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Purpose: Preterm labor (TPL), which can result in preterm birth, is known as one of the most common causes of pregnancy complications and neonatal morbidities. This study investigates the relationship between positive urogenital culture and preterm labor in patients with TPL. Materials and Methods: Between 2018 and 2022, medical records of patients monitored due to threatened preterm labor (TPL) were reviewed. Demographic data, gestational histories, and results of vaginal swabs and urine samples were recorded. Transvaginal ultrasound was used to measure cervical length during preterm and term births, categorized as 0.05). However, it was observed that positive culture results increased parallel to cervical length shortening (CL

Introduction: The association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of urogenital infections remains controversial. This study aimed to investigate the association between SGLT2 inhibitors and the incidence of perineal soft tissue infections, including Fournier's gangrene (FG), genital bacterial infections, and urinary tract infections (UTIs), using administrative claims data in Japan. Methods: In this retrospective cohort study, we utilized the JMDC Claims Database. The study included patients aged 18 years or older diagnosed with type 2 diabetes mellitus, identified by a diagnostic code, who received new prescriptions for SGLT2 inhibitors or dipeptidyl peptidase 4 (DPP-4) inhibitors between April 2014 and August 2020. Using one-to-one propensity score (PS) matching, we compared the incidence of perineal soft tissue infections, including FG, genital bacterial infection, and UTIs between groups treated with SGLT2 and DPP-4 inhibitors. Hazard ratios (HR) and their 95% confidence intervals (CI) were estimated using the Cox proportional hazards model. Results: We identified 34,897 patients in the SGLT2 inhibitor group and 135,311 patients in the DPP-4 inhibitor group. After one-to-one PS matching, 31,665 pairs were generated. The mean age of the patients was 51 years, with approximately 70% being male. The use of SGLT2 inhibitors was associated with a decreased risk of UTI (HR 0.90, 95% CI 0.83–0.98) and an increased risk of genital bacterial infection (HR 1.23, 95% CI 1.03–1.46) compared to DPP-4 inhibitors. However, no significant association was observed with perineal soft tissue infection (HR 1.05, 95% CI 0.61–1.81). Conclusions: SGLT2 inhibitors were associated with a reduced risk of UTI and an increased risk of genital bacterial infection. They showed no significant association with perineal soft tissue infection when compared to DPP-4 inhibitors. Future research should explore broader demographics, focusing on the elderly and achieving gender balance, to gain a comprehensive understanding of infection risks. [ABSTRACT FROM AUTHOR]

Background: Tolerance enables bacteria to survive intermittent antibiotic exposure without an increase in antimicrobial susceptibility. In this study, we investigated the presence of tolerance to three antimicrobials, ceftriaxone, azithromycin and ciprofloxacin, in clinical isolates and the WHO (World Health Organization) reference panel of Neisseria gonorrhoeae. Methods: We used the modified tolerance disk (TD test) to assess for tolerance to ceftriaxone, azithromycin and ciprofloxacin in 14 WHO reference strains and 62 N. gonorrhoeae clinical isolates—evenly divided between anorectal and urogenital infections. The isolates underwent a three-step incubation process wherein the isolates were exposed to an antibiotic disk for 20 h of incubation (Step I), followed by the replacement of the antibiotic disk with a nutrient disk for overnight incubation (Step II) and additional overnight incubation with extra nutrients (Step III). Results: A total of 4 of the 62 clinical anorectal isolates and none of the urogenital isolates exhibited tolerance to azithromycin (p = 0.033). Tolerance to ceftriaxone and ciprofloxacin was observed in eight and four isolates, respectively, with no difference between infection sites. Tolerance was also detected in 8 (K, M, N, O, P, U, V, W) out of the 14 WHO reference strains, with varying patterns of tolerance to ceftriaxone (n = 8), ciprofloxacin (n = 2) and azithromycin (n = 1). Conclusions: This study identified ceftriaxone, azithromycin and ciprofloxacin tolerance in clinical and WHO reference N. gonorrhoeae isolates. Azithromycin tolerance was more common in anorectal than urogenital infections. [ABSTRACT FROM AUTHOR]

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Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to reduce adverse cardiovascular events in patients with type 2 diabetes mellitus, all-cause mortality, and heart failure hospitalization in patients with heart failure, as well as adverse renal outcomes. However, concerns regarding the heightened risk of genitourinary (GU) infections, particularly urinary tract infections, remain a significant barrier to their wider adoption. Addressