1887

Abstract

Purulent or exudative genitourinary infections are a frequent cause of consultation in primary and specialized healthcare. The objectives of this study were: to determine the prevalence of and co-infections with and in vaginal secretion; and to use multilocus sequence typing (MLST) to analyse the genetic diversity of strains.

The samples were submitted for analysis (=5230) to a third-level hospital in Granada (Southern Spain) between 2011 and 2014; eight strains isolated during 2015 were randomly selected for MLST analysis. Culture and nucleic acid hybridization techniques were used to detect microorganisms in the samples.

The prevalence of was 2.4 % between 2011 and 2014, being higher during the first few months of both 2011 and 2012. Among samples positive for , co-infection with was detected in 29 samples and co-infection with spp. in 6, while co-infection with all three pathogens was observed in 3 samples. The only statistically significant between-year difference in co-infection rates was observed for with due to an elevated rate in 2011. MLST analysis results demonstrated a high genetic variability among strains circulating in our setting.

These findings emphasize the need for the routine application of diagnostic procedures to avoid the spread of this sexually transmitted infection.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000603
2017-10-01
2020-01-25
Loading full text...

Full text loading...

/deliver/fulltext/jmm/66/10/1436.html?itemId=/content/journal/jmm/10.1099/jmm.0.000603&mimeType=html&fmt=ahah

