of 101 patients were recruited of which 99 patients participated. Analysis showed a significant (p = 0.05) difference between the prevalence of abnormal smears in patients with (22%) and without (6%) immunosuppressive therapy, while the latter had cervical abnormalities comparable with healthy controls (5%). All immunosuppressants showed similarly high risks for abnormal smear results. Only 11/99 (11%) patients had positive high-risk HPV tests, which is comparable with general population. The prevalence of abnormal cervical smears is higher in IBD patients compared to healthy individuals, but the difference is confined to patients with IBD and immunosuppressive therapy. Annual screening is advisable.

Cervical, oral and anal Human papillomavirus infection in women attending the Dermatology Unit of a regional reference hospital in Genoa, Italy: a prevalence study.

Between January 2016 and December 2018, the female patients attending the STI center (cases) and those requiring a full body skin examination for skin cancer screening ("supposed" healthy population: controls) were recruited. Cervical/anal/oral samples were collected with ThinPrep liquid based cytology preparation system: polymerase chain reaction for HPV and cytological evaluation were performed. Overall, 85 cases and 31 controls were recruited. Cervical HPV infection was detected in 60% of the cases and 48% of the controls; anal HPV infection in 44% of the cases and 26% of the controls. Cervical and anal HPV infection resulted associated, especially in the control group. Moreover, 32% of the cases and 29% of the controls proved HPV positive in the oral cavity. In the cases of our series, prevalence of cervical, anal and oral HPV infection was higher compared with the controls. The high prevalence of anal-oral infections and the frequent association between anal and cervical infections, provide reason to suggest HPV screening also in the anal and oral regions, which may represent HPV reservoirs and grounds for cancer development.

Bacterial vaginosis, cervical Human Papillomavirus infection and cervical cytological abnormalities in adult women in Central Brazil: A cross-sectional study

Introduction: Bacterial vaginosis is the most common cause of vaginal discharge and occurs when there is an imbalance in the vaginal microbiota, predominantly composed of Lactobacillus spp. Human Papillomavirus is the most common sexually transmitted virus in the world. Persistent infection with high-risk Human Papillomavirus genotypes is the main cause of the development of cervical intraepithelial neoplasia and cervical cancer. Objective: To investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection and between bacterial vaginosis and cervical cytological abnormalities in adult women. Methods: Cross-sectional study carried out in a gynecology outpatient clinic of the public health network. A total of 202 women were included in the study and underwent gynecological examination with cervical specimen collection. Cervical cytopathological examinations and bacterioscopy by the Nugent method were performed to identify bacterial vaginosis, and PCR and reverse hybridization were carried out for Human Papillomavirus detection and genotyping. Bivariate analysis was performed to investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection, and between bacterial vaginosis and cervical cytological abnormalities. The odds ratio was calculated, with the respective 95% confidence intervals (95%CI) and 5% significance level (p≤0.05). Results: The prevalence of bacterial vaginosis was 33.2% (67/202), the prevalence of cervical Human Papillomavirus infection was 38.6% (78/202) and the prevalence of cervical cytological abnormalities was 6.0% (12/202). Bivariate analysis showed no significant association between bacterial vaginosis and cervical Human Papillomavirus infection (OR 0.69; 95% CI 0.37–1.27; p=0.23), or between bacterial vaginosis and cervical cytological abnormalities (OR 0.65; 95%CI 0.17–2.50; p=0.54). Conclusion: In this study, bacterial vaginosis did not represent a risk factor for cervical Human Papillomavirus infection or for the presence of cervical cytological abnormalities in the investigated adult women.

