Nugent Score Research Articles

The evaluation of the Allplex™ BV molecular assay for the diagnosis of bacterial vaginosis in symptomatic South African females

Bacterial vaginosis (BV) is a dysbiosis of vaginal microbiota characterized by a shift from Lactobacillus species predomination to a heterogeneous mixture of anaerobes. We compared the performance characteristics of the Allplex ™ BV molecular assay with the reference test, Nugent score microscopy, for vaginal swab specimens from symptomatic South African women. A total of 213 patients were enrolled, of whom 99 (46.5%) and 132 (62.0%) were diagnosed with BV by Nugent and Allplex™, respectively. The Allplex™ BV assay displayed a sensitivity of 94.9% (95% CI, 88.7%−97.8%) and a specificity of 66.7% (95% CI, 57.6%−74.6%), with an agreement of 79.8% (95% CI, 73.9%−84.7%) (κ = 0.60). Assay design may be enhanced for improved specificity by accounting for differences in healthy and BV-associated vaginal microbiomes among women of different ethnicities.

A Healthy Vaginal Microbiota Remains Stable during Oral Probiotic Supplementation: A Randomised Controlled Trial.

The primary objective of this randomised, placebo-controlled, triple-blind study was to assess whether orally consumed Lactobacillus acidophilus La-14 (La-14) and Lacticaseibacillus rhamnosus HN001 (HN001) colonise a healthy human vagina. Furthermore, potential effects on vaginal microbiota and immune markers were explored. Fifty women devoid of vaginal complaints (Nugent score 0-3 and vaginal pH ≤ 4.5) were randomised into a 2-week intervention with either La-14 and HN001 as the verum product or a comparable placebo. Vaginal swab samples were collected at baseline, after one and two weeks of intervention, and after a one-week follow-up, for assessing colonisation of the supplemented lactobacilli, vaginal microbiota, and six specific immune markers. Colonisation of L. acidophilus and L. rhamnosus was not observed above the assay detection limit (5.29 and 5.11 log 10 genomes/swab for L. acidophilus and L. rhamnosus, respectively). Vaginal microbiotas remained stable and predominated by lactobacilli throughout the intervention, and vaginal pH remained optimal (at least 90% of participants in both groups had pH 4.0 or 4.5 throughout the study). Immune markers elafin and human β-defensin 3 (HBD-3) were significantly decreased in the verum group (p = 0.022 and p = 0.028, respectively) but did not correlate with any microbiota changes. Adverse events raised no safety concerns, and no undesired changes in the vaginal microbiota or immune markers were detected.

Prevention of recurrence of bacterial vaginosis using lactobacilli-containing vaginal tablets among women with HIV: a randomized, placebo-controlled, double-blinded phase IV trial

ObjectivesThe effectiveness of lactobacilli-containing vaginal tablets (VT) in bacterial vaginosis (BV) recurrence prevention among women infected with HIV treated with standard oral metronidazole in Pune, India was studied. MethodsWomen infected with HIV with confirmed BV diagnosis (Nugent score ≥7 and Amsel criteria >3) were enrolled in a 12-month, double-blind, randomized, placebo-controlled, phase IV study between 2018 and 2021. After a standard course of oral metronidazole for 7 days (400 mg three times a day), women were randomly assigned to either lactobacilli-containing or placebo VT arms to receive VTs for 4 months. BV recurrence was assessed after the initial cure from BV. ResultsOf the 464 women infected with HIV, 80 women with confirmed BV were enrolled. The retention was affected due to the COVID-19 pandemic (6-month retention rates 78%). The cure was seen in 85% and 93.5% of participants from the treatment and placebo arms, respectively, after four VT cycles. BV recurrence was seen in 41.4% and 44.8% in the treatment and placebo arm, respectively, with no significant difference in the two groups. ConclusionThe lactobacilli-containing VT was acceptable and safe; however, the addition of VT over standard oral metronidazole did not show any additional benefit in the prevention of BV recurrence in women infected with HIV, indicating the need for long-term randomized trials among them. Registered at Clinical Trials Registry- India, (CTRI) Number: CTRI/2018/04/013298