References

  1. World Health Organization Prevalence and incidence of selectod sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis: methods and results used by WHO to generate 2005 estimates. 2011
  2. World Health Organization Global prevalence and incidence of selected curable sexually transmitted infections: overview and estimates. 2001
  3. Ibarrola Vidaurre M, Benito J, Azcona B, Zubeldía N. Infectious pathology: vulvovaginitis, sexually transmitted diseases, pelvic inflammatory disease, tubo-ovarian abscesses. An Sist Sanit Navar 2009;32:29–38[PubMed]
    [Google Scholar]
  4. Smith KS, Tabrizi SN, Fethers KA, Knox JB, Pearce C et al. Comparison of conventional testing to polymerase chain reaction in detection of Trichomonas vaginalis in indigenous women living in remote areas. Int J STD AIDS 2005;16:811–815 [CrossRef][PubMed]
    [Google Scholar]
  5. Wangnapi RA, Soso S, Unger HW, Sawera C, Ome M et al. Prevalence and risk factors for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis infection in pregnant women in Papua New Guinea. Sex Transm Infect 2015;91:194–200 [CrossRef][PubMed]
    [Google Scholar]
  6. Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Paxton L et al. A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda. AIDS 1998;12:1211–1225 [CrossRef][PubMed]
    [Google Scholar]
  7. Van der Pol B, Kraft CS, Williams JA. Use of an adaptation of a commercially available PCR assay aimed at diagnosis of chlamydia and gonorrhea to detect Trichomonas vaginalis in urogenital specimens. J Clin Microbiol 2006;44:366–373 [CrossRef][PubMed]
    [Google Scholar]
  8. Sutton M, Sternberg M, Koumans EH, Mcquillan G, Berman S et al. The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001–2004. Clin Infect Dis 2007;45:1319–1326 [CrossRef][PubMed]
    [Google Scholar]
  9. Van der Pol B, Williams JA, Orr DP, Batteiger BE, Fortenberry JD. Prevalence, incidence, natural history, and response to treatment of Trichomonas vaginalis infection among adolescent women. J Infect Dis 2005;192:2039–2044 [CrossRef][PubMed]
    [Google Scholar]
  10. Silver BJ, Guy RJ, Kaldor JM, Jamil MS, Rumbold AR. Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis. Sex Transm Dis 2014;41:369–376 [CrossRef][PubMed]
    [Google Scholar]
  11. Cotch MF, Pastorek JG, Nugent RP, Hillier SL, Gibbs RS et al. Trichomonas vaginalis associated with low birth weight and preterm delivery. The vaginal infections and prematurity study group. Sex Transm Dis 1997;24:353–360[PubMed]
    [Google Scholar]
  12. Moodley P, Wilkinson D, Connolly C, Moodley J, Sturm AW. Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus. Clin Infect Dis 2002;34:519–522 [CrossRef][PubMed]
    [Google Scholar]
  13. Schwebke JR, Burgess D. Trichomoniasis. Clin Microbiol Rev 2004;17:794–803 [CrossRef][PubMed]
    [Google Scholar]
  14. Adad SJ, de Lima RV, Sawan ZT, Silva ML, de Souza MA et al. Frequency of Trichomonas vaginalis, Candida sp and Gardnerella vaginalis in cervical-vaginal smears in four different decades. Sao Paulo Med J 2001;119:200–205 [CrossRef][PubMed]
    [Google Scholar]
  15. Sutcliffe S, Neace C, Magnuson NS, Reeves R, Alderete JF. Trichomonosis, a common curable STI, and prostate carcinogenesis–a proposed molecular mechanism. PLoS Pathog 2012;8:e1002801 [CrossRef][PubMed]
    [Google Scholar]
  16. Laga M, Manoka A, Kivuvu M, Malele B, Tuliza M et al. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS 1993;7:95–102 [CrossRef][PubMed]
    [Google Scholar]
  17. Van der Pol B, Kwok C, Pierre-Louis B, Rinaldi A, Salata RA et al. Trichomonas vaginalis infection and human immunodeficiency virus acquisition in African women. J Infect Dis 2008;197:548–554 [CrossRef][PubMed]
    [Google Scholar]
  18. Wang CC, Mcclelland RS, Reilly M, Overbaugh J, Emery SR et al. The effect of treatment of vaginal infections on shedding of human immunodeficiency virus type 1. J Infect Dis 2001;183:1017–1022 [CrossRef][PubMed]
    [Google Scholar]
  19. Kirkcaldy RD, Augostini P, Asbel LE, Bernstein KT, Kerani RP et al. Trichomonas vaginalis antimicrobial drug resistance in 6 US cities, STD Surveillance Network, 20092010. Emerg Infect Dis 2012;18:939–943 [CrossRef][PubMed]
    [Google Scholar]
  20. Paulish-Miller TE, Augostini P, Schuyler JA, Smith WL, Mordechai E et al. Trichomonas vaginalis metronidazole resistance is associated with single nucleotide polymorphisms in the nitroreductase genes ntr4Tv and ntr6Tv. Antimicrob Agents Chemother 2014;58:2938–2943 [CrossRef][PubMed]
    [Google Scholar]
  21. Van der Pol B. Trichomonas vaginalis infection: the most prevalent nonviral sexually transmitted infection receives the least public health attention. Clin Infect Dis 2007;44:23–25 [CrossRef][PubMed]
    [Google Scholar]
  22. Cornelius DC, Robinson DA, Muzny CA, Mena LA, Aanensen DM et al. Genetic characterization of Trichomonas vaginalis isolates by use of multilocus sequence typing. J Clin Microbiol 2012;50:3293–3300 [CrossRef][PubMed]
    [Google Scholar]
  23. Soliman MA, Ackers JP, Catterall RD. Isoenzyme characterisation of Trichomonas vaginalis. Br J Vener Dis 1982;58:250–256 [CrossRef][PubMed]
    [Google Scholar]
  24. Krieger JN, Holmes KK, Spence MR, Rein MF, Mccormack WM et al. Geographic variation among isolates of Trichomonas vaginalis: demonstration of antigenic heterogeneity by using monoclonal antibodies and the indirect immunofluorescence technique. J Infect Dis 1985;152:979–984 [CrossRef][PubMed]
    [Google Scholar]
  25. Upcroft JA, Delgadillo-Correa MG, Dunne RL, Sturm AW, Johnson PJ et al. Genotyping Trichomonas vaginalis. Int J Parasitol 2006;36:821–828 [CrossRef][PubMed]
