Vaginal Swab Samples Research Articles

The reproductive tract microbiome in women with polycystic ovary syndrome and across different menstrual cycle phases.

Do polycystic ovary syndrome (PCOS), menstrual cycle phases, and ovulatory status affect reproductive tract (RT) microbiome profiles? We identified microbial features associated with menstrual cycle phases in the upper and lower RT microbiome, but only two specific differences in the upper RT according to PCOS status. The vaginal and uterine microbiome profiles vary throughout the menstrual cycle. Studies have reported alterations in the vaginal microbiome among women diagnosed with PCOS. This prospective case-control study included a cohort of 37 healthy control women and 52 women diagnosed with PCOS. Microbiome samples were collected from the vagina as vaginal swabs (VS) and from the uterus as endometrial flushing (EF) aspirate samples, and compared according to PCOS diagnosis, the menstrual cycle phases, and ovulatory status, at Oulu University Hospital (Oulu, Finland) from January 2017 to March 2020. A total of 83 VS samples and 80 EF samples were collected. Age and body mass index (BMI) were matched between women with and without PCOS. Clinical characteristics were assessed using blood samples collected between cycle days 2 and 8, and microbial DNA was sequenced on the Ion Torrent platform. Microbial alpha diversity (i.e. the observed number of unique genera and Shannon diversity index) was analysed across sample types, PCOS diagnosis and menstrual cycle phases. Linear mixed-effects models were utilised to identify microbial features in relation to PCOS and the menstrual cycle phases. Associations between the beta diversity of the RT microbiome and PCOS- and cycle-related clinical features were calculated using PERMANOVA. Microbial alpha diversity showed no difference with PCOS (VS: Pobserved feature = 0.836, Pshannon = 0.998; EF: Pobserved feature = 0.366, Pshannon = 0.185), but varied with menstrual cycle phases (VS: Pobserved feature = 0.001, Pshannon = 0.882; EF: Pobserved feature = 0.026, Pshannon = 0.048). No difference was observed in beta diversity based on either PCOS or the menstrual cycle phases (VS: PPCOS = 0.280, Pcycle = 0.115; EF: PPCOS = 0.234, Pcycle = 0.088). In the endometrial flushing samples, we identified two novel microbial features, characterised by the ratio of differential abundance of two genera, associated with PCOS (FDR ≤ 0.1) and 13 novel features associated with the menstrual cycle phases (FDR ≤ 0.1). Although this was the first study to simultaneously analyse, the lower and upper RT microbiome in women with and without PCOS, the limited sample size of anovulatory cases may hinder the detection of differences related to PCOS and ovulatory status. The main finding suggests that PCOS and the menstrual cycle phases are associated with specific microbial features in the upper RT, indicating that the analysis of the upper RT microbiome can potentially identify biomarkers for both PCOS and menstrual cycle phases. This research was funded by the Research Council of Finland (grants no. 315921, 321763, 336449), the Sigrid Jusélius Foundation, Novo Nordisk Foundation (grant no. NNF21OC0070372), and the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant (MATER, grant no. 813707). This research was also funded by the Estonian Research Council (grants no. PRG1076, PRG1414), the Horizon Europe grant (NESTOR, grant no. 101120075) of the European Commission, and EMBO Installation Grant (grant no. 3573). The funders did not participate in any processes of the study. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. N/A.

Vaginal colonization and vertical transmission of Candida species: prevalence and associated factors among pregnant women and their neonates at public health facilities of Northeast Ethiopia

BackgroundVaginal colonization by Candida can lead to vulvovaginal candidiasis, which is the second most prevalent vaginal condition globally. It is frequently associated with sepsis and adverse neonatal outcomes in pregnant women. This issue is worsening in Sub-Saharan Africa, including Ethiopia. However, evidence of the existing problem is very scarce yet crucial. Thus, this study aimed to determine the vaginal colonization and vertical transmission of Candida species and their associated factors among pregnant women and their neonates in public health facilities of northeast Ethiopia.MethodsA facility-based cross-sectional study was conducted at selected public health facilities in Dessie town from April 1 to June 30, 2023, among 348 pregnant women and their newborns, using convenience sampling techniques. Socio-demographic, and clinical-related data were collected using a pre-tested, semi-structured questionnaire. Vaginal swab samples from pregnant women and pooled swabs from the external ear, nasal area, and umbilical areas of the newborns were collected and transported using Amies transport media. The samples were inoculated into Sabouraud Dextrose Agar for isolation, followed by inoculation onto a standard CHROM agar Candida plate for species identification, and a germ-tube test confirmed pseudophyphae of C.albicans. Data was entered into Epi Data version 4.6.0 software and exported and analyzed by SPSS version 25.0. A stepwise logistic regression model was used to identify the associated factors. Variables with p < 0.05 and their 95% confidence interval were considered statistically significant.ResultA total of 348 pregnant women attending vaginal delivery were included in the study. The maternal and neonatal colonization rates of Candida species were 14.1% (49/348) and 6.3% (22/348), respectively. The overall proportion of vertical transmission of Candida species was 44.9% (22/49, 95% CI: 41.2, 49.7). Among Candida isolates, 63.3% (31/49) were C. albicans and 36.7% (18/49) were C. krusei. Gestational diabetes mellitus (AOR: 4.2, 95% CI: 1.23–38.6, P = 0.047) and HIV (AOR: 1.58, 95% CI: 1.11–6.12, P = 0.049) were independently associated with maternal colonization of Candida species. Moreover, rural residence (AOR = 3.6, 95% CI: 1.37–9.5, P = 0.010) and maternal age above 28 years (AOR = 2.39, 95% CI: 1.97–5.89, P = 0.048) were independently associated with vertical transmission of Candida species.ConclusionThe findings of this study highlight the need for effective screening and treatment of Candida colonization during antenatal care.