Best practice for the treatment of descending mediastinitis: A review of review articles and studies looking at cause, diagnosis, treatment and outcomes of head and neck descending necrotizing mediastinitis

Introduction: Descending necrotizing mediastinitis (DNM) is a rare but serious infection. The aim of this review is to highlight the common pathogens and risk factors associated with DNM as well as depicting both the medical and surgical treatments. Methods: A literature search of the Cochrane libraries and PubMed libraries for articles published between January 2000 and December 2020 reporting on DNM were reviewed. The key words used: descending necrotizing mediastinitis, odontogenic infection, cervical infection. 3 surgeons evaluated 40 abstracts. Only literature reviews and studies were included. Results: The total number of papers included were 14, 8 articles were reviews of the literature and 6 articles were original studies. Patient outcomes are better the earlier that the condition is diagnosed and treated. CT neck and thorax was the best imaging modality. Odontogenic with streptococcal species is most common cause and the most effective antibiotic sensitivity is a third-generation cephalosporin or clindamycin combined with metronidazole. An alternative is a penicillin with metronidazole. Prompt surgical management is required to effectively debride necrotic tissue. Airway management is an important consideration. Hyperbaric oxygen can be an useful adjunct to treatment. Conclusions: Early treatment of descending mediastinits is imperative for best outcome. Imaging of choice is a CT neck and thorax. Early broad-spectrum antibiotics and surgical intervention is key. Introduction: Descending necrotizing mediastinitis (DNM) is a rare but serious infection. The aim of this review is to highlight the common pathogens and risk factors associated with DNM as well as depicting both the medical and surgical treatments. Methods: A literature search of the Cochrane libraries and PubMed libraries for articles published between January 2000 and December 2020 reporting on DNM were reviewed. The key words used: descending necrotizing mediastinitis, odontogenic infection, cervical infection. 3 surgeons evaluated 40 abstracts. Only literature reviews and studies were included. Results: The total number of papers included were 14, 8 articles were reviews of the literature and 6 articles were original studies. Patient outcomes are better the earlier that the condition is diagnosed and treated. CT neck and thorax was the best imaging modality. Odontogenic with streptococcal species is most common cause and the most effective antibiotic sensitivity is a third-generation cephalosporin or clindamycin combined with metronidazole. An alternative is a penicillin with metronidazole. Prompt surgical management is required to effectively debride necrotic tissue. Airway management is an important consideration. Hyperbaric oxygen can be an useful adjunct to treatment. Conclusions: Early treatment of descending mediastinits is imperative for best outcome. Imaging of choice is a CT neck and thorax. Early broad-spectrum antibiotics and surgical intervention is key.

Ex Vivo HIV Infection Model of Cervico-Vaginal and Rectal Tissue.

Globally, the most frequent route of HIV transmission is through sexual intercourse. In women, sexual transmission of HIV involves cervical, vaginal, endometrial, and rectal mucosal exposure to the virus. Here we describe technical protocols for ex vivo cervical, vaginal, and rectal tissue infection models and cultures that can be used to assess tissue susceptibility to infection under different conditions as well as the potential antiviral efficacy of a treatment for HIV prevention or cure.

The Prevalence of Cervical HPV Infection and Genotype Distribution in 856,535 Chinese Women with Normal and Abnormal Cervical Lesions: A Systemic Review.

Cervical cancer is the commonest cancer affecting women worldwide. During the last decades, the incidence and mortality rates of cervical cancer have increased in China. This research aims to assess the overall and genotype-specific prevalence of the human papillomavirus (HPV) infection among Chinese women with normal cervix, considering age, and geographic location. We selected studies about HPV prevalence in women from Chinese in Mainland China with normal cervix and abnormal cervical lesions, published between January 1995 and December 2020. The HPV prevalence was analyzed using meta-analysis based on the following: cytological and histological diagnoses, regions, and ages. The overall HPV prevalence in 856,535 women was 14.3%, 95% confidence interval (CI) and it increased from 8.2% to 16.5% in studies published from 2006 to 2020. The prevalence of high-risk (HR) and low-risk (LR) HPV types was 11.3% and 2.7%, respectively. The commonest types of HPV in women from Mainland China were HPV 16 (2.6%), 52 (2.4%), 58 (1.7%), 18 (0.9%), and 33 (0.8%). According to the geographical analysis, the prevalence of different HPV genotypes varied by region, Central China had the highest overall HPV prevalence. HPV16 was the commonest type in all the regions except in South China and East China, where HPV52 was found to be common. Regarding diagnosis, the HPV infection led to cervical cancer diagnosis by cytology and histology with 90.1% and 91.5% rates, respectively. HPV16 and HPV18 were common types associated with cervical cancer diagnosed by cytology and histology. HPV 16, 58, 52, 18, and 33 were the commonest types found in women with normal cervixes from Mainland China. The prevalence of different HPV genotypes varied by age group and region.

