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Objectives: The objectives of this study were to: calculate the frequency of urogenital trichomoniasis, describe the socio-demographic characteristics and analyze the biological samples. Methodology: This was a six (6) month cross-sectional prospective study carried out in the maternity ward (gynecological consultation) and in the laboratory of the Prefectural Hospital of Macenta. All the women who came for gynecological consultation were included in the study and among them, all those who presented a laboratory examination report for vaginal secretions and / or urine during the study period. Not included in the study were all the women who came for a gynecological consultation but who had not received a laboratory examination report for vaginal secretions and / or urine and all those already undergoing treatment to imidazole in the 15 days preceding the survey were not included. After applying the selection procedure (inclusion and non-inclusion criteria), we obtained a sample size N = 703 cases. Results:The frequency of urogenital trichomoniasis was 26.46% among urogenital infections. The epidemiological profile was that of: young women aged 22-27 (42.47%), housewife (39.76%), having a primary education (30.43%) and married (28.53%). half of the patients were asymptomatic followed by those with fetid leucorrhoea 32.61%. High positivity was found in vaginal secretions (30.41%). Conclusion: Urogenital trichomoniasis is a sexually transmitted infection, common in women of childbearing or childbearing age. It constitutes a public health problem, one of the control strategies for which it involves sensitization and care for women / couples at all levels of the health pyramid.

Fifteen percent of male infertility is associated with urogenital infections, several pathogens are able to alter the testicular and accessory glands’ microenvironment, resulting in the impairment of biofunctional sperm parameters. The purpose of this study was to assess the influence of urogenital infections on the quality of 53 human semen samples through standard analysis, microbiological evaluation, and molecular characterization of sperm DNA damage. The results showed a significant correlation between infected status and semen volume, sperm concentration, and motility. Moreover, a high risk of fragmented sperm DNA was demonstrated in the altered semen samples. Urogenital infections are often asymptomatic and thus an in-depth evaluation of the seminal sample can allow for both the diagnosis and therapy of infections while providing more indicators for male infertility management.

Background: Sexually transmitted infections play a great role in formation of inflammatory diseases of female urogenital system. These diseases can cause a decrease in the level of female sex hormones, as well as the ratio of estrogens and androgens. Objective: To determine changes in the state of sex hormones in women with inflammatory diseases of ovaries associated with opportunistic urogenital flora. Materials and Methods: 136 women aged 18-39 yr participated in this cross-sectional clinical study. They were examined with the use of a complex of clinical, laboratory and instrumental methods of examination. The patients with confirmed diagnosis of inflammatory disease of reproductive system associated with opportunistic urogenital infection have been under blood analysis to reveal the concentration of follicle-stimulating hormone, luteinizing hormone, and estrogens. Results: After the treatment the functional capacity of ovary significantly increased, proved by a corresponding increase in the concentration of estradiol hormone in blood serum in all phases of menstrual cycle. According to estradiol in follicular phase its concentration was increased from 421.8±10.8 nmol/L to 581.3±10.2 nmol/L. The elevation in the ratio of estradiol/testosterone hormones in blood serum also is demonstrated. Conclusion: Inflammatory diseases associated with opportunistic urogenital infection is responsible for a decrease of female sex hormones and the ratio of estrogens and androgens.

Backgrounds and Objectives: Mycoplasmas are distinguished phenotypically from other bacteria by their minute size and total lack of a cell wall and are involved in urogenital infections in both male and females. The aim of this study was to evaluate the presence of Mycoplasma genus and Mycoplasma homonis and genitalium in urine samples of athletes and non-athletes. Methods: In this study, urine samples were taken from 50 athlete and non-athlete males and were transported to laboratory. After DNA extraction, PCR was performed using specific primers to identify Mycoplasma genus and species hominis and genitalium. Results: Among 100 samples, 5 were positive for Mycoplasma genus which all the 5 isolate belonged to non-athlete persons. In 5 positive samples, 3 belonged to Mycoplasma hominis and 2 belonged to Mycoplasma genitalium. Conclusions: This study showed the presence of Mycoplasma in athletes were less than non-athletes. In addition PCR was a sensitive and precise method to identify Mycoplasma genus and species.

Mycoplasma lipoproteins play a relevant role in pathogenicity and directly interact with the host immune system. Among human mycoplasmas, Mycoplasma hominis is described as a commensal bacterium that can be associated with a number of genital and extragenital conditions. Mechanisms of M. hominis pathogenicity are still largely obscure, and only a limited number of proteins have been associated with virulence. The current study focused on investigating the role of MHO_0730 as a virulence factor and demonstrated that MHO_0730 is a surface lipoprotein, potentially expressed in vivo during natural infection, acting both as a nuclease with its amino acidic portion and as a potent inducer of Neutrophil extracellular trapsosis with its N-terminal lipid moiety. Evidence for M. hominis neutrophil extracellular trap escape is also presented. Results highlight the relevance of MHO_0730 in promoting infection and modulation and evasion of innate immunity and provide additional knowledge on M. hominis virulence and survival in the host.

