Diagnosis of Genital Infections

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: closed (15 October 2021) | Viewed by 8692

Special Issue Editor


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Guest Editor
1. Infectious Diseases and Vulva Pathology in OB/GYN, Antwerp University Hospital and Antwerp University, Wilrijkstraat 10, 2650 Edegem, Belgium
2. Director Femicare VZW, Clinical Research for Women, Gasthuismolenstraat 31, 3300 Tienen, Belgium
Interests: vulvo-vaginitis; painful intercourse; probiotic therapy; contraception; preterm birth; sexually transmitted infections
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Special Issue Information

Dear Colleagues,

Genital infections, especially vulvovaginitis, are amongst the most frequent pathologies presented to general practitioners, dermatovenerologists, urologists, and gynecologists. Despite this, most patients presenting with worries or symptoms are not properly diagnosed, either because they prefer self-diagnosis and treatment or because they are not examined with adequate tools. Additionally, disinterest or insufficient training of physicians in diagnosing genital infections can be a contributing factor. Using modern classification techniques, office-based phase microscopy of a vaginal or urethral swab of both men and women offers a wide variety of diagnoses and enables assessment of host response and potential risk factors for developing cancers or pregnancy complications. For some genital infections, transmission to partners can occur rather frequently, while others are rather rare. Physicians and patients need to be aware of this. At present, rapid tests based on molecular biology are gradually being introduced in our clinics and offer huge advantages but also harbor inherent disadvantages and pitfalls. This book is aimed at refueling the clinician with fresh information about the possibilities to properly diagnose genital infections, in the hope that it triggers renewed interest and increased awareness. As the subject is broad and the message should be clear, we will put emphasis on diagnostic means in women, and less on men or pregnant women.

Prof. Dr. Gilbert Donders
Guest Editor

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Keywords

  • Bacterial vaginosis
  • Vulvovaginitis
  • Aerobic vaginitis
  • Candida vulvovaginitis
  • Cytolytic vaginosis
  • Cervicitis
  • Pelvic inflammatory infection
  • Molecular biology
  • Genital tract microbioma
  • Chorioamnionitis
  • Trichomonas
  • Mycoplasmata
  • Sexually transmitted infections
  • Microscopy
  • Point of care tests

Published Papers (2 papers)

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Research

9 pages, 263 KiB  
Article
Aerobic Vaginitis—Underestimated Risk Factor for Cervical Intraepithelial Neoplasia
by Olga Plisko, Jana Zodzika, Irina Jermakova, Kristine Pcolkina, Amanda Prusakevica, Inta Liepniece-Karele, Gilbert G. G. Donders and Dace Rezeberga
Diagnostics 2021, 11(1), 97; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11010097 - 09 Jan 2021
Cited by 25 | Viewed by 2908
Abstract
The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University [...] Read more.
The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University Hospital Outpatient department in the study group. 118 women without cervical pathology were chosen as controls. Certified colposcopists performed interviews, gynaecological examinations and colposcopies for all participants. Material from the upper vaginal fornix was taken for pH measurement and wet-mount microscopy. Cervical biopsy samples were taken from all subjects in the study group and in case of a visual suspicion for CIN in the control group. Cervical pathology was more often associated with smoking (34.6% vs. 11.0%, p < 0.0001), low education level (47.2% vs. 25.5%, p = 0.001), increased vaginal pH (48.2% vs. 25.4%, p < 0.0001), abnormal vaginal microbiota (50% vs. 31.4%, p = 0.004) and moderate to severe aerobic vaginitis (msAV) (13.6% vs. 5.9%, p = 0.049) compared to controls. The most important independent risk factors associated with CIN2+ were smoking (OR 3.04 (95% CI 1.37–6.76), p = 0.006) and msAV (OR 3.18 (95% CI 1.13–8.93), p = 0.028). Bacterial vaginosis (BV) was found more often in CIN1 patients (8/31, 25.8%, p = 0.009) compared with healthy controls (8/118, 6.8%), or CIN2+ cases (8/79, 10.1%). In the current study msAV and smoking were the most significant factors in the development of CIN in HPV-infected women, especially high grade CIN. We suggest that AV changes are probably more important than the presence of BV in the pathogenesis of CIN and progression to cervix cancer and should not be ignored during the evaluation of the vaginal microbiota. Full article
(This article belongs to the Special Issue Diagnosis of Genital Infections)
15 pages, 2006 KiB  
Article
The Dwindling Microbiota of Aerobic Vaginitis, an Inflammatory State Enriched in Pathobionts with Limited TLR Stimulation
by Eline F. M. Oerlemans, Sander Wuyts, Gert Bellen, Stijn Wittouck, Ilke De Boeck, Kateryna Ruban, Camille Nina Allonsius, Marianne F. L. van den Broek, Gilbert G. G. Donders and Sarah Lebeer
Diagnostics 2020, 10(11), 879; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10110879 - 28 Oct 2020
Cited by 22 | Viewed by 4542
Abstract
While bacterial vaginosis (BV) is a well-known type of vaginal dysbiosis, aerobic vaginitis (AV) is an inflammatory condition that remains understudied and under-recognised. It predisposes women to serious complications including urogenital infections and pregnancy problems. Here, we investigated the bacterial community in AV [...] Read more.
While bacterial vaginosis (BV) is a well-known type of vaginal dysbiosis, aerobic vaginitis (AV) is an inflammatory condition that remains understudied and under-recognised. It predisposes women to serious complications including urogenital infections and pregnancy problems. Here, we investigated the bacterial community in AV to explore its possible role in AV pathogenesis. We collected vaginal lavage fluid samples of women (n = 58) classified by wet-mount microscopy as suffering from AV or BV and included an asymptomatic reference group without signs of AV or BV. AV samples showed reduced absolute abundances of bacteria in general and specifically of lactobacilli by qPCR, but 16S rRNA gene sequencing and amplicon sequence variant analysis revealed that Lactobacillus remained the dominant taxon in 25% of the AV samples studied. The other AV samples showed high relative abundances of Streptococcus agalactiae and, unexpectedly, the anaerobes Gardnerella vaginalis and Prevotella bivia in more than half of the AV samples studied. Yet, despite increased relative abundance of these potential pathogens or pathobionts in the AV bacterial communities, the AV samples only slightly stimulated Toll-like receptor 4 and showed reduced activation of Toll-like receptor 2/6, receptors of two pathways central to mucosal immunity. Our findings indicate that the reduced total bacterial abundance with associated enrichment in certain pathobionts in AV might be mainly a consequence of the inflammatory conditions and/or altered hormonal regulation rather than bacteria being a major cause of the inflammation. Full article
(This article belongs to the Special Issue Diagnosis of Genital Infections)
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