Epidemiology of Vulvovaginal Candidiasis in Greece: A 2-Year Single-Centre Study.

The epidemiology of vulvovaginal candidiasis (VVC) in Greece remains poorly reported and outdated. We therefore conducted a 2-year retrospective survey to assess the epidemiological aspects of the infection among symptomatic Greek patients. High vaginal swab samples were collected from adult women with clinically suspected VVC attending a private diagnostic laboratory in Athens. VVC was confirmed through microscopic examination of a wet mount preparation revealing yeasts and Candida-positive culture. Species were identified by MALDI-ToF MS, and invitro susceptibility was determined according to the EUCAST-E.Def 7.4. Predisposing host factors were associated with the occurrence of the infection and isolated Candida spp. using Fisher's exact test, and epidemiological changes over time were analysed with the χ2 test for trend. Among 1300 women screened, 283 VVC episodes were recorded among 233 (18%) patients, whereof 11 (5%) had recurrent VVC (RVVC) and 19 (8%) had mixed Candida infections. Coinfection with other pathogens and recent prior use of antifungals were associated with RVVC. Candida albicans was the most prevalent pathogen (50%), followed by Candida parapsilosis sensu stricto (SS) (35%), Nakaseomyces glabratus (former Candida glabrata) (10%), Pichia kudriavzevii (former Candida krusei) (3%), Candida orthopsilosis (1.5%) and Clavispora lusitaniae (former Candida lusitaniae) (0.5%). Regarding the RVVC cases, 54% were attributed to C. albicans, 37% to N. glabratus and 9% to C. parapsilosis SS. Resistance to fluconazole was found in 4% of C. albicans and 23% of N. glabratus strains with cross-resistance to other azoles. Fluconazole-resistant isolates were recovered from 5 of 11 RVVC patients, whereof 4 of 5 had previous exposure to azoles. During the study period, an increase in N. glabratus VVC and fluconazole resistance was noted. VVC is common in our region, with C. albicans as the predominant species, followed by C. parapsilosis SS and N. glabratus. Fluconazole resistance is low in C. albicans but high in N. glabratus, emphasising the need for targeted antifungal strategies.

Investigation of the Most Common Specimens in the Pediatric Hospital in Kirkuk and the Epidemiology of Predominant Bacteria Using Multiple Antibiotic Resistance Indices

Background: Urinary tract infections (UTIs) are among the most prevalent infectious diseases in children and are a leading cause of antibiotic use and pediatric hospitalization. Objectives: This study aimed to investigate the most common specimens and determine the frequency of Multiple Antibiotic Resistance Indexes (MARI) for predominant bacteria in the pediatric hospital of Kirkuk. Methods: A total of 299 different samples were collected from the pediatric hospital in Kirkuk province between May 1st and October 1st. The samples were cultured on blood agar, mannitol agar, and MacConkey agar and incubated for 24 hours at 37°C. Identification was based on morphological and microscopic examination, as well as the API kit. Results: The results showed that most of the samples were urine, with 221 samples collected. Of these, 66 (28.50%) showed positive growth, and 155 (71.49%) showed negative growth. Blood samples were the second most common, with 51 samples collected, of which 4 (9.61%) were positive, and 47 (90.38%) were negative. Stool samples amounted to 13, with 2 (15.38%) showing positive growth, and 11 (84.61%) showing negative growth. Cerebrospinal fluid (CSF), throat swab, and vaginal swab samples amounted to 11, 2, and 1, respectively, with no bacterial growth observed in them. The majority of isolates were from urine, with Escherichia coli being the most common species (28 isolates, 42.42%). Other species isolated included Klebsiella pneumoniae (13 isolates, 19.69%), Staphylococcus spp. (12 isolates, 19.05%), Enterobacter spp. (7 isolates, 10.61%), and Pseudomonas spp. (4 isolates, 6.06%). Proteus spp. and Streptococcus spp. each accounted for 1 isolate (1.25%). The bacteria isolated from blood were Acinetobacter spp., Enterobacter spp., Pseudomonas spp., and Klebsiella spp., each representing 1 isolate (1.25%) of the total. Two (100%) E. coli isolates were obtained from stool samples. E. coli isolates from urine were resistant to ampicillin (Am), tetracycline (Te), amoxicillin/clavulanic acid (AMC), and doxycycline (Do). Klebsiella spp. were resistant to Am, Staphylococcus spp. to erythromycin (E) and azithromycin (AZM), Enterobacter spp. to amikacin (AK) and AMC, and Pseudomonas aeruginosa to gentamicin (CN), all exhibiting 100% resistance. The MARI was greater than 0.2 in 27 isolates of E. coli (96.42%), 13 isolates of Klebsiella spp. (100%), 11 isolates of Staphylococcus spp. (91.66%), 7 isolates of Enterobacter spp. (100%), and 4 isolates of P. aeruginosa (100%). Conclusions: The current study concludes that urinary tract infection is the most common pathological condition among the young age group. Urine is one of the most frequently examined samples, with E. coli being the most predominant pathogen. The study also highlights the prevalence of antibiotic-resistant bacteria, as evidenced by the elevated MARI in isolates of E. coli, K. pneumoniae, Enterobacter spp., and Pseudomonas spp.

