Urogenital Infections In Women Research Articles

The relationship between HIV status and clinical manifestations of urogenital infections in women during pregnancy: a scoping review

Introduction: Maternal and child health are essential to public health, especially during pregnancy, where urogenital infections can affect mothers and fetuses. Sexually transmitted infections (STIs) increase obstetric risks and have complex connections with the human immunodeficiency virus — HIV. In Brazil, pregnant women with HIV are a growing concern, requiring focus and appropriate interventions. Objective: This study aimed to examine the clinical and epidemiological characteristics of urogenital infections in pregnant women with and without HIV and to assess whether there are notable differences between these groups. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses — Extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute guidelines. Databases such as Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO) were explored using relevant terms. Inclusion/exclusion criteria selected nine studies for analysis. A Population, Intervention, Comparison, Outcome, and Study Design (PICOS) approach directed the search. Results: Pregnant women with HIV had a high prevalence of STIs, including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and bacterial vaginosis. HIV infection appears to influence the risk and severity of urogenital infections. Pregnancy increases the risk of STIs, regardless of HIV status. Male partners may also influence the presence of STIs in pregnant women, especially those with HIV. Conclusion: This study highlights the association between HIV status and urogenital infections in pregnant women, indicating the need for appropriate screening and care. Prevention and treatment of STIs in pregnant women are essential for maternal and child health, regardless of HIV status. An in-depth understanding of these issues can improve public policies, clinical practices, and preventive interventions that target the overall health of these vulnerable populations.

Effect of intimate hygiene fluids on the number of Listeria monocytogenes isolated from women

Introduction. Listeria monocytogenes is an etiological factor of listeriosis, widespread in the environment. The consequence of fetal infection in the second trimester of pregnancy in most cases is the death of the fetus or stillbirth. Material and methods. In this study, 7 strains of L. monocytogenes isolated from the vagina of women and the reference strain L. monocytogenes ATCC 19111 were used. The examined strains were treated with five commercially available intimate hygiene washes. The efficacy of the wash fluids used was based on the induced decrease in the number of bacteria expressed as a logarithmic colony-forming unit (CFU) × ml-1. Results. The study showed that probiotic fluid (pH = 3.5) decreased the number of bacteria by an average of 4.56 log CFU × ml-1, while wash fluid intended for pregnant and puerperal women (pH = 4.0) reduced the number of L. monocytogenes by an average of 1.55 log CFU × ml-1. Lower bactericidal efficacy was observed in the case of wash fluids intended for everyday use. The fluid containing marigold extract and the liquid with the addition of rice proteins and arnica extract decreased the number of L. monocytogenes by an average of 1.11 log CFU × ml-1, and the fluid with silver and copper nanoparticles by 1.14 log CFU × ml-1. Conclusions. Everyday use of intimate hygiene washes reduces the risk of urogenital infections in women and supports their treatment. Prevention with the use of probiotic wash solutions may reduce the number of vaginal infections caused by L. monocytogenes, which is especially important in the case of pregnant women because the number of patients diagnosed with listeriosis has increased.