Prevalence of high-risk human papilloma virus infection and cervical cytological abnormalities in female Turkish patients with rheumatologic disease

Background/Aim: It is believed that patients with rheumatological diseases (RDs) are more prone to infectious diseases, possibly due to both disease-related immune dysfunction and chronic inflammation, and immunosuppressive agents used in the treatment of rheumatological diseases. In this context, we aimed to evaluate the prevalence of high-risk human papillomavirus (Hr-HPV) infection and cervical cytological abnormalities in Turkish female patients with RDs and compare them with healthy controls (HCs). Methods: 362 sexually active patients with RDs followed up between January 2014 and June 2021 were included in this cross-sectional study. Patients with RDs were classified as autoimmune and non-autoimmune groups according to seropositivity. Data of 883 age-matched HCs were used for comparison. Demographic features, cervical cytology reports of the patients and HPV test results were retrieved from hospital database. Cervical cytological abnormalities was categorized according to Bethesda 2014. Cobas assay was used for detecting and typing for Hr-HPV. Results: The RDs group and the HCs group were similar in terms of mean age, BMI, and rate of smokers (P>0.05). Cytological evaluation was carried out in all of 362 patients with RDs (161 autoimmune and 201 non-autoimmune) and in all of 883 HCs. HPV test was applied in 286 patients with RDs and 776 of HCs. 16 (4.4%) patients with RDs and 58 (6.6%) HCs had cervical cytological abnormality. Of the patients who underwent HPV testing; 22 (7.7%) patients with RDs and 75 (9.7%) HCs had Hr-HPV. The prevalence of cervical cytologic abnormalities and Hr-HPV infection rate were similar between patient groups and HCs (P=0.186 and P=0.400, respectively). Conclusion: It was determined that chronic systemic inflammation, which plays a role in the pathogenesis of rheumatological diseases, and immunosuppressive agents used in the treatment did not increase the prevalence of Hr-HPV infection and cervical cytological abnormalities.

Cytokine gene polymorphisms of TNF, IFN-γ, and IL-12 as potential predictors in the onset of cervical disease in HR HPV-positive women with behavioral risk cofactors

Introduction/Objective. The aim of this study was to investigate the distribution of genotypes and alleles of proinflammatory cytokines TNF, IFN-?, and IL-12 and their effect on the development of a cervical illness and also to determine their associated influence with cofactors in HR HPV-positive women in Serbia. Methods. We have investigated 24 women and based on the cytological findings they were classified into four groups: PAP II, ASCUS, LSIL, and HSIL. Analysis of TNF, IL-12, and IFN-? polymorphisms was performed using the real-time PCR TaqMan method. Statistical analysis was performed using parametric and non-parametric tests and correlation and multiple regression analysis. Results. Significantly higher frequency of high production-related TNF AA genotype was observed in severe dysplasia. The correlation between TNF gene polymorphism and cervical findings were highly significant. There was a moderate, significant correlation between low production IFN-? AA genotype and earlier cervical infections. There was a significant correlation between the IL-12 polymorphism of the low production IL-12 AA genotype and cervical lesions. Conclusion. Results of this study show that HSIL is associated with significantly higher frequency of high production TNF AA genotype. It is known that polymorphisms of certain cytokine genes encoding proteins involved in Th1 and Th2 cellular responses may be associated with better or worse prognosis of cervical disease in women with persistent HR HPV infection. Therefore, they may be considered as biomarkers that may have a predictive role in the development of cervical cancer.

