Bacterial vaginosis and trichomoniasis: prevalence, associated factors, and performance of diagnostic tests

Introduction: Bacterial vaginosis and vaginal trichomoniasis are frequent causes of health care demand. Objective: To estimate the prevalence, identify associated factors, and investigate the performance of diagnostic tests for bacterial vaginosis and trichomoniasis. Methods: Cross-sectional study with participants over 18 years old. All of them were submitted to an interview and gynecological examination with evaluation of vaginal secretion, pH verification, collection of material for Pap smear, wet mount test, Whiff test, bacterioscopy, and polymerase chain reaction for trichomoniasis detection. Logistic regression analysis was applied to identify associated factors with bacterial vaginosis. Diagnostic performance for bacterial vaginosis was evaluated following Amsel criteria, the Ison and Hay score, and the Pap smear, considering the Nugent score as the gold standard. As for trichomoniasis, diagnostic performance was evaluated through the Pap smear and the wet mount test, using the polymerase chain reaction as the gold standard. Results: The prevalence of bacterial vaginosis was 33.7%, and for trichomoniasis, 0.5%. The complaint of abnormal vaginal secretion was associated with the diagnosis of bacterial vaginosis (odds ratio 2.2). The diagnostic accuracy by Amsel criteria, the Ison and Hay score, and the Pap smear was 35.6, 97.0, and 84.2%, respectively. The sensitivity for trichomoniasis through wet mount test was 0.0%, and through the Pap smear, 100%. Conclusion: The prevalence of bacterial vaginosis was high, and trichomoniasis was low. The only associated factor with bacterial vaginosis was the report of abnormal vaginal secretion. The methods with the most accurate diagnostic performance for bacterial vaginosis were the Ison and Hay score and the Pap smear and, for trichomoniasis, the Pap smear

Prevalence of Trichomonas vaginalis in women attended at a private laboratory / Prevalência de Trichomonas vaginalis em mulheres atendidas em um laboratório privado

Introduction: Sexually Transmitted Infections (STIs) are caused by viruses, fungi, bacteria, or other microorganisms, thus being a serious public health issue. Trichomonas vaginalis is the disease causative agent of trichomoniasis, a worldwide protozoan. The prevalence of trichomoniasis depends on some factors, including age, sexual activity, number of sexual partners, hygiene habits, among others. Objective: To evaluate the prevalence of Trichomonas vaginalis in gynecological cytology in a private laboratory in the city of Fortaleza, state of Ceará, Brazil. Methods: This is a retrospective, quantitative, and descriptive study carried out in a private laboratory in Fortaleza, state of Ceará. Data for the research, such as age, marital status, and symptoms, were collected from the patients' medical records as well as the prevalence of cases in liquid-based cytology (LBC) and conventional cytology (CC). Results: In 2019, 83 women were positive for trichomoniasis. The most prevalent age group was between 36 and 51 years old (41%), with an average of 39.9 years old. Regarding symptoms, 14 (16.8%) were asymptomatic and 41 (49.3%) had some symptom. Conclusion: The data obtained in this study describe the profile of women affected by Trichomonas vaginalis.

As infecções sexualmente transmissíveis são causadas por vírus, fungos, bactérias ou outros microrganismos, sendo assim um grave problema de saúde pública. O Trichomonas vaginalis, um protozoário presente em todo o mundo, é o agente etiológico causador da tricomoníase. A prevalência dessa doença depende de alguns fatores, incluindo idade, atividade sexual, números de parceiros sexuais, hábitos de higiene, entre outros. Objetivo: Avaliar a prevalência de Trichomonas vaginalis, em citologia ginecológica em um laboratório privado em Fortaleza, Ceará, Brasil. Métodos: Trata-se de estudo retrospectivo, quantitativo e descritivo realizado em laboratório privado em Fortaleza. Os dados para a pesquisa, como idade, estado civil, sintomas, foram retirados de prontuários das pacientes, assim como a prevalência de casos em citologia em meio líquido e CO. Resultados: No ano de 2019, 83 mulheres apresentaram positividade para tricomoníase. A faixa etária mais prevalente foi a de 36 a 51 anos (41%), ficando com a média de 39,9 anos. Em relação aos sintomas, 14 (16,8%), apresentaram-se assintomáticas e 41 (49,3%) apresentaram algum sintoma. Conclusão: Os dados obtidos neste estudo descrevem o perfil das mulheres acometidas pelo Trichomonas vaginalis.

