Vaginal Secretions Of Women Research Articles

Investigation of SARS-CoV-2 in vaginal secretions of women with coronavirus disease 2019

Abstract Objectives The present study investigates the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the vaginal swabs of female patients diagnosed with coronavirus disease 2019 (COVID-19) based on a positive real-time reverse transcription polymerase chain reaction (RT-PCR) test on a combined throat and nasopharyngeal swab. Methods This study included 48 female patients hospitalized in two tertiary hospitals diagnosed with COVID-19 based on a positive RT-PCR test of the combined throat and nasopharyngeal swab samples, along with clinical and radiological findings. The IBM SPSS software package was used for the statistical analysis of the study data. Results SARS-CoV-2 positivity was detected in only one patient (2.08 %) in the present study from RT-PCR tests of vaginal swab samples. This patient was a 64-year-old, postmenopausal woman who tested positive for SARS-CoV-2 in a RT-PCR test of a vaginal swab sample six days after having tested positive in an RT-PCR test of a combined throat and nasopharyngeal swab. The patient’s partner also tested positive for SARS-CoV-2 in an RT-PCR of a combined throat and nasopharyngeal swab. Conclusions The present study is the first to report the presence of SARS-CoV-2 in vaginal secretions in Türkiye. The authors believe there is a need for studies investigating the presence of SARS-CoV-2 in the semen samples of the male partners of female patients to establish whether the presence of SARS-CoV-2 in vaginal secretions can play a role in the transmission of the virus.

Detection of Creatinine in Vaginal Secretions of Women with Premature Rupture of Membranes in Third Trimester from Semiurban Population: A Cross-sectional Study

Introduction: Spontaneous rupture of the membranes any time beyond the 28th week of pregnancy but before the onset of labour is called Premature Rupture of Membranes (PROM). There are many techniques for diagnosing PROM that is based on both clinical assessments and biological studies. Each of these procedures has benefits and drawbacks. Since foetal urine is the major source of amniotic fluid, the presence of vagina and a high creatinine level may aid in the diagnosis of PROM. Aim: To determine the cut-off levels of serum creatinine in predicting the PROM. Materials and Methods: A cross-sectional study was conducted at Dr. DY Patil Medical College, Hospital and Research Centre in Pune, Maharashtra, India from June 1 2020 to June 5 2021. Two equal groups of 140 each pregnant women with gestational ages ranging from 28-42 weeks were created: one with a history of vaginal leaking (the study group, P), and the other with gestationally matched no leakage (the control group, C). Patient’s details such as age, gestational age, and obstetric history were noted. Each patient was examined and cervicovaginal secretions were collected. A 5 mL of saline was flushed in the posterior fornix of vagina. This fluid with vaginal wash was aspirated and creatinine concentration from vaginal fluid was determined by Jaffee synthetic chemical colorimetric method. The Student’s t-test and the Chi-square test were used to analyse the data. Results: The study group’s vaginal fluid creatinine level was substantially higher (p-value<0.001). The cut-off value of 0.6 mg/dL had highest sensitivity 96.1% and specificity 100%. The area under the Receiver Operating Characteristics (ROC) curve was 0.917. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of serum creatinine at cut-off 0.6 mg/dL was 100% and 96.3% respectively. Conclusion: Vaginal fluid creatinine is simple and easily available, which makes it acceptable to the candidate for a diagnosis of PROM.

Investigation and Analysis of 49343 Case Women's Vaginal Microecology.

Background:We aimed to investigate the pathogen infection in vaginal secretions of women in Linyi area.Methods:From October 2016 to September 2018, a total of 49,343 vaginal secretion specimens from women who attended Women and Children’s Health Care Hospital of Linyi District, Shandong Province, China were used to detect the cleanliness, Candida, clue cells, Trichomonas, etc. with Ultra-high power microscopy.Results:Among the 49343 patients, 6377 had vaginal cleanliness of degree I∼II, the detection rate was 37.89%; 10455 cases of III∼IV degree, the detection rate was 62.11%; 13193 cases of simple vaginal pathogen infection, the detection rate was 26.74%. Among them, 9256 cases of vaginal Candida (VVC) had a detection rate of 18.76%; 3176 cases of Bacterial vaginosis (BV) had a detection rate of 6.44%; and 761 cases of Trichomonas infection (TV) had a detection rate 1.54%; 899 cases of mixed infection. The detection rate was 1.82% and the detection rate of each pathogen in the 18–30 year old group was the highest. The detection rates of VVC, BV, TV and MVI were 10.80%, 3.25%, 0.65%, 1.00%, repsectively.Conclusion:The incidence of VVC women with vaginitis in Linyi was the highest, and the incidence was mainly between 18 and 40 years old. The infection rate of VVC, BV and MVI pathogens was the highest in summer, and the infection rate of TV was the highest in autumn.

