Urogenital Tract Infections Research Articles

Fournier’s Gangrene: Literature Review and Clinical Cases

Background: Fornier gangrene is an extremely rare disease of the genitals. This disease is a result of the urogenital tract, anorectal area, and genital skin infections, appearing usually in immunocompromised patients with diabetes, obesity, and malignant neoplasms. The basic treatment of Fournier gangrene includes an emergency surgical intervention combined with antibiotic therapy and detoxification. Methods: A review of recent papers comprising studies and reviews published in 2005–2016 was performed. The clinical cases were studied at the Department of Purulent Surgery Central Clinical Hospital No. 1, where 7 patients were diagnosed and treated. Results: The etiology, pathogenesis, clinical and laboratory presentation, diagnosis, treatment, and prognosis of Fournier gangrene are described in this article. The authors have described several clinical cases of patients with Fournier gangrene and with necrotic cellulitis and fasciomyositis of anterior abdominal wall, which is a manifestation of Fournier gangrene. Making allowance for the unfavorable epidemiological situation of syphilis in Russia, the increase in the incidence of complicated, atypical chancre, and therefore, the need for differentiation of Fournier gangrene with such manifestations of syphilis as necrotizing, esthiomenous chancre, indurative edema, the appropriate clinical examples are well explained in this article.

Efficacy of magneto-laser therapy in the treatment of ureaplasma infection

Aim. To study clinical and epidemiological data in males and females with ureaplasma infection and to evaluate efficacy of magneto-laser therapy used as additional treatment of ureaplasma infection.
 Methods. 104 patients (94 men and 10 women) with urogenital ureaplasma infection were observed. Patients were divided into two groups: a study group (n=55) that received standard and magneto-laser therapy, and a comparison group (n=49) that received only standard treatment. Polymerase chain reaction was used to investigate samples for Mycoplasma hominis, Ureaplasma parvum and urealyticum, and bacteriological study for Mycoplasma hominis and Ureaplasma spp. was additionally performed with determining their antibiotic susceptibility. Magnetic therapy was conducted with the use of Michelangelo device (Italy) for 10 minutes to small pelvis area for 10 days.
 Results. As a result, 78 (82.9%) males were diagnosed with uretritis, 52 (55.3%) with prostatitis, 37 (39.3%) with cystitis. In females monoinfection was more prevalent than in males (50.0% vs 40.4%). Ureaplasmosis predominantly affected subjects aged 20-29 (97.8%) and 30-39 (86.0%) years. In female group, patients aged 20-29 years prevailed, while in a male group - patients aged 30-39 years. In males, the association of Ureaplasma with Mycoplasma hominis (36.1%) prevailed.
 Conclusion. Complex treatment of ureaplasma infection of urogenital tract including magneto-laser therapy demonstrated high clinical efficacy and allowed achieving clinical and laboratory cure of ureaplasma infection in 85.4% of cases.

Lactobacilli and lactoferrin: Biotherapeutic effects for vaginal health

Protective human vaginal microbiota is characterized by several microbial strains, mainly members of Lactobacillus genus. During vaginal infections, the balance among these strains is altered producing opportunistic or pathogenic bacteria overgrowth. Antibiotic treatments often select for resistant organism or lead to adverse effects on beneficial microbiota. In this study the effect of a combination of L. acidophilus GLA-14 and L. rhamnosus HN001 with lactoferrin, a glycoprotein of the innate immune system exerting antimicrobial, immunomodulatory, and prebiotic actions, has been investigated. Results obtained using a human cervix in vitro model showed that supernatants from both probiotics exert a beneficial effect on cervix cells and that both strains were able to grown in biofilm and exhibited aggregation and adherence properties to biotic or abiotic surfaces. These properties are modulated and even increased by lactoferrin demonstrating the beneficial activity of this biotherapeutic agent combination to prevent and manage urogenital tract infections in women.

Cytotoxic Escherichia coli strains encoding colibactin isolated from immunocompromised mice with urosepsis and meningitis.