Investigation of Tritrichomonas foetus in cryopreserved bovine semen by culture and polymerase chain reaction / Pesquisa por Tritrichomonas foetus em sêmen bovino criopreservado mediante isolamento e reação em cadeia da polimerase

Bovine Trichomoniasis (BT) is an infectious disease caused by Tritrichomonas foetus that can be transmitted either sexually or by fomites. In males, the disease is asymptomatic and permanent. T. foetus has been detected in semen samples where it is able to remain viable even when frozen. The objective of this study was to investigate the presence of T. foetus in 27 samples of commercial frozen bovine semen by culture and Polymerase Chain Reaction (PCR). Samples were thawed in water at 37°C. Part of the samples was inoculated in a test tube containing Diamond's medium and incubated at 35°C. Growth was evaluated every 24 hours via direct examination under a microscope. The other part was placed in an Eppendorf tube and frozen for later molecular analysis. After 10 days of culture, all samples were negative for T. foetus. The Quick-DNA Miniprep Kit (Zymo Research) without proteinase K was used for DNA extraction. The primers used in PCR were TRF3 and TRF4. PCR results were negative for all samples. In conclusion, bovine semen samples were negative for T. foetus in both diagnostic methods, according to the adopted methodology.(AU)

A tricomonose genital bovina (TGB), uma doença infectocontagiosa causada pelo Tritrichomonas foetus, é transmitida por via venérea e fômites contaminados. Em machos a doença é assintomática e permanente. O agente já foi encontrado em amostras de sêmen e é capaz de permanecer viável quando congelado. Este trabalho teve por objetivo investigar a presença de T. foetus em 27 amostras de sêmen bovino comercial congelado, por meio de cultivo e reação em cadeia da polimerase (PCR). As amostras foram descongeladas em água a 37ºC; parte foi inoculada em tubo de ensaio contendo meio Diamond, incubada a 35ºC com consequente avaliação de crescimento e avaliada a cada 24 horas, via exame direto em microscópio, e a outra parte foi diluída em PBS para análise molecular. Após 10 dias de cultivo, todas as amostras foram negativas. Para a detecção molecular foi utilizado o kit Quick-DNA Miniprep (Zymo Research) sem proteinase K para extração do DNA. Os iniciadores utilizados na PCR foram TRF3 e TRF4. O resultado da PCR foi negativo para todas as amostras. Conclui-se que as amostras utilizadas foram realmente negativas para a presença do patógeno em ambos os métodos diagnósticos, o que comprovou a inocuidade do sêmen testado.(AU)

How a discerning cytological examination can aid in the diagnosis of infectious diseases: case reports

Infections caused by uncommon and resistant pathogens in unusual sites have been increasingly reported in medical literature. We describe four cases of rare cytological findings and clinical impact for patients. In the first case, Aspergillus sp and Pneumocystis jirovecii were observed in the bronchoalveolar lavage of a patient with severe systemic lupus. In the second and third cases, we describe the presence of Trichomonas sp and Strongyloides sp larvae in samples of pleural and peritoneal fluid, respectively. The fourth report is about a patient with a wrist subcutaneous nodule whose synovial aspiration and cytology revealed the presence of brown septate hyphae. The early identification of the infectious agent in the cytological examination was essential for the introduction and/or re-adaptation of therapy in the four cases described. Patients in this report were immunocompromised with severe comorbidities, conditions often associated with unfavorable clinical outcomes.

Pulmonary artery aneurysm rupture

Pulmonary artery aneurysm is a disorder of varying etiology and should be diagnosed early for appropriate interventions. A 45-year-old man was hospitalized for chest pain, dyspnea, cough, chills, diarrhea, and vomiting, which had started 3 weeks before admission. Physical examination indicated a reduced vesicular murmur in the right hemithorax. A chest x-ray performed indicated a pneumothorax and pulmonary abscess in the right hemithorax. Thoracostomy released abundant purulent and fetid fluid. Direct examination of the pleural fluid using saline revealed structures similar to Trichomonas. Non-contrast chest computed tomography revealed right pneumothorax along with an irregular cavitation located at the pleuropulmonary interface of the posterior margin of the right lower lobe. A pleurostomy was performed. On the second postoperative day, the patient suffered a sudden major hemorrhage through the surgical wound and died on the way to the operating room. The autopsy revealed an abscess and ruptured aneurysm of the lower lobar artery in the lower right lung. Microscopic examination revealed extensive liquefactive necrosis associated with purulent inflammation and the presence of filamentous fungi and spores. This case can be characterized as a severe disorder that requires early diagnosis to achieve a good therapeutic response and to avoid fatal outcomes.

TRICHOMONAS VAGINALIS in female prison inmates from Uberlândia, Minas Gerais, Brazil: prevalence, diagnosis and epidemiological aspects

Trichomonas vaginalis is the etiological agent of trichomoniasis one of the most prevalent sexually transmitted infections worldwide. This paper aimed to determine the prevalence and the risk factors associated to the dissemination of the parasite in the prison environment, as well as comparing the diagnostic methods used for its detection. The present study included 56 female inmates at Professor Jacy de Assis Penitentiary, in Uberlandia, Minas Gerais, Brazil, regardless of ethnicity, socioeconomic status, age and sexual orientation. To diagnose T. vaginalis, wet mount and culture in TYM medium were utilized. The results were compared to the Papanicolaou test, the routine diagnostic method used in prisons. To outline the socioepidemiological profile of the participants an investigative survey was applied during an interview preceding the medical consultation. Of the 56 women included in the present study, six were diagnosed positive for T. vaginalis, by the three methods resulting in a prevalence of 10.7%. Culture and wet mount presented 100% specificity and sensitivity. On the other hand, sensitivity and specificity of the Papanicolaou test were 75% and 96%, respectively. None of the variables analysed, herein, could be associated with the infection. Despite the presence of the parasite, it was not possible to set an epidemiological pattern for positive patients, highlighting the particularities of this population. Regarding the diagnostic methods, wet mount and culture were equally efficient and superior to Papanicolaou in detecting T. vaginalis.

Oral trichomoniasis in raptors in Southern Brazil / Tricomoníase oral em rapinantes no sul do Brasil

A retrospective study of oral trichomoniasis cases in raptors was carried out at "Laboratório Regional de Diagnóstico" of "Faculdade de Veterinária" of "Universidade Federal de Pelotas" (LRD-UFPel) from December 2014 to August 2017. Seven necropsy reports were reviewed. All raptors including Falconiformes and Strigiformes orders were from periurban zones. Four birds were adults, and there was no apparent sex predisposition. Clinical signs included dysphagia, regurgitation, and anorexia. Gross lesions were characterized by multifocal yellow to coalescent caseous nodules adhered to the oral cavity, which extended to the entrance of the esophagus. Microscopically, the lesions were characterized by severe focally extensive heterophilic granulomatous stomatitis. Trichomonas gallinae was isolated in modified Diamond medium of all samples collected from birds. It is believed the transmission occurred by the predation of domestic pigeons (Columbia livia domestica) contaminated with T. gallinae that agglomerate in patios of grain processing complexes.(AU)

Foi realizado um estudo retrospectivo de casos de tricomoníase oral em rapinantes recebidos no Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD-UFPel) no período de dezembro de 2014 a agosto de 2017. Foram revisados os protocolos de necropsia encontrando-se sete casos. Os animais eram todos de zonas periurbanas e foram afetadas a ordem Falconiformes e a ordem Strigiformes. Das aves afetadas 4/7 eram adultas e não houve aparente predisposição por sexo. Os sinais clínicos incluíram disfagia, regurgitação e anorexia. As lesões se caracterizaram por nódulos amarelados multifocais a coalescentes aderidos a cavidade oral, que se estendiam até a entrada do esôfago. Histologicamente as lesões caracterizaram-se por estomatite heterofílica granulomatosa focalmente extensiva acentuada. Foi isolado em meio Diamond modificado Trichomonas gallinae de todas as amostras coletadas das aves. Acredita-se que a fonte de transmissão tenha ocorrido a partir da predação por estes rapinantes de pombas domésticas (Columbia livia domestica) portadoras com T. gallinae que se aglomeram em pátios de complexos de beneficiamento de grãos.(AU)

Cribado de infecciones cervicales de transmisión sexual en mujeres embarazadas y su relación con la microbiota vaginal / Screening of cervical sexually transmitted infections in pregnant women and the relation with the vaginal microbiota

Resumen Introducción: La mujer embarazada está expuesta anumerosas infecciones de transmisión sexual (ITS), las que pueden producir aborto, enfermedad en el feto y/o en el recién nacido, además de alteraciones en el curso normal del embarazo. Objetivo: Realizar tamizaje de infección cervical asintomática en mujeres embarazadas y su relación con la microbiota. Pacientes y Métodos: Se enrolaron 85 mujeres embarazadas sin cervicitis clínica que consultaron en control de rutina de embarazo (47 pacientes) o que fueron derivadas a una unidad de ITS (38 pacientes). Se tomaron muestras de fondo de saco vaginal, que fueron analizadas por técnicas clásicas de microscopía y cultivo corriente y reacción de polimerasa en cadena para Neisseria gonorrhoeae, Trichomonas vaginalis y Chlamydia trachomatis. Resultados: Se encontró 12,9% de infección por C. trachomatis, 2,4% de T. vaginalis. En este estudio no se encontró N. gonorrhoeae. El 23,3% de pacientes con microbiota alterada (vaginosis bacteriana y microbiota intermedia) fue positiva para C. trachomatis. Conclusión: En este trabajo, encontramos una alta frecuencia de infección por C. trachomatis, que se relaciona en forma significativa con la presencia de microbiota alterada. Esta alta frecuencia debería promover estrategias preventivas en los controles de salud de la mujer embarazada.

Background: Pregnant woman is exposed to many sexual transmitted infections (STI). Many of these infections may produce diseases in the fetus and newborn, and also alteration in the normal course of the pregnancy. Aim: Screening of asymptomatic cervical infection in pregnant woman and its relationship with the vaginal microbiota. Patients and Methods: 85 pregnant women without clinical cervicitis who consult in the routine pregnant control (47 patients) and women derived from STI service (38 patients). The samples were obtained from the vaginal fund sac and were analyzed with optic microscopy, cultures and PCR of Neisseria gonorrhoeae, Trichomonas vaginalis and Chlamydia trachomatis. Results: 12,9% of the enrolled women were positive for C. trachomatis, 2,4% for T. vaginalis. In this study, we did not found N. gonorrhoeae. We observed 23,3% of patients with altered microbiota (bacterial vaginosis and intermediate microbiota) was positive for C. trachomatis. Conclusions: In this study, we found a high frequency of C. trachomatis infection, that correlates with the presence of altered microbiota. This high frequency would promote preventive strategies in the pregnant women routine controls.

The Association of Glutaminase (glut) P3 Different Alleles of Trichomonas vaginalis with Infertility in a sample of Iraqi women

Trichomonas vaginalis (T. vaginalis), the etiologic agent of human trichomoniasis, is a flagellated protozoan parasite, has been associated sith advese pregnancy outcomes, HIV transmission, and infertilityh. A total of one hundred and fifty-seven (157) women at childbearing age (14-49 years), were included in the presnt study, eighty six (86) symptomatic fertile while the other seventy-one (71) were infertile with or without sumptoms attending the Gynecology outpatient Department in Al-Emamayn Al-Kadhimayn Medical City, the High Institute of Infertility Diagnosis and Assisted Reproductive Technoligies at Al-Nahrain University in Baghdad, the maternity Teaching hospital, and Dr. Khawer center for infertility and IVF in Erbil province in Iraq. Two vaginal swab specimens were obtained from each of them:; one swab was immediately examined by wet mount microscopy, the other swab for molecular study (DNA extraction and p3 nested PCR). One hundred (100) samples positive in one or more test were identified: 20 (12.7%) infecions were detected by wet mount microscopy, while nested PCR was positive in 100 (63.7%) samples. These positive samples were seguenced and phylogenetic tree were done and, there was no association between the variations in glut (p3) gene of T. vaginalis isolated from infected women (fertile and infertile)

Prevalencia y factores asociados con vaginosis bacterianas, candidiasis y tricomoniasis en dos hospitales de los municipios de Apartadó y Rionegro -Antioquia, 2014 / Prevalence of bacterial vaginosis, candidiasis, trichomoniasis, and associated factors in two hospitals of Apartadó and Rionegro - Antioquia, 2014

RESUMEN Objetivo: determinar la prevalencia de vaginosis bacteriana (VB), candidiasis, tricomoniasis y sus factores asociados, en las mujeres que consultan al servicio de citología de dos empresas sociales del estado (ESEs) de los municipios de Apartadó y Rionegro, año 2014. Metodología: estudio descriptivo de corte transversal. Fuente de información secundaria: base de datos del Laboratorio de Citología de la Escuela de Microbiología. Población: 6447 registros de mujeres del servicio de citología de los municipios de Apartadó y Rionegro. 3.762 registros de Apartadó y 2.685 registros de Rionegro año 2014. Se calcularon frecuencias absolutas, relativas e intervalos de confianza. Se exploró la asociación entre las variables independientes con relación significativa con los microorganismos estudiados, luego se ingresaron a un modelo de ajuste multivariado de regresión logística binaria. Nivel de significación estadística del 0,05. Los datos se almacenaron y analizaron en SPSS 20,1®. Resultados: la prevalencia de vaginosis bacteriana fue 29,9 %, candidiasis del 10,7 %, y tricomoniasis del 3,2 %. No hubo diferencias significativas en las infecciones en ambos municipios. No se encontró asociación estadística significativa con los factores de riesgo estudiados. Conclusiones: el comportamiento de las VB, cándida y trichomona fue muy similar al reportado en otras investigaciones y no se encontró diferencia en el comportamiento en los municipios estudiados, a pesar de ser contextos socioeconómicos y culturales diferentes.