Bacterial Vaginosis: Prevalence and Risk Factors among Women in Dakar, Senegal

Introduction: Bacterial vaginosis (BV) is an imbalance of the vaginal flora that most commonly affects women of childbearing age. It is characterised by discomfort due to vaginal discharge and is associated with serious complications in women. We aimed to determine the prevalence of BV and its risk factors.
 Methodology: We conducted a prospective cross-sectional descriptive study in November 2020 at the Pasteur Institute of Dakar among women who were seen for vaginal sampling. We collected the following parameters: age, parity, history of infection, pregnancy and contraception. VB was diagnosed using the Amsel criteria and the Nugent score. Scoring is based on the presence of different bacterial morphotypes where a score ≥ 7 indicates the presence of BV, 4-6 indicates intermediate flora and 0- 3 normal flora. Analysis was performed using SPSS version 20.0.A statistically significant difference between the occurrence of bacterial vaginosis and a risk factor was retained for a p value < 0.05.
 Results: A total of 236 patients were included with a median age of 38 years. The prevalence of BV was 20.3%. It was more prevalent in women aged between [30-40 years] (28/101, 27.7%) followed by the age group [20-30 years] (13/51, 25.5%) with a statistically significant difference (p=0.0001).VB was more prevalent in nulliparous or primiparous women (28/118, 23.7%) and in those with no history of vaginal infections (20/83, 24.1%). Pregnant women and women without contraception were more affected with respectively (12/42, 28.6%) and (43/199, 21.6%). No relationship was found between BV and these previous potential risk factors.
 Conclusion: BV is a very common condition in women of childbearing age. Its complexity motivates numerous researches in order to elucidate its real implication in the occurrence of adverse gynecological conditions.

Immunomodulation of the Vaginal Ecosystem by Ligilactobacillus salivarius CECT 30632 Improves Pregnancy Rates among Women with Infertility of Unknown Origin or Habitual Abortions

In this study, the probiotic potential of Ligilactobacillus salivarius CECT 30632 was assessed, including properties specifically related with gynecological targets. This strain displayed co-aggregative and antimicrobial activity against a wide spectrum of vaginal pathogens while being respectful with the growth of vaginal lactobacilli. The strain produced a high concentration of lactic acid and displayed α-amylase activity when assayed in vitro. It showed a noticeable survival rate after exposition to conditions similar to those present in the human digestive tract and was adhesive to both vaginal and intestinal cells. Subsequently, their capacity to increase pregnancy rates among women with habitual abortion or infertility of unknown origin was studied. Administration of L. salivarius CECT 30632 (~9 log10 CFU) daily for a maximum of six months to these women was safe and led to a successful pregnancy rate of 67.5% (80% and 55% for women with repetitive abortion and infertile women, respectively). Significant differences in Nugent score, vaginal pH, and vaginal concentrations of lactobacilli, TGF-β, and VEFG were observed when the samples collected before the intervention were compared with those collected after the treatment among those women who got pregnant. Therefore, this strain can modulate the vaginal ecosystem and lead to better fertility outcomes.

Efficacy and Safety of MED-01 Probiotics on Vaginal Health: A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Bacterial vaginosis (BV) is the most common disease in women of childbearing age and is caused by the growth of abnormal microbiota in the vagina. Probiotic consumption can be an effective alternative treatment to preserve or improve vaginal health. In the present study, MED-01, a complex of five strains of probiotic candidates isolated from the vagina of Korean women, was used. This study was designed as a 12-week, randomized, multicenter, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of MED-01 on vaginal health. A total of 101 reproductive-aged women with a Nugent score of 4-6 took MED-01 (5.0 × 109 CFU) or a placebo once a day, and 76 participants completed the procedure. MED-01 significantly reduced the Nugent score compared with the placebo. Quantitative PCR analysis confirmed that Lactobacillus plantarum was significantly increased in the vagina, whereas harmful bacteria such as Mobiluncus spp., Gardnerella vaginalis, and Atopobium vaginae were suppressed after 12 weeks of MED-01 ingestion. No adverse events to the test food supplements were observed in the participants. These results confirmed that MED-01 can be used as a probiotic for treating BV, as it improves the vaginal microbiota.