Objective. The research objective is the development of effective method for the treatment of complicated ectopia of the cervix, allowing to reduce the frequency of relapses. Materials and methods. A comprehensive examination of 86 women with complicated ectopia of the cervix has been undertaken. In the main group (n=45) our proposed method of treatment of ectopia of the cervix has been applied, which, in addition to the performance of coagulation, involves two successive stages: preparing for coagulation and treatment in the postoperative period including Galavit (patent for invention № 2568768). In the comparison group (n=41) coagulation ectopia of uterine cervix was preceded by empirical antibiotic and antiviral therapy. Diagnostic measures included bacteriological and cytological examination, HPV testing, extended colposcopy, PCR diagnostic and ELISA blood test for the detection of causative agents of urogenital infections. Results. The analysis of the postoperative period and control the colposcopy showed that in the majority of cases in the main group the reparative process ended by the end of the 3rd week (62.2%), the full impact of all the patients was recorded at the 5th week after the treatment (100%), the relapse has not been revealed within 2 years. In the comparison group the slowing down of terms of epithelialization of the wound surface of the uterus after coagulation has been noted, the lack of treatment effect has been found in 9.8% of patients, and the relapse within 2 years and 17.1% of women has been stated. Conclusion. The developed method allows to increase the efficiency of treatment by sequential combined effects on cause and effect of pathological changes on the cervix: the elimination of etiopathogenetic factors ectopia of the cervix, coagulation of the pathological section, stimulation of the immune system and reparative processes.

Varicocele, a pathology developing in 15 % males, is associated with 30 % male infertility cases. The role of urogenital infections coinciding with varicocele in infertile men has not been studied in sufficient detail. Objective: to examine the effects of bacterial and viral infections on ejaculate parameters in infertile patients with varicocele. The study included 49 patients with infertility and varicocele and 26 healthy males undergoing prophylactic medical examination. Highlevel infection was recorded after examination of ejaculates and urethral scrapes of 49 patients: bacterial (30.6 %) and viral (14.3 %) pathogens. Quantitative analysis of viral DNA showed high contamination of ejaculates with herpes viruses (> 3 lg10/ml). Detailed analysis of spermatograms demonstrated a decrease in all basic parameters in patients with varicocele and infertility compared with those in healthy subjects. The presence of infectious agents had a statistically significant negative effect on ejaculate parameters. Spermiological examination revealed high level of sperm abnormalities (astenozoospermia, oligoteratozoospermia, and oligoastenoteratozoospermia) in patients with infertility, varicocele and bacterioviral infection of urogenital tract compared with uninfected infertile patients with varicocele. Laboratory tests for bacterial and viral infections should be recommended in infertility associated with varicocele even in the absence of clinical signs of these infections. Quantitative analysis of urogenital pathogens allows one to determine the necessity of etiotherapy of hidden infection and to monitor the effectiveness of treatment.

Chlamydia trachomatis is an obligate intracellular pathogen with global health and economic impact. Upon infection, C. trachomatis resides within a protective niche, the inclusion, wherein it replicates and usurps host cell machinery and resources. The inclusion membrane is the key host-pathogen interface that governs specific protein-protein interactions to manipulate host signaling pathways. At the conclusion of the infection cycle, C. trachomatis exits the host cell via lysis or extrusion. Extrusion depends on the phosphorylation state of myosin light chain 2 (MLC2); the extent of phosphorylation is determined by the ongoing opposing activities of myosin phosphatase (MYPT1) and myosin kinase (MLCK). Previously, it was shown that MYPT1 is recruited to the inclusion and interacts with CT228 for regulation of host cell egress. In this study, we generated a targeted chromosomal mutation of CT228 (L2-ΔCT228) using the TargeTron system and demonstrate a loss of MYPT1 recruitment and increase in extrusion production in vitro. Mutation of CT228 did not affect chlamydial growth in cell culture or recruitment of MLC2. Moreover, we document a delay in clearance of L2-ΔCT228 during murine intravaginal infection as well as a reduction in systemic humoral response, relative to L2-wild type. Taken together, the data suggest that loss of MYPT1 recruitment (as a result of CT228 disruption) regulates the degree of host cell exit via extrusion and affects the longevity of infection in vivo.