SUMMARY Objective: To determine the prevalence of bacterial vaginosis, candidiasis, trichomoniasis, and associated factors in women who use the cytology service of two hospitals in Apartadó and Rionegro in 2014. Methodology: Descriptive cross-sectional study. Data source: the cytology laboratory database of the School of Microbiology. Study population: 6447 samples from women who attended the cytology service in Apartadó hospital with 3,762 records and Rionegro hospital with 2,685 records. Absolute and relative frequencies with confidence intervals were calculated, the association between the independent variables that showed significant association with the microorganisms studied were explored, and then, entered in a multivariate binary logistic regression model. In all analyzes statistical significance level of 0.05 was accepted and data were stored and analyzed with SPSS 20,1®. Results: The prevalence of bacterial vaginosis was 29.9 %, candidiasis 10.7% and trichomoniasis 3.2 %. No significant differences between municipalities were observed nor statistically significant association with any of the risk factors studied. Conclusions: The behavior of BV, candida and trichomona were very similar to those reported in other researches and no difference was found between the studied municipalities, despite the differences in socioeconomic and cultural contexts.

Prevalencia de tricomoniasis vaginalis en mujeres en edad fértil de 15 a 35 años / Prevalence of vaginalis trichomoniasis in women in fertility age 15 to 35 years old

El objetivo fue determinar la prevalencia de Trichomoniasis vaginalis en mujeres de edad fértil de 15 a 35 años que se realizaron examen bacteriológico en el periodo comprendido de los meses de enero a agosto de 2018 en el servicio de laboratorio del Hospital Virgen de Remedios del Municipio de Sopachuy. El presente trabajo de investigación es de tipo descriptivo transversal y retrospectivo. La población de estudio estuvo conformada por 137 mujeres en edad fértil, quienes acudieron al laboratorio del Hospital Virgen de Remedios. De los 137 casos de mujeres en edad fértil que accedieron a realizarse análisis laboratorial para tricomoniasis, el 26% resultó ser positivo. De los cuales el 33% se encontraban entre la edad de 15 a 19 años, el 53% cursó la primaria, el 53% de las mujeres no tienen conocimiento de la enfermedad y 81% de las mujeres no emplean métodos de protección en sus relaciones sexuales.

The objective was to determine the prevalence of Trichomoniasis vaginalis in women of childbearing age from 15 to 35 years who underwent bacteriological examination in the period from January to august 2018 in the laboratory service of the Virgen de Remedios Hospital of the Municipality of Sopachuy This research work is of a descriptive cross-sectional and retrospective type. The study population consisted of 137 women of childbearing age, who went to the laboratory of the Virgen de Remedios Hospital. Of the 137 cases of women of childbearing age who agreed to have laboratory tests for trichomoniasis, 26% were positive. Of which 33% were between the ages of 15 and 19, 53% attended primary school, 53% of women are not aware of the disease and 81% of women do not use methods of protection in their relationships sexual.

Trichomonas vaginalis / awareness of trichomoniasis in women attended by the health service of Bagé, RS, Brazil

This study aimed to measure the level of awareness of Trichomonas vaginalis / trichomoniasis and other sexually transmitted diseases (STDs), in 300 women from 19 municipalities in the southwest region of Rio Grande do Sul, Brazil, who sought the gynecology sector of the Basic Healthcare Centers in the Municipality of Bagé from January to June 2013. The data were collected through a semi-structured questionnaire, and the results were tabulated and organized using Excel® 2010 software. Only 5.7% of the participants said they were aware of T. vaginalis / trichomoniasis and had a little information on HIV and Aids in reference to other STDs. Schooling alone was significant (p = 0.0135), as women who had a high school diploma or higher education were 6.6 times more likely to be aware of T. vaginalis. There is, therefore, a need to devise better educational campaigns, addressing this and other STDs, such as trichomoniasis, given the lack of knowledge about this parasite, its high frequency and possible escalation.

