Common Vaginal Infection Research Articles

Secnidazole for treatment of bacterial vaginosis: a systematic review

BackgroundBacterial vaginosis (BV) is one of the common vaginal infections among childbearing women. The usual treatment for BV is metronidazole; hence 30% of women have recurrence within 60 to 90 days after treatment. There are some studies which assessed the effect of secnidazole on BV. The aim of this systematic review was to investigate the effectiveness of secnidazole for treatment of BV.MethodsThe Cochrane Library, MEDLINE (PubMed), Scopus, and Web of Science (all databases from inception till October 28, 2018) were searched. Primary outcomes were clinical cure rate and microbiologic cure rate and the secondary outcomes were adverse events. Data was extracted from eligible studies by two review authors individually and analyzed by RevMan 5.3.ResultsOur search found six trials involving 1528 participants. Treatment with 2 g secnidazole could significantly reduce the risk of BV in patients with three or less episodes of BV in the last year by OR: 7.54 (95% CI, 3.89–14.60, p < 0.00001) and in patients with four or more episodes of BV in the last year (OR: 4.74, 95% CI: 1.51–14.84, p = 0.0.008). Secnidazole (2 g) could significantly increase the microbiologic cure rate in women with 3 or less episodes of BV in the last year (OR: 7.63, 95% CI: 2.30–25.33, p = 0.0009) but not in the women with 4 or more episodes of BV in the last year (OR: 20.17, 95% CI: 1.06–382.45, p = 0.05). The clinical cure rate, microbiological effect and the therapeutic cure rate of 2 g secnidazole was significantly more than that of 1 g secnidazole.The results showed that the clinical cure rate of 2 g secnidazole was not different from the following medications: metronidazole (500 mg bid for 5 days), secnidazole plus vaginal metronidazole, 2 g single dose of oral metronidazole and 2 g secnidazole plus vaginal ornidazole.ConclusionThis review showed that 2 g and 1 g secnidazole were better than placebo, however, 2 g secnidazole was more effective than 1 g. Secnidazole 2 g was not different from metronidazole (500 mg bid for 5 days), or from secnidazole plus vaginal metronidazole, or 2 g single dose of oral metronidazole or from 2 g secnidazole plus vaginal ornidazole.

Modern opportunities for the diagnosis and treatment of vulvovaginal candidiasis (in aid of a practitioner)

Vulvovaginal candidiasis (VVC) is one of the most common vaginal infections, representing 40% to 50% of all cases of infectious vulvovaginitis. Between 70-75% of sexually active women experience at least one episode of VVC in their lifetime, and 8-10% of adult women have recurrent VVC. The treatment of VVC remains as one of the most pressing challenges of gynecology. The share of recurrent disease event rates remains high, despite the modern medicines used to treat various forms of VVC.

Perception about Bacterial Vaginosis: A Common Vaginal Infection

Bacterial vaginosis (BV) is a type of vaginal inflammation caused by natural overgrown bacteria in the vagina that disturbs the natural balance. Healthy bacteria (lactobacilli) typically outweigh poor bacteria (anaerobes). But if too many anaerobic bacteria are present, they upset the vagina’s microorganism natural balance and trigger bacterial vaginosis. Bacterial vaginosis is usually associated with women of reproductive age.

Perception about bacterial vaginosis: a common vaginal infection

The objective of the study was the perception of Bacterial vaginosis amongst female residents of Lagos State Nigeria Bacterial vaginosis is the most common vaginal infection found in women of reproductive age caused by an imbalance in the natural vaginal flora women participated in the study of which women representing of the participants have experienced Bacterial vaginosis at some point women had symptoms ranging from smelly vagina discharge after sexual intercourse to grey or whitish vaginal discharge The women identified vaginal douching as the major risk factor of Bacteria vaginosis of the participants responded to have treated Bacterial vaginosis using Metronidazole Flagyl

High Global Burden and Costs of Bacterial Vaginosis: A Systematic Review and Meta-Analysis.

Bacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age and is associated with important adverse health outcomes. Estimates of the burden of BV and associated costs are needed to inform research priorities. We conducted a systematic review and meta-analysis of global BV prevalence among reproductive-aged women in the general population. We searched PubMed and Embase and used random effects models to estimate BV prevalence by global regions. We estimated the direct medical costs of treating symptomatic BV. Assuming a causal relationship, we also estimated the potential costs of BV-associated preterm births and human immunodeficiency virus cases in the United States. General population prevalence of BV is high globally, ranging from 23% to 29% across regions (Europe and Central Asia, 23%; East Asia and Pacific, 24%; Latin America and Caribbean, 24%; Middle East and North Africa, 25%; sub-Saharan Africa, 25%; North America, 27%; South Asia, 29%). Within North America, black and Hispanic women have significantly higher (33% and 31%, respectively) prevalence compared with other racial groups (white, 23%; Asian, 11%; P < 0.01). The estimated annual global economic burden of treating symptomatic BV is US $4.8 (95% confidence interval, $3.7-$6.1) billion. The US economic burden of BV is nearly tripled when including costs of BV-associated preterm births and human immunodeficiency virus cases. The BV prevalence is high globally, with a concomitant high economic burden and marked racial disparities in prevalence. Research to determine the etiology of BV and corresponding prevention and sustainable treatment strategies are urgently needed to reduce the burden of BV among women. Additionally, the exceptionally high cost of BV-associated sequelae highlights the need for research to understand potential causal linkages between BV and adverse health outcomes.

Education Intervention Guideline on Knowledge and Self-Care Practice for Women With Vulvovaginities

Background Bacterial vaginosis (BV) is the most common vaginal infection affecting women of reproductive age (15-49 years of age). 5-8% of women with acute infection experience recurrent vulvo-vaginal candidiasis. Side effects of vaginitis can affect other aspects of health, which could be prevented by promoting a healthy related to vaginal health. Aim of the study. The aim of the present study was to evaluate the Education intervention guideline on knowledge and self-care practice for women with vulvovaginities. Design: A quasi- experimental design was adopted in the current study. Sample: A purposive sample of (130) women's were included in the current study. Setting: the current study was conducted at outpatient clinic affiliated at obstetric department at Benha University Hospital. Data collection: Two tools were used for data collection, first, interviewing questionnaire to collect data about the women' socio demographic characteristics and women's knowledge regarding vulvovaginities as definition, risk factors, complication, second tool, Self-Care Assessment Structured Interviewing Schedule as (Clean genital area after each toilet, dry after cleanliness) Results: the result of the present study should that the total knowledge was improved from (9.2%) at pre intervention to (86.2%) at post intervention phase. In addition there was demonstrates that, 87.7% of the women had an unsatisfactory level of self-care practices before the educational intervention. Meanwhile, after the educational intervention, 75.4% of them got a satisfactory level of self-care practices. Conclusion: Educational intervention was effective in improving the women's knowledge and self-care practices regarding vulvovaginities. Recommendations: Provide different educational programs regarding knowledge and self-care practice for women with vulvovaginities at different female health care settings.

Prevalence and Risk Factors of Lower Reproductive Tract Infections in Symptomatic Women in Dakar, Senegal.

Background:Lower reproductive tract infections in women are important causes of morbidity but can also lead to complications and sequelae. This study aimed to establish the prevalence and risk factors of lower genital tract infections among women of reproductive age in Dakar (Senegal).Methods:This was a prospective study conducted in 6 maternity hospitals from July to November 2015. Participants ranged in age from 18 to 49 years and presented at health facilities with signs and symptoms of genital infection. Consenting individuals who met the inclusion criteria were recruited for the study.Results:During the reporting period, 276 patients were enrolled. According to the laboratory results, the prevalence of any genital infection was 69.6% (192 of 276). The most common vaginal infections were bacterial vaginosis (39.5%) and vaginal candidiasis (29%), with the third most common cause, trichomoniasis, trailing behind in terms of prevalence (2.5%). Among the microorganisms responsible for cervical infections, Ureaplasma urealyticum was the most frequent (27.5%), followed by Mycoplasma hominis (14.5%), Chlamydia trachomatis (4.7%), and Neisseria gonorrhoeae (1.1%). Multivariate analysis showed that young women and women with low levels of education were at increased risk for vaginal/cervical infections.Conclusions:This study revealed a high prevalence of bacterial vaginosis and vaginal candidiasis and suggests that health care providers should increase awareness and communication to improve vaginal hygiene practices. If infection with Trichomonas vaginalis, C trachomatis or N gonorrhoeae is suspected, we also recommend systematically performing laboratory diagnostic confirmation.