Clinical and anamnestical aspects of very early preterm birth

The objective: determine risk factors, causes and clinical features of patients with very early preterm birth. Materials and methods. The study analyzed the data of anamnesis, the course of pregnancy, childbirth and perinatal outcomes of 166 women of reproductive age with very early preterm birth at 22–27 weeks of gestation. The fact of childbirth at these stages of pregnancy is the main criterion of inclusion. The patients were divided into two groups depending on the criteria of live birth: group 1 – 79 women, whose labor was regarded as late miscarriage (retrospective study); group 2 – 87 women, whose labor occurred as a very early preterm (prospective study). Exclusion criteria: congenital malformations of the fetus. Patients of both groups have got a comprehensive examination using clinical, instrumental and laboratory research methods. Results. During the management of pregnancy of patients of these groups, special attention was paid to the assessment of risk factors for the development of very early preterm labor, among which the main ones were urogenital infections (83,7% and 78,9% in groups 1 and 2, respectively), which caused perinatal mortality in both groups (p˂0,05). A combination of pathogens was found in almost half of the subjects (43% in group 1,44% in group 2). Patients of both groups had a serious general and obstetric anamnesis, high frequency of inflammatory processes of the genitals, surgery and hormonal disorders with diseases caused by them. The main complications of gestation of pregnant women of both groups in the second trimester were the miscarriage risk (43% and 30%, respectively) and dysfunction of the fetoplacental complex (FPC) (22,7% and 21,8%, respectively), which caused the syndrome of delayed fetal development in both groups of subjects - in 66% and 63% of children, respectively. Conclusion. Analysis of general and obstetric history, the presence of infectious factor in combination with extragenital pathology confirm the polyetiology of the causes that leads to very early preterm birth. Considering the main risk factors of preterm birth, a thorough examination for urogenital infections in women at the stage of pre-pregnancy and during pregnancy, followed by treatment and restoration of normal vaginal biocenosis, as well as study of fetoplacental system function from early pregnancy. Preventive measures and timely treatment of fetoplacental disorders should promote prolonging pregnancy to longer gestations, which is the best way to improve perinatal outcomes.

Causes and clinical picture of very early preterm birth

The objective: the determination of the risk factors, causes and clinical features of very early preterm birth.Materials and methods. The data of anamnesis, the course of pregnancy, childbirth and perinatal outcomes in 166 women of reproductive age with very early preterm birth at 22–27 weeks of gestation were analyzed. The fact of childbirth at these terms of pregnancy is the main criterion of inclusion. The patients were divided into two groups depending on the criteria of live birth: 1 group — 79 women, whose labor was regarded as late miscarriage (retrospective study); 2 group — 87 women with very early preterm (prospective study). Exclusion criteria: congenital malformations of the fetus. Results. The main risk factors for the development of very early preterm labor are urogenital infections (83.7 % and 78.9 % in 1 and 2 groups, respectively). A combination of pathogens was found in almost half of the subjects (43 % in 1 group, 44 % in 2 group). The patients in both groups had a complicated general and obstetric anamnesis, in particular, a significant frequency of inflammatory processes of the genital organs (50.0 % – in 1 group and 59.2 % – in 2 group), surgical interventions (50.0 % and 59.2 %, respectively), as well as hormonal disorders and related diseases (ovarian dysfunction – 27.8 % and 27.6 %, uterine fibroids – 16.4 % and 17. 2%, ovarian cysts – 11.4 % in both groups). 35.4 % of patients in 1 group and 28.7 % of patients in 2 group had a history of chronic foci of infections, pathology of the urinary system – 30.3 % and 28.7 %, respectively, of the digestive tract – 24 % and 22.98 %, hypertension – 32.9 % and 31 %. The main complications of gestation in pregnant women in both groups in the II trimester were the threat of abortion (43 % and 30 %, respectively) and dysfunction of the fetoplacental complex (22.7 % and 21.8 %). This caused fetal growth retardation in both groups – 66 % and 63 % of newborns, respectively.Conclusions. Analysis of the general and obstetric history, the presence of infectious factor in combination with extragenital pathology confirm the polyetiology of the causes that leads to very early preterm birth. Considering the main risk factors of preterm birth, a complete examination for urogenital infections in women before and during pregnancy, followed by treatment and restoration of normal vaginal biocenosis, as well as the study of fetoplacental system function from early pregnancy is neseccary.Preventive measures and timely treatment of fetoplacental disorders should prolong pregnancy for the terms in which there is the best way to improve perinatal outcomes.

In vitro determining the effect of vaginal lactobacillus on some pathogenic of urogenital infections in women

In vitro determining the effect of vaginal lactobacillus on some pathogenic of urogenital infections in women

Targeted point-of-care testing compared with syndromic management of urogenital infections in women (WISH): a cross-sectional screening and diagnostic accuracy study

Sexually transmitted and urogenital infections are typically managed by WHO-recommended syndromic algorithms in resource-poor countries, and presumptively in Europe. However, algorithms for vaginal discharge and lower abdominal pain perform poorly in women. The women's improvement of sexual and reproductive health (WISH) study in Kigali, Rwanda, sought to improve case-finding and infection management in women by introducing point-of-care tests. The main aim was to compare the performance of the WISH algorithms and the WHO vaginal discharge and lower abdominal pain algorithms with gold standard testing. This cross-sectional screening and diagnostic accuracy study recruited women aged 18 years or older with or without urogenital symptoms at risk of acquiring sexually transmitted infections in Kigali, Rwanda. Recruitment activities were implemented by study staff with the help of community mobilisers at health centres, pharmacies, markets, women's organisations, and at "umuganda" community meetings. At the study visit, participants had a face-to-face interview that included questions about current urogenital symptoms. Participants were first asked without prompting (spontaneous reporting), followed by questions about 14 specific symptoms (structural reporting). Next, the WISH algorithms were implemented. All participants had point-of-care tests for bacterial vaginosis (vaginal pH of 5·0 or above) and Trichomonas vaginalis (immunoassay) regardless of symptom reporting. Women with a positive risk score had point-of-care tests for Chlamydia trachomatis and Neisseria gonorrhoea (nucleic acid amplification tests). Vulvovaginal candidiasis was treated presumptively. Nucleic acid amplification tests for C trachomatis, N gonorrhoeae, T vaginalis, bacterial vaginosis, and vulvovaginal candidiasis were the gold standard, and all patients provided swabs for these. Participants were recruited between July 5, 2016, and March 14, 2017. 705 participants were enrolled in the study and completed a study visit, and 51 attended 53 additional visits. Prevalence by gold standard testing was 8·5% for C trachomatis, 7·1% for N gonorrhoeae, 16·1% for T vaginalis, 18·1% for bacterial vaginosis, and 8·6% for vulvovaginal candidiasis. The WISH algorithms identified similar numbers of C trachomatis, N gonorrhoeae, and T vaginalis infections, but much higher numbers of bacterial vaginosis and vulvovaginal candidiasis infections. Compared with gold standard testing, the WISH algorithms had a good sensitivity and high specificity for C trachomatis (sensitivity 71·7%, specificity 100%), N gonorrhoeae (sensitivity 76·0%, specificity 100%), and T vaginalis (sensitivity 68·5%, specificity 97·4%), high sensitivity but low specificity for bacterial vaginosis (sensitivity 95·2%, specificity 41·2%), and moderate sensitivity and specificity for vulvovaginal candidiasis (sensitivity 64·4%, specificity 69·4%). The performance of vaginal pH testing for bacterial vaginosis improved by increasing the cutoff to 5·5, followed by confirmatory testing (sensitivity 73·6%, specificity 100%). The WHO algorithms had moderate sensitivity and poor specificity for all infections compared with gold standard testing: C trachomatis sensitivity 58·3%, specificity 44·7%; N gonorrhoeae sensitivity 66·0%, specificity 45·2%; T vaginalis sensitivity 60·4%, specificity 45·6%; bacterial vaginosis sensitivity 61·6%, specificity 46·0%; and vulvovaginal candidiasis sensitivity 74·6%, specificity 50·6%. Two participants attended additional visits because they had a mild allergic reaction to metronidazole. Staff and participants considered point-of-care testing feasible and acceptable. Point-of-care testing for urogenital infections might improve case-finding and infection management and is feasible in resource-poor settings. Point-of-care tests should be further developed, including those targeting multiple conditions. Additional studies in other populations, including populations with low prevalence of sexually transmitted and urogenital infections, are warranted. European and Developing Countries Clinical Trials Partnership.

Роль TLR в патогенезе и диагностике урогенитальных инфекций женщин

Роль TLR в патогенезе и диагностике урогенитальных инфекций женщин

Probiotics for Treatment and Prevention of Urogenital Infections in Women: A Systematic Review.