Tricomonose e campilobacteriose em bovinos: revisão de literatura / Trichomoniasis and campylobacteriosis in cattle: a literature review / Tricomoniasis y campilobacteriosis en ganado: revisión de literatura

O aumento da produção de leite no Brasil tem sido essencial para o crescimento do país no mercado internacional, com destaque para a região Sul do país. Com o avanço tecnológico na atividade leiteira, avançou também o cuidado com a sanidade dos rebanhos, que engloba o manejo sanitário da reprodução desses rebanhos. A Tricomonose e a Campilobacteriose são doenças sexualmente transmissíveis que afetam bovinos em várias idades. Tritrichomonas foetus é o agente causador da Tricomonose e C. fetus subsp. venerealis o da Campilobacteriose, sendo, respectivamente, um protozoário e uma bactéria Gram-negativa. O diagnóstico dessas doenças se dá via coleta de lavado prepucial ou cervicovaginal, para a pesquisa de Tritrichomonas spp, e pelo swab prepucial ou cervicovaginal para a pesquisa de Campylobacter spp. Não há tratamento específico para essas doenças, visto que o controle e profilaxia baseiam-se na retirada dos machos portadores do rebanho, ou realização de descanso reprodutivo de quatro ou cinco estros nas fêmeas, já que as mesmas eliminam os agentes etiológicos. Diante do exposto é necessário reconhecer a necessidade de estudos relacionados a Tricomonose e Campilobacteriose em rebanhos leiteiros, principalmente aqueles inseridos em sistema de produção familiar, subsidiando essa revisão de literatura.(AU)

The increase in dairy production in Brazil has been essential to the country's growth in the international market, especially in the southern region of the country. With the technological advances in dairy farming, the caring for the health of herds has also increased, as well as the health management of the reproduction of these animals. Trichomoniasis and campylobacteriosis are sexually transmitted diseases that affect cattle at different ages. Tritrichomonas fetus is a protozoan that promotes Trichomoniasis and C. fetus subsp. venerealis is a gram-negative bacterium that promotes campylobacteriosis. In order to diagnose these diseases, the prepucial or cervicovaginal wash has been collected for Tritrichomonas spp. and the preputial or cervicovaginal swab has been collected for Campylobacter spp. There is no specific treatment for these diseases, since the control and prophylaxis are based on the removal of infected males, or in carrying out reproductive rest between four or five estrous cycles in females, since these actions can eliminate the etiologic agent. Thus, it is important to study trichomoniasis and campylobacteriosis in dairy herds, especially those placed in family farming, supporting this literature review.(AU)

El aumento de la producción de leche en Brasil ha sido esencial para el crecimiento del país en el mercado internacional, especialmente en la región sur del país. Con los avances tecnológicos en la industria lechera también se avanzó el cuidado con la salud de los rebaños, que incluye el manejo sanitario de la reproducción de esos rebaños. La tricomoniasis y la campilobacteriosis son enfermedades sexualmente transmisibles que afectan al ganado de diferentes edades. Tritrichomonas fetus es el agente causante de la tricomoniasis y C. fetus subsp. venerealis o de la campilobacteriosis, siendo, respectivamente, un protozoos y una bacteria Gram- negativa. El diagnóstico de esas enfermedades se produce a través de colección de lavado de prepucio o cervicovaginal, para la investigación de Tritrichomonas spp, y por el swab prepucio o cervicovaginal para la investigación de Campylobacter spp. No existe tratamiento específico para esas enfermedades, ya que el control y profilaxis se basan en la retirada de los machos portadores del rebaño, o realización de descanso reproductivo de cuatro o cinco celos en las hembras, pues las mismas eliminan los agentes etiológicos. Delante el expuesto, es necesario reconocer la necesidad de realizar estudios relacionados con la tricomoniasis y campilobacteriosis en rebaños lecheros, especialmente los situados en el sistema de producción familiar, subsidiando esa revisión de literatura.(AU)

Utilidad de la reacción de polimerasa en cadena convencional para la detección de Mycoplasma hominis, Ureaplasma spp. y Trichomonas vaginalis en muestras genitales de mujeres en consulta ambulatoria / Usefulness of conventional polymerase chain reaction for the detection of Mycoplasma hominis, Ureaplasma spp. and Trichomonas vaginalis in female outpatient's genital samples

Introduction: Trichomonas vaginalis, Mycoplasma hominis and Ureaplasma spp. are microorganisms responsible for genitourinary and pregnancy pathologies. Nucleic acid amplification methods have shown several advantages, but have not been widely studied for the detection of these microorganisms. Aim: To implement a conventional polymerase chain reaction (PCR) for the detection of the microorganisms and to compare its results versus the methods currently used at our laboratory. Material and Methods: 91 available samples were processed by PCR, culture (M. hominis y Ureaplasma spp.) and wet mount (T vaginalis). Results were compared and statistically analyzed by kappa agreement test. Results: 85, 80 and 87 samples resulted in agreement for the detection of M. hominis, Ureaplasma spp. y T. vaginalis, respectively. For M. hominis and Ureaplasma spp., agreement was substantial, whereas for T. vaginalis it was moderate, however, for the latter, PCR detected more cases than wet mount. Conclusion: We recommend the implementation of PCR for detection of T. vaginalis whereas culture kit is still a useful method for the other microorganisms.