Bacterial vaginosis - diagnostic dilemma and implications

Background/Aim. Bacterial vaginosis (BV) is one of the most common microbial dysbiosis, characterized by a decrease of Lactobacillus spp. with an increase of other anaerobic bacteria species [Gardnerella (G.) vaginalis, Atopobium (A.) vaginae, Prevotella spp, Mobiluncus spp, etc.] causing serious gynecological and obstetric complications. There-fore, it is particularly important to have accurate and reliable diagnostic standards. The aim of this study was to compare the results of various diagnostic methods for detecting BV, such as Amsel, Nugent, and Ison and Hay criteria, as well as multiplex quantitative real-time polymerase chain reaction (mqRT-PCR) test. Methods. This study involved vaginal swabs from 235 patients of reproductive age. Nugent criteria were used as the ?gold standard? compared with Amsel and Ison/Hay criteria as well as mqRT-PCR test based on the detection and quantification of G. vaginalis, A. vaginae, Lactobacillus spp., and total concentration of bacterial DNA. The kappa coefficient was employed to measure agreement between tests. Results. Our analysis demonstrated excellent agreement between Ison/Hay criteria and Nugent scores (kappa = 0.95), good agreement between Amsel and Nugent criteria (kappa = 0.78), while between Nugent criteria and mqRT-PCR test agreement was moderate (kappa = 0.59). Total agreements of Ison/Hay, Amsel, and mqRT-PCR against Nugent scores were 94.9%, 90.2%, and 74%, respectively. Nugent methods classified the highest number of intermediate patients - 60 (25.2%). The largest number of BV patients was detected by the mqRT-PCR method, while the largest number of healthy patients was detected by Amsel criteria. Conclusion. The mqRT-PCR is the best choice for BV diagnosis because it is more efficient at differentiating patients with intermediate results. Compared to Amsel and Nugent methods that group patients into 2 or 3 categories, the mqRT-PCR method recognizes other conditions of vaginal flora important for correct diagnoses and application of better therapeutic approaches, as well as preventing possible clinical consequences of this dysbiosis.

Microablative fractional radiofrequency for sexual dysfunction and vaginal Trophism: A randomized clinical trial

ObjectivesTo evaluate Microablative Fractional Radiofrequency (MAFRF) as a possible option in treating vaginal atrophy. MethodsThis was a randomized, controlled clinical trial with postmenopausal women diagnosed with vaginal atrophy. The treatment consisted of three sessions of MAFRF, compared to vaginal estrogen administration and an untreated control group. Assessments occurred at baseline and 90 days. The primary endpoints were sexual function, evaluated by the Female Sexual Function Index (FSFI), and vaginal health, assessed by the Vaginal Health Index (VHI). Secondary outcomes included vaginal microbiota composition (Nugent score) and epithelial cell maturation (Maturation Value ‒ MV). ResultsOne hundred and twenty women (40 in each group) were included. Concerning the FSFI, both groups, MAFRF (median 4.8 [3.6‒6.0]) and vaginal estrogen (mean 4.7 ± 1.1), experienced improved sexual desire when compared to the control group (median 3.6 [2.4‒4.8]). Regarding the total score of VHI, the authors observed an improvement in the mean of the MAFRF (23.7 ± 2.0) and vaginal estrogen groups (23.5 ± 1.9) when compared to the control (14.8 ± 2.9). The Nugent score was reduced in the MAFRF and estrogen groups (p < 0.01) compared to the control group. Lastly, the MV was modified after treatment with MAFRF (p < 0.01) and vaginal estrogen (p < 0.001). No differences existed between the MAFRF and vaginal estrogen groups in the studied variables. No adverse effects were reported following the MAFRF protocol. ConclusionsRadiofrequency was comparable in efficacy to estrogen administration for treating vulvovaginal atrophy. It deserves consideration as a viable option in managing this condition.