The Frequency of Trichomonas vaginalis Infection in Married Women in Al-Khums City, Libya

Trichomonas vaginalis is a parasitic protozoan that infects the urogenital tract of individuals globally, affecting both women and men. There are various methods to detect T. vaginalis, including clinical diagnosis and laboratory examination. "The purpose of this study was to determine the prevalence of T. vaginalis among married women in Al-Khums, Libya. The comparison between four different diagnostic methods to detect T. vaginalis, vaginal swab samples from women who visited Souq Al-Kamlesh Hospital during the period from February 2022 to July 2022 from different regions of the city (Al-Khums, Lebdah, Seline, Souq AlKhamees, Kaam and Caucasus) and collected 350 samples and analyzed them. The highest infection rate is recorded at pH &lt; 7 in 68.75% of cases. The Whiff test resulted in 13 positive samples (3.71%), the culture medium method Cystine-Peptone-Liver infusion- Maltose (CPLM) recorded 16 positive samples (4.57%), and the Giemsa dye staining method recorded 16 positive samples (4.57%). The age groups were more affected by women aged 45 years (28.5%), followed by the age groups between 35 and 45 years at a rate of 4.59%. The lowest infection rate was in the 15-25 (1.90%) age group, with significant differences (P ? 0.05). Furthermore, the most common injuries among women were from Al-Khums region (7.76%), followed by Souq Al-Khamees region (3.94%) and finally Kaam region (2.94%). Cases of miscarriage (10.15%) are found more frequently in this study. The culture and staining methods were used to detect the highest infection rate of Trichomonas vaginal and achieve better results than other methods.

Utility of Cand PCR in the Diagnosis of Vulvovaginal Candidiasis in Pregnant Women.

Vulvovaginal candidiasis (VVC) can lead to multiple complications when it occurs during pregnancy, so it is necessary to diagnose it promptly for effective treatment. Traditional methods for identifying Candida spp. are often too time-consuming and have limited specificity and sensitivity. In this work, we evaluated the diagnostic utility of an endpoint PCR assay (Cand PCR) in vaginal swab specimens. Using a cotton swab, 108 vaginal swab samples were taken from pregnant women who consented to participate in the study. The samples were inoculated in Sabouraud agar plates (the gold standard) and subsequently used to extract DNA directly from the exudate. The yeasts isolated from the Sabouraud agar were identified in CHROMagar™ Candida. DNA extracted from vaginal swabs was amplified by Cand PCR. Based on the results of the Cand PCR and the gold standard, sensitivity (S), specificity (E), positive predictive values (PPVs), and negative predictive values (NPVs) were determined. Cand PCR presented an S = 65%, E = 100%, PPV = 100% and NPV = 91%. Cand PCR showed low sensitivity for detecting Candida spp. directly from vaginal swabs, but it was useful for identifying the etiologic agent and reducing the time to obtain the result, which is usually at least 48 h.