Adolescent is an important segment of the world population accounting for about one fifth. It is a transition state between childhood and adulthood and characterized with the development of behaviours with lifelong consequences. Such behaviours include unhealthy sexual practices with its associated risks like unwanted pregnancy and sexually transmitted diseases. This was a cross sectional descriptive study of 321 adolescents who presented at the general outpatient clinic of a tertiary health institution. The diagnosis of urinary infection was by the use of rapid dipstick test to detect the presence of nitrites, while the presence of pus cells, white blood cells greater than 5 per high power fluid, epithelial cells and trichomonal vaginalis were identified microscopically. Their HIV status was also determined. The fifty three (16.25) of the respondents who had coital experience were screened for evidence of urinary infection. The prevalence of urinary infection was 24.5% among the respondents with 10% and 5% of the sexually exposed females reported homosexual and bisexual experience. Parental higher socioeconomic class was protective against sexual exposure among the adolescents. In view of the high level of poverty with a large part of the population belonging to low socioeconomic class, it is necessary to research into possible interventional study on how to prevent unhealthy sexual behavior among adolescents from low socioeconomic class.Key words: sexual behavior; Urogenital Infection; Adolescents

Objective: To determine whether interactions between coital frequency, cervical length, and urogenital infection affect obstetric outcomes. Materials and Methods: A total of 268 unselected pregnant women were recruited in the study. The study population consisted of four groups of women: group 1 (n=203) screened negative for bacterial vaginosis (BV) both in the first and second trimesters; group 2 (n=18) screened negative for BV in the first trimester but positive in the second trimester; group 3 (n=33) screened positive for BV in the first trimester but negative in the second trimester; and group 4 (n=14) screened positive for BV both in the first and second trimesters. Urine culture, cervico-vaginal cultures, and bacterial vaginosis were screened between 11-14 weeks and 20-24 weeks. Results: Two hundred fifty women were eligible for analysis in the study after lost-to-follow up patients were excluded. Previous abortion ≥1 and previous preterm delivery at 24-34 weeks ≥1 were statistically significantly higher in group 2. The number of patients who were diagnosed as having preterm premature rupture of membranes (PPROM) was statistically significantly higher in group 4. Sexual intercourse during the first trimester, cervical length during the second trimester, and history of preterm birth (PTB) were statistically significant risk factors for preterm birth

Significant incidence of chronic urogenital diseases, both of viral and bacterial origin in women of reproductive age leads to an increase in the frequency of intrauterine infections. These disorders lead to disturbances of postnatal adaptation of newborns and increased numbers of infectious complications. In order to assess the state of immune system, we examined forty-eight children born to women with urogenital infection, including twenty-nine infants with complicated course of early adaptation period (study group) and twenty children diagnosed as healthy upon discharge by the day 3 to 5 after birth (comparison group). By means of flow cytometry, the following subpopulations were assayed in cord blood: CD3+, CD3+CD4+, CD3+CD8+, CD19+, CD3CD16+CD56+ cells, expression levels of markers specific to activated monocytes CD14 (HLA-DR), and lymphocytes (CD25+, CD69+), like as markers of functionally mature cells (CD45R0, CD45RA), both in total lymphocyte pool and among T cell populations. Contents of IL-1β, TNFα, IFNγ, IL-4, IL-6, IL-8, IL-10 were assessed by ELISA technique. Our studies have shown that umbilical cord blood samples from the main group of newborns showed a statistically significant decrease in relative content of CD3+, CD4+, CD8+ and CD4+CD25+ cells, along with increase in the absolute numbers of leukocytes and lymphocytes, B-cells and NK cells, as well as expression of CD45RO+, CD45RA+ and CD3+CD45RO+ receptors, CD69+ and CD14+HLADR+ activation markers, accompanied by a significant increase of IL-8 production. Numerical determination of CD45RO+, CD3+CD45RO+, CD69+ and CD14+HLA-DR+ cells, and IL-8 contents in newborns, may serve as prognostic criteria for assignment of risk group for early adaptation disturbances and development of infectious diseases.

Objectives To study the state of immunity in pregnancies associated with urogenital infection and complicated by intrauterine infection. Material and methods The comparative study involved the examination of 250 pregnant women with urogenital infection and ultrasonographic signs of intrauterine infection and their newborns in order to assess the state of cellular and humoral immunity components and nonspecific resistance. A direct prospective examination of pregnant women was carried out in the 2nd and 3rd trimesters of gestation. Depending on the outcome of each pregnancy on the basis of the follow-up of newborns, performed on the first day after birth, the patients were retrospectively divided into two groups. The study group included 93 (37.2%) pregnant women who developed intrauterine infection. The comparison group (n=157 (62.8%)) comprised pregnant-carriers of perinatally significant infection who gave birth to conditionally healthy children. The control group consisted of 50 healthy women with a physiological pregnancy. Results In the gestation period under investigation, the development of intrauterine infection in pregnant women with urogenital infections was found to be associated with a deficiency of T-helpers / inducers, an increase in thymus-dependent lymphocyte killer activity, a high content of IL- 1β, TNF-α in the systemic circulation, and a decrease in the level of IL- 10 secondary to the oppression of the effector link of phagocytic neutrophils of peripheral blood. Conclusions An increased concentration of systemic proinflammatory cytokines IL-1β, IL-6 and TNFα with a simultaneous decrease in the IL-10 content and suppression of the killing activity of peripheral blood phagocytes reflects the presence of an active inflammatory process in the mother-placenta-fetus system and can be one of the factors affecting the development of intrauterine infection in pregnancy, complicated by urogenital infection.