The current state of the problem of pathogenesis and pharmacotherapy of varicose disease in obstetrics

The article provides an overview of modern Ukrainian and foreign publications on the etiopathogenesis and pharmacotherapy of varicose disease (VD) during pregnancy. The issues of the prevalence of VD in pregnant women, the peculiarities of the venous system in the physiological and pathological course of pregnancy, modern views on the mechanisms of venous hemodynamic disturbance and its influence on the state of the fetoplacental complex are considered. Attention is paid to the local activation of the hemostasis system in case of damage to the endothelium in the presence of venous hypertension under the influence of activated neutrophilic granulocytes and monocytes. The analysis of extragenital pathology in pregnant women with VD was carried out. The role of connective tissue dysplasia in the genesis of VD and the necessity for timely diagnosis and prevention of complications of pregnancy and the development of placental disorders in women with VD, and for the determination of the endothelial dysfunction markers were established. The emphasis is made on the role of the state of the reproductive system and chronic foci of vaginal and cervical infection in the progression of VD and obstetric complications, which is explained by the development of oxidative stress and tissue hypoxia and deterioration of preimplantation conditions and a promising scenario for gestation. The modern classification of VD by morphological changes in the venous bed and the consequences of phlebohemodynamic disorders and the clinical class of lower extremity vein disease used in obstetric practice are presented. The main directions of diagnostics and conservative treatment of pregnant women with VD in Ukraine (compression therapy, systemic pharmacotherapy and local topical therapy) according to the international standards are presented. The attention is paid to the special effect of diosmin on the reduction of the symptoms of VD and endothelial dysfunction in the presence of immune-inflammatory damage of the endothelium and vein walls on the background of oxidative stress. This effect is confirmed by the improvement in the state of the intrauterine fetus and perinatal outcomes in pregnant women with placental disorders.

Colposcopic features of cervical oncotropic papilloma-virus infection in patients with various pathology of uterine cervix

In order to estimate the colposcopic manifestations of cervical oncotropic human papilloma-virus (HPV)-infection, a total of 693 patients were examimed. Among them, there were 298 patients with benign tumors pathology, 57 patients with 1-3 Grade cervical dysplasia of mucosa, 50 patients with uterine cervix cancer, 288 healthy women.&#x0D; All patients underwent bimanual examination, taking of cervical smears for cytological examination and uterine cervix colposcopy. Diagnosis for HPV16/18 infection was made by the method of polimerase chain reaction.&#x0D; А large variety in colposcopic manifestations of HPV-infection was found, namely: areas of atypical vessels, leukoplakia sites,fields of atypical epithelium, iodine-negative sites. It was related to the influence of oncogenic types of HPV infection. In these patients,fields of atypical epithelium, atypical vessels, iodinenegative areas were observed 1.2, 2.5, 10.5 times more frequently, respectively.&#x0D; It was found that all varieties of papillomas occurred among patients with pathology, whereas flat condylomas presenting the most difficulties of or diagnosis prevailed in patients with cervical neoplasms and uterine cervix cancer The most pronounced colposcopic evidences of uterine cervix epithelium malignancy were observed in patients with virus-positive uterine cervix cancer.

Efek Kefir Terhadap Kadar Superokdidase Dismutase, Malondialdehyde Pada Mencit Balb/C Diinduksi Streptococcus Agalactiae