Livestock abortion surveillance in Tanzania reveals disease priorities and importance of timely collection of vaginal swab samples for attribution

Lack of data on the aetiology of livestock diseases constrains effective interventions to improve livelihoods, food security and public health. Livestock abortion is an important disease syndrome affecting productivity and public health. Several pathogens are associated with livestock abortions but across Africa surveillance data rarely include information from abortions, little is known about aetiology and impacts, and data are not available to inform interventions. This paper describes outcomes from a surveillance platform established in Tanzania spanning pastoral, agropastoral and smallholder systems to investigate causes and impacts of livestock abortion. Abortion events were reported by farmers to livestock field officers (LFO) and on to investigation teams. Events were included if the research team or LFO could attend within 72 hr. If so, samples and questionnaire data were collected to investigate (a) determinants of attribution; (b) patterns of events, including species and breed, previous abortion history, and seasonality; (c) determinants of reporting, investigation and attribution; (d) cases involving zoonotic pathogens. Between 2017–2019, 215 events in cattle (n=71), sheep (n=44), and goats (n=100) were investigated. Attribution, achieved for 19.5% of cases, was significantly affected by delays in obtaining samples. Histopathology proved less useful than PCR due to rapid deterioration of samples. Vaginal swabs provided practical and sensitive material for pathogen detection. Livestock abortion surveillance, even at a small scale, can generate valuable information on causes of disease outbreaks, reproductive losses and can identify pathogens not easily captured through other forms of livestock disease surveillance. This study demonstrated the feasibility of establishing a surveillance system, achieved through engagement of community-based field officers, establishment of practical sample collection and application of molecular diagnostic platforms.

Livestock abortion surveillance in Tanzania reveals disease priorities and importance of timely collection of vaginal swab samples for attribution.

Lack of data on the aetiology of livestock diseases constrains effective interventions to improve livelihoods, food security and public health. Livestock abortion is an important disease syndrome affecting productivity and public health. Several pathogens are associated with livestock abortions but across Africa surveillance data rarely include information from abortions, little is known about aetiology and impacts, and data are not available to inform interventions. This paper describes outcomes from a surveillance platform established in Tanzania spanning pastoral, agropastoral and smallholder systems to investigate causes and impacts of livestock abortion. Abortion events were reported by farmers to livestock field officers (LFO) and on to investigation teams. Events were included if the research team or LFO could attend within 72 hr. If so, samples and questionnaire data were collected to investigate (a) determinants of attribution; (b) patterns of events, including species and breed, previous abortion history, and seasonality; (c) determinants of reporting, investigation and attribution; (d) cases involving zoonotic pathogens. Between 2017-2019, 215 events in cattle (n=71), sheep (n=44), and goats (n=100) were investigated. Attribution, achieved for 19.5% of cases, was significantly affected by delays in obtaining samples. Histopathology proved less useful than PCR due to rapid deterioration of samples. Vaginal swabs provided practical and sensitive material for pathogen detection. Livestock abortion surveillance, even at a small scale, can generate valuable information on causes of disease outbreaks, reproductive losses and can identify pathogens not easily captured through other forms of livestock disease surveillance. This study demonstrated the feasibility of establishing a surveillance system, achieved through engagement of community-based field officers, establishment of practical sample collection and application of molecular diagnostic platforms.

BVDV comprehensive studies and species identification in high-yielding livestock populations in the Sverdlovsk Oblast

The paper presents results of comprehensive studies of the bovine viral diarrhea virus circulating in cattle populations in the Sverdlovsk Oblast. In 2018–2024, 113 biological samples were tested using polymerase chain reaction, the viral RNA specific regions were detected in 15.9% of cases.The BVDV RNA was isolated from biological samples collected from aborted cows (61.1%) and calves under one month of age (38.9%). Based on typing results, the virus isolates detected in four samples (nasopharyngeal swabs of calves, suspension prepared from aborted fetus organs and placenta) were classified as BVDV-1 virulent genotypes. The BVDV RNA, Mycoplasma bovis and Chlamydophila pecorum DNAs were detected simultaneously in 44% of vaginal swab samples from aborted cows and, in single cases, in the placenta and parenchymatous organs of dead calves; BVDV RNA and Bovine herpesvirus type 1 DNA were detected in 16% of pathological samples from dead calves. In some cases, the BVDV RNA, Chlamydophila pecorum and Mycoplasma bovigenitalium DNA were detected in nasopharyngeal swabs of calves. The “Comprehensive Programme for Biosecurity and Bovine Viral Diarrhea Situation Improvement in Agricultural Organizations”implemented in the Sverdlovsk Oblast in 2018 resulted in decreased number of agricultural establishments affected by bovine viral diarrhea. Acute and persistent infection forms among young animals were recorded 4 and 3.5 times less frequently, respectively, but at the same time, a 2.5-fold increase in the diagnosed latent form of the disease was observed in adult livestock, which is associated with an increase in the number of laboratory tests performed.

Effect of metronidazole on concentrations of vaginal bacteria associated with risk of HIV acquisition.