Bacterial vaginosis and trichomoniasis: prevalence, associated factors, and performance of diagnostic tests

Introduction: Bacterial vaginosis and vaginal trichomoniasis are frequent causes of health care demand. Objective: To estimate the prevalence, identify associated factors, and investigate the performance of diagnostic tests for bacterial vaginosis and trichomoniasis. Methods: Cross-sectional study with participants over 18 years old. All of them were submitted to an interview and gynecological examination with evaluation of vaginal secretion, pH verification, collection of material for Pap smear, wet mount test, Whiff test, bacterioscopy, and polymerase chain reaction for trichomoniasis detection. Logistic regression analysis was applied to identify associated factors with bacterial vaginosis. Diagnostic performance for bacterial vaginosis was evaluated following Amsel criteria, the Ison and Hay score, and the Pap smear, considering the Nugent score as the gold standard. As for trichomoniasis, diagnostic performance was evaluated through the Pap smear and the wet mount test, using the polymerase chain reaction as the gold standard. Results: The prevalence of bacterial vaginosis was 33.7%, and for trichomoniasis, 0.5%. The complaint of abnormal vaginal secretion was associated with the diagnosis of bacterial vaginosis (odds ratio 2.2). The diagnostic accuracy by Amsel criteria, the Ison and Hay score, and the Pap smear was 35.6, 97.0, and 84.2%, respectively. The sensitivity for trichomoniasis through wet mount test was 0.0%, and through the Pap smear, 100%. Conclusion: The prevalence of bacterial vaginosis was high, and trichomoniasis was low. The only associated factor with bacterial vaginosis was the report of abnormal vaginal secretion. The methods with the most accurate diagnostic performance for bacterial vaginosis were the Ison and Hay score and the Pap smear and, for trichomoniasis, the Pap smear.

Effectiveness of Gardnerella vaginalis culture and Nugent scoring in identifying bacterial vaginosis in pregnant women

Effectiveness of Gardnerella vaginalis culture and Nugent scoring in identifying bacterial vaginosis in pregnant women

Бактериальный вагиноз: сравнительная оценка терапевтической эффективности 5-нитроимидазолов

Aim: to perform a comparative analysis of clinical and microbiological efficacy and compliance to treatment with 5-nitroimidazole derivatives in patients with bacterial vaginosis (BV). Patients and Methods: this prospective open randomized study included 96 patients diagnosed with BV. The patients were divided into two groups: group 1 (n=48) received antimicrobials — oral secnidazole 2000 mg in a single dose (decontamination therapy) and vaginally administered L. casei rhamnosus Doderleini for 14 days to restore the vaginal flora (contamination therapy); group 2 (n=48) received oral metronidazole 500 mg twice daily for 7 days (decontamination therapy) and vaginally administered L. casei rhamnosus Doderleini for 14 days (contamination therapy). Clinical efficacy was evaluated one and six months after the end of therapy. The treatment efficacy criteria included the absence of specific patient's complaints, clinical and laboratory findings (pH; Nugent score), and PCR results. The compliance to treatment was assessed using clinical and psychological tests (the Morisky-Green Scale and the Modified Medication Compliance Scale). The assessment of safety profile was based on the analysis of adverse events (AE). Results: one month after the end of treatment all patients had a statistically significant (p&lt;0.05) reduction in the prevalence of BV symptoms (unpleasant vaginal odor, pathological vaginal discharge, itching, dyspareunia, dysuria events) as compared to those at the baseline. At month 1 after the end of treatment, subgroup analysis did not demonstrate a significant difference. Six months after the end of treatment the proportion of the group 1 patients who had pathological vaginal discharge with specific odor increased to 16.7%, while in the group 2 patients it reduced to 8.3% (p&lt;0.05). Microbiological assessment (PCR) of the combination therapy in two groups of patients with BV demonstrated a high antibacterial efficacy of 5-nitroimidazole derivatives during the first month of follow-up. The patients were considered fully compliant if they scored 4 on the Morisky — Green Scale and scored 30 on the Modified Medication Compliance Scale of V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology. The percentage of full compliance was 76.2±2.8% in the group 1 patients and 93.75±3.25% in the group 2 patients. Conclusion: a high comparative clinical and microbiological effectiveness of treatments with 5-nitroimidazole derivatives (metronidazole and secnidazole) with further vaginal colonization with lactobacilli was demonstrated in patients with bacterial vaginosis. Full medication compliance was higher in patients receiving secnidazole for BV treatment. KEYWORDS: bacterial vaginosis, vaginal microbiota, vaginal discharge, 5-nitroimidazole derivatives, metronidazole, secnidazole, compliance. FOR CITATION: Kutsenko I.G., Borovikov I.O., Kravtsova E.I. et al. Bacterial vaginosis: comparative effectiveness of treatments with 5-nitroimidazole derivatives. Russian Journal of Woman and Child Health. 2023;6(2):78–87 (in Russ.). DOI: 10.32364/2618-8430-2023- 6-2-78-87.