Bifidobacteria are predominant microorganisms in the intestinal flora, but at the same time represent a subdominant group of the vaginal microbiota. For this reason, oral administration of these probiotic bacteria can provide beneficial effect for both intestinal and urogenital ecosystems. The first aim of this study was to test the strain Bifidobacterium breve BC204, isolated from a vaginal swab of a healthy woman, for its capability to adhere to human cells, to survive to gastric acids and bile salts and to exert antimicrobial activities. The second aim of the work was to develop an oral formulation able to guarantee bacterial survival during storage and administration, thus favouring intestinal and vaginal colonization. B. breve BC204 was encapsulated by spray-drying and subsequently formulated in time-dependent erodible tablets. B. breve BC204 showed good ability to adhere to Caco-2 cells and moderate ability to resist to gastrointestinal stress. Moreover, it exerted a strong antimicrobial activity against urogenital and enteric pathogens. Microencapsulation followed by tablet production allowed high loading and survival of B. breve BC204, associated to a delayed release and mucoadhesive ability. These characteristics are required to achieve appropriate amount and persistence of viable microbial cells in the treatment site.

Chlamydia trachomatis is the leading cause of bacterial sexually transmitted infections (STIs) and preventable blindness. Untreated, asymptomatic infection as well as frequent re-infection are common and may drive pelvic inflammatory disease, ectopic pregnancy, and infertility. In vivo models of chlamydial infection continue to be instrumental in progress toward a vaccine and further elucidating the pathogenesis of this intracellular bacterium, however significant gaps in our understanding remain. Chlamydial host cell exit occurs via two mechanisms, lysis and extrusion, although the latter has yet to be reported in vivo and its biological role is unclear. The objective of this study was to investigate whether chlamydial extrusions are shed in vivo following infection with multiple strains of Chlamydia. We utilized an established C3H/HeJ murine cervicovaginal infection model with C. trachomatis serovars D and L2 and the Chlamydia muridarum strain MoPn to monitor the (i) time course of infection and mode of host cell exit, (ii) mucosal and systemic immune response to infection, and (iii) gross and histopathology following clearance of active infection. The key finding herein is the first identification of chlamydial extrusions shed from host cells in an in vivo model. Extrusions, a recently appreciated mode of host cell exit and potential means of dissemination, had been previously observed solely in vitro. The results of this study demonstrate that chlamydial extrusions exist in vivo and thus warrant further investigation to determine their role in chlamydial pathogenesis.

Development of adequate models in laboratory animals is highly important to detect etiological links between urogenital tract pathology and chlamydia, mycoplasma and ureaplasma bacteria. These model systems can be very useful to find solutions in combating with urogenital tract diseases. One of the obligatory conditions to use monkeys in development of experimental models of infectious and somatic human diseases is knowledge of spontaneous pathology in primates. The present study has shown high frequency of urogenital infections bacteria in the urogenital tract of healthy and sick monkeys.

The present day there is no universally accepted algorithm for the application of PCR for the diagnostics of urogenital infections and interpretation of results. At the same time, the application of PCR for diagnostics of infection by opportunistic such pathogens as M. hominis, U. parvum can make the antibiotictherapy to be unnecessary.

Objective To assess the prevalence of urogenital infection symptoms and their association with occupational stress among women working in export production factories in China. Methods Six hundred and thirty-eight women workers in three factories in Tianjin, China were surveyed. Information was collected on women's demographic characteristics, levels of occupational stress, and urogenital infection symptoms. Data were analyzed using multiple logistic regression. Results Among the 638 women who provided information on urogenital symptoms, 30.9% reported at least one symptom: 27.9% reported abnormal discharge, 2.4% reported genital sores, and 6.3% reported pain with urination. Feeling exhausted was associated with an increased risk for reporting genital sores [ OR =1.35 (1.05, 1.73)] and pain with urination [ OR =1.21 (1.06, 1.39)], while reporting low job security was significantly associated with reporting at least one symptom of urogenital infection [ OR =1.51 (1.03, 2.20)]. Conclusions Many women working in China's export factories report symptoms of urogenital infection. Occupational stress may be linked to an increased risk for urogenital infection. Focused efforts are needed to improve accessibility to reproductive health services for women working in China's export production factories.

