Age and sex trends of Gardnerella vaginalis infection in patients with sexually transmitted infections in Korea
Abstract
Background and Objectives: Gardnerella vaginalis and Candida albicans are the most common causative agents of bacterial vaginosis, and infections with these pathogens lead to inflammation, endometritis, and pruritus. The aim of this retrospective study was to determine the trends of G. vaginalis infections based on real-time PCR data according to age and sex in patients with sexually transmitted diseases.
Materials and Methods: A total of 59,381 specimens isolated at a clinical laboratory from September 2018 to December 2020 were subjected to real-time PCR for the detection of G. vaginalis DNA. Sample types included catheter, pus, tissue, swab, and urine samples.
Results: Among 59,381 samples, 20,718 (34.8%) were positive for G. vaginalis. Of the positive samples, 13,186 (63.7%) were from male patients and 7,532 (36.3%) were from female patients. Average patient age was 39.1 years (the average age of male and female patients was 38.34 and 40.43 years, respectively). Female patients younger than 19 years exhibited the highest incidence of G. vaginalis, at 71.57%, followed by 68.46% incidence in those aged 20-29 years; the lowest incidence was in women aged 40-49 years. Further, among specimen types, the highest number of G. vaginalis-positive specimens was obtained by the swab sampling method.
Conclusion: From 2018 to 2020 in Korea, the number of tests conducted for bacterial vaginosis has increased, while the incidence of G. vaginalis infections appears to have decreased. the finding that female adolescents have a high tendency to carry the pathogen is important. and for effective surveillance of BV, sampling by cotton swabs and detection by multiplex PCR might be a good approach.
2. Srinivasan S, Hoffman NG, Morgan MT, Matsen FA, Fiedler TL, Hall RW, et al. Bacterial communities in women with bacterial vaginosis: high resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria. PLoS One 2012; 7(6): e37818.
3. Bilardi JE, Walker S, Temple-Smith M, McNair R, Mooney-Somers J, Bellhouse C, et al. The burden of bacterial vaginosis: women’s experience of the physical, emotional, sexual and social impact of living with recurrent bacterial vaginosis. PLoS One 2013; 8(9): e74378.
4. Haggerty CL, Totten PA, Tang G, Astete SG, Ferris MJ, Norori J, et al. Identification of novel microbes associated with pelvic inflammatory disease and infertility. Sex Transm Infect 2016; 92: 441-446.
5. Allsworth JE, Peipert JF. Severity of bacterial vaginosis and the risk of sexually transmitted infection. Am J Obstet Gynecol 2011; 205(2): 113.e1-6.
6. Payne VK, Florence Cécile TT, Cedric Y, Christelle Nadia NA, José O. Risk factors associated with prevalence of Candida albicans, Gardnerella vaginalis, and Trichomonas vaginalis among women at the district hospital of Dschang, west region, Cameroon. Int J Microbiol 2020; 2020: 8841709.
7. Fredricks DN, Fiedler TL, Thomas KK, Oakley BB, Marrazzo JM. Targeted PCR for detection of vaginal bacteria associated with bacterial vaginosis. J Clin Microbiol 2007; 45: 3270-3276.
8. Zozaya-Hinchliffe M, Lillis R, Martin DH, Ferris MJ. Quantitative PCR assessments of bacterial species in women with and without bacterial vaginosis. J Clin Microbiol 2010; 48: 1812-1819.
9. Pleckaityte M, Janulaitiene M, Lasickiene R, Zvirbliene A. Genetic and biochemical diversity of Gardnerella vaginalis strains isolated from women with bacterial vaginosis. FEMS Immunol Med Microbiol 2012; 65: 69-77.
10. Lewis WG, Robinson LS, Gilbert NM, Perry JC, Lewis AL. Degradation, foraging, and depletion of mucus sialoglycans by the vagina-adapted Actinobacterium Gardnerella vaginalis. J Biol Chem 2013; 288: 12067-12079.
11. Patterson JL, Stull-Lane A, Girerd PH, Jefferson KK. Analysis of adherence, biofilm formation and cytotoxicity suggests a greater virulence potential of Gardnerella vaginalis relative to other bacterial-vaginosis-associated anaerobes. Microbiology (Reading) 2010; 156: 392-399.
12. Castro J, Alves P, Sousa C, Cereija T, França Â, Jefferson KK, et al. Using an in-vitro biofilm model to assess the virulence potential of bacterial vaginosis or non-bacterial vaginosis Gardnerella vaginalis isolates. Sci Rep 2015; 5: 11640.
13. Aroutcheva AA, Simoes JA, Behbakht K, Faro S. Gardnerella vaginalis isolated from patients with bacterial vaginosis and from patients with healthy vaginal ecosystems. Clin Infect Dis 2001; 33: 1022-1027.
14. Kang GU, Jung DR, Lee YH, Jeon SY, Han HS, Chong GO, et al. Potential association between vaginal microbiota and cervical carcinogenesis in Korean women: a cohort study. Microorganisms 2021; 9: 294.
15. De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut–skin axis: current knowledge of the interrelationship between microbial dysbiosis and skin conditions. Microorganisms 2021; 9: 353.
16. Chen YB, Hochstedler B, Pham TT, Acevedo-Alvarez M, Mueller ER, Wolfe AJ. The urethral microbiota: a missing link in the female urinary microbiota. J Urol 2020; 204: 303-309.
17. Naicker D, Ramsuran V, Naicker M, Dessai F, Abbai N. Quantitative detection of bacteria associated with BV in urine versus swab samples using droplet digital PCR. Int J Infect Dis 2020; 101: 444-449.
18. Xu L, Hu Z, Yu F, Tang Y. Analysis of characteristics of vulvo-vaginal infections in 14- to 18-year-old girls in late puberty. J Int Med Res 2020; 48: 300060520946506.
19. Shigehara K, Kawaguchi S, Sasagawa T, Furubayashi K, Shimamura M, Maeda Y, et al. Prevalence of genital Mycoplasma, Ureaplasma, Gardnerella, and human papillomavirus in Japanese men with urethritis, and risk factors for detection of urethral human papillomavirus infection. J Infect Chemother 2011; 17: 487-492.
20. Sehgal PG, Dadwal R, Sharma B, Sehgal A, Bagga R, Chopra S, et al. Detection of co-infection of Gardnerella vaginalis and Atopobium vaginae using qualitative PCR: A better predictor of bacterial vaginosis. Anaerobe 2021; 69: 102343.
21. Kim JJ, de Castro Junior RL, Schauer M, Bauler LD. Rare case of osteomyelitis caused by Gardnerella vaginalis and Streptococcus parasanguinis in a postmenopausal woman. BMJ Case Rep 2021; 14(2): e237611.
22. Alfraji N, Douedi S, Akoluk A, Dattadeen J, Fune L, Liu E. Gardnerella vaginalis bacteremia in an elderly healthy male. IDCases 2020; 21: e00807.
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Issue | Vol 13 No 6 (2021) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijm.v13i6.8079 | |
Keywords | ||
Bacterial vaginosis; Dermatology; Gardnerella vaginalis; Multiplex real-time polymerase chain reaction; Sexually transmitted disease |
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