Evaluation of SARS-CoV-2 in the Vaginal Secretions of Women with COVID-19: A Prospective Study.

Objective: We aimed to investigate the likelihood of vaginal colonization with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant and non-pregnant women with Coronavrus Disease 2019 (COVID-19). Materials and Methods: Vaginal swabs were taken from women diagnosed with mild to moderately acute SARS-CoV-2 infection, at Wolfson Medical Center, Israel, from March 2020 through October 2020. COVID-19 was diagnosed by real-time polymerase chain reaction (RT-PCR) performed on nasopharyngeal swabs. Vaginal swabs were tested for the presence of SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Results: In total, 51 women diagnosed with COVID-19 were included in the study. Of the 51 women with COVID-19 enrolled in this study, 16 (31.4%) were pregnant at enrollment and 35 (68.6%) were non-pregnant. Mean age was 43.5 ± 15.3 years (range 21–74 years). Compared to the non-pregnant group, the pregnant group was characterized by a higher white blood cell and absolute neutrophil count (p = 0.02 and p = 0.027, respectively). The non-pregnant patients were more likely to have chronic diseases (p = 0.035) and to be hospitalized (p < 0.001). Only one patient (1.9%) aged 60 years tested positive for SARS-CoV-2 in vaginal secretions. Mean gestational age at the diagnosis of COVID-19 of the pregnant group was 32.3 ± 7.8 weeks. Thirteen patients delivered during the study period; all delivered at term without obstetric complications and all neonates were healthy. Conclusions: Detection of SARS-CoV-2 in the vaginal secretions of patients diagnosed with COVID-19 is rare. Vaginal colonization may occur during the viremia phase of the disease, although infectivity from vaginal colonization needs to be proven.

High Co-Infection Rate of Trichomonas vaginalis and Candidatus Mycoplasma Girerdii in Gansu Province, China

Trichomonas vaginalis (Tv) is a flagellated protist parasite that infects the human urogenital tract. The symbiotic relationship between Tv and Mycoplasma hominis has been reported. Recent studies have identified a new Mycoplasma strain, Candidatus Mycoplasma girerdii (Ca. M. girerdii), present in the vaginal secretions of women and have shown that this strain may be related to trichomoniasis. Here, we evaluated the presence of Tv, M. hominis and Ca. M. girerdii in 312 clinical samples from adult women diagnosed with vaginitis in Zhangye, Gansu province, China. Among these samples, 94, 153, and 48 were Tv, M. hominis and Ca. M. girerdii positive, respectively. Moreover, Tv was highly frequent in 17–30-year-old women in this region. Forty samples (83.3%) positive for Ca. M. girerdii were also positive for Tv. Six Tv isolates were successfully cultured, including five isolates that showed symbiotic relationships with Mycoplasma. This is the first report to evaluate the genetic characteristics of Ca. M. girerdii in China and may therefore provide insights into the effects of Ca. M. girerdii on the reproductive health of women.

A Non-Invasive Determination of LOXL1 and Fibulin-5 Levels in the Vaginal Secretions of Women with and Without Pelvic Organ Prolapse.

The aim of this study was to determine if lysyl oxidase-like 1 (LOXL1) and Fibulin-5 (Fib-5), two crucial proteins in the elastin metabolism pathway, are detectable in the vaginal secretions of women with and without pelvic organ prolapse (POP). We then sought to quantify levels of these proteins in relation to prolapse. Vaginal secretions were obtained from 48 subjects (13 (27.1%) without and 35 (72.9%) with POP-Q Stage 2-4 prolapse). Eleven (22.9%) subjects were premenopausal and 37 (77.1%) were postmenopausal. Presence of LOXL-1 and Fibulin-5 within specimens were first identified via western blotting. Enzyme-Linked Immunosorbent Assays specific for LOXL1 and Fibulin-5 were conducted to quantify total protein secretion. LOXL1 was detected in 45/48 (93.8%) and Fibulin-5 was seen in 24/48 (50%) of subjects. LOXL1 values were lower in women without prolapse (13.3 ng/100 mg median, 24.4 IQR) vs. those with prolapse (26.4 ng/100 mg, 102.2 IQR). On multivariate analysis controlling for age, women with prolapse had a 544% (p=0.0042 higher LOXL1 protein level compared to those without. There was no significant differences in LOXL1 or Fibulin-5 protein detection with relation to menopausal status in bivariate analysis. This is the first published report of non-invasively measuring urogenital LOXL1 and Fibulin-5. In vaginal secretions, LOXL1 protein is higher in subjects with POP than those without.