Several bacterial vaginosis (BV)-associated bacteria have been associated with elevated risk of human immunodeficiency virus (HIV) acquisition; however, susceptibility of these bacteria to antibiotics is poorly understood. Vaginal samples were collected from 22 persons daily for 2 weeks following BV diagnosis. Metronidazole treatment was prescribed for 5-7 days. Changes in bacterial concentrations were measured with taxon-specific 16S rRNA gene quantitative PCR (qPCR) assays. A culture-based antimicrobial assay confirmed presence of antibiotics in vaginal swab samples. Bacterial DNA concentrations decreased during antibiotic administration for all 13 bacterial taxa tested. Comparison of bacterial DNA concentrations in samples before administration of antibiotics to samples taken on the last day of antimicrobial assay-confirmed antibiotic presence showed a 2.25-4.78 log10-fold decrease across all taxa. Concentrations were frequently reduced to the qPCR assay's limit of detection, suggesting eradication of bacteria. Mean clearance time varied across taxa (1.2-7.9 days), with several bacteria (e.g., Sneathia spp., Vaginal TM7, and Eggerthella-like sp.) taking >7 days to suppress. Metronidazole reduces quantities of bacterial taxa associated with increased HIV acquisition risk.IMPORTANCEHuman immunodeficiency virus (HIV) transmission through sex remains a major public health challenge despite efforts at risk reduction and use of anti-retroviral pre-exposure prophylaxis. Many bacterial vaginosis (BV)-associated vaginal bacteria have been associated with increased HIV infection risk among women. If these bacteria help mediate HIV infection risk, then eradication of these bacteria is one potential strategy to reduce this risk. However, the best approach to eradicate HIV-high risk bacteria from the vagina is not known. We analyzed vaginal swabs collected daily from women with BV to determine the impact of metronidazole treatment on 13 vaginal bacterial taxa linked to elevated risk of HIV infection through use of taxon-directed quantitative PCR assays. We conclude that eradication of high-risk vaginal bacteria using metronidazole is one promising avenue for reducing HIV acquisition risk, and we provide evidence that a 5-7-day treatment course may not be sufficient to suppress all bacteria.

Analysis of risk factor microflora colonization on pregnancy vagina in makassar

Introduction: Worldwide infection rates based on estimated 20-30 % colonization at 35 weeks gestation. During normal pregnancy colonization transient, intermittent, or chronic infection and the spectrum varies from asymptomatic colonization to the sepsis. Intrapartum transmission of bacteria from mother to neonatal, will cause the infection develops into neonatal sepsis during childbirth. This study aimed to determine the proportion of the colonization of gram positive and negative bacteria in pregnant women over 31 weeks of age. Research Methodology: This research uses vaginal swab samples from pregnant women and blood samples from babies who are born, then these samples will be examined in the Unhas Hospital laboratory. Vaginal swab samples via transport medium will be placed in BHIB medium then incubated at 270 C for 24 hours. Result: Prevalence of gram-positive bacterium identified Streptococcus species (0.9%), S. Aureus (11.8%) and S. Epidermidis (78.4%). For gram-negative bacteria had identified; Enterobacter Sp (32.3%), Providencia Sp (12.7%), Proteus Sp (8.8%), Acinetobacter sp (5.9%) and E. Coli (6.9%). Candida Sp obtained on SDA culture and gram staining followed by a number of 54 samples (55.1%). The symptom was to be is Discharge Vagina over 30% cases. Among 76.6% with habitually antiseptic usual. Based on data statistical analysis can be concluded that the age have a significance level 0:01 (ρ &lt; 0.05) .and contraceptive used have a significance level of 0.038 (ρ &lt; 0.05), had a relationship with a potential fetomaternal infection to infant. Conclusion: that maternal age and history of contraceptive use are significantly associated with bacterial colonization in pregnant women. These findings underscore the need to consider demographic and behavioral factors when assessing and managing vaginal health during pregnancy. Effective educational interventions focusing on proper hygiene practices and the risks associated with antiseptic soap use, coupled with targeted monitoring of older pregnant women and those with a history of contraceptive use, are recommended to reduce the risks associated with vaginal microbial colonization

Molecular Detection of Coxiella burnetii in Vaginal Swab Samples from Sheep That Aborted.

Background: Coxiella burnetii, an obligate intracellular bacterium, is the etiological agent of Q fever in humans and one of the causes of abortion in small ruminants. Although coxiellosis is considered an exotic disease, there are a few reports in Mexico. Methods: The objective of this work was to determine the presence of C. burnetii DNA in vaginal samples from sheep that presented abortion and ram semen. A total of 180 vaginal exudate samples and 20 semen samples were obtained from five Central and Southern States of Mexico. Total DNA was extracted from vaginal swabs and C. burnetii was identified by PCR amplification and sequencing of the IS1111 insertion sequence. Results and Conclusion: In total, 110 (110/180) vaginal samples and 12 (12/20) semen samples were positive for C. burnetii. This is the first report of C. burnetii in sheep that aborted and in ram semen in Mexico.