Immune-compromised mouse models allow for testing the preclinical efficacy of human cell transplantations and gene therapy strategies before moving forward to clinical trials. However, CRISPR/Cas9 gene editing of the Wsh/Wsh mouse strain to create an immune-compromised model lacking function of Rag2 and Il2rγ led to unexpected morbidity and mortality. This warranted an investigation to ascertain the cause and predisposing factors associated with the outbreak. Postmortem examination was performed on 15 moribund mice. The main lesions observed in these mice consisted of ascending urogenital tract infections, suppurative otitis media, pneumonia, myocarditis, and meningoencephalomyelitis. As Escherichia coli strains harboring polyketide synthase (pks) genomic island were recently isolated from laboratory mice, the tissue sections from the urogenital tract, heart, and middle ear were subjected to E. coli specific PNA-FISH assay that revealed discrete colonies of E. coli associated with the lesions. Microbiological examination and 16S rRNA sequencing confirmed E. coli-induced infection and septicemia in the affected mice. Further characterization by clb gene analysis and colibactin toxicity assays of the pks+ E. coli revealed colibactin-associated cytotoxicity. Rederivation of the transgenic mice using embryo transfer produced mice with an intestinal flora devoid of pks+ E. coli. Importantly, these barrier-maintained rederived mice have produced multiple litters without adverse health effects. This report is the first to describe acute morbidity and mortality associated with pks+ E. coli urosepsis and meningitis in immunocompromised mice, and highlights the importance of monitoring and exclusion of colibactin-producing pks+ E. coli.

Dysbiosis of the Vaginal Microbiota and Higher Vaginal Kynurenine/Tryptophan Ratio Reveals an Association with Chlamydia trachomatis Genital Infections.

The natural course of Chlamydia trachomatis urogenital tract infections varies between individuals. While protective immunity can occur, some women can become reinfected, contributing to the development of severe pathology. While the reasons for these differences are unknown, an individual's response to induced interferon-γ (IFN-γ) is suggested to be critical. IFN-γ induction of the enzyme indoleamine 2,3-dioxygenase, which depletes tryptophan, may be the key. One hypothesis suggests that indole-producing bacteria in the vaginal microbiota can provide a substrate for the Chlamydia to synthesize tryptophan, rescuing the Chlamydia from host IFN-γ attack. We studied a cohort of 25 women who were either, Chlamydia negative, Chlamydia positive with a single infection, or Chlamydia positive with repeated infection, to test our hypothesis. We characterized their vaginal microbiota, cytokine response, as well as their tryptophan, kynurenine and indole concentrations directly in vaginal secretions. We found that C. trachomatis urogenital tract infections either initial or repeat infections, were associated with elevated vaginal kynurenine/tryptophan ratios, primarily as a result of elevated kynurenine levels. In addition, vaginal microbiota of community state type (CST) IV showed significantly lower vaginal tryptophan levels compared to CST I and III, which might be related to a higher abundance of indole producers found within this group. Furthermore, we found a higher abundance of indole producers in women who cleared their Chlamydia infection post antibiotic treatment. This study demonstrates for the first time in vivo, the association between high vaginal kynurenine/tryptophan ratios and C. trachomatis infections. In addition, tryptophan depletion was associated with vaginal microbiota of CST IV.

Inhibitory effects of Garlic extract on uropathogenic Escherichia coli; Proteus mirabilis and Trichomonas vaginalis isolated from urogenital tract cases

Since various and numerous pathogenic microorganisms can infect and dwell human's urogenital tract, and because the ability of bacteria to develop resistance to antibiotics, in addition to the side effects of some of these antibiotics in treatment of infectious diseases, therefore we need to alternative herbal and non-antibiotic therapy for treating the urogenital tract infections such as Garlic (Allium sativum L.). The aim of the study is to investigate the antimicrobial effects of Garlic extract on local uropathogenic species of Escherichia coli, Proteus mirabilis and Trichomonas in cases of urogenital tract infections. The tested urogenital microorganisms were isolated and identified according to diagnostic features as golden of morphology and biophysiology for Escherichia coli, Proteus mirabilis and Trichomonas vaginalis. Fresh garlic bulbs were obtained from local markets of Iraq. The aqueous garlic extract (AGE) was performed according to standard method. The antibacterial activity of AGE was done against motility, adherence and biofilm formation, and compared with some UTI antibiotics. The antiparasitic activity of AGE was done against growth rate, motility and viability of cultured in vitro by use medium. current study suggest that the AGE has antibacterial effects against E. coli and Pr. mirabilis. The diameter of the inhibition zone was ranged from 27.0 to 28.0 mm for garlic extract, as compared with 12.0 to 18.0 mm for Ciprofloxacin against both genera; E. coli and Proteus mirabilis, respectively. The efficacy of adherence and biofilm formation by E. coli and Pr. Mirabilis was much reduced. The motility of these bacteria was completely inhibited following AGE exposure to 30%, and temporally inhibited by 20%. Furthermore, the growth rate, viability and motility of the studied protozoan parasite vaginalis were completely inhibited following exposure to crude extract of AGE post 1 hour, completely inhibited following AGE exposure of 30% post 24 hour, completely inhibited by 20% post 48 hour, completely inhibited by 10% post 72 hour and temporally inhibited by 5% post 96 hour, respectively.