Predictive value of vaginal IL-6 and TNFα bedside tests repeated until delivery for the prediction of maternal-fetal infection in cases of premature rupture of membranes

ObjectiveExamine the predictive value for maternal-fetal infection of routine bedside tests detecting the proinflammatory cytokines, TNFα and IL-6, in the vaginal secretions of women with premature rupture of the membranes (PROM). Study designThis prospective two-center cohort study included all women hospitalized for PROM over a 2-year period. A bedside test assessed IL-6 and TNFα in vaginal secretions. Both centers routinely tested CRP and leukocytes, assaying both in maternal serum, and analyzed vaginal bacterial flora; all samples were repeated twice weekly until delivery. ResultsThe study included 689 women. In cases of preterm PROM (PPROM) before 37 weeks (n=184), a vaginal sample positive for one or more bacteria was the only marker associated with early neonatal infection (OR 5.6, 95%CI; 2.0–15.7). Its sensitivity was 82% (95%CI; 62–94) and its specificity 56% (95%CI; 47–65). All positive markers of infection were associated with the occurrence of chorioamnionitis. In cases of PROM from 37 weeks onward (n=505), only CRP >5mg/dL was associated with early neonatal infection (OR=8.3, 95%CI; 1.1–65.4) or clinical chorioamnionitis (OR=6.8, 95%CI; 1.5–30.0). The sensitivity of CRP >5mg/dL was 91% (95%CI; 59–100) and its specificity 45% (95%CI; 40–51) for predicting early neonatal infection, and 89% (95%CI; 65–99) and 46% (95%CI; 41–51), respectively, for predicting clinical chorioamnionitis. ConclusionThe association of vaginal cytokines with maternal-fetal infection is weak and thus prevents their use as a good predictor of maternal-fetal infection. CRP and vaginal samples may be useful for identifying a group of women at low risk of infection.

Expression of Cytokines in Vaginal Secretion of Women with Yeast Colonization

Expression of Cytokines in Vaginal Secretion of Women with Yeast Colonization

Placental α-Microglobulin-1 in Vaginal Secretions of Women with Evidence of Preterm Labor.

To evaluate the presence of placental α-microglobulin-1 (PAMG-1) in vaginal secretions in women with symptoms of preterm labor and assess its use as a predictor of preterm birth. A prospective cohort study of women between 16 and 34 weeks of gestation with symptoms of preterm labor and intact membranes was conducted. The presence of PAMG-1 was determined using a commercially available kit (AmniSure, AmniSure International LLC, Boston, MA). A total of 100 women were enrolled, of which 86 had outcome data available. PAMG-1 was detected in 19/86 (22.1%) subjects. These women were more likely to deliver within 7 days than those without PAMG-1 detected (6/19 [31.6%] vs. 5/67 [7.5%]; odds ratio 5.6; 95% confidence interval 1.5-21.6). These findings persisted after adjusting for potential confounders. The sensitivity was 54.6%, specificity was 82.7%, positive predictive value was 31.6%, and the negative predictive was 92.5%. The presence of PAMG-1 is associated with an increased likelihood of delivery within 7 days.

Is variation in copy number of the human beta defensin gene cluster associated with preterm birth?

BackgroundIncreased expression of antimicrobial peptides including human beta defensins (HBD) has been reported in the amniotic fluid and vaginal secretions of women who deliver preterm. We have previously shown that these women have increased first trimester serum HBD2. The gene encoding HBD2, DEFB4A, is part of a defensin beta (DEFB) cluster on chromosome 8 that is variable in copy number. Increased serum HBD2 is associated with increased DEFB copy number. We aimed to test the hypothesis that variation in DEFB copy number is associated with preterm birth. MethodsIn a retrospective, case-control study, genomic DNA and serum were extracted from blood collected from white European women at 11–13 weeks' gestation attending King's College Hospital between March 1, 2006, and Sept 30, 2010. DEFB copy number was determined by paralogue ratio test. Serum HBD2 concentration was measured by ELISA. Data were analysed with Pearson correlation (Excel, version 2010) and binary logistic regression (SPSS, version 20). FindingsCases were 102 women who either delivered preterm in the index pregnancy or had a history of preterm delivery. Controls were 152 women who had had at least one previous term delivery and delivered at term in the index pregnancy; they had no history of preterm birth. Modal copy number was 4 (range 2–7). Serum was available from 140 women (30 cases, 54 controls, 56 not included in the genetic association study). Median HBD2 concentration was 761·5 pg/mL (IQR 449·6–1232·0). There was no association between DEFB copy number and preterm birth, nor was there a correlation between copy number and serum HBD2 concentration. InterpretationAlthough variation in HBD2 protein expression in the first trimester might be useful to predict risk of preterm birth, we found no association between DEFB copy number and preterm birth. Nor did we find a correlation between DEFB copy number and serum HBD2 expression in the first trimester of pregnancy; this might be due to variation in regulatory sequences—some of which are progesterone and oestrogen sensitive—between individual copies. FundingWellcome Trust, Wellbeing of Women.

