Bacterial vaginosis among a group of married Jordanian women: occurrence and laboratory diagnosis

A total of 310 vaginal swabs collected from a group of married Jordanian women complaining of vaginal discharge were examined for bacterial vaginosis. The scoring system of Nugent for the interpretation of Gram staining was employed. This system revealed the presence of the condition in 29.7% of patients. Results obtained using the scoring system correlated significantly with the detection of clue cells and the scarcity of white blood cells in the vaginal discharge. An inverse relationship was found between bacterial vaginosis and Lactobacillus morphotypes determined by Gram staining. No definite relationship was detected between bacterial vaginosis and the recovery of Gardnerella vaginalis by culture as this organism was isolated from swabs which according to the Nugent criterion were negative for bacterial vaginosis. Bacterial vaginosis among the women investigated was more prevalent than vaginitis caused by Trichomonas vaginalis or yeasts.     

Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis

Background

Identifying modifiable factors that increase women''s vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition.

Methods and Findings

We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (I ² values 0.0%–16.1%). Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18–1.83), insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00–1.71), and intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01–1.53) remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04–1.47). Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, p<0.001) or at the visit before the estimated date of HIV infection (aHR 1.41 and 1.53, p<0.001), respectively.

Conclusions

This study provides evidence to suggest that some intravaginal practices increase the risk of HIV acquisition but a direct causal pathway linking intravaginal cleaning with soap, disruption of vaginal flora, and HIV acquisition has not yet been demonstrated. More consistency in the definition and measurement of specific intravaginal practices is warranted so that the effects of specific intravaginal practices and products can be further elucidated. Please see later in the article for the Editors'' Summary     

Interactions in syntrophic associations of endospore-forming, butyrate-degrading bacteria and h(2)-consuming bacteria

Butyrate is an important intermediate in the anaerobic degradation of organic matter. In sulfate-depleted environments butyrate is oxidized to acetate and hydrogen by obligate proton reducers, in syntrophic association with hydrogen-consuming methanogens. This paper describes two enrichments of endospore-forming bacteria degrading butyrate in consortia with methanogens. The isolates are readily established in coculture with H(2)-consuming, sulfate-reducing bacteria by pasteurizing the culture. The two original enrichments differed in that one grew to an optically dense culture while the second grew in clumps. Examination by scanning electron microscopy showed that clumping resulted from the production of large amounts of extracellular polymer. Several H(2)-consuming methanogens were identified in the enrichments. Some of them grew closely associated to the butyrate degraders. This attachment to the hydrogen producer may permit some methanogens to compete for the growth substrate against other bacteria having higher substrate affinity.     

In vitro inhibitory activity of human vaginal lactobacilli against pathogenic bacteria associated with bacterial vaginosis in Kenyan women

Lactobacilli have been shown to inhibit in vitro growth of many pathogens and have been used as probiotics to treat a broad range of gastrointestinal and/or vaginal disorders. We sought to determine the in vitro inhibitory potential of lactobacilli of vaginal origin to some bacteria associated with bacterial vaginosis (BV), to characterize the inhibitory substances produced by these lactobacilli and to assess H₂O₂ production. Vaginal specimens were obtained by swabbing the lateral vaginal walls from 107 women two months following BV treatment. One hundred and fifty eight Lactobacillus spp. were isolated in 82 of the 107 women. Lactobacillus jensenii was the predominant strain isolated among these women (29/158; 18.4%). Among 158 culture supernatants tested for antibacterial activity against BV-associated bacteria, none inhibited the growth of Bacteroides fragilis while 23% (37/158), 28% (45/158) and 29% (46/158) inhibited the growth of Prevotella bivia, Gardnerella vaginalis and Mobiluncus spp. respectively. The lactobacilli produced supernatants with a pH range between 2.62 and 6.71; the highly acidic (pH 2–3.99) supernatants were more inhibitory to the indicator strains. There was significant reduction in the mean zones of inhibition following chemical and physical treatment of the supernatants (p = 0.0025). Acid, bacteriocins and H₂O₂ demonstrated potential for antagonism of the bacterial pathogens. These substances may augment each other rather that each working independently on the pathogens.     