Meta-Analysis on Safety of Dapagliflozin in Patients with Type 2 Diabetes Mellitus

Objective: To evaluate the safety of dapagliflozin for Type 2 Diabetes Mellitus (T2DM). Methods: A systematic search of Pubmed, Embase, Cochrance Library, Web of Science, CNKI, Wanfang Data and VIP database for randomized controlled trials (RCTs) comparing dapagliflozin with placebo was performed up to February 2018. The index words included dapagliflozin, type 2 diabetes mellitus and randomized controlled trial. Results: A total of 19 RCTs involving 7704 participants were incorporated into the study. Compared with placebo, dapagliflozin did not increase the risk of hypoglycemia [OR = 1.14, 95%CI (0.95, 1.36), P = 0.17] and hypotension [OR = 1.43, 95%CI (0.94, 2.17), P = 0.10], but significantly increased the incidences of renal adverse events [OR = 1.57, 95%CI (1.17, 2.09), P = 0.002], genital tract infection [OR = 3.65, 95%CI (2.93, 4.56), P < 0.00001] and urinary tract infection [OR = 1.36, 95%CI (1.15, 1.61), P = 0.0004] and related doses. Conclusions: Generally, dapagliflozin had no risk of hypoglycemia and hypotension in patients with T2DM, but there were risks of renal adverse events and urogenital tract infection. Due to the limitations of this study, larger samples and RCTs with long-term follow-up are needed for further verification.

Study the Association Between Diet Program on Human Semen, Biological Profile, and Anthropometric Measurements in Obese Men

Obesity has grown leading global health issues owing to its strong association with a high incidence of diseases that including male infertility. Infertility is the disability of a sexually active, non-contracepting couple to achieve pregnancy and reproduce. Congenital factors, acquired urogenital abnormalities, urogenital tract infections, endocrine disturbances, genetic abnormalities, immunological factors, obesity and lifestyle factors are among of infertility causes. Seminal analysis and serum levels of testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH) thyroid-stimulating hormone (TSH), Triiodothyronine (T3), Thyroxine (T4) as well as biological profile and anthropometric measurements in obese men evaluated before and after six-month weight loss programme as compared with baseline and reference range. There is a significant reduction in weight and high improvement semen, hormonal, biological profile and anthropometric measurements as compared to the reference range. The results may be due to the combination of the weight loss and improved nutrition.

Опыт клинического менеджмента смешанных инфекций урогенитального тракта у женщин

Опыт клинического менеджмента смешанных инфекций урогенитального тракта у женщин

Epidemiology of chlamydial infection and disease in a free-ranging koala (Phascolarctos cinereus) population.