DESEMPENHO DO EXAME CITOPATOLÓGICO NO DIAGNÓSTICO DE VAGINOSE BACTERIANA

ABSTRACT Objective: to assess Pap smear performance in bacterial vaginosis diagnosis in women of childbearing age. Method: a cross-sectional, retrospective study carried out in a health unit in a city in the interior of São Paulo. The study included information from 1,173 women who underwent collection of Pap smear and Gram-stained vaginal smears (reference standard test for bacterial vaginosis diagnosis) and analysis based on the Nugent score, from January 2013 to June 2020. Secondary data collected from the information and internal control systems were used. Results: the prevalence of bacterial vaginosis in the sample was 31.8%. The degree of agreement between the two diagnostic methods by the Kappa index was 0.54, considered moderate, with a value &lt;0.001. Sensitivity was 55.2% and specificity was 94.1%, with accuracy of 81.7% and positive predictive value of 81.4% and negative of 81.8%. Conclusion: Pap smear showed agreement with the reference standard of 0.77, however, does not replace the Gram-stained vaginal smear, but can be used as an auxiliary method for bacterial vaginosis diagnosis.

Oral Intake of the Commercial Probiotic Blend Synbio® for the Management of Vaginal Dysbiosis

A healthy vaginal microbiota is Lactobacillus-dominated. Several factors can interfere with the state of balance leading to dysbiosis, such as vaginal infections caused by bacteria and Candida species. The present single-arm, uncontrolled open-label study aimed to evaluate the ability of the SYNBIO® probiotic combination, taken as an oral formulation, to contribute to vaginal health. Thirty pre-menopausal participants were included in the study. Participants were instructed for daily oral intake of SYNBIO® probiotic capsules for 15 days. Vaginal swabs were collected at baseline (T0), 15 days after the start of the treatment (T1), and 7 days after the end of the treatment (T2). Amsel criteria, Nugent score, and vaginal pH were evaluated at each sampling time. In addition, the participants' quality of life was assessed by the WHOQOL-BREF questionnaire. The administration of SYNBIO® once daily for 15 days resulted in a substantial improvement in the vaginal flora in terms of an increase in lactobacilli and a decrease in enterococci, staphylococci, Gardnerella spp., and Candida spp. According to the results, statistically significant changes in leucorrhoea, itching, and vulvo-vaginal erythema/edema as well as a decrease in all the Amsel criteria were recorded. The oral consumption of SYNBIO® demonstrated enhanced benefits for vaginal health.