Comparison of the Effects of Artemisia Vaginal Cream and Clotrimazole on Vaginal Candidiasis Infection

Abstract Candida vaginitis is the second most common vaginal infection which is treatable by azole. Overconsumption of azole is associated with resistance to drug and treatment failure. Studies conducted in laboratory conditions confirm the anti-fungal effects of Artemisia plant. The aim of this study was to compare the effect of vaginal Artemisia cream and clotrimazole on vaginal candidiasis infection. This is a clinical triple-blind trial that was performed on 72 non-pregnant women referred to Mashhad health centers in 2012-2017. After confirmation of Candida infection, the research units were randomly allocated into two groups: Artemisia and clotrimazole vaginal cream recipients treated for 7 nights. After the treatment, the data were analyzed by SPSS software (version 24). The results of the study showed that the mean reduction in the score of signs and symptoms of vaginal Candida infection was 7.4 ± 4. 1 and 7.6 ± 3.8 in the Artemisia and clotrimazole group, respectively. Wilcoxon test showed that improvement in both groups treated by Artemisia and clotrimazole was significantly higher than before treatment (p &lt; 0.001). There was no significant difference between the two groups regarding the improvement of symptoms (p &gt; 0.05). Acta facultatis medicae Naissensis 2018; 35(4):299-310 The present study showed that Artemisia vaginal cream and clotrimazole cream both improved the symptoms related to vaginal Candida infection. In addition, the therapeutic effect of the two drugs was not statistically significant in comparison with each other. Therefore, it can be used as an alternative treatment for vaginal candidiasis.

Vaginal microbiome variances in sample groups categorized by clinical criteria of bacterial vaginosis

BackgroundOne of the most common and recurrent vaginal infections is bacterial vaginosis (BV). The diagnosis is based on changes to the “normal” vaginal microbiome; however, the normal microbiome appears to differ according to reproductive status and ethnicity, and even among individuals within these groups. The Amsel criteria and Nugent score test are widely used for diagnosing BV; however, these tests are based on different criteria, and so may indicate distinct changes in the vaginal microbial community. Nevertheless, few studies have compared the results of these test against metagenomics analysis.MethodsVaginal flora samples from 77 participants were classified according to the Amsel criteria and Nugent score test. The microbiota composition was analyzed using 16S ribosome RNA gene amplicon sequencing. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and function.ResultsOnly 3 % of the participants diagnosed BV negative using the Amsel criteria (A−) were BV-positive according to the Nugent score test (N+), while over half of the BV-positive patients using the Amsel criteria (A+) were BV-negative according to the Nugent score test (N−). Thirteen genera showed significant differences in distribution among BV status defined by BV tests (e.g., A − N−, A + N− and A + N+). Variations in the four most abundant taxa, Lactobacillus, Gardnerella, Prevotella, and Escherichia, were responsible for most of this dissimilarity. Furthermore, vaginal microbial diversity differed significantly among the three groups classified by the Nugent score test (N−, N+, and intermediate flora), but not between the Amsel criteria groups. Numerous predictive microbial functions, such as bacterial chemotaxis and bacterial invasion of epithelial cells, differed significantly among multiple BV test, but not between the A− and A+ groups.ConclusionsMetagenomics analysis can greatly expand our current understanding of vaginal microbial diversity in health and disease. Metagenomics profiling may also provide more reliable diagnostic criteria for BV testing.

Emergence of Resistance to Fluconazole in Candida albicans Isolated From Vaginal Discharge

To provide information about the emergence of fluconazole resistance in Candida albicans isolated from vaginal discharge, in a global context, and to update the in vitro susceptibility profile of this species from Argentina. Vulvovaginal candidiasis is the second most common vaginal infection after vaginal bacteriosis. C. albicans remains the prevalent etiological yeast species, and despite antifungal treatment, the rate of recurrence remains high, which may be associated to antifungal resistance. Data here presented were obtained from the study of C. albicans strains isolated from patients with clinical signs of vulvovaginal candidiasis from 1996 to 2017. Data obtained could represent the susceptibility profile of C. albicans strains circulating in Argentina and could be of potential usefulness to monitor and guide therapy, and also suggests the need for greater surveillance programs to detect fluconazole resistance over time.

Experimental in Vivo Models of Candidiasis.

Candidiasis is a multifaceted fungal disease including mucosal-cutaneous, visceral, and disseminated infections caused by yeast species of the genus Candida. Candida infections are among the most common human mycoses. Candida species are the third to fourth most common isolates from bloodstream infections in neutropenic or immunocompromised hospitalized patients. The mucosal-cutaneous forms—particularly vaginal infections—have a high prevalence. Vaginitis caused by Candida species is the second most common vaginal infection. Hence, candidiasis is a major subject for research, including experimental in vivo models to study pathogenesis, prevention, or therapy of the disease. The following review article will focus on various experimental in vivo models in different laboratory animals, such as mammals (mice, rats, rabbits), the fruit fly–Drosophila melanogaster, the larvae of the moth Galleria mellonella, or the free-living nematode Caenorhabditis elegans. The review will describe the induction of the different clinical forms of candidiasis in the various models and the validity of such models in mimicking the human clinical situations. The use of such models for the assessment of antifungal drugs, evaluation of potential vaccines to protect before candidiasis, exploration of Candida virulence factors, and comparison of pathogenicity of different Candida species will be included in the review. All of the above will be reported as based on published studies of numerous investigators as well as on the research of the author and his group.