650例疑似细菌性阴道病BV患者阴道分泌物检测分析

目的探讨生化检测法在细菌性阴道病（BV）诊断中的应用价值。方法对绍兴市人民医院妇科门诊650例阴道分泌物进行常规及生化检测。结果在650例疑似细菌性阴道病患者中,以“唾液酸苷酶阳性＋过氧化氢阳性”为诊断标准,共检出BV患者483例（占总数的74．31％）;使用Amsel法检出细菌性阴道病患者481例（占总数的74％）。使用生化检测法和Amsel法检出细菌性阴道病的阳性率差异无统计学意义（x2=0．53,P〉O．05）,二者的符合率为94．15％（612／650）,具有很高的一致性。结论生化检测准确、快速,具有较高的临床应用价值。     

Dissimilarity in the occurrence of Bifidobacteriaceae in vaginal and perianal microbiota in women with bacterial vaginosis

Recent data point at the similarity between the perianal and vaginal microflora in terms of Lactobacillus species involved. Bacterial vaginosis, the most common perturbation of the vaginal microflora involving primarily overgrowth of Gardnerella vaginalis, has also been suggested to involve a recto-vaginal pathway. We addressed this issue with regard to bacteria of the Bifidobacteriaceae family. In particular, we investigated the putative concordance of the presence of G. vaginalis and a series of Bifidobacteria between the perianal and vaginal microflora in 10 patients with bacterial vaginosis through multicolor fluorescence in situ hybridization analysis of desquamated epithelial cells.G. vaginalis was found in a biofilm mode of growth at the perianal and vaginal sites. In most women at least one of the following species was detected perianally: Bifidobacterium adolescentis, Bifidobacterium longum, Bifidobacterium breves, Bifidobacterium bifidum and Bifidobacterium catenulatum. At the vaginal site, none of these Bifidobacteria was found.We conclude that bacterial vaginosis does not occur as a result of simple growth per continuum of perianal bacteria. Only some species originating from the intestinal tract do display pronounced vaginotropism, like G. vaginalis, whereas many other species do not.     

Molecular Survey of Bacterial Communities Associated with Bacterial Chondronecrosis with Osteomyelitis (BCO) in Broilers

Bacterial chondronecrosis with osteomyelitis (BCO) is recognized as an important cause of lameness in commercial broiler chickens (meat-type chickens). Relatively little is known about the microbial communities associated with BCO. This study was conducted to increase our understanding of the microbial factors associated with BCO using a culture-independent approach. Using Illumina sequencing of the hyper-variable region V6 in the 16S rRNA gene, we characterized the bacterial communities in 97 femoral or tibial heads from normal and lame broilers carefully selected to represent diverse variations in age, line, lesion type, floor type, clinical status and bone type. Our in-depth survey based on 14 million assembled sequence reads revealed that complex bacterial communities exist in all samples, including macroscopically normal bones from clinically healthy birds. Overall, Proteobacteria (mean 90.9%) comprised the most common phylum, followed by Firmicutes (6.1%) and Actinobacteria (2.6%), accounting for more than 99% of all reads. Statistical analyses demonstrated that there are differences in bacterial communities in different types of bones (femur vs. tibia), lesion types (macroscopically normal femora or tibiae vs. those with pathognomonic BCO lesions), and among individual birds. This analysis also showed that BCO samples overrepresented genera Staphylococcus, whose species have been frequently isolated in BCO samples in previous studies. Rarefaction analysis demonstrated the general tendency that increased severities of BCO lesions were associated with reduced species diversity in both femoral and tibial samples when compared to macroscopically normal samples. These observations suggest that certain bacterial subgroups are preferentially selected in association with the development of BCO lesions. Understanding the microbial species associated with BCO will identify opportunities for understanding and modulating the pathogenesis of this form of lameness in broilers.     