510. Secretory IgA in the Vaginal Mucosa Inhibits Herpes Simplex Virus Infection

Abstract Background HSV2 increases HIV risk and is twice as common among women. We previously showed that cervicovaginal secretions exhibit innate anti-HSV2 activity that was lower in adolescents and women with HIV-- conditions associated with vaginal dysbiosis and increased HSV shedding. Our current study aims to test the hypothesis that vaginal dysbiosis is associated with low anti-HSV activity and to explore the molecules and mechanisms that contribute. Methods Cervicovaginal lavage (CVL) (10 ml normal saline wash) was collected from 20 women who presented with clinical bacterial vaginosis (BV) (Day 0) and then 1 and 4 weeks after completing a 7-day oral metronidazole course; parent study results were reported (PMID 34003290). Anti-HSV2 activity of CVL (diluted 1:4) was determined by plaque reduction assay. CVL IgG, IgA, cytokines and antimicrobial peptides were quantified by ELISA or multiplex Luminex and select microbiota by quantitative real-time PCR. CVL was enriched for IgA and IgG using protein L (binds all Ig) and Protein G (binds only IgG). HSV-specific antibodies in CVL were assessed by ELISA. Statistical analyses including Spearman correlation coefficients (SCC) were performed with GraphPad Prism version 9.1.2 software. Results Anti-HSV2 activity of CVL was highly variable at Day 0 (mean 18.6% SD 36.7) and trended to increase after treatment (mean 22.56% SD 33.8). The anti-HSV2 activity correlated positively with Nugent scores (SCC= -0.28, p= 0.03) and qPCR levels of BV-associated microbes (SCC = -0.2 to -0.3, p&amp;lt; -0.1) but positively with IgA (r= 0.49, p&amp;lt; 0.01) and IgG (r= 0.33, p= 0.01). IgA and IgG were isolated from pools of CVL with high inhibitory activity greater than 40% (n= 8). The anti-HSV2 activity mapped to the IgA fraction (56.5% inhibition) compared to the IgG or non-Ig fraction (0% inhibition) even though, as expected, the CVL concentration of IgG was higher than IgA (8.3μg/mL vs 4.9 μg/mL). The anti-HSV2 activity did not correlate with HSV-specific Ig in CVL. Conclusion Our findings suggest that secretory vaginal IgA contributes to innate anti-HSV2 activity and may trap viral particles to prevent viral entry. We speculate that sialidases, which cleave IgA and are elaborated by BV-associated microbiota, contribute to the low anti-HSV2 activity observed in high-risk cohorts. Disclosures Betsy Herold, MD, Viracor (Eurofins): Advisor/Consultant|X-Vax, Technologies: Advisor/Consultant|X-Vax, Technologies: Grant/Research Support|X-Vax, Technologies: Serve on Scientific Advisory Board for X-Vax, Technologies and receiving reserach funding for related worl. Betsy Herold, MD, Viracor (Eurofins): Advisor/Consultant|X-Vax, Technologies: Advisor/Consultant|X-Vax, Technologies: Grant/Research Support|X-Vax, Technologies: Serve on Scientific Advisory Board for X-Vax, Technologies and receiving reserach funding for related worl.

Bacterial Vaginosis in Postmenopausal Women.

Bacterial vaginosis (BV) is the most common vaginal infection worldwide, but most research has been conducted in premenopausal women. After menopause, endogenous estrogen production decreases, often leading to the genitourinary syndrome of menopause (GSM), characterized by vulvovaginal dryness and irritation. The estrogen-deficient postmenopausal state results in an elevated vaginal pH and depletion of vaginal lactobacilli. Use of traditional BV diagnostics (Amsel criteria, Nugent score) is difficult in post-menopausal women, especially those not on estrogen replacement therapy, as these methods were originally developed in premenopausal women. In this review, we discuss recent clinical data on BV in postmenopausal women, difficulties in diagnosis using traditional methods, the role of BV molecular diagnostics, and our current expert opinion for managing BV in this population. BV prevalence has been found to range between 2%-57% among postmenopausal women per Amsel and Nugent criteria. This is likely an over-estimate of the true prevalence due to limitations in these criteria which were only validated in pre-menopausal women. Despite increasing diagnostic options for BV in recent years, including highly sensitive and specific BV nucleic acid amplification tests (NAATs), the physiologic changes of menopause and limited inclusion of postmenopausal women in clinical studies, diagnosis is difficult in this population. Recent studies utilizing 16s rRNA gene sequencing suggest that the vaginal microbiota of premenopausal and postmenopausal women is quite different, even if BV is not present. Data also suggest that obese postmenopausal women have significantly lower rates of BV compared to non-obese postmenopausal women, although further research is needed in this area. Multiple treatment options exist for vaginal atrophy and BV in this population. Data are limited regarding optimal diagnostic approaches for BV in postmenopausal women; BV NAATs and 16s rRNA gene sequencing may have a role for diagnosing BV in symptomatic women although further studies are needed. Menopausal women with characteristic vaginal symptoms and an elevated vaginal pH should be initially treated for estrogen deficiency prior to considering a diagnosis of BV; subsequent treatment for BV should be driven by symptoms.

Effect of vaginal flora on clinical outcome of frozen embryo transfer.