Genital ulceration does not increase HIV-1 shedding in cervical or vaginal secretions of women taking antiretroviral therapy

ObjectivesGenital ulcer disease (GUD) is associated with increased HIV-1-RNA shedding in antiretroviral therapy (ART)-naive women. The effect of GUD on HIV-1 shedding among ART-treated women is not known. The objective...

519: Validity of bedside test to detect inflammatory status in vaginal secretions of women with premature rupture of membranes

Infection/inflammation after Premature Rupture of the Membranes (PROM) is one of the most important complications to avoid. However, the results of usual tests may take days and often are not available in time for clinical decisions. The aim of this study was to compare the results of repetitive screening with the immunochromatographic bedside test to detect IL-6 and IL-8 in vaginal secretions after PROM with the results of ELISA tests.

Importance of Isolation and Biotypization of Gardnerella Vaginalis in Diagnosis of Bacterial Vaginosis

The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13.5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20.5% of women with subjective problems of vaginal infection, and in 48.80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2.58% of cases it was solitary, while in 1.28% it was found in combination with other aerobic and anaerobic bacteria and, in 1.28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0.05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2.58% cases. Following Benit biotype scheme, biotypes IVa, IVc and IIc were identified in 12.90% cases, while biotypes IIIa, IIa, Ia, IVb, IIb were found in 6.45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.

Antifungal activity of the extracts and saponins from Sapindus saponaria L.

Extracts from the dried pericarp of Sapindus saponaria L. (Sapindaceae) fruits were investigated for their antifungal activity against clinical isolates of yeasts Candida albicans and C. non-albicans from vaginal secretions of women with Vulvovaginal Candidiasis. Four clinical isolates of C. albicans, a single clinical isolated of each of the species C. parapsilosis, C. glabrata, C. tropicalis, and the strain of C. albicans ATCC 90028 were used. The hydroalcoholic extract was bioactivity-directed against a clinical isolate of C. parapsilosis, and showed strong activity. The n-BuOH extract and one fraction showed strong activity against all isolates tested. Further column-chromatography on silica gel separation of this fraction afforded two pure triterpene acetylated saponins: 3-O-(4-acetyl-beta-D-xylopyranosyl)-(1->3)-alpha-L-rhamnopyranosyl-(1->2)-alpha-L-arabinopyranosyl-hederagenin (1) and 3-O-(3,4-di-acetyl-beta-D-xylopyranosyl)-(1->3)-alpha-L-rhamnopyranosyl-(1->2)-alpha-L-arabynopyranosyl-hederagenin (2). The structures of the compounds were based on spectral data ((1)H and 13C NMR, HSQC, HMBC and MS), and on with literature. The saponins isolated showed strong activity against C. parapsilosis.

Improving Second-Generation Surveillance

Second-generation surveillance for HIV includes measures of high-risk behaviors among the general adult population and sex workers (SW). Questionnaires are prone to social desirability biases because individuals minimize the frequency of behaviors not expected from them. Determine whether the prostate-specific antigen (PSA) could be used as a biological marker of unprotected intercourse. We measured the presence of PSA in vaginal secretions of women who were (n = 508) or were not (n = 658) SW presenting with vaginal discharge in health facilities of Ghana, Togo, Guinea, and Mali. The cutoff for a positive assay was determined as > or =0.4 microg/L based on a subsample of 95 non-SW claiming abstinence for 3 months. A positive PSA assay was correlated with infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium. Among non-SW, a positive PSA was more common among those with HIV, but less frequent in those better educated. Among SW and non-SW, women from Ghana were less likely to have a positive PSA and had a lower prevalence of sexually transmitted infections than those from elsewhere. PSA can be used as a biological marker of unprotected intercourse, allowing interventions to target efforts on those at highest risk.

