Prevalence of Gardnerella vaginalis infection and antibiotic resistance pattern of isolates of gynecology clinic patients at Shahriar Noor Hospital from January to June 2020 by PCR and culture methods
,
Abstract
Background and Objectives: Gardnerella vaginalis is one of the most important causes of prevalent genital infections that pose serious risks. This study aimed to determine the prevalence of Gardnerella vaginalis and antibiotic resistance pattern of isolates of patients referred to the gynecology clinic of Shahriar Noor Hospital by PCR and culture methods.
Materials and Methods: The study was conducted on 500 patients who had suffered from a vaginal infection. The demographic data of patients were studied. For diagnosis of Gardnerella vaginalis isolates, cultivation in anaerobic conditions, biochemical tests, PCR and Gardnerella vaginalis antibiotic susceptibility test to metronidazole and clindamycin were performed. Data analysis was performed utilizing SPSS statistical software version 19 and the Chi-square test.
Results: Among the 500 patients, 173 were diagnosed with Gardnerella vaginitis. There was a significant relationship between age group, level of education, and contraceptive method with Gardnerella vaginosis incidence. Performing antibiotic susceptibility tests showed that the resistance of Gardnerella vaginalis isolated strains to metronidazole and clindamycin was 86.12% and 17.34%, respectively.
Conclusion: The high prevalence of Gardnerella vaginalis infections confirms the critical role of the bacterium in the occurrence of bacterial vaginosis. Therefore, it is necessary to check the prevalence of bacterial infections to recommend the correct medical treatment in different societies.
1. Castro J, Machado D, Cerca N. Unveiling the role of Gardnerella vaginalis in polymicrobial Bacterial Vaginosis biofilms: the impact of other vaginal pathogens living as neighbors. ISME J 2019; 13: 1306-1317.
2. Hodoglugil NN, Aslan D, Bertan M. Intrauterine device use and some issues related to sexually transmitted disease screening and occurrence. Contraception 2000; 61: 359-364.
3. De Backer E, Verhelst R, Verstraelen H, Claeys G, Verschraegen G, Temmerman M, et al. Antibiotic susceptibility of Atopobium vaginae. BMC Infect Dis 2006; 6: 51.
4. Hilbert DW, Schuyler JA, Adelson ME, Mordechai E, Sobel JD, Gygax SE. Gardnerella vaginalis population dynamics in bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2017; 36: 1269-1278.
5. Onderdonk AB, Delaney ML, Fichorova RN. The human microbiome during bacterial vaginosis. Clin Microbiol Rev 2016; 29: 223-238.
6. Schwebke JR, Muzny CA, Josey WE. Role of Gardnerella vaginalis in the pathogenesis of bacterial vaginosis: a conceptual model. J Infect Dis 2014; 210: 338-343.
7. Gelber SE, Aguilar JL, Lewis KL, Ratner AJ. Functional and phylogenetic characterization of Vaginolysin, the human-specific cytolysin from Gardnerella vaginalis. J Bacteriol 2008; 190: 3896-3903.
8. Ravel J, Brotman RM, Gajer P, Ma B, Nandy M, Fadrosh DW, et al. Daily temporal dynamics of vaginal microbiota before, during and after episodes of bacterial vaginosis. Microbiome 2013; 1: 29.
9. Coudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol 2020; 245: 143-148.
10. Machado A, Cerca N. Influence of biofilm formation by Gardnerella vaginalis and other anaerobes on bacterial vaginosis. J Infect Dis 2015; 212: 1856-1861.
11. Chen H-M, Chang T-H, Lin F-M, Liang C, Chiu C-M, Yang T-L, et al. Vaginal microbiome variances in sample groups categorized by clinical criteria of bacterial vaginosis. BMC Genomics 2018; 19(Suppl 10): 876.
12. Bradshaw CS, Morton AN, Garland SM, Horvath LB, Kuzevska I, Fairley CK. Evaluation of a point-of-care test, BVBlue, and clinical and laboratory criteria for diagnosis of bacterial vaginosis. J Clin Microbiol 2005; 43: 1304-1308.
13. Balouiri M, Sadiki M, Ibnsouda SK. Methods for in vitro evaluating antimicrobial activity: A review. J Pharm Anal 2016; 6: 71-79.
14. Gergova RT, Strateva TV, Mitov IG. Gardnerella vaginalis-associated bacterial vaginosis in Bulgarian women. Braz J Infect Dis 2013; 17: 313-318.
15. Sherrard J, Wilson J, Donders G, Mendling W, Jensen JS. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS 2018; 29: 1258-1272.
16. Sabour S, Arzanlou M, Vaez H, Rahimi G, Sahebkar A, Khademi F. Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis. Arch Gynecol Obstet 2018; 297: 1101-1113.
17. Mohammadzadeh R, Sadeghi Kalani B, Kashanian M, Oshaghi M, Amirmozafari N. Prevalence of vaginolysin, sialidase and phospholipase genes in Gardnerella vaginalis isolates between bacterial vaginosis and healthy individuals. Med J Islam Repub Iran 2019; 33: 85.