Speciation and antifungal susceptibility profiles of Candida isolates from vaginitis patients attending STD Clinic at a Tertiary Care Hospital

Back ground: Candidiasis is the most common vaginal infection affecting approximately 50–72% of women. Rapid identification of yeast isolates to species level is essential to optimize antifungal treatment. Aim: To determine the prevalence of various Candida species among vaginal candidiasis and to determine the antifungal susceptibility pattern of the isolates. Materials and Methods: A total of 471 women who were clinically diagnosed to have vaginal candidiasis were included in the study. Out of 471 vaginitis patients, 91 were positive for Candida species. All the isolates were speciated comprising five species – C. albicans 42 (46.1%), C. krusei 5 (5.5%), C. glabrata 40 (43.9%), C. tropicalis 3 (3.3%), and C. gullermondi 1 (1.1%). Antifungal susceptibility testing result of all Candida isolates are 100% susceptible to amphotericin B, nystatin, flucytosine, econazole, ketoconazole, miconazole, fluconazole. C. krusei isolates are showing 100% resistance to fluconazole. Discussion: In the present study, C. albicans is most common species 46.1% followed by C. glabarata. C. albicans adhere to vaginal, epithelial cells in significantly higher number than other Candida species. This could explain relative higher frequency of C. albicans in vaginal candidiasis. Conclusion: Presumptive identification followed by confirmation of Candida species helps to initiate early appropriate antifungal treatment, thereby reducing the morbidity and mortality.

Bacterial vaginosis: A practical review.

Bacterial vaginosis is a common vaginal infection that causes discharge, odor, and irritation. It can predispose women to sexually transmitted infections (STIs) including HIV. Recurrent bacterial vaginosis may require prolonged treatment to return the vaginal flora to a normal predominately lactobacilli-dominated environment.

Herbal Medicine and Vaginal Candidiasis in Iran: A Review

Candidiasis is the second most common vaginal infection. Given the frequent recurrence of the disease, many women tend to use herbal remedies. Thus, the present study aimed to review the association between vaginal candidiasis and herbal medicines in Iran. In this review, we retrieved articles published from 2001 to 2016. Then, the results were expressed both quantitatively and qualitatively. In this study, nine articles were reviewed, which had investigated thyme, garlic, garlic-thyme, olive oil, propolis, myrtus, Nigella sativa (black cumin), and Bunium perscicum boiss (black zira). Subsequently, each of these plants was thoroughly dealt with. The studies on black cumin, garlic, and thyme reported positive effects for these herbs, and they were widely produced for therapeutic purposes. In addition, myrtus was found to have a salutary impact on vaginal candidiasis.

Correlation between cervical cancer and vaginal microbes

Cervical cancer is a serious disease endangering the health of women, which is next only to breast cancer and colon cancer. There are nearly 130 000 new cases of cervical cancer arise in China each year, accounting for 1/5 of the total number of new cases in the world. Epidemiological survey has found that cervical cancer is related to various factors, such as human papilloma virus infection, multiple sexual partners, smoking, premature sexual life, sexually transmitted diseases, economic status and immunosuppression. Cervical cancer is pathologically characterized by cervical dysplasia cervical atypical hyperplasia (mild, moderate, severe) to carcinoma in situ and to infiltrating carcinoma. Female vagina is a relatively anoxic and unique dynamic micro ecological system colonized with a large number of bacteria. And the vaginal microflora is the kernel of maintaining vaginal micro ecological balance. The uterine cervix is directly exposed to the vagina, and is closely related to vaginal microbes. However, there are few reports on the direct relationship between cervical cancer and vaginal microbes. In this review, the roles and significance of vaginal microbial imbalance and common vaginal infections in cervical cancer will be discussed from different angles. Key words: Cervical cancer; Vaginal microbe; Human papilloma virus; Vaginal infection

IL-23, IFN-α, and IFN-β in the vaginal fluid of patients suffering from vulvovaginal candidosis

The study included 202 non-pregnant women; 71 patients with clinical symptoms of VVC and 131 asymptomatic patients served as control. IL-23, IFN-α, and IFN-β were measured in the vaginal fluid by ELISA. Microbiological cultures were used for Candida detection. C. albicans was detected in 67.6% of patients, C. glabrata in 2 1.1% of patients, and 5.6% were infected with C. krusei or coinfected with C. albicans and C. krusei. Levels of IL-23 (p < 0.001) and IFN-β (p < 0.017) were significantly lower in the VVC group. IFN-α was elevated in the VVC group compared to the asymptomatic patients (p < 0.001). IL-23 and IEFN-β seem to play a protective role against VVC. Decreased levels in VVC patients suggest a compromised local immune response at the time of occurrence of symptoms. In contrast, IFN-α seems to be released once the infection has occurred. These cytokines may be prospective targets in the treatment and prevention of primary and recurrent vaginal infections with Candida species.