Probiotics are a complementary and integrative therapy useful in the treatment and prevention of urogenital infections in women. This study extends the work of researchers who systematically investigated the scientific literature on probiotics to prevent or treat urogenital infections. A systematic review was conducted to determine the efficacy of probiotics for prevention and/or treatment of urogenital infections in adult women from January 1, 2008, through June 30, 2015. We searched in CINAHL, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Dissertations and Theses, and Alt-HealthWatch. After removing duplicates and studies that did not meet inclusion criteria, 20 studies were reviewed. All included at least one species of Lactobacillus probiotic as an intervention for treatment or prevention of urogenital infections. Data extracted included samples, settings, study designs, intervention types, reported outcomes, follow-up periods, and results. We evaluated all randomized controlled trials for risk of bias and made quality appraisals on all studies. Fourteen of the studies focused on bacterial vaginosis (BV), 3 on urinary tract infections (UTIs), 2 on vulvovaginal candidiasis, and one on human papillomavirus (HPV) as identified on Papanicolaou test. Studies were heterogeneous in terms of design, intervention, and outcomes. Four studies were of good quality, 9 of fair, and 7 poor. Probiotic interventions were effective for treatment and prevention of BV, prevention of recurrences of candidiasis and UTIs, and clearing HPV lesions. No study reported significant adverse events related to the probiotic intervention. The quality of the studies in this systematic review varied. Although clinical practice recommendations were limited by the strength of evidence, probiotic interventions were effective in treatment and prevention of urogenital infections as alternatives or co-treatments. More good quality research is needed to strengthen the body of evidence needed for application by clinicians.

Prevalence and associated risk factors of group b streptococcus in pregnant women attending antenatal care in a Nigerian urban hospital

Background: Group B Streptococcus (GBS) is one of the common microbial agents causing urogenital infections in women of reproductive age especially pregnant women; it is also a common cause of neonatal infections in the world. Objective: To determine the prevalence and associated risk factors of GBS colonisation in pregnant women in an Urban Hospital in Nigeria.Methods: A prospective cross sectional study of 150 pregnant women conducted in an Urban Hospital in Uyo, Nigeria between May and October 2013. Vaginal and anorectal swabs were collected from each participant and processed using standard microbiological methods and cultured on CHROMagarTM Strep B medium. Questionnaires for data were also used. Results: The age range of the participants was between 18 to 44years. Only 2 out of the 150 pregnant women were GBS carriers. The 2 women (1.33%) were found to be anorectal carriers, although 1 (0.67%), in addition had vaginal GBS. There was a statistically significant association between GBS colonisation and premature rupture of amniotic membranes (P<0.05). However, there was no association between GBS colonisation and risk factors such as age and gravidity.Conclusions: Group B Streptococcus colonisation in pregnant women in Uyo, Nigeria, is associated with premature rupture of amniotic membrane.

Рецидивирующие смешанные инфекции урогенитального тракта у женщин: стратегия коррекции мукозального иммунитета

Рецидивирующие смешанные инфекции урогенитального тракта у женщин: стратегия коррекции мукозального иммунитета

Encapsulation and subsequent freeze-drying of Lactobacillus reuteri CRL 1324 for its potential inclusion in vaginal probiotic formulations

Probiotic formulations must include a high number of viable and active microorganisms. In this work, the survival of human vaginal Lactobacillus reuteri CRL 1324 during encapsulation, lyophilization and storage, and the activity of encapsulated and/or freeze-dried bacterial cells were evaluated. Extrusion–ionic gelation technique was applied to encapsulate L. reuteri CRL 1324, using xanthan and gellan. Encapsulated and free bacterial cells were freeze-dried with or without lactose and skim milk as lyoprotectors. The different systems obtained were stored at room temperature and at 4°C for 150days. The following determinations were performed: L. reuteri CRL 1324 viability, microorganism released from capsules, survival in a medium simulating the vaginal fluid and maintenance of beneficial properties (growth inhibition of opportunistic pathogenic Streptococcus agalactiae NH 17 and biofilm formation). L. reuteri CRL 1324 encapsulation was efficient, allowing the recovery of a high number of entrapped lactobacilli. The survival of encapsulated L. reuteri during lyophilization and storage was significantly higher in the presence of lyoprotectors. At the end of storage, the highest numbers of viable cells were obtained in free or encapsulated cells freeze-dried with lyoprotectors, stored at 4°C. Encapsulated and/or lyophilized L. reuteri cells maintained their viability in simulated vaginal fluid as well as the ability to inhibit S. agalactiae NH 17 growth and to form biofilm. Encapsulated and freeze-dried L. reuteri CRL 1324 can be included in a suitable pharmaceutical form for vaginal application to prevent or treat urogenital infections in women.