Introducción: Trichomonas vaginalis, Mycoplasma hominis y Ureaplasma spp. son microorganismos causantes de patología genito-urinaria y durante el embarazo. Los métodos de amplificación de ácidos nucleicos han demostrado numerosas ventajas, pero no han sido ampliamente estudiados para la detección de estos microorganismos. Objetivo: Implementar una reacción de polimerasa en cadena convencional (RPC) para su detección y comparar sus resultados con los métodos actuales de nuestro laboratorio. Material y Métodos: Se procesaron 91 muestras mediante RPC, cultivo (M. hominis y Ureaplasma spp.) y observación microscópica al fresco (T. vaginalis). Los resultados fueron comparados y analizados estadísticamente mediante el test de concordancia kappa. Resultados: 85, 80 y 87 muestras tuvieron resultados concordantes para la detección de M. hominis, Ureaplasma spp. y T. vaginalis, respectivamente. Para M. hominis y Ureaplasma spp. el nivel de concordancia fue considerable mientras que para T. vaginalis fue moderado; sin embargo, para esta última, la RPC detectó más casos que la microscopia al fresco. Conclusión: Se recomienda la implementación de la RPC para la detección de T. vaginalis. Para M. hominis y Ureaplasma spp. el kit de cultivo continúa siendo un buen método.

COMPARISON OF PERMANENT STAINING METHODS FOR THE LABORATORY DIAGNOSIS OF TRICHOMONIASIS

Trichomonas vaginalis is the etiologic agent of trichomoniasis, the most common non-viral sexually transmitted disease (STD) in the world. The diagnosis is based on wet mount preparation and direct microscopy on fixed and stained clinical specimens. The aim of this study was to compare the performance of different fixing and staining techniques used in the detection of T. vaginalis in urine. The smears were fixed and submitted to different methods of permanent staining and then, the morphological aspects of the parasites were analyzed and compared. The Papanicolaou staining with ethanol as the fixative solution showed to be the best method of permanent staining. Our data suggest that staining techniques in association with wet mount examination of fresh specimens contribute to increase the sensitivity in the diagnosis of trichomoniasis.

Influence of 120 kDa Pyruvate:Ferredoxin Oxidoreductase on Pathogenicity of Trichomonas vaginalis

Trichomonas vaginalis is a flagellate protozoan parasite and commonly infected the lower genital tract in women and men. Iron is a known nutrient for growth of various pathogens, and also reported to be involved in establishment of trichomoniasis. However, the exact mechanism was not clarified. In this study, the author investigated whether the 120 kDa protein of T. vaginalis may be involved in pathogenicity of trichomonads. Antibodies against 120 kDa protein of T. vaginalis, which was identified as pyruvate:ferredoxin oxidoreductase (PFOR) by peptide analysis of MALDI-TOF-MS, were prepared in rabbits. Pretreatment of T. vaginalis with anti-120 kDa Ab decreased the proliferation and adherence to vaginal epithelial cells (MS74) of T. vaginalis. Subcutaneous tissue abscess in anti-120 kDa Ab-treated T. vaginalis-injected mice was smaller in size than that of untreated T. vaginalis-infected mice. Collectively, the 120 kDa protein expressed by iron may be involved in proliferation, adhesion to host cells, and abscess formation, thereby may influence on the pathogenicity of T. vaginalis.

Prevalence of Trichomonas vaginalis in Women Visiting 2 Obstetrics and Gynecology Clinics in Daegu, South Korea

This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.

Trichomonas Vaginalis Infection Among Women Attending in the Public Service in Rio Grande do Sul,Brazil: Frequency, Risk Factors and Clinical Signs / Infecção por Trichomonas Vaginalis em Mulheres a Tendidas pelo Serviço Público no Rio Grande do Sul, Brasil: Frequência, Fatores de Risco e Sinais Clínicos

