Multiplex PCR detection of problematic pathogens of clinically heterogeneous bacterial vaginosis in Bulgarian women

Abstract

Background/aim: This study aimed to investigate the correlation between the prevalence of problematic pathogens and the clinical status of women with bacterial vaginosis (BV).Materials and methods: Gardnerella vaginalis, Atopobium vaginae, and Mobiluncus spp. were detected using a multiplex PCR assay, and their role in the infection of Bulgarian women with clinically heterogeneous BV was evaluated. Results:The predominant BV-associated pathogen identified was G. vaginalis with an incidence of 98.39%, followed by A. vaginae (68.05%) and Mobiluncus spp. at 17.01%. The coexistence of A. vaginae and G. vaginalis was more common in women with discharge (in 72.04%) and in patients with chronic recurrent BV than among asymptomatic or newly diagnosed BV cases (P < 0.05). Mobiluncus spp. was detected mostly in coinfections, in association with Trichomonas vaginalis. The coinfections were predominantly related to recurrent BV and with complications (P < 0.05). Conclusion:This is the first study about the correlation between problematic pathogens and clinically heterogeneous BV in Bulgarian women. High frequency of infection with key BV-related pathogens was observed in childbearing women. The incidence was shown to often correlate with coexistent T. vaginalis, with severity of infection, and with complicated and recurrent BV after unsuccessful treatments. Screening should be considered in reproductive health programs.

Vaginal microbiota evaluation and prevalence of key pathogens in ecuadorian women: an epidemiologic analysis

“…In the USA, Schwebke and colleagues 98 detected A. vaginae in similar prevalence colonization (54.0%) when compared to our study (55.4%). Likewise, several studies conducted in Europe (such as Lithuania 99 and Bulgaria 100 ) reported a higher prevalence of the same BV-associated anaerobes, but maintaining the same hierarchy order (see Table 7 ). Finally, in China, two studies demonstrated a similar prevalence of Gardnerella species and A. vaginae in their group sets 101 , 102 , more precisely, 63.2–82.8% and 17.1–65.5%, respectively.…”

Cationic amphiphiles against Gardnerella vaginalis resistant strains and bacterial vaginosis-associated pathogens

“…Bacterial vaginosis is a polymicrobial biofilm-associated infection, in which opportunistic anaerobic pathogens such as G. vaginalis, P. bivia, P. anaerobius and M. curtisii outgrow and replace the commensal microbiota. Each of these species has shown resistance to either clindamycin or metronidazole (Petrina et al 2017;Tosheva-Daskalova et al 2017;Veloo et al 2018), and our lab was able to develop a clindamycin-resistant variant of G. vaginalis ATCC 14018 to investigate in addition to a metronidazole-resistant strain, G. vaginalis 14019 metR. When tested against planktonic cells, series 1 compounds (composed of hydrolytically stable ether linkages) were generally more effective than those from series 2 (compounds containing hydrolyzable ester linkages), though the trend was less noticeable and even reversed in some instances with compounds 1c and 2c.…”