Background: The ability of adherence to the host cell surface, present of sidrophore receptors and α-hemolysin (hlyA) are common virulence attributes produced by Escherichia coli that enhances virulence in a number of clinical infections. It has been revealed that E. coli strains that infect uro-genital tracts have different virulence factors. This study was aimed to determine the prevalence of genes encoding virulence factors in cervico-vaginal pathogenic E. coli isolated from women attending Gynecology clinics in Zabol-Iran. Materials and Methods: In this study, 380 cervico-vaginal swabs were obtained from patients with genital tract infections referred to Gynecology clinics in Zabol-Iran during the period (from January to July 2013). A total 132 E. coli isolates were confirmed by conventional biochemical tests. DNA was extracted from all isolates by the boiling method and then DNA was used to determine the presence and prevalence of selected virulence genes including hlyA, iroN, iucD and fimH. The phylo-groups of isolates were determined by detection of yjaA and chuA genes and fragment TspE4.C2. Results: In 132 samples, the frequency of hlyA, iroN, iucD and fimH genes were 71, 37, 31 and 17% respectively. Four major phylogenetic lineages (A, B1, B2, and D) were found in 7%, 19%, 62% and 14% of isolates, respectively. Isolates present in group B2 showed highest presence of virulence genes. Conclusion: This results show that the iroN, iucD, and fimH genes were the most virulent genes of E. coli isolates obtained from patients with uro-genital tract infection. These findings can be valuable in etiology of cervico-vaginal infections (CVIs), CVI administration and management and success of treatment strategies.

The article presents current data on the laboratory diagnosis of urogenital infections. Recommendations on the tactics of the management of patients with clinical and laboratory signs of the urogenital infections are given. The possibility of using various antimicrobials include antiviral was investigated. The choice of drugs for treatment was discussed.

Context: The administration of pharmabiotics is a promising alternative to antimicrobial drugs for the treatment and/or prevention of female urogenital infections. Objective: To design pharmabiotic formulations including bioactive ingredients of microbial origin combined with non-microbial substances and then to evaluate the stability of the combinations during freeze-drying and storage. Materials and Methods: Different formulations including Lactobacillus gasseri CRL 1263, Lactobacillus salivarius CRL 1328, salivaricin CRL 1328 (a bacteriocin) and non-microbial compounds (lactose, inulin and ascorbic acid) were assayed and the ingredients were freeze-dried together or separately. The formulations were stored in gelatin capsules at 4ºC for 360 days. Results: The viability of lactobacilli was affected to different extents depending on the strains and on the formulations assayed. L. salivarius and ascorbic acid were successfully combined only after the freeze-drying process. Salivaricin activity was not detected in formulations containing L. gasseri. However, when combined with ascorbic acid, lactose, inulin or L. salivarius, the bacteriocin maintained its activity for 360 days. The selected microorganisms proved to be compatible for their inclusion in multi-strain formulations together with lactose, inulin and ascorbic acid. Salivaricin could be included only in a L. salivarius CRL 1328 single-strain formulation together with non-microbial substances. Conclusions: This study provides new insights into the design of urogenital pharmabiotics combining beneficial lactobacilli, salivaricin CRL 1328 and compounds with different functionalities. Fil: Vera Pingitore, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucuman. Centro de Referencia Para Lactobacilos; Argentina Fil: Juárez Tomás, María Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucuman. Centro de Referencia Para Lactobacilos; Argentina Fil: Weise, Birgitt. Hannover Medical School. Institute of Biometry; Alemania Fil: Nader, Maria Elena Fatima. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucuman. Centro de Referencia Para Lactobacilos; Argentina

Toll-like receptors (TLR) are involved into innate immune recognition of microorganisms, including pathogenic bacteria. The aim of this work is to assess relative levels of TLR2 and TLR9 expression in cervical epithelial cells of women with inflammatory diseases of pelvic organs. The total group of patients consisted of 47 persons, including 20 women with urogenital infections, and 27 women comprised a control group. Using real-time PCR, we identified the opportunistic pathogens and gene expression levels of TLR2, TLR9 in the cervix epithelial cells. It was shown that expression of TLR9 in the group with urogenital infections was 13.7-fold higher than in control group. We have revealed that a significant increase of TLR9 expression in the mucosal epithelium from cervical canal correlated with detection of infectious pathogens in the samples.