Trichomoniasis is a cosmopolitan disease that can affect the female fertility, and is commonly underdiagnosed, both in private practices and in public health services, because of the low sensitivity of the wet mount exam used routinely. Objective: To understand the occurrence of T. vaginalis infection by means of in vitro culture in women receiving care in a public health unit, in the city of Pelotas, Rio Grande do Sul, Brazil, as well as to identify the possible risk factors associated with this infection. Methods: Cross­sectional study was carried out, which included 201 women undergoing interview and gynecological exam, with the collection of vaginal discharge in the Gynecology Ambulatory at the School of Medicine of Universidade Federal de Pelotas. The material collected was examined in the form of fresh smears and cultivated in Diamond's medium. Epidemiological data were obtained by means of patient interviews and clinical trials, from the medical records. The results were statistically analyzed through χ 2 and Fisher's exact tests, using version 9.0 of the Statistix program. Results: The occurrence of T. vaginalis infection was 7% (14/201). In the wet mount exam, used routinely for the diagnosis of this agent, only 42.85% of the infected women (6/14) were positive. It was noted that 21.4% of the infected women were asymptomatic, and 89.05% were not aware of the existence of the Trichomonas vaginalis infection. Factors independently associated with the infection were the smoking habit (odds ratio [OR] = 11.8), not having a stable sexual partner (OR = 6.36), presence of vaginal discharge with odor (OR = 5.65), and altered vaginal microbiota (OR = 5.31). Conclusion : T. vaginalis infection was present among the women studied, being underestimated because of the diagnostic technique, and because many of them were asymptomatic. The smoking habit, not having a stable sexual partner, having fetid discharge, and altered vaginal microbiota are the risk factors for infection.

A tricomoníase é cosmopolita, pode afetar a fertilidade feminina, e geralmente é subdiagnosticada, tanto em consultórios particulares, quanto em serviços públicos, devido à baixa sensibilidade do exame a fresco, usado rotineiramente. Objetivo: Conhecer a ocorrência de infecção por Trichomonas vaginalis , através de cultivo in vitro , em mulheres atendidas em unidade pública, na cidade de Pelotas, Rio Grande do Sul, além de identificar os possíveis fatores de risco associados a essa infecção. Métodos: Estudo de corte transversal que incluiu 201 mulheres, submetidas a entrevista e exame ginecológico, com coleta de conteúdo vaginal, no Ambulatório de Ginecologia da Faculdade de Medicina da Universidade Federal de Pelotas. O material coletado foi examinado a fresco e cultivado em meio de Diamond. Foram obtidos dados epidemiológicos através de entrevista, e clínicos, nos prontuários. Os resultados foram analisados estatisticamente através dos testes do χ 2 e exato de Fisher, utilizando o programa Statistix versão 9.0. Resultados: A ocorrência da infecção por T. vaginalis foi de 7% (14/201). No exame a fresco, usado como rotina para o diagnóstico desse agente, apenas 42,85% das infectadas (6/14) foram positivas. Constat ou­se que 21,4% das mulheres infectadas são assintomáticas, e que 89,05% desconhecia a existência da tricomoníase. Os fatores independent emente associados com a infecção foram o hábito de fumar (OR=11,8), não ter companheiro fixo (OR=6,36), apresentar corrimento vaginal fétido (OR=5,65) e microbiota vaginal alterada (OR=5,31). Conclusão: A infecção por T. vaginalis está presente entre as mulheres estudadas, e sendo subestimada, devido à técnica de diagnóstico e por muitas serem assintomáticas. O hábito de fumar, não ter companheiro fixo, ter corrimento fétido e microbiota vaginal alterada são fatores de risco para a infecção.

Tricomoniasis: una visión amplia / Trichomoniasis: a wide-scope view

La tricomoniasis es responsable hasta del 30% de las infecciones de transmisión sexual no virales. La mayor frecuencia es en mujeres de 16 a 35 años. Puede ser asintomática, lo que facilita su transmisión. El agente etiológico es el protozoo Trichomonas vaginalis, transmitido casi siempre por contacto sexual. Se presenta una revisión que incluye los siguientes aspectos: epidemiología, taxonomía, fisiopatología, hábitat y ciclo de vida, sintomatología y complicaciones, métodos diagnósticos, tratamiento y relación entre Trichomonas vaginalis, VIH, virus del papiloma humano y Mycoplasma hominis.

Worldwide, trichomoniasis is the most widespread non-viral sexually transmitted infection; it causes up to 30% of such infections. The highest incidence occurs among women 16 to 35 years old. It may be asymptomatic, which facilitates transmission. Its etiologic agent is the protozoan parasite Trichomonas vaginalis, usually transmitted by sexual contact. This review includes the following aspects: epidemiology, taxonomy, physiopathology, habitat and life cycle, symptomatology, diagnostic methods, treatment, and relationship with VIH, PVH and Mycoplasma hominis infections.