Streptococcus agalactiae are pathogenic bacteria which cause vaginal infection. Vaginal and cervical infections in pregnant women can reduce elasticity of the membranes that cause premature rupture of membranes. This can also impact to neonatal morbidity and mortality in first week of birth. Kefir is known as a probiotic that can act as an immunomodulator. The role of kefir is believed to improve the immune system. The role of kefir in preventing infection is still rarely studied, especially as an immunomodulator and in reducing the number of pathogenic bacteria.This study aimed to evaluate superoxide dismutase (SOD) level, Malondialdehyde (MDA) level, and the population of the colonization Streptococcus agalactiae in BALB-C mice fed kefir. This study was true experimental with post test only control group design. Sample was BALB-C mice induced by Streptococcus agalactiae. SOD and MDA level was examined by enzyme-linked immunosorbent assay (ELISA) and Streptococcus agalactiae identification by colony count. The results of the one-way ANOVA analysis showed there was no significant differences between all groups for SOD levels (P 0.393). In the level of MDA there was also no difference between all groups (P 0.204). Whereas in the number of Streptococcus agalactiae colonies there was a significant difference (P 0.000) with the smallest number of colonies found at dose of 0.5 ml / day. Conclusion: kefir as a probiotic drink did not affect to the SOD and MDA level of BALB/ C mice induced by Streptococcus agalactiae, but kefir affected to number of Streptococcus agalactiae colonies. Further research needs to show the relation of kefir as probiotics with proinflammatory and other anti-inflammatory parameters such as interleukin and immunological vaginal mucosa.

A Data Analytics Approach for Revealing Influencing Factors of HPV-Related Cancers From Population-Level Statistics Data

Human papillomavirus (HPV) is considered as one of the major causes of multiple cancers, including cervical, anal, and vaginal cancers. Some studies analyzed the infection patterns of cancers caused by HPV using individual clinical test data, which is resource and time expensive. In order to facilitate the understanding of cancers caused by HPV, we propose to use data analytics methods to reveal the influencing factors from the population-level statistics data, which is available more easily. Particularly, we demonstrate the effectiveness of data analytics approach by introducing a predictive analytics method in studying the risk factors of cervix cancer in the United States. Besides accurate prediction of the number of infections, the predictive analytics method discovers the population statistic factors that most affect the cervical cancer infection pattern. Furthermore, we discuss the potential directions in developing more advanced data analytics approaches in studying cancers caused by HPV.

Characteristics of the Cervicovaginal Microenvironment in Childbearing-Age Women with Different Degrees of Cervical Lesions and HR-HPV Positivity.

Persistent infection with high-risk human papillomavirus (HR-HPV) is the most important determinate in the development of cervical cancer, and cervical microecology can modulate cervical viral infection. However, few studies have been conducted on the microecological analysis of cervical diseases using strict physiological factors. This study investigated the characteristics and dynamics of cervical microecology in childbearing-age Chinese women with different degrees of HR-HPV-positive cervical lesions. A total of 168 subjects were selected according to the selection criteria, including healthy HPV-negative individuals (n = 29), HR-HPV-infected individuals (n = 29), low-grade squamous intraepithelial lesion individuals (LSIL, n = 32), high-grade squamous intraepithelial lesion individuals (HSIL, n = 40), and cervical cancer individuals (n = 38). We sampled cervical secretions from each subject and performed comparative analysis using the 16S rRNA sequencing method. Comparison analysis showed that Lactobacillus and Ignatzschineria were the dominant genera in the healthy group, while Gardnerella and Prevotella were more enriched in the disease groups. Based on the taxa composition, we roughly divided the development of cervical cancer into two phases: phase I was from healthy status to HR-HPV infection and LSIL; phase II was from LSIL to HSIL and cervical cancer. Different interactions among different genera were observed in different groups. Prevotella inhibited the abundance of Lactobacillus in the healthy group, while Prevotella inhabited the abundance of Gardnerella in the other groups. In the HR-HPV infection group, Ignatzschineria and Enterococcus showed a positive interaction but dissociated with the increase in cervical lesions, which might eventually lead to a continuous decrease in the abundances of Lactobacillus and Ignatzschineria.