Diagnosis of Chlamydia abortus by Isolation in Cell Culture and Real Time PCR in Aborted Sheep and Goats

Background: Ovine enzootic abortion (OEA) caused by Chlamyidia abortus is one of the most important abortive disease in small ruminants. Diagnosis of Ovine enzootic abortion depends on the isolation and detection of the agent or its nucleic acid. The aim of the present study was to detect Chlamydia abortus using both isolation method and real-time PCR in Brucella free flocks in Iran. Methods: Twenty-eight vaginal and conjunctival swab samples which were Chlamydia abortus seropositive, were selected from ewes and does with recent abortion. Then the samples were tested by real-time PCR and positive molecular samples were inoculated into McCoy cells. Results: Using real-time PCR, 18 samples (64.3%) were positive and 7 (25%) of them were isolated in cell culture. Conclusion: The present results indicate that Chlamydia can play a relatively significant role in the abortion in does and ewes in Iran. Although the isolation of Chlamydia abortus have 100% specificity, because of low sensitivity, time consuming, cost and high probability of contamination, it is not suitable for routine laboratory diagnosis. Therefore, applying real-time PCR which have high sensitivity and specificity is recommended.

Integrating Clinical and Microbiological Expertise to Improve Vaginal Candidiasis Management.

Vaginal candidiasis (VC) is a prevalent condition among women of reproductive age and poses a significant global public health challenge. However, the disease is often diagnosed and treated without mycological information. We investigated the epidemiology, laboratory diagnostics, and antifungal susceptibility of VC. We included 300 women from Çukurova University Obstetrics and Gynecology outpatient clinic in Adana, Türkiye. Participants underwent a health survey and provided vaginal swab samples for microscopic examination and fungal culture. The microscopic analysis involved wet-mount and gram-stained slides, whereas fungal identification involved CHROMAgar Candida, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and real-time polymerase chain reaction high-resolution melting analysis (RT-PCR HRMA). Antifungal susceptibility tests were conducted at pH 7 and 4 using the CLSI document M44-A2. Of the 106 women with positive fungal cultures, 86.8% were diagnosed with VC, whereas 13.2% showed Candida colonization. Among those with VC, 55.4% had acute and 44.6% had recurrent VC; a family history of allergies increased the risk for both types. We recovered 115 yeast isolates, predominantly C. albicans, C. glabrata, and C. krusei. Diagnostic accuracy of CHROMAgar Candida was 91.3% for the most common isolates, and HRMA was consistent in differential diagnosis. Antifungal resistance varied with pH; susceptibility to fluconazole, itraconazole, and ketoconazole decreased at pH 4, whereas susceptibility to miconazole increased. Our findings underscore the need for a diagnostic algorithm and enhanced collaboration between clinicians and microbiologists to improve VC management. Recommendations include using Gram staining, CHROMAgar Candida, MALDI-TOF MS, and antifungal susceptibility tests at both pH levels.

Molecular Diagnosis of Vaginal Microbiota Associated with Spontaneous Abortion in Women

Spontaneous abortion (SA) is a sever disease in which a women losses her foetus usually before 24 weeks of the pregnancy. About 10% -50% of pregnancy cases are run out with SA for reasons related with women's age and health. This condition occurrence may increases if the patient has a history of bacterial vaginosis. This study aimed at the characterization and isolation of vaginal microbiota generally and highlight on commensal bacteria becoming opportunistic when circumstances are favourable. From October to December 2022, about 100 samples were collected, 50 specimens from women with SA and 50 specimens from healthy pregnant outcomes (control). The high vaginal swabs samples were collected from Babylon Teaching Hospital for Maternity and Children and Imam Sadiq Teaching Hospital in Babylon, Iraq. To culture the samples, they were transported by media swab to laboratory. The culture of bacteria was done on 4 types of agar media: UTI chromogenic agar, MRS agar, MacConkey agar and blood agar. The first identification of bacteria was based on phenotypic traits of colonies, using manual biochemical tests and gram stain. Finally, the diagnosis was confirmed genetically by extracting bacterial genomic DNA for 20 of bacterial isolates under study and using PCR technique for 16S rRNA Loci gene and sequencing. The current study results showed difference in bacterial genera in women with SA compared with healthy women. It was also noted that embroilment of Enterococcus faecalis occurred in most cases of SA with an estimated percentage of 56% (28/50), thus defeating Escherichia coli by 32% (16/50) and 4% (2/50) for Klebsiella pneumonia and 4% (2/50) for Enterococcus gallinarum. In this study, some very rare bacteria species were identified including Acinetobacter junii at 2% (1/50) and Corynebacterium coyleae at 2% (1/50). While the percentage of bacteria associated with healthy women was: 30% (15/50) for E. faecalis, 26% (13/50) for E. coli, 18% (9/50) for K. pneumonia, 24% (12/50) for Staphylococcus epidermidis, and 2% (1/50) for Metabacillus niabensis (which was diagnosed for the first time in Iraq as well as the rest of the world in a clinical sample).