Detection of interleukin-6 in vaginal secretions of women with preterm premature rupture of membranes and its association with neonatal infection: A rapid immunochromatographic test

The purpose of this study was to evaluate the diagnostic value of an interleukin-6 (IL-6) bedside test of vaginal secretions for neonatal infection in cases of preterm premature rupture of membranes. This prospective clinical study included 73 patients. Interleukin-6 protein in vaginal secretions was determined with an immunochromatographic bedside test in <20 minutes. Elevated C-reactive protein level (>20 mg/dL; odds ratio, 5.1; 95% CI, 0.9-28.6) and positive interleukin-6 level (odds ratio, 4.6; 95% CI, 1.2-18.4) were both associated with neonatal infection. After adjustment, only interleukin-6 remained associated with neonatal infection (odds ratio, 4.5; 95% CI, 1.1-18.5). The sensitivity of interleukin-6 for the prediction of neonatal infection was 79% (95% CI, 65-92); its specificity was 56% (95% CI, 42-70); its positive predictive value was 30% (95% CI, 12-47), and its negative predictive value was 92% (95% CI, 84-99). Interleukin-6 protein determination by this new immunochromatographic test is a noninvasive prenatal vaginal marker of neonatal infection.

Induction of vaginal Lactobacillus phages by the cigarette smoke chemical benzo[ a]pyrene diol epoxide

Because smoking increases a woman's risk of contracting bacterial vaginosis (BV), which is manifested by a reduction of vaginal lactobacilli and an overgrowth of anaerobic bacteria, chemicals contained in cigarette smoke were analyzed in vitro to determine their role in reducing lactobacilli. The result showed that trace amounts of benzo[ a]pyrene diol epoxide (BPDE), which can be found in vaginal secretion of women who smoke, significantly increased phage induction in lactobacilli. This finding implies that smoking may reduce vaginal lactobacilli by promoting phage induction.

A study of the prevalence of hydrogen peroxide generating Lactobacilli in bacterial vaginosis: the determination of H2O2 concentrations generated, in vitro, by isolated strains and the levels found in vaginal secretions of women with and without infection

The concentration of hydrogen peroxide in the vaginal secretions of normal women were compared with levels found in women infected with bacterial vaginosis (BV). The mean concentration found in 90 normal samples was 0.171 μg per ml, whereas in women with BV, the mean level was 0.04 mug per ml (P < 0.001). In vitro culture experiments using TMB agar showed that in normal women, 75% of Lactobacillus strains produced H2O2 and 25% did not, whereas in women 'infected' with BV. 14% of the isolates produced H2O2 and 86% did not (P < 0.001). Quantitative culture tests showed that both anaerobic and facultative strains of Lactobacilli isolated from normal women generated significantly higher levels of H2O2 than strains cultured from women with BV. Anaerobic strains isolated from normal women produced a mean level of 6.8 μg per ml, compared with the mean level of 1.4 μg per ml from women with BV. Facultative strains from normal women produced mean levels of 18.3 μg per ml compared with 2.4 μg per ml produced by strains from BV-infected women, which had been incubated under the same conditions (P < 0.001). There results indicate that Lactobacilli which produce H2O2 probably have a significant role in protecting the vaginal ecosystem from BV infection.

Comparative analysis of methods for collection and measurement of immunoglobulins in cervical and vaginal secretions of women

The purpose of this study was to systematically compare 3 collection methods, Sno-strips, wicks and cervical–vaginal lavage, for analysis of immunoglobulin concentrations in female genital secretions. In each of 8 women, absorbent wicks and Sno-strips were applied at 4 locations: the lateral wall of the vagina; the posterior vaginal fornix; the surface of the exocervix; and the endocervical canal. Cervical–vaginal lavage was then performed in 4 women with 5 ml PBS. Immunoglobulin and protein concentrations in lavage samples were generally over 100 times lower than in the secretions captured directly from mucosal surfaces with either Sno-strips or wicks. Capture of undiluted secretions with either wicks or Sno-strips allowed calculation of actual immunoglobulin concentrations at specific mucosal sites: for example, median IgA levels were consistently highest in the endocervix and lowest in the vagina. Such information may be crucial in evaluating the correlates of protective immunity against micro-organisms that infect or invade discrete regions of the genital mucosa.

The determination of amines in the vaginal secretions of women in health and disease.

The presence of amines in vaginal fluid is thought to be an important contributory factor in the pathogenesis of bacterial vaginosis (BV). As part of on-going work investigating the aetiology of this infection, two separate studies were performed in which gas chromatography was used to measure and compare the amines present in the vaginal secretions of normal women, a group infected with BV and some having other sexually transmitted diseases. The amines studied were methylamine, isobutylamine, putrescine, cadaverine and phenylethylamine. The results of the studies were contrary to expectations, in that they showed an overall similarity in both normal women and in those with BV and other vaginal infections. These findings now bring in to question the validity of amines being a reliable focus, either in the diagnosis of BV, or in investigations into the aetiology of the disease.