Vaginal microbiota imbalance is a high risk factor for premature birth, and is closely related to female pelvic inflammation and sexually transmitted diseases. The effect of vaginal microbiota on the outcome of assisted reproductive technology is still unclear. In this study, the vaginal microbial composition and the pregnancy outcome of frozen embryo transfer (FET) was investigated. From October 2020 to December 2021, 275 FET cycles were selected from the center of reproductive medicine in Affiliated Hospital of Nantong University. Vaginal secretions were collected on the day of endometrium transformation, and smears were Gram stained. According to the Nugent score they were divided into three groups, including normal group, mild dysbiosis group and sever dysbiosis group. The clinical outcomes of each group were compared. In 275 FET cycles, the embryo implantation rate, clinical pregnancy rate and ongoing pregnancy rate in the normal group (66.9%,84.3% and 83.1%) were significantly higher than those in the mild dysbiosis group (45.5%, 57.3% and 49.3%) and in sever dysbiosis group (29.6%, 34.2% and 27%). The difference was statistically significant (P<0.01). When compared the preclinical pregnancy loss rate and the miscarriage rate, the normal group (1.3% and 1.3%) was significantly lower than those in the mild dysbiosis group (20.4% and 14.0%) and the sever dysbiosis group (25.5% and 21.1%). The difference was statistically significant (P<0.01), but there was no significant difference between the mild dysbiosis group and sever dysbiosis group (P>0.05). Nugent score is directly related to the clinical outcome of FET. The Lactobacilli-dominant vaginal flora was a favorable factor for the good clinical outcome of FET, while asymptomatic bacterial vaginosis had a negative correlation with the outcome of FET.

High-Throughput Sequencing-Based Analysis of Changes in the Vaginal Microbiome during the Disease Course of Patients with Bacterial Vaginosis: A Case-Control Study.

The vaginal microbiome is closely associated with the onset and recurrence of bacterial vaginosis (BV). In the present study, the state of vaginal microbiota during the onset and post-treatment asymptomatic stages of BV were compared to that of a healthy population to evaluate the changes in different characteristic bacteria during the onset, progression, and remission of BV. A case-control study was performed to explore these changes. Women with clinical symptoms of BV were divided into the disease group (M) and case-control group (C) based on the Nugent score. Subjects in the disease group whose symptoms were resolved after the treatment were assigned to the treated group (T) and healthy subjects were recruited into the normal control (N) group. The V3-V4 hypervariable regions of bacterial 16S rRNA genes were sequenced on the Illumina MiSeq platform. The N harbored the highest number of detected species and a higher abundance of microbiota; they had a significantly higher abundance of Lactobacillus and different bacterial community composition compared to the other three groups. In group M, Gardnerella vaginalis was the dominant species, whereas Lactobacillus iners was predominant in the other three groups. While Lactobacillus was more commonly present in Group C compared to group M. it was significantly increased in group T. Alpha diversity analysis of bacterial communities revealed significant differences in community richness and diversity among all four groups (p &lt; 0.05). Significant differences in the distribution of various bacterial communities among the different groups were also observed (p &lt; 0.05). Specifically, the abundance of eight bacterial taxa (Megasphaera, Aerococcus christensenii, Clostridiales, Gardnerella, Peptostreptococcus, Veillonellaceae, Akkermansia, Coriobacteriales) differed significantly among the four groups (p &lt; 0.05). Significant differences in the composition and alpha diversity of the vaginal microbiota at different stages of BV and the distribution of bacterial communities were observed among the investigated groups. In addition to Gardnerella, Sneathia sanguinegens and Prevotella timonensis play an important role in the pathogenesis of BV. The appearance of BV-like clinical symptoms was closely associated with the decrease in Prevotella and Atopobium vaginae populations.