Chlamydia trachomatis es un patógeno de alta prevalencia en infecciones urogenitales; según datos de la OMS, anualmente se detectan 89 millones de nuevos casos a nivel mundial. Con la finalidad de comparar la sensibilidad del método de inmunofluorescencia directa (IFD) con técnicas de amplificación por PCR (Reacción en cadena de la polimerasa), e investigar la prevalencia de Chlamydia trachomatis en mujeres sintomáticas y asintomáticas, se analizaron 54 muestras de hisopado endocervical de pacientes quienes solicitaron atención ginecológica en un Ambulatorio de la ciudad de Maracaibo. Para investigar Chlamydia trachomatis por IFD se utilizó el kit Chlamydia Direct IF (bioMerieux®). La detección molecular se realizó mediante reacción en cadena de la polimerasa (PCR-CTP), utilizando los oligonucleótidos CTP1 y CTP2 dirigidos a secuencias de un plásmido endógeno de Chlamydia trachomatis que genera un producto de 201 pb. 5/54 muestras resultaron positivas con PCR-CTP; mientras que mediante IFD se detectaron 3 casos. 49 muestras fueron negativas por ambos ensayos. La prevalencia de Chlamydia trachomatis fue de 5,55% para IFD y 9,26% para PCR-CTP. Comparada con el ensayo PCR-CTP, la sensibilidad del análisis por IFD fue de 60,00%. Los métodos moleculares ofrecen una estrategia diag-nóstica que puede contribuir al diseño de programas de control epidemiológico, dirigidos a disminuir la prevalencia de este microorganismo. Chlamydia trachomatis is a pathogen of high prevalence in urogenital infections; according to data of the WHO, annually 89 millions of new cases are detected at world wide level. With the purpose of comparing the method sensibility of direct immunofluorescence (DIF) and amplification techniques by PCR to the Chlamydia trachomatis detection in clinical samples, and to investigate the Chlamydia trachomatis prevalence in symptomatic and asymptomatic women; 54 endocervical swabbing specimens of patient that solicited gynecological attention in a Ambulatory of Maracaibo were analyzed. To investigate Chlamydia trachomatis by DIF Chlamydia Direct IF kit (bioMerieux®) was used. The molecular detection was carried out by polymerase chain reaction (PCR-CTP), using the CTP1 and CTP2 oligonucleotide directed to sequences of endogenous plasmid of Chlamydia trachomatis that generated a 201 pb product. 5/54 samples were positive with PCR-CTP; while by DIF 3 cases was detected. 49 samples were negative for both tests The prevalence of Chlamydia trachomatis was of 5,55% for DIF and 9,26% for PCR-CTP Compared with PCR-CTP test, the sensibility of the DIF analysis was 60,00%. The molecular methods offer a diagnostic strategy that can contribute to the design of epidemiological control programs, directed to diminish the prevalence of this microorganism.

Zusammenfassend läßt sich feststellen, daß Enterokokken und Staphylococcus saprophyticus keinen wesentlichen Einfluß auf die Spermatozoenmotilitätsparameter haben, so daß bei asymptomatischem Nachweis dieser Keime im Ejakulat eher von einer Kontamination ausgegangen werden kann. Bei klinisch manifesten Symptomen sollte jedoch eine antibiogrammgerechte Therapie angestrebt werden. Als relevante Keime für die männliche Subfertilität sind diese Erreger sicherlich von untergeordneter Rolle. Die Rolle von Pseudomonas aeruginosa und deren Einfluß auf die Motilitätsparameter und somit auf die männliche Fertilität konnte nicht eindeutig geklärt werden. Es läßt sich aus unseren Experimenten zurückhaltend ableiten, daß ein Motilitätsverlust von Pseudomonas aeruginosa in sehr hohen Konzentrationen und nach einer Inkubationszeit von mehr als 6 Stunden auftreten kann. Deshalb wäre bei signifikanter asymptomatischer Bakteriospermie mit diesem Erreger sicherlich auch schon eine antibiogrammgerechte Therapie in Betracht zu ziehen. Des weiteren konnte in dieser Arbeit der motilitätshemmende Effekt von Candida albicans, wie schon von Tuttle et al. (1977) nachgewiesen, bestätigt werden. Die klinische Relevanz kann jedoch abschließend nicht eindeutig festgelegt werden, da die Motilitätsminderung nur in initial sehr hohen Konzentrationen von 20 Mio. Erregern/ml, wie sie in vivo nicht erreichbar sind, stattfand. Agglutinationsphänomene, wie sie Tuttle et al. (1977) beschrieben, konnten nicht beobachtet werden. Kritisch anzumerken ist, daß nach den Versuchsbeobachtungen die Candida-Partikel in hohen Konzentrationen wie eine mechanische Barriere zu fungieren scheinen. Eine asymptomatische Candidose hat vermutlich keinen Einfluß auf die Fertilität und muß nicht unbedingt therapiert werden. Bei den Versuchen mit den ß-hämolysierenden Streptokokken zeigte sich eine deutliche Verschlechterung der Motilitätsparameter, die besonders eindrucksvoll in der höchsten initialen Bakterienkonzentration von 2 Mio. Keimen/ml nach 6 Stunden Inkubation war. Morphologische Veränderungen, die dafür verantwortlich gemacht werden könnten, wie z.B. Agglutination und Adhäsion der Bakterien, konnten nicht beobachtet werden. Das Vorhandensein eines Enterotoxins, das die Immobilisierung der Spermatozoen zur Folge hätte, ist zu diskutieren. Somit sollte auch eine signifikante Bakteriospermie, gegebenenfalls auch wenn sie asymptomatisch verläuft, antibiotisch therapiert werden. Die im Rahmen dieser Dissertation durchgeführten Versuche konnten aufzeigen, daß ein negativer Einfluß von verschiedenen Erregern auf die Spermatozoenmotilität erreger-, konzentrations- und zeitabhängig ist und nicht einheitlich beurteilt werden kann. Enterococcus and Staphylococcus saprophyticus indicate no significant influence on sperm motility parameters. Therefore it can be concluded, that if an asymptomatic proof of these bacteria is given, it is more likely to be a contamination. If a patient has clinical symptoms an antibiotic therapy should be undertaken. These bacteria are probably secondary as relevant pathologic germs in male subfertility. The role of Pseudomonas aeruginosa and its influence on sperm motility parameters could not be clarified. The effect on sperm motility parameters can be seen only in high concentrations of Pseudomonas aeruginosa after more than 6 hours of incubation. Therefore an antibiotic therapy is useful in patients with a significant, although asymptomatic bacteriospermia. A significant inhibitory effect of Candida albicans on sperm motility parameters, like Tuttle et al. (1977) investigated before, could be confirmed. The clinical relevance can not be clearly established, because a significant decrease in motility was only detected in the samples with a very high initial concentration of 20 Mill. germs/ml, which is not found in vivo. The phenomenon of agglutination of spermatozoa, as before detected by Tuttle et al. (1977), could not be confirmed. It has to be mentioned critically, that the Candida particles in high concentrations seemed to loom large compared to the spermatozoa and seemed to function as a mechanical barrier. An asymptomatic candidiasis has probably no influence on fertility and needs not to be treated absolutely. In the experiments with ß-haemolytic streptococci group B a clear decrease of motility parameters could be investigated. This was particularly impressive in the highest initial bacterial concentration of 2 Mill. germs/ml after 6 hours of incubation. Morphological correlations, such as agglutination or adhesion of the bacteria could not be detected. The existing of an enterotoxin as a factor of immobilization for the spermatozoa has to be discussed. Therefore a significant, even clinical asymptomatic bacteriospermia should be treated antibiotically. In conclusion, the data underline that a negative influence on sperm motility is always dependent on the different types of individual microorganisms. Concentrations and time of growth are also of great importance.