The Rationale for Probiotics Improving Reproductive Health and Pregnancy Outcome

Medical problems of most importance to reproductive health of women differ to some extent between the developed world and resource-disadvantaged countries. Nevertheless, many share a common link in microbial involvement. A review of the peer-reviewed literature on microbiota, probiotics, and reproductive health. Indigenous and probiotic lactobacilli express properties antagonistic to pathogens, but complementary to host immunity. These organisms are associated with conception, reducing the risk of infection, as well as potentially lowering the risk of a number of complications of pregnancy that otherwise lead to maternal and infant mortality and morbidity. The ability to manipulate the microbiome and to improve immunity through probiotics holds much promise. The lack of improvements over the past 40years in managing urogenital infections in women is incomprehensible. Support for innovative diagnostic and treatment options is needed, including testing and implementing probiotic therapies, especially for women with poor access to healthcare and good nutrition.

Urogenital pathogen inhibition and compatibility between vaginal Lactobacillus strains to be considered as probiotic candidates

ObjectivesTo evaluate the production of inhibitory substances against several urogenital pathogens and to determine the compatibility between selected vaginal lactobacilli to be considered as probiotic candidates. Study designThe inhibitory activity of 38 vaginal Lactobacillus strains against urogenital pathogens was assessed using the agar plate diffusion. MethodThe production of hydrogen peroxide was determined by the semi-qualitative tetramethyl-benzidine-peroxidase assay and that of lactic acid by high performance liquid chromatography. Pre-selected lactobacilli were genetically identified by ribosomal 16S-DNA sequencing and used to determine the compatibility of strains. Correlation values between some inhibitory properties were calculated. Results45% of the lactobacilli assayed inhibited the growth of various urogenital pathogens, except Candida albicans, mainly by the effect of organic acids. Even though 71% of the Lactobacillus strains produced hydrogen peroxide in the semi-qualitative test, the antimicrobial effect of the oxidative metabolite on pathogens was not detected under the experimental conditions assayed. On the other hand, the inhibition spectrum of salivaricin CRL 1328 was widened with respect to the one previously reported by our research team. With respect to the degree of interaction between the pre-selected lactobacilli, most of them showed inhibition of at least one strain, mainly due to the effects of both organic acids and hydrogen peroxide. ConclusionSeveral lactobacilli that showed inhibitory activity against urogenital pathogens or produced hydrogen peroxide are compatible between them. Therefore, different potential combinations of strains are proposed for their inclusion in the design of probiotic products to be vaginally administered for the prevention of urogenital infections in women.

Estimation of combined effects of carbon and nitrogen sources on the growth and bacteriocin production of Lactobacillus salivarius from human source

Vaginal Lactobacillus salivarius CRL 1328 (Centro de Referencia para Lactobacilos Culture Collection) or the bacteriocin that produces could be included in a urogenital probiotic formula to prevent urogenital infections in women. The objective of this work was to determine the effects of different carbon and nitrogen sources on the growth and bacteriocin production of this microorganism. A fractional factorial design 3(5-1) was applied to evaluate the effects of five nutrients (glucose, lactose, yeast extract, tryptone and meat peptone), at three different concentrations (0, 1 and 2%). Results were statistically analyzed for linear and quadratic effects of nutrients, along with their interactions. All the nutrients tested stimulated the cell growth and bacteriocin production, but lactose had not a significant influence on the last response. The linear effects of higher magnitude on biomass and bacteriocin production were those of yeast extract and tryptone. The results demonstrated that there were significant interactions between the different nutrients, depending on the response evaluated. Maximum bacteriocin production was reached in different growth media with a lower cost than conventional culture media used in the laboratory. These findings will contribute to the design of a pharmaceutical product for the restoration of ecological balance of urogenital tract.