Risk Factors Associated with Bacterial Vaginosis in Pregnant Women in Senegal

Background: Bacterial vaginosis (BV) is associated with a high risk of complications, particularly during pregnancy.&#x0D; Objectives: The aims of this study were to determine the prevalence of BV in pregnant women in Dakar, Senegal, and to identify its associated risk factors.&#x0D; Patients and Methods: This prospective cross-sectional study was conducted from July 2020 to March 2021 in pregnant women with 34 to 38 weeks of gestation and seen for their routine prenatal consultation at the Nabil Choucair health center in Dakar, Senegal. Vaginal swabs were taken and examined using the Nugent scoring system for the diagnosis of the BV. Data analysis on SPSS (version 25) was done using the chi-square test to measure the strength of association. A value of p ≤ 0.05 was considered statistically significant.&#x0D; Results: BV was found in 28.0% (112/400) of the screened women with a median age 24 (21-29) years. A pH &gt;4.5 predictive of BV was found in 80.4% (90/112) of samples. BV was associated with vaginal candidiasis in 49.1% (55/112) while Trichomonas vaginitis was found in 1.8% (02/112). In 80.4% (90/112) of affected women, BV was caused by Gardnerella vaginalis. Mobiluncus spp. was found in 19.6% (22/112) pregnant women in association with G. vaginalis. Symptoms characterized by episodes of pruritus, pelvic pain, burning and/or dyspareunia were seen among 59.8% (67/112) of these women with BV while 40.1% (45/112) of them reported no symptoms.&#x0D; Conclusion: In view of these results and in order to reduce gestational complications and adverse outcomes in the newborn, screening for BV in pregnant women should be favored in developing countries.

Recombinant Interferon α-2B Gel Combined with Lactobacillus as a Vaginal Capsule in Patients with Cervical High-Risk Human Papillomavirus

This study was performed to investigate the effects of Lactobacillus vaginal capsules combined with recombinant human interferon α-2b gel on clinical efficacy, vaginal microbial function indicators, vaginal microecological balance, inflammation levels, and drug safety in patients with persistent cervical high-risk human papillomavirus infection. Patients with human papillomavirus infection (n = 128) were randomly divided into control and observation groups of equal size. Patients in the control group were treated with recombinant human interferon α-2b gel alone. Patients in the observation group were treated with Lactobacillus vaginal capsules and human interferon α-2b gel. After treatment, the clinical efficiency, microbial function index, and human papillomavirus-DNA conversion rate of patients in the observation group were significantly higher than those in the control group. Further, pH, Nugent scores, human papillomavirus-DNA viral load, vaginal microecological dysregulation rate, and inflammation level were significantly lower than those in the control group. Lactobacillus vaginal capsules in combination with recombinant human interferon α-2b gel improved clinical outcomes and disease regression rates in patients with human papillomavirus infection, while also improving vaginal microecological balance and suppressing inflammatory responses.

A randomized comparative study of Kakrasingi (Pistacia integerrima J. L. Stewart ex Brandis) and metronidazole in bacterial vaginosis

ObjectiveTo determine and compare the efficacy of Kakrasingi (Pistacia integerrima J.L. Stewart ex Brandis) with metronidazole in bacterial vaginosis (BV). MethodsA randomized (1:1) standard controlled, single-center study was conducted in diagnosed patients (n = 62) of BV. The intervention group (n = 31) and standard group (n = 31) received orally, the gall of P. integerrima powder (1 g) and metronidazole (400 mg) respectively twice a day for 7 days. The primary efficacy endpoint included clinical cure as assessed by Amsel’s criteria evaluated at the test of cure visit (day 14–18). The secondary efficacy endpoints were a microbiologic cure (considered as a Nugent score of 0–3), therapeutic cure (includes both clinical and microbiologic cure) evaluated at the test of cure visit (day 14–18), and vaginal symptoms scale (VSS) at day 14–18, 21–24, and 30–34 and safety profile. The data were statistically inferred by the parametric and non-parametric tests with a 5 % level of significance and a 95% confidence interval. ResultsThe clinical, microbiological, and therapeutic cure rates were 54.83 %, 51.61 %, and 51.61 % for the intervention and 51.61 %, 45.16 %, and 45.16 % for the control group. The comparison showed no significant difference in clinical (p = 0.88), microbiological (p = 0.93), and therapeutic cure rates (p = 0.93). The VSS mean score on days 14–18 was 3.67 ± 2.90 and 4.22 ± 2.61 in the intervention and control groups respectively, moderately statistically more significant (p = 0.03) in the intervention than in the control group. ConclusionP. integerrima showed a similar effect as metronidazole in treating BV with no adverse effects.