Zusammenfassend läßt sich feststellen, daß Enterokokken und Staphylococcus saprophyticus keinen wesentlichen Einfluß auf die Spermatozoenmotilitätsparameter haben, so daß bei asymptomatischem Nachweis dieser Keime im Ejakulat eher von einer Kontamination ausgegangen werden kann. Bei klinisch manifesten Symptomen sollte jedoch eine antibiogrammgerechte Therapie angestrebt werden. Als relevante Keime für die männliche Subfertilität sind diese Erreger sicherlich von untergeordneter Rolle. Die Rolle von Pseudomonas aeruginosa und deren Einfluß auf die Motilitätsparameter und somit auf die männliche Fertilität konnte nicht eindeutig geklärt werden. Es läßt sich aus unseren Experimenten zurückhaltend ableiten, daß ein Motilitätsverlust von Pseudomonas aeruginosa in sehr hohen Konzentrationen und nach einer Inkubationszeit von mehr als 6 Stunden auftreten kann. Deshalb wäre bei signifikanter asymptomatischer Bakteriospermie mit diesem Erreger sicherlich auch schon eine antibiogrammgerechte Therapie in Betracht zu ziehen. Des weiteren konnte in dieser Arbeit der motilitätshemmende Effekt von Candida albicans, wie schon von Tuttle et al. (1977) nachgewiesen, bestätigt werden. Die klinische Relevanz kann jedoch abschließend nicht eindeutig festgelegt werden, da die Motilitätsminderung nur in initial sehr hohen Konzentrationen von 20 Mio. Erregern/ml, wie sie in vivo nicht erreichbar sind, stattfand. Agglutinationsphänomene, wie sie Tuttle et al. (1977) beschrieben, konnten nicht beobachtet werden. Kritisch anzumerken ist, daß nach den Versuchsbeobachtungen die Candida-Partikel in hohen Konzentrationen wie eine mechanische Barriere zu fungieren scheinen. Eine asymptomatische Candidose hat vermutlich keinen Einfluß auf die Fertilität und muß nicht unbedingt therapiert werden. Bei den Versuchen mit den ß-hämolysierenden Streptokokken zeigte sich eine deutliche Verschlechterung der Motilitätsparameter, die besonders eindrucksvoll in der höchsten initialen Bakterienkonzentration von 2 Mio. Keimen/ml nach 6 Stunden Inkubation war. Morphologische Veränderungen, die dafür verantwortlich gemacht werden könnten, wie z.B. Agglutination und Adhäsion der Bakterien, konnten nicht beobachtet werden. Das Vorhandensein eines Enterotoxins, das die Immobilisierung der Spermatozoen zur Folge hätte, ist zu diskutieren. Somit sollte auch eine signifikante Bakteriospermie, gegebenenfalls auch wenn sie asymptomatisch verläuft, antibiotisch therapiert werden. Die im Rahmen dieser Dissertation durchgeführten Versuche konnten aufzeigen, daß ein negativer Einfluß von verschiedenen Erregern auf die Spermatozoenmotilität erreger-, konzentrations- und zeitabhängig ist und nicht einheitlich beurteilt werden kann., Enterococcus and Staphylococcus saprophyticus indicate no significant influence on sperm motility parameters. Therefore it can be concluded, that if an asymptomatic proof of these bacteria is given, it is more likely to be a contamination. If a patient has clinical symptoms an antibiotic therapy should be undertaken. These bacteria are probably secondary as relevant pathologic germs in male subfertility. The role of Pseudomonas aeruginosa and its influence on sperm motility parameters could not be clarified. The effect on sperm motility parameters can be seen only in high concentrations of Pseudomonas aeruginosa after more than 6 hours of incubation. Therefore an antibiotic therapy is useful in patients with a significant, although asymptomatic bacteriospermia. A significant inhibitory effect of Candida albicans on sperm motility parameters, like Tuttle et al. (1977) investigated before, could be confirmed. The clinical relevance can not be clearly established, because a significant decrease in motility was only detected in the samples with a very high initial concentration of 20 Mill. germs/ml, which is not found in vivo. The phenomenon of agglutination of spermatozoa, as before detected by Tuttle et al. (1977), could not be confirmed. It has to be mentioned critically, that the Candida particles in high concentrations seemed to loom large compared to the spermatozoa and seemed to function as a mechanical barrier. An asymptomatic candidiasis has probably no influence on fertility and needs not to be treated absolutely. In the experiments with ß-haemolytic streptococci group B a clear decrease of motility parameters could be investigated. This was particularly impressive in the highest initial bacterial concentration of 2 Mill. germs/ml after 6 hours of incubation. Morphological correlations, such as agglutination or adhesion of the bacteria could not be detected. The existing of an enterotoxin as a factor of immobilization for the spermatozoa has to be discussed. Therefore a significant, even clinical asymptomatic bacteriospermia should be treated antibiotically. In conclusion, the data underline that a negative influence on sperm motility is always dependent on the different types of individual microorganisms. Concentrations and time of growth are also of great importance.