Clinical Validation and Comparison of Bacterial Vaginosis Detection

Abstract Introduction/Objective Bacterial vaginosis (BV) is considered a top reason for women’s gynecological visits, causing symptoms such as vaginal discharge, foul odor, itching, and burning associated with the alteration of the normal vaginal microbiome. It is often presented as a decrease in Lactobacillus spp. and an increase in anaerobic organisms such as Gardnerella vaginalis and Atopobium vaginae. In response to the demand for more automated and less subjective testing, molecular methods have recently been developed to aid in BV testing. The objectives of this study are to validate and compare the molecular Aptima® Bacterial Vaginosis Assay by Hologic® to the established BV Screen via a Gram stained vaginal smear graded through Nugent scoring at RUSH University Medical Center in Chicago, IL and perform a cost analysis between the testing methods. Methods/Case Report Samples of known BV value were tested on the Panther® instrument to validate the Aptima® Bacterial Vaginosis Assay for accuracy and precision. Clinical samples of vaginal swabs were used to make a Gram stained BV screen for Nugent scoring, then afterwards were placed into Hologic Multitest Aptima® probes for molecular testing on the Panther® instrument. Nugent scoring was performed blind by the molecular test. Molecular results of negative, positive, and invalid were then compared to the Nugent scores: scores of 0-3 for negative/normal vaginal flora, 7-10 for positive BV, and 4-6 for intermediate/altered scores were screened for discrepancy. Results (if a Case Study enter NA) The Aptima® BV Assay tested 52 known samples with 97% accuracy and 100% precision. A total of 80 clinical samples of vaginal swabs used for Gram stained BV screens were run on the Aptima® BV Assay; 61 provided conclusive data for comparative analysis. When compared to the original Nugent scores, the positive percent agreement (PPA) was 77.0% and negative percent agreement (NPA) was 92.9%. Conclusion The Aptima® BV Assay proved to be both accurate and precise in its validation testing. Clinically, it was able to screen for BV in vaginal samples with a good percent agreement to Gram stained BV screens. Further testing of additional clinical samples are to be done to continue analysis. Although the supplies needed to perform a Gram stain cost less than molecular testing, the reimbursement payment for molecular testing is much greater and overall reduces employee time costs for performing the test, making it the more cost effective choice for the laboratory.

Frequent Evaluation of Herpes Simplex Virus Type 2 in Women with Genital Herpes by Realtime PCR

Background: Herpes simplex type 2 is a common infection worldwide. This disease is common in both developed and developing countries. Early detection of infection is very important to reduce the risk of infection. Real-time reliable PCR is a very sensitive and specific method that can be used as the best marker in determining the therapeutic effect by identifying a viral genome in an individual. The prevalence of herpes simplex virus type 2 in women with genital herpes was evaluated by Real time PCR method. Methods: From January 1999 to March 2010, 45 samples of vaginal swabs and cervix of women with genital herpes were examined for HSV virus DNA detection using Real Time PCR. Results: The mean age of the patients was 35.9 + 5.9. The percentage of positive cases of herpes simplex virus type 2 in the studied women was 22.2% and the history of infection with hpv was 33.3% vs. 12.5%. = 0.094 which was significant. Conclusion: Clinical specimens of vaginal swabs from genital herpes caused by herpes simplex virus 2 can be quantitatively analyzed instead of nucleic acid extraction and amplification by PCR.

Evaluation of the Causative Microorganisms and Antibiogram Results in Women with Vaginal Swab Culture Taken with Prediagnosis of Vaginitis

Aim: Vaginitis occurs when the vaginal flora is disturbed. This study aimed to evaluate the demographic data, causative microorganisms, and antibiogram results of women who underwent vaginal swab culture with a prediagnosis of vaginitis. Methods: Vaginal swab samples from 314 women who visited the Kafkas University Department of Obstetrics and Gynecology were included in the study. Women with immunosuppressive diseases, gynecological malignancies, and IUD use were excluded. Vaginal discharge or swab samples were Gram stained and cultured on various media. Microorganisms were identified using conventional and biochemical methods, and antibiotic susceptibility tests were performed using the Kirby-Bauer disk diffusion method, according to the EUCAST guidelines. Statistical analyses were performed using SPSS, with categorical variables assessed using the chi-square test or Fisher's exact test, and continuous variables assessed using the Mann-Whitney U test. The study complied with the recommendations of the Declaration of Helsinki for human biomedical research and was approved by the Non-Interventional Clinical Research Ethics Committee of the Kafkas University Faculty of Medicine. Results: The median age of 314 women included in this study was 39 (20-69) years. . In total, 73.6% (n=231) were premenopausal, 24.5% (n=77) were postmenopausal, and 1.9% (n=6) were pregnant. The most common complaint was abdominal/pelvic pain (142, 45.2%). Vaginal cultures from 123 women (39.1%) showed the growth of different microorganisms. The most common causative microorganism was Escherichia coli (41.5%). According to the antibiogram results, the most sensitive antibiotic was gentamicin (65.9%), and ampicillin (52.8 %) was the most resistant. Conclusion: It is important to quickly and accurately identify microorganisms involved in the etiology of the correct treatment.