Chlamydia trachomatis Serovars Causing Urogenital Infections in Women in Melbourne, Australia

Studies on the prevalence of Chlamydia trachomatis serovars and genotypes could improve our understanding of C. trachomatis epidemiology and transmission. There have been few studies characterizing C. trachomatis detected in clinical specimens in Australia ([4][1], [7][2]). In one study of C.

Potential uses of probiotics in clinical practice.

Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. There is now mounting evidence that selected probiotic strains can provide health benefits to their human hosts. Numerous clinical trials show that certain strains can improve the outcome of intestinal infections by reducing the duration of diarrhea. Further investigations have shown benefits in reducing the recurrence of urogenital infections in women, while promising studies in cancer and allergies require research into the mechanisms of activity for particular strains and better-designed trials. At present, only a small percentage of physicians either know of probiotics or understand their potential applicability to patient care. Thus, probiotics are not yet part of the clinical arsenal for prevention and treatment of disease or maintenance of health. The establishment of accepted standards and guidelines, proposed by the Food and Agriculture Organization of the United Nations and the World Health Organization, represents a key step in ensuring that reliable products with suitable, informative health claims become available. Based upon the evidence to date, future advances with single- and multiple-strain therapies are on the horizon for the management of a number of debilitating and even fatal conditions.

Persistence of Lactobacillus fermentum RC-14 and Lactobacillus rhamnosus GR-1 but not L. rhamnosus GG in the human vagina as demonstrated by randomly amplified polymorphic DNA.

Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 are well-characterized probiotic strains with efficacy in the prevention and treatment of urogenital infections in women. The aim of the present study was to apply a molecular biology-based methodology for the detection of these strains and L. rhamnosus GG (a commercially available intestinal probiotic) in the human vagina in order to assess probiotic persistence at this site. Ten healthy women inserted vaginally a capsule containing either a combination of strains GR-1 and RC-14 or the GG strain for 3 consecutive nights. Vaginal swabs taken before and at various time points after probiotic insertion were analyzed, and the Lactobacillus flora was assessed by randomly amplified polymorphic DNA (RAPD) analysis. This method generated discrete DNA fingerprints for GR-1, RC-14, and GG and enabled successful detection of these strains in the vagina. Strain GR-1 and/or strain RC-14 was found to persist in the vaginal tract for up to 19 days after vaginal instillation, while L. rhamnosus GG was detectable for up to 5 days postadministration. In conclusion, the fates of probiotic L. rhamnosus and L. fermentum strains were successfully monitored in the human vagina by RAPD analysis. This technique provides molecular biology-based evidence that RC-14 and GR-1, strains selected as urogenital probiotics, persist in the human vagina and may be more suited to vaginal colonization than L. rhamnosus GG. This highlights the importance of proper selection of strains for urogenital probiotic applications.

Peculiarities of the course of urogenital infections in women of pre and postmenopause

Peculiarities of the course of urogenital infections in women of pre and postmenopause

31] Biosurfactants produced by Lactobacillus

Lactobacillus bacterial species have been shown to be important in the maintenance of a healthy gastrointestinal microbiota in men and women and to help protect against urogenital infections in women. The critical components of importance in antagonizing pathogenic bacteria include an ability of the lactobacilli to adhere to surfaces, inhibit attachment and growth of the pathogens, resist spermicidal killing, and coaggregate with other members of the microbiota to produce a balanced microbial niche. Strains of lactobacilli were found to produce a biosurfactants collectively termed surlactin, characterized by the ability to reduce liquid surface tension, as measured by the axisymmetric drop shape analysis (ADSA) and by the ability to inhibit the adhesion of enterococci and other uropathogens to polymer surfaces. The intriguing part about the surlactin is its potential importance in helping to regulate the microbiota of the urogenital tract, making it potentially a critical factor in health maintenance of a balanced microbiota. This chapter describes the methods used to identify biosurfactants. Expected results and clinical relevance has also been discussed.