The gastrointestinal and urogenital tracts are complex microbial habitats, which for the most part, are infection-free throughout life. Given the diversity of the world's people, the enormous variation in diet and differences in climate, sexual practices, and exposure to antimicrobials which disrupt and change the flora, it is quite remarkable that naturally occurring infections are not even more common than reported. The composition, dynamics and structure of the normal flora biofilms appear to play a role in protecting the host from infectious upset. Specifically, lactobacilli and in the gut bifidobacteria, have been found to possess properties which enhance the host's ability to compete against pathogens. The search for 'good' probiotic organisms continues, but recent findings of biosurfactant production and an ability to colonize the vagina, suggest that such strains do exist. Molecular typing has made it possible to follow the strains as they colonize or move through the host, and to investigate the genetic basis for their capabilities. Increasing concerns over drug resistance, and a growing desire by patients to have a more natural approach to their health management, is driving further scientific and clinical enquiry. This has led to some studies showing that potentially nutrients can be used to regulate, restore and stimulate the normal flora. Also of interest is the ability of probiotic organisms to reduce the risk of device-associated infections, and to deliver vaccines to the mucosal tissue. Subject to availability of grant funding for this non-traditional approach, the next 10 years should see some major breakthroughs of great benefit to the health of people around the globe.

In recent years there has been a significant upsurge in research on the characterisation and verification of the potential health benefits associated with the use of probiotics. In addition, the market for probiotics continues to expand exponentially as consumers (mostly healthy individuals) rely on health claims made by manufacturers to make their choices. This review appraises the available evidence for and against the health claims associated with probiotics. The use of probiotics in promoting gastrointestinal health and immunity, and their use in the prevention of urogenital infections, allergies and cancer are reviewed. Furthermore, issues surrounding the use of probiotics in healthy individuals, the safety of probiotics and regulatory concerns are addressed. There is scientific evidence that specific strains of probiotic microorganisms confer health benefits on the host and are safe for human use. However, this evidence cannot be extrapolated to other strains, as these effects are strain-specific. Probiotics have potential health benefits for conditions such as gastrointestinal infections, genitourinary infections, allergies and certain bowel disorders, all of which afflict a considerable proportion of the global population. However, considerable work is still needed to confirm these potential health benefits.