ASSESSMENT OF VAGINAL INFECTION AND IDENTIFICATION OF MICROBES ASSOCIATED WITH UNEXPLAINED PRETERM LABOUR

Background: Preterm birth (&lt; 37 completed gestation weeks) is a leading contributor to neonatal morbidity and mortality. Despite advances in perinatal medicine in recent decades, preterm delivery continues to pose a challenge to both the obstetricians and the neonatologists. Among many factors that trigger preterm labour, infection is a possible cause. The present study deals with the demographic and baseline characteristics of preterm labour patients, identification of vaginal flora and their relationship with unexplained preterm labour. Material and methods: For the present prospective observational study, 350 cases of preterm labour were included. All the pregnant women in the present study were enrolled after excluding all exclusion criteria. A thorough systemic and obstetric examination was done along with detailed history of each patient. Vaginal swab samples were taken from the posterior fornix of the vagina. Samples were examined microscopically and also inoculated onto appropriate culture media to identify vaginal flora and degree of infection. Results: Maximum cases of preterm labour were reported in females of the 20-25 years age group. Females of primigravida showed the highest number of preterm labour as well as infections. Concerning the gestation period (weeks), 34-36 weeks showed a higher frequency of preterm labour as well as infections.Incidence of preterm labour was higher in females who had a previous history of two preterm deliveries and who had a previous history of one abortion. Vaginal infection and urinary tract infection were reported in 34.57% and 24% of total cases studied, respectively. In vaginal swabs Lactobacillus, Gardnerella vaginalis, fungi(yeast), Candida, Gram positive Cocci, Escherichia coli and mixed microbes were the prevalent microorganisms identified. Gram staining results of vaginal swabs revealed the presence of Lactobacillus,Gardnerella vaginalis,Mobiluncus, Fungi(yeast),Gram positive bacilli,Gram negative cocci. Among these Lactobacillus and Gardnerella were the most common.In vaginal swab culture Enterococusspp,Streptococcusaureus,Escherichiacoli,Proteus mirabilis,Pseudomonas,Staphylococcus coagulase,Candida,Acetinobacter,Klebseillaand mixed microbes were isolated and identified.Among these Candida,Escherichia coliand mixed microbes were the most commonly isolated micro-organisms. Conclusion: Vaginal infection significantly contributes to the cause of preterm labour. It indicates the need to screen, all antenatal women for the precipitating cause of PTL, especially asymptomatic genitourinary infections. There should be measures to manage them as early recognition and timely and prompt treatment can help to reduce preterm labour cases and associated neonatal morbidity and mortality of premature newborns.

Evaluation of the Prevalence, Antimicrobial Resistance Trait, and Virulence Determinants in Staphylococcus aureus Isolates from the Anogenital Area of 35-37 Weeks Pregnant Women

Staphylococcus aureus is a major pathogen in the postpartum period being frequently implicated as a cause of mastitis, and nursery outbreaks, among others as well as its increasing resistance to common antibiotics. This study therefore aimed at evaluating the presence of S. aureus in pregnant women attend¬ing clinics in rural towns in Eastern Cape, South Africa. A total of 82 pregnant women at 35‒37 weeks of gestation were sampled for the presence of S. aureus. Using standard microbiological methods, presump¬tive S. aureus isolates were obtained from vaginal and rectal swab samples. The isolates were confirmed by conventional polymerase chain reaction and then tested for antimicrobial susceptibility using the disc diffusion technique. Presence of resistance genes and virulence determinants were equally profiled. A to¬tal of 47 (57.3%) out of 82 pregnant women were colonized with S. aureus. Only two virulence genes PVL- 37/47 (78.7%) and eta-10/47 (21.3%) were detected in the isolates. The isolates were all resistant to penicillin G and clindamycin (100%), while resistances to tetracycline, vancomycin, rifampicin were 71% and resistance to oxacillin and erythromycin were above 80% while resistance to other antibiotics tested were below 40%. The isolates showed multiple resistance to 5-6 antimicrobials with indices ranging from 0.5-0.6. Genes encoding resistance to erythromycin (ermB), tetracycline (tetM), and rifampicin (rPOB) were found in 72.7% (34/47) of the isolates, while 15% (7/47) possessed the Bla-Z (penicillin). The high antibiotics resistance traits found in the isolates analysed indicates limited therapeutic options and portents a major threat to public health.