Chlamydial disease continues to be one of the main factors threatening the long-term survival of the koala (Phascolarctos cinereus). Despite this, large epidemiological studies of chlamydial infection and disease in wild koala populations are lacking. A better understanding of the prevalence, transmission and pathogenesis is needed to improve control measures, such as the development of vaccines. We investigated the prevalence of Chlamydia pecorum infection and disease in 160 koalas in a peri-urban wild population in Queensland, Australia and found that 31% of koalas were Chlamydia PCR positive and 28% had clinically detectable chlamydial disease. Most infections were at the urogenital site (27%; both males and females) with only 14% at the ocular site. Interestingly, we found that 27% (4/15) of koalas considered to be sexually immature (9–13 months) were already infected with C. pecorum, suggesting that a significant percentage of animals are infected directly from their mother. Ocular infection levels were less prevalent with increasing age (8% in koalas older than 4 years), whereas the prevalence of urogenital tract infections remained high into older age (26% in koalas older than 4 years), suggesting that, after mother-to-young transmission, C. pecorum is predominantly a sexually transmitted infection. While 28% of koalas in this population had clinically detectable chlamydial disease (primarily urogenital tract disease), many PCR positive koalas had no detectable disease and importantly, not all diseased animals were PCR positive. We also observed higher chlamydial loads in koalas who were C. pecorum infected without clinical disease than in koalas who were C. pecorum infected with clinical disease. These results shed light on the potential mechanisms of transmission of C. pecorum in koalas and also guide future control measures, such as vaccination.

A twelve–year retrospective analysis of prevalence and antimicrobial susceptibility patterns of Ureaplasma spp. and Mycoplasma hominis in the province of Lower Silesia in Poland

ObjectiveGenital mycoplasmas are opportunistic pathogens that have been associated with urogenital infections in humans. Only a few groups of antimicrobials are available for treatment of urogenital tract infections caused by genital mycoplasmas. However, emerging resistance of mycoplasmas to antimicrobial agents has been reported worldwide. The aim of the study was a retrospective analysis of the prevalence and antimicrobial susceptibility patterns of M. hominis and Ureaplasma spp. in patients with urogenital tract infections during a twelve-year period between 2003 and 2015. Study designMycoplasma IST2 test was used for the detection, enumeration, identification and antimicrobial susceptibility testing of genital mycoplasmas in 1182 samples from 778 women and 404 men with genitourinary tract infection. Indicative enumeration in the test determines whether the mycoplasma count in the sample is equal or higher than the threshold set at 104 colony forming units. ResultsA total of 152 (12.8%) samples were found to be positive for genital mycoplasmas. M. hominis was detected only in three samples and Ureaplasma spp. in 141 samples. Both, M. hominis and Ureaplasma spp. were detected in the remaining eight samples. In the analyzed period between 2003 and 2015, a gradually increasing resistance of ureaplasmas to ciprofloxacin and clarithromycin and decreasing resistance to ofloxacin, erythromycin and tetracycline were observed. Pristinamycin, josamycin and doxycycline were most active against Ureaplasma spp. In contrast, fluoroquinolones had the lowest efficacy against Ureaplasma spp. and as many as 116 (82.3%) and 77 (54.6%) of Ureaplasma spp. isolates were resistant to ciprofloxacin and ofloxacin, respectively. M. hominis isolates were uniformly resistant to azithromycin, clarithromycin and erythromycin but susceptible to josamycin, ofloxacin, doxycycline and pristinamycin. One-third of these isolates were resistant to ciprofloxacin and tetracycline. ConclusionIn the study Ureaplasma spp. and M. hominis were detected with relatively low frequency in comparison with other studies however, most of these isolates were resistant to ciprofloxacin indicating the need for better management of ciprofloxacin prescription. Important limitations of Mycoplasma IST2 assay concerning antimicrobial susceptibility testing and divergences between breakpoints in the test and EUCAST guidelines point the need to introduce new methodologies to improve evaluation of resistant strains at our region.

Human Escherichia coli isolates from hemocultures: Septicemia linked to urogenital tract infections is caused by isolates harboring more virulence genes than bacteraemia linked to other conditions