Contraception use and associations with intimate partner violence among women in Bangladesh

This study examines the association between contraception use and intimate partner violence (IPV) among women of reproductive age in Bangladesh. The observational study of 10,996 women used the chi-squared test and logistic regressions to assess the associations. Almost 80% of all respondents had used contraceptives at some point in their lives. About half of the respondents (48%) were victims of physical violence, while 11% experienced sexual abuse from their husbands. Urban residents, higher educated women and women aged 20-44 were more likely to use contraceptives than their peers in rural areas, those with lower education and those in their late forties (45-49 years). Women exposed to physical violence were almost two times (OR 1.93, CI 1.55-2.41) more likely to use contraceptives compared with their non-abused peers. Sexual abuse had no significant association with contraceptive use. Physical violence is a predictor for higher levels of contraceptive use among women in Bangladesh. The findings emphasize the importance of screening for IPV at health care centres. The differences in urban and rural contraceptive use and IPV exposure identified by the study have policy implications for service delivery and planning.     

Genetic and biochemical diversity of Gardnerella vaginalis strains isolated from women with bacterial vaginosis

Gardnerella vaginalis is considered a substantial player in the progression of bacterial vaginosis (BV). We analysed 17 G. vaginalis strains isolated from the genital tract of women diagnosed with BV to establish a potential link between genotypes/biotypes and the expression of virulence factors, vaginolysin (VLY) and sialidase, which are assumed to play a substantial role in the pathogenesis of BV. Amplified ribosomal DNA restriction analysis revealed two G. vaginalis genotypes. Gardnerella vaginalis isolates of genotype 2 appeared more complex than genotype 1 and were subdivided into three subtypes. Biochemical typing allowed us to distinguish four different biotypes. A great diversity of the level of VLY production among the isolates of G. vaginalis may be related to a different cytotoxicity level of the strains. We did not find any correlation between VLY production level and G. vaginalis genotype/biotype. In contrast, a link between G. vaginalis genotype and sialidase production was established. Our findings on the diversity of VLY expression level in different clinical isolates and linking sialidase activity with the genotype of G. vaginalis could help to evaluate the pathogenic potential of different G. vaginalis strains.     

Coordination dynamics: (in)stability and metastability in the behavioural and neural systems

For more than 20 years, coordination dynamics have provided research on human movement science with new views about the nonlinear relationships between behavioral and neural dynamics. A number of studies across various experimental settings including bimanual, postural or interpersonal coordination, and also coordination between movements of a limb and an external event in the environment revealed the self-organized nature of human coordination. Here we review an extensive body of literature - in the human movement science and the neuroscience fields - that has investigated the coordination dynamics of brain and behavior when individuals are involved in two rhythmic coordination patterns: synchronization (on-the-beat movements) and syncopation (in-between beats movements). When the frequency of movement approaches 2 Hz, the syncopation mode is destabilized and synchronization is spontaneously adopted. The abrupt change between the two patterns illustrates a phenomenon known as non-equilibrium phase transition. Phase transitions offer a novel entry point into the investigation of pattern formation (and dissolution) at both the behavioral and the cerebral levels as they illustrate the loss of stability of the system. Brain imaging methods (MEG, EEG and fMRI) were used to reveal the neural signatures of (in)stability underlying the differences between behavioral coordination patterns, and pointed at the role of self-organization and metastability principles in brain functioning. Relationships between behavioral and brain dynamics can therefore be investigated within a unified empirical and theoretical framework.     

Factors of the local immune defence of the reproductive tract in pregnant women with vaginosis

Clinico-immunological examination of 99 pregnant women with diagnosed vaginosis and 132 pregnant women without genital infection as a control group, was carried out. The immunological factors of cervical and vaginal secretions in pregnant women before and after local treatment were studied. The conclusion was made that the established changes in the cell-mediated and humoral factors of the immune resistance of the reproductive system could probably play some pathogenetic role in the development of vaginosis and its relapses in pregnant women. As found in this study, more pronounced changes in the local factors of immune protection (the signs of the functional irritation of neutrophils in combination with the prevalence of sIgA and lysozyme simultaneously with a decrease in the level of IgM and IgG in cervical slime) developed in patients with subsequent relapses of vaginosis, these changes remaining after local treatment. The defects of cell-mediated and humoral factors of cervical and humoral secretions, together with some clinical parameters, were shown to be prognostically unfavorable with respect to the relapses of vaginosis in pregnant women.