    [Google Scholar]
  26. Vanácová S, Tachezy J, Kulda J, Flegr J. Characterization of trichomonad species and strains by PCR fingerprinting. J Eukaryot Microbiol 1997;44:545–552 [CrossRef][PubMed]
    [Google Scholar]
  27. Snipes LJ, Gamard PM, Narcisi EM, Beard CB, Lehmann T et al. Molecular epidemiology of metronidazole resistance in a population of Trichomonas vaginalis clinical isolates. J Clin Microbiol 2000;38:3004–3009[PubMed]
    [Google Scholar]
  28. Meade JC, de Mestral J, Stiles JK, Secor WE, Finley RW et al. Genetic diversity of Trichomonas vaginalis clinical isolates determined by EcoRI restriction fragment length polymorphism of heat-shock protein 70 genes. Am J Trop Med Hyg 2009;80:245–251[PubMed]
    [Google Scholar]
  29. Conrad M, Zubacova Z, Dunn LA, Upcroft J, Sullivan SA et al. Microsatellite polymorphism in the sexually transmitted human pathogen Trichomonas vaginalis indicates a genetically diverse parasite. Mol Biochem Parasitol 2011;175:30–38 [CrossRef][PubMed]
    [Google Scholar]
  30. Maiden MC. Multilocus sequence typing of bacteria. Annu Rev Microbiol 2006;60:561–588 [CrossRef][PubMed]
    [Google Scholar]
  31. Brown HL, Fuller DD, Jasper LT, Davis TE, Wright JD. Clinical evaluation of affirm VPIII in the detection and identification of Trichomonas vaginalis, Gardnerella vaginalis, and Candida species in vaginitis/vaginosis. Infect Dis Obstet Gynecol 2004;12:17–21 [CrossRef][PubMed]
    [Google Scholar]
  32. Okonechnikov K, Golosova O, Fursov M. Unipro UGENE: a unified bioinformatics toolkit. Bioinformatics 2012;28:1166–1167 [CrossRef][PubMed]
    [Google Scholar]
  33. Van der Veer C, Himschoot M, Bruisten SM. Multilocus sequence typing of Trichomonas vaginalis clinical samples from Amsterdam, the Netherlands. BMJ Open 2016;6:e013997 [CrossRef][PubMed]
    [Google Scholar]
  34. Lamont RF, Sobel JD, Akins RA, Hassan SS, Chaiworapongsa T et al. The vaginal microbiome: new information about genital tract flora using molecular based techniques. BJOG 2011;118:533–549 [CrossRef][PubMed]
    [Google Scholar]
  35. Zheng MY, Zhao HL, di JP, Lin G, Lin Y et al. Association of human papillomavirus infection with other microbial pathogens in gynecology. Zhonghua Fu Chan Ke Za Zhi 2010;45:424–428[PubMed]
    [Google Scholar]
  36. Rodriguez-Cerdeira C, Sanchez-Blanco E, Alba A. Evaluation of association between vaginal infections and high-risk human papillomavirus types in female sex workers in Spain. ISRN Obstet Gynecol 2012;2012:1–7 [CrossRef][PubMed]
    [Google Scholar]
  37. World Health Organization Prevalence and incidence of selected curable sexually transmitted infections, Geneva. 2005;1–38
  38. Badman SG, Vallely LM, Toliman P, Kariwiga G, Lote B et al. A novel point-of-care testing strategy for sexually transmitted infections among pregnant women in high-burden settings: results of a feasibility study in Papua New Guinea. BMC Infect Dis 2016;16:250 [CrossRef][PubMed]
    [Google Scholar]
  39. Vallely A, Page A, Dias S, Siba P, Lupiwa T et al. The prevalence of sexually transmitted infections in Papua New Guinea: a systematic review and meta-analysis. PLoS One 2010;5:e15586 [CrossRef][PubMed]
    [Google Scholar]
  40. Vallely LM, Toliman P, Ryan C, Rai G, Wapling J et al. Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey. Sex Health 2016;13:420–427 [CrossRef][PubMed]
    [Google Scholar]
  41. Fernández G, Martró E, González V, Saludes V, Bascuñana E et al. Usefulness of a novel multiplex real-time PCR assay for the diagnosis of sexually-transmitted infections. Enferm Infecc Microbiol Clin 2016;34:471–476 [CrossRef][PubMed]
    [Google Scholar]
  42. Perea EJ, Alvarez-Dardet C, Borobio MV, Bedoya JM, Escudero J et al. Three years' experience of sexually transmitted diseases in Seville, Spain. Br J Vener Dis 1981;57:174–177 [CrossRef][PubMed]
    [Google Scholar]
  43. Romero Herrero D, Andreu Domingo A. Bacterial vaginosis. Enferm Infecc Microbiol Clin 2016;34:14–148 [CrossRef][PubMed]
    [Google Scholar]
  44. Varela JA, Otero L, García MJ, Palacio V, Carreño F et al. Trends in the prevalence of pathogens causing urethritis in Asturias, Spain, 1989-2000. Sex Transm Dis 2003;30:280–283 [CrossRef][PubMed]
    [Google Scholar]
  45. Vázquez F, Otero L, Ordás J, Junquera ML, Varela JA. Up to date in sexually transmitted infections: epidemiology, diagnostic approaches and treatments. Enferm Infecc Microbiol Clin 2004;22:392–411
    [Google Scholar]
  46. Bowden FJ. Was the Papanicolaou smear responsible for the decline of Trichomonas vaginalis?. Sex Transm Infect 2003;79:263 [CrossRef][PubMed]
    [Google Scholar]
  47. Papeš D, Pasini M, Jerončić A, Vargović M, Kotarski V et al. Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study. Int J STD AIDS 2017;28:613–615 [CrossRef][PubMed]
    [Google Scholar]
  48. Hesseltine HC, Wolters SL, Campbell A. Experimental human vaginal trichomoniasis. J Infect Dis 1942;71:127–130 [CrossRef]
    [Google Scholar]
  49. Bautista CT, Wurapa E, Sateren WB, Morris S, Hollingsworth B et al. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res 2016;3:4 [CrossRef][PubMed]
    [Google Scholar]
  50. Sobel JD. Nontrichomonal purulent vaginitis: clinical approach. Curr Infect Dis Rep 2000;2:501–505 [CrossRef][PubMed]
    [Google Scholar]
  51. Hawksworth J, Levy M, Smale C, Cheung D, Whittle A et al. Population structure and genetic diversity of the parasite Trichomonas vaginalis in Bristol, UK. Infect Genet Evol 2015;34:36–43 [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000603
Loading
/content/journal/jmm/10.1099/jmm.0.000603
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error