The Relationship Between Contraceptive Methods and Common Vaginal Infections

The Relationship Between Contraceptive Methods and Common Vaginal Infections

Prevalence and Associated Factors of Genital and Sexually Transmitted Infections in Married Women of Iran.

This study aimed to determine the prevalence of genital and sexually transmitted infections and its related factors in married women in Iran. We conducted a cross-sectional study of 4 274 married women living in urban and rural areas of the Zanjan province from 2012 to 2013. We used stratified cluster sampling to select the participants. Data collection included demographic characteristics, reproductive status, and cervical cytology results. The prevalence of lower genital infections and sexually transmitted infections were 20.1% and 7.4%, respectively. The most common vaginal infection was bacterial vaginosis with a prevalence of 8.5%, and the most common sexually transmitted infection was Trichomonas vaginalis (1.4%). The use of the intrauterine device (IUD) as a contraceptive, living in an urban area, and experiencing vaginal discharge were significantly related to genital tract and sexually transmitted infections. There was a high prevalence of genital infection among women living in Zanjab. Screening and treatment of genital infection are necessary to prevent adverse consequences in women who use an IUD or live in urban areas.

Lack of a Pharmacokinetic Interaction Between SYM-1219 Granules Containing 2 Grams of Secnidazole and a Combined Oral Contraceptive in a Phase 1, Randomized, Open-Label Study in Healthy Female Volunteers.

Bacterial vaginosis (BV) is a serious infection that is the most common vaginal infection in women of childbearing potential. SYM-1219 is a novel, granule formulation containing 2g of secnidazole that is being developed as a single, oral dose to treat women with BV. Because many of the women diagnosed with BV use hormonal contraception, the effect of SYM-1219 on the pharmacokinetics (PK) of commonly prescribed oral contraceptive drugs, ethinyl estradiol (EE2), and norethindrone (NET) was evaluated. This two-period, randomized, open-label study examined effects in 54healthy female subjects. During the first period of the study, each subject received EE2 0.035-mg/NET 1-mg tablets. During the second period of the study, subjects were randomized to receive either EE2 0.035-mg/NET 1-mg tablets with concomitant 2-g SYM-1219 or 2-g SYM-1219 followed by EE2 0.035-mg/NET 1-mg tablets 1day later. The PK of EE2 and NET were analyzed for 24h following administration. Coadministration of SYM-1219 and EE2/NET, either on the same day or 1day apart, had no clinically relevant effects on the bioavailability of EE2 or NET. The combined use of SYM-1219 with EE2/NET was well tolerated. Taken together, these results indicate that contraceptive efficacy should be maintained during coadministration of SYM-1219 and EE2/NET. SYM-1219 is a valuable single-dose treatment option for women with BV that will not interfere with combined oral contraceptive methods. Symbiomix Therapeutics.

Analysis of clinical and microbiological indicators of vulvovaginal candidiasis

ABSTRACTVulvovaginal candidiasis (VVC) is the most common vaginal infection. It is considered to be the reason for 15%–30% of all vulvovaginal symptoms. A diagnosis based only on clinical signs and/or on a syndrome-based approach, recommended by some authors and health institutions, is in many cases incorrect. There is no indisputable diagnostic method that guarantees high specificity, sensitivity and predictive value. There is no pathognomonic clinical feature of VVC. The aim of the present study was to assess the role of selected clinical and mycological indicators in the diagnosis of VVC using the standard complex scoring system. The research is retrospective and was conducted in several stages to give a more precise and detailed assessment of the examined clinical and microbiological indicators. Clinical, microbiological and statistical methods were used. The results showed the lowest level of compliance between clinical and laboratory diagnosis in VVC: 67.65%. We did not observe a statistically significant relation between the density of the vaginal smear, inflammation, odour test and VVC (p > 0.05). The results showed a moderate association between the positive yellow swab test and VVC (p < 0.05). A significant positive association was established between VVC and presence of microscopic signs of invasiveness (p < 0.001). The most common isolate was Candida albicans: 72.81% of all vaginal Candida isolates.