Genotyping of Escherichia coli Causing Vaginal Infection in Dysplastic Patients with Similar Genetic Backgrounds Between Commensal and Virulent Strains

Background: Escherichia coli in the vagina includes several virulence factors in its genome mobile genetic elements and can facilitate colonization, mainly in immunosuppressed patients. Objectives: This work aimed to demonstrate that E. coli strains of vaginal origin isolated from dysplastic patients possess virulence and resistance genes Methods: This study included one hundred and five E. coli strains isolated from women with cervical dysplasia and vaginal infection. The strains were characterized by antimicrobial susceptibility. The Clermont algorithm performed the phylogenetic assignment. The structure of class 1 integrons was performed by identifying integrase (int1), the variable region, and qacEΔ1-sul1 genes. The variable region was amplified, sequenced, and analyzed. Enterobacterial repetitive intergenic consensus (ERIC) PCR and virus typing typed strains with identical genetic arrangements by detecting virulence genes related to cytotoxicity, adherence, and iron uptake. Results: Escherichia coli strains showed great resistance to β-lactams and quinolones, and phylogenetic assignment showed that the group A/C was highly predominant. Sixteen integrons were identified, with monogenic arrays represented by aadA1, dfrB4dfrA7, dfr2D, and dfrA17 cassettes. The prevalence of the biogenic arrays aadA1/dfrA1 and aadA5/dfrA17 was lower than that of blaOXA-1/aadA1. Concerning virulence genes, fimH, traT, and iutA were the most predominant. Conclusions: The high incidence of virulence and resistance factors in commensal and virulent strains of E. coli revealed potential tools in the pathogenesis of vaginal infection.

Analysis of genetic variation in human papillomavirus type 16 E1 and E2 in women with cervical infection in Xinjiang, China

BackgroundXinjiang is one of the regions with a high incidence of cervical cancer, and the genetic variation of human papillomavirus may increase its ability to infect the human body and enhance virus-mediated immune escape ability.MethodsSanger sequencing of the HPV16 genome from 165 samples positive for HPV16 infection and phylogenetic analysis of the E1 and E2 genes revealed the gene polymorphism of HPV16 in Xinjiang.ResultsThe results showed that there were 109 samples with variations in HPV16 E1, 48 sites with nucleotide variations (19 missense variations and 29 synonymous variations), and 91 samples with variations in HPV16 E2, 25 sites with nucleotide variations (20 missense variations and five synonymous variations).ConclusionsFrom the phylogenetic tree results, 149 samples were of the European variant and 16 samples were of the Asian variant. No African or North American/Asian variant types were found.

Incremental risk of clinical chorioamnionitis associated with cervical examination

Clinical chorioamnionitis is associated with significant maternal and neonatal morbidity, yet there is no clear evidence on the association between cervical examinations and infection. We sought to assess the association between the number of cervical examinations performed during term labor management and the risk of clinical chorioamnionitis. This is a retrospective cohort study of term (≥37 weeks of gestation), singleton pregnancies who labored at our tertiary care center from 2014 to 2018. The primary outcome of clinical chorioamnionitis was defined as maternal intrapartum fever (single oral temperature of >39°C or 38°C-38.9°C for 30 minutes) and 1 or more of the following: maternal leukocytosis, purulent cervical drainage, or fetal tachycardia. The primary exposure was the number of digital cervical exams documented in the medical record. Log-binomial regression was used to model the effect of cervical examinations on the risk of clinical chorioamnionitis while adjusting for potential confounders. A total of 20,029 individuals met the inclusion criteria and 1028 (5%) patients experienced clinical chorioamnionitis. The number of cervical exams was associated with increased risk of developing infection after adjusting for potential confounders. Individuals with ≥8 cervical exams had 1.7 times the risk of developing clinical chorioamnionitis compared with those with 1 to 3 exams. Prolonged rupture time, nulliparity, Black race, Medicaid insurance, higher gestational age, and higher body mass index were associated with increased risk of clinical chorioamnionitis, whereas smoking and group B Streptococcus colonization were associated with a lower risk. Our study found that the number of cervical exams performed during labor is an independent risk factor for developing clinical chorioamnionitis. Unnecessary cervical exams should be avoided during labor management at term.