18. Janulaitiene M, Paliulyte V, Grinceviciene S, Zakareviciene J, Vladisauskiene A, Marcinkute A, et al. Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis. BMC Infect Dis 2017; 17: 394.
19. Leyva-Gómez G, Prado-Audelo MLD, Ortega-Peña S, Mendoza-Muñoz N, Urbán-Morlán Z, González-Torres M, et al. Modifications in vaginal microbiota and their influence on drug release: Challenges and opportunities. Pharmaceutics 2019; 11: 217.
20. Morris MC, Rogers PA, Kinghorn GR. Is bacterial vaginosis a sexually transmitted infection? Sex Transm
Infect 2001; 77: 63-68.
21. Ahmadnia E, Kharaghani R, Maleki A, Avazeh A, Mazloomzadeh S, Sedaghatpisheh T, et al. Prevalence and associated factors of genital and sexually transmitted infections in married women of Iran. Oman Med J 2016; 31: 439-445.
22. Tsai C-C, Lai T-M, Hsieh Y-M. Evaluation of Lactobacilli for antagonistic activity against the growth, adhesion and invasion of Klebsiella pneumoniae and Gardnerella vaginalis. Indian J Microbiol 2019; 59: 81-89.
23. Maria C, Zahra R, Sara P. Prevalence of cervical-vaginal infections in the pap-smear samples in Iran. Glob J Health Sci 2013; 6: 201-206.
24. Bahram A, Hamid B, Zohre T. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in zanjan, iran. Oman Med J 2009; 24: 288-293.
25. Ranjit E, Raghubanshi BR, Maskey S, Parajuli P. Prevalence of bacterial vaginosis and its association with risk factors among nonpregnant women: a hospital based study. Int J Microbiol 2018; 2018: 8349601.
26. Nagaraja P. Antibiotic resistance of Gardnerella vaginalis in recurrent bacterial vaginosis. Indian J Med Microbiol 2008; 26: 155-157.
27. Hakimi S, Farhan F, Farshbaf-Khalili A, Dehghan P, Javadzadeh Y, Abbasalizadeh S, et al. The effect of prebiotic vaginal gel with adjuvant oral metronidazole tablets on treatment and recurrence of bacterial vaginosis: a triple-blind randomized controlled study. Arch Gynecol Obstet 2018; 297: 109-116.
28. Decena DC, Co JT, Manalastas RM Jr, Palaypayon EP, Padolina CS, Sison JM, et al. Metronidazole with Lactacyd vaginal gel in bacterial vaginosis. J Obstet Gynaecol Res 2006; 32: 243-251.
29. Bostwick DG, Woody J, Hunt C, Budd W. Antimicrobial resistance genes and modelling of treatment failure in bacterial vaginosis: clinical study of 289 symptomatic women. J Med Microbiol 2016; 65: 377-386.
30. Tibaldi C, Cappello N, Latino MA, Masuelli G, Marini S, Benedetto C. Vaginal and endocervical microorganisms in symptomatic and asymptomatic non-pregnant females: risk factors and rates of occurrence. Clin Microbiol Infect 2009; 15: 670-679.
2. Hodoglugil NN, Aslan D, Bertan M. Intrauterine device use and some issues related to sexually transmitted disease screening and occurrence. Contraception 2000; 61: 359-364.
3. De Backer E, Verhelst R, Verstraelen H, Claeys G, Verschraegen G, Temmerman M, et al. Antibiotic susceptibility of Atopobium vaginae. BMC Infect Dis 2006; 6: 51.
4. Hilbert DW, Schuyler JA, Adelson ME, Mordechai E, Sobel JD, Gygax SE. Gardnerella vaginalis population dynamics in bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2017; 36: 1269-1278.
5. Onderdonk AB, Delaney ML, Fichorova RN. The human microbiome during bacterial vaginosis. Clin Microbiol Rev 2016; 29: 223-238.
6. Schwebke JR, Muzny CA, Josey WE. Role of Gardnerella vaginalis in the pathogenesis of bacterial vaginosis: a conceptual model. J Infect Dis 2014; 210: 338-343.
7. Gelber SE, Aguilar JL, Lewis KL, Ratner AJ. Functional and phylogenetic characterization of Vaginolysin, the human-specific cytolysin from Gardnerella vaginalis. J Bacteriol 2008; 190: 3896-3903.
8. Ravel J, Brotman RM, Gajer P, Ma B, Nandy M, Fadrosh DW, et al. Daily temporal dynamics of vaginal microbiota before, during and after episodes of bacterial vaginosis. Microbiome 2013; 1: 29.
9. Coudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol 2020; 245: 143-148.
10. Machado A, Cerca N. Influence of biofilm formation by Gardnerella vaginalis and other anaerobes on bacterial vaginosis. J Infect Dis 2015; 212: 1856-1861.
11. Chen H-M, Chang T-H, Lin F-M, Liang C, Chiu C-M, Yang T-L, et al. Vaginal microbiome variances in sample groups categorized by clinical criteria of bacterial vaginosis. BMC Genomics 2018; 19(Suppl 10): 876.
12. Bradshaw CS, Morton AN, Garland SM, Horvath LB, Kuzevska I, Fairley CK. Evaluation of a point-of-care test, BVBlue, and clinical and laboratory criteria for diagnosis of bacterial vaginosis. J Clin Microbiol 2005; 43: 1304-1308.
13. Balouiri M, Sadiki M, Ibnsouda SK. Methods for in vitro evaluating antimicrobial activity: A review. J Pharm Anal 2016; 6: 71-79.
14. Gergova RT, Strateva TV, Mitov IG. Gardnerella vaginalis-associated bacterial vaginosis in Bulgarian women. Braz J Infect Dis 2013; 17: 313-318.
15. Sherrard J, Wilson J, Donders G, Mendling W, Jensen JS. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS 2018; 29: 1258-1272.
16. Sabour S, Arzanlou M, Vaez H, Rahimi G, Sahebkar A, Khademi F. Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis. Arch Gynecol Obstet 2018; 297: 1101-1113.
17. Mohammadzadeh R, Sadeghi Kalani B, Kashanian M, Oshaghi M, Amirmozafari N. Prevalence of vaginolysin, sialidase and phospholipase genes in Gardnerella vaginalis isolates between bacterial vaginosis and healthy individuals. Med J Islam Repub Iran 2019; 33: 85.
18. Janulaitiene M, Paliulyte V, Grinceviciene S, Zakareviciene J, Vladisauskiene A, Marcinkute A, et al. Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis. BMC Infect Dis 2017; 17: 394.
19. Leyva-Gómez G, Prado-Audelo MLD, Ortega-Peña S, Mendoza-Muñoz N, Urbán-Morlán Z, González-Torres M, et al. Modifications in vaginal microbiota and their influence on drug release: Challenges and opportunities. Pharmaceutics 2019; 11: 217.
20. Morris MC, Rogers PA, Kinghorn GR. Is bacterial vaginosis a sexually transmitted infection? Sex Transm
Infect 2001; 77: 63-68.
21. Ahmadnia E, Kharaghani R, Maleki A, Avazeh A, Mazloomzadeh S, Sedaghatpisheh T, et al. Prevalence and associated factors of genital and sexually transmitted infections in married women of Iran. Oman Med J 2016; 31: 439-445.
22. Tsai C-C, Lai T-M, Hsieh Y-M. Evaluation of Lactobacilli for antagonistic activity against the growth, adhesion and invasion of Klebsiella pneumoniae and Gardnerella vaginalis. Indian J Microbiol 2019; 59: 81-89.
23. Maria C, Zahra R, Sara P. Prevalence of cervical-vaginal infections in the pap-smear samples in Iran. Glob J Health Sci 2013; 6: 201-206.
24. Bahram A, Hamid B, Zohre T. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in zanjan, iran. Oman Med J 2009; 24: 288-293.
25. Ranjit E, Raghubanshi BR, Maskey S, Parajuli P. Prevalence of bacterial vaginosis and its association with risk factors among nonpregnant women: a hospital based study. Int J Microbiol 2018; 2018: 8349601.
26. Nagaraja P. Antibiotic resistance of Gardnerella vaginalis in recurrent bacterial vaginosis. Indian J Med Microbiol 2008; 26: 155-157.
27. Hakimi S, Farhan F, Farshbaf-Khalili A, Dehghan P, Javadzadeh Y, Abbasalizadeh S, et al. The effect of prebiotic vaginal gel with adjuvant oral metronidazole tablets on treatment and recurrence of bacterial vaginosis: a triple-blind randomized controlled study. Arch Gynecol Obstet 2018; 297: 109-116.
28. Decena DC, Co JT, Manalastas RM Jr, Palaypayon EP, Padolina CS, Sison JM, et al. Metronidazole with Lactacyd vaginal gel in bacterial vaginosis. J Obstet Gynaecol Res 2006; 32: 243-251.
29. Bostwick DG, Woody J, Hunt C, Budd W. Antimicrobial resistance genes and modelling of treatment failure in bacterial vaginosis: clinical study of 289 symptomatic women. J Med Microbiol 2016; 65: 377-386.
30. Tibaldi C, Cappello N, Latino MA, Masuelli G, Marini S, Benedetto C. Vaginal and endocervical microorganisms in symptomatic and asymptomatic non-pregnant females: risk factors and rates of occurrence. Clin Microbiol Infect 2009; 15: 670-679.
| Files | ||
| Issue | Vol 15 No 4 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v15i4.13505 | |
| Keywords | ||
| Antibiotic resistance; Bacterial vaginosis; Gardnerella vaginalis; Prevalence; Polymerase chain reaction | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Rashidifar S, Harzandi N, Honarmand Jahromi S, Gharavi MJ. Prevalence of Gardnerella vaginalis infection and antibiotic resistance pattern of isolates of gynecology clinic patients at Shahriar Noor Hospital from January to June 2020 by PCR and culture methods. Iran J Microbiol. 2023;15(4):513-520.