Escherichia coli is the most common cause of bloodstream infections and community-acquired sepsis. The main aim of this study was to determine virulence characteristics of E. coli isolates from hemocultures of patients with a primary disease of urogenital tract, digestive system, a neoplastic blood disease, or other conditions. Results from a set of 314 E. coli isolates from hemocultures were compared to data from a previously published analysis of 1283 fecal commensal E. coli isolates. Genetic profiling of the 314 E. coli isolates involved determination of phylogenetic group (A, B1, B2, D, C, E, and F), identification of 21 virulence factors, as well as 30 bacteriocin-encoding determinants. Pulsed-field gel electrophoresis was used to analyze clonal character of the hemoculture-derived isolates. The E. coli isolates from hemocultures belonged mainly to phylogenetic groups B2 (59.9%) and D (21.0%), and less frequently to phylogroups A (10.2%) and B1 (5.7%). Commonly detected virulence factors included adhesins (fimA 92.0%, pap 47.1%, and sfa 26.8%), and iron-uptake encoding genes (fyuA 87.9%, fepC 79.6%, aer 70.7%, iucC 68.2%, and ireA 13.7%), followed by colibactin (pks island 31.5%), and cytotoxic necrotizing factor (cnf1 11.1%). A higher frequency of microcin producers (and microcin M determinant) and a lower frequency of colicin Ib and microcin B17 was found in hemoculture-derived isolates compared to commensal fecal isolates. E. coli isolates from hemocultures harbored more virulence genes compared to fecal E. coli isolates. In addition, hemoculture E. coli isolates from patients with primary diagnosis related to urogenital tract were clearly different and more virulence genes were detected in these isolates compared to both fecal isolates and hemoculture-derived isolates from patients with blood and gastrointestinal diseases.

Antimicrobial Activities of Some Medicinal Plants Against Multiresistants Microorganisms Causing Urogenital Tract Infections in Cameroon

Urogenital tract infections remain a serious global treat especially in women. The control of these infections is increasingly complicated due to development of resistance against available drugs. Therefore a perpetual search of new antimicrobial molecules is needed to face the challenge of microbial resistance. This study was initiated to screen the antimicrobial activities of methanol extracts of nine Cameroonian medicinal plants, used for the treatment of infectious diseases, against multiresistant pathogens isolated from urogenital infected patients. The plants included: <i>Cussonia arborea, Dissotis longipetala, Lonchocarpus sepium, Nauclea pobeguinii, Picralima nitida, Rumex abyssinicus, Rumex berqueatii, Sapium ellypticum, Psorospermum febrifigum,</i> They were tested on seven strains including six clinical isolates (<i>Escherichia coli, Proteus vulgaris, Providencia stuartii, Pseudomonas aeruginosa, Staphylococcus saprophiticus, Candida krusei</i>) and one reference strain <i>(E. coli JM109)</i>. Clinical strains were checked for their multiresistance using disc diffusion method. The antimicrobial activities were determined by agar well diffusion method. MICs were determined using microdilution assay. The phytochemical screening of plants was also done. All the bacteria strains were found to be multidrug-resistant (MDR) against at least 7 of the 12 antibiotics tested. Antimicrobial activities demonstrated that 6/9 (SE, DL, RA, RB, PN, LS) plants were active on at least six microorganisms. MICs ranged from 0.125 to 128mg/ml for crude extracts, from 0.5 to 0.16µg/ml for gentamicin and was 0,002mg/ml for fluconazole. One extract (NP) which showed limited results on agar, inhibited the growth of all the strains with MICs ranging from 1to 16mg/ml showing a limited activity of this extract on agar. We found that four extracts (SE, NP, RA, DL) have significant activities since they presented MICs ≤ 8mg/ml on at least 5 tested microorganism individually. Findings from phytochemical screening showed that most active extracts contain tannins, alkaloids and saponins which could be responsible of these activities.

2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis

2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis

2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Recurrent Urinary Tract Infection

2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Recurrent Urinary Tract Infection

Draft Genome Sequence of Streptococcus anginosus BVI, a New Vaginal Pathogen Candidate.

Streptococcus anginosus is a pathogen implicated in urogenital and gastroinstestinal tract infections. Here, we report the draft genome sequence of S. anginosus BVI, isolated from a bacterial vaginosis patient attending a prenatal care unit in Cali, Colombia. The genome sequence of BVI consists of 2,014,025 bp, encoding 2,008 predicted proteins.

Анализ результатов всеукраинского исследования применения препарата Лаферомакс в комплексной терапии урогенитальных инфекций и патологии шейки матки у женщин различного возраста

The article presents the results of a multicentre observational study conducted in Ukraine in 2015-2016. The purpose of which was to investigate the efficacy and safety of Laferomaks drug in women of different ages with HPV infection, combined with urogenital disorders mixed infection and cervical epithelium pathology. In 128 hospitals obstetrical and gynecological almost all regions of Ukraine was carried out a multicentre observational study, which was attended by 1 400 patients with various diseases of the pelvic organs. Studied Age ranged from 17 to 95 years. All included in the study was conducted a comprehensive survey, after which all patients received Laferomaks 3 million units. per day for 10 days in a combination or alone. Results of the study confirm the high efficiency of Laferomaks in the treatment of the urogenital tract infections: in patients with a diagnosis of CIN 1 and CIN 2 at follow-up examination CIN 0 probability was about 76%; in patients with warts was noted in 83% of their complete disappearance; in patients with a diagnosis of HPV in 71% indicated a negative result of PCR after treatment. It registered only 58 cases of side effects from the 1400, which made up 4.1%, which ensured to Laferomaks high compliance of patients. Received positive dynamics of subjective and objective state of the women surveyed, marked by high efficiency, good tolerability and safety of the drug Laferomaks. Key words: human papillomavirus, cervical pathology, urogenital mixed infection, Laferomaks.

Infecciones micóticas del tracto urogenital masculino, importantes aunque poco frecuentes: revisión sistemática

Introducción: las infecciones del tracto urogenital son una de las causas más frecuentes durante las consultas por infertilidad masculina. Comúnmente se evalúan aquellas causadas por bacterias y virus, mientras que las producidas por hongos han sido subvaloradas; sin embargo, en las últimas décadas su frecuencia ha aumentado. Objetivo: describir algunas micosis del tracto urogenital masculino y su posible efecto sobre la fertilidad. Materiales y métodos: se realizó una revisión sistemática de la literatura publicada sobre las micosis del tracto urogenital masculino y la fertilidad en las bases de datos PubMed, ScienceDirect, SciELO, Redalyc, Springer y Google Académico. Resultados: se encontraron un total de 3.426 publicaciones que hablaban sobre el tema. Entre la información revisada se comprobó que el 90% de las micosis reportadas en el tracto urogenital masculino son ocasionadas por Candida spp., Aspergillus spp., Cryptococcus spp. y Coccidioides spp., microorganismos que podrían ser los causantes de uretritis, balanopostitis, úlceras, pseudotumores, orquitis y prostatitis; además de afectar negativamente la calidad espermática, lo que causa alteraciones en la fecundación. Conclusiones: las infecciones fúngicas del tracto urogenital pueden desatar infertilidad, que si se tratan correctamente disminuirán la diseminación, morbilidad y mortalidad a causa de estos microrganismos.

A closer look at travellers' infections abroad: Finnish nationwide data with incidences, 2010 to 2012.

Although infections represent the most common health problem of travellers abroad, data on morbidity and incidences of various infections are scarce. Data on infections of Finnish travellers during 2010-2012 were retrieved from the database of SOS International, an assistance organization covering 95% of Finns requiring aid abroad. The study included 30,086 cases. For incidence calculation, the data were linked to the numbers of Finns visiting these regions during the same period as recorded by the Official Statistics of Finland. The incidence of infections was particularly high in Africa, southern Europe plus the eastern Mediterranean, and Asia plus Oceania. The most frequent diagnoses were acute gastroenteritis (38.0%) and respiratory-tract infections (RTI) (34.5%), followed by infections of the ear (12.6%), skin or subcutaneous tissue (5.1%), urogenital tract (4.2%), eye (3.1%), and systemic febrile infections (2.2%). Vaccine-preventable diseases (VPD) accounted for 0.8% of cases, with varicella as most (49%) and influenza as second-most (27%) common. Incidence of infections was higher in southern than in eastern and western Europe. Gastroenteritis and RTI proved the most frequent diagnoses, whereas systemic febrile infections were uncommon. Despite pre-travel immunizations, VPDs still occurred; pre-travel consultation should cover both varicella and influenza.

Infection and infertility

Infections in the urogenital tract are accepted causes of male infertility. Epidemiologic data indicate 6-10 % of all males undergoing andrological work-up for infertility having an infectious etiology. This review gives acomprehensive overview on the most important urogenital tract infections (prostatitis, epididymitis, orchitis, male accessory gland infection-MAGI) and the impact on fertility. In males suffering infertility, evidence is also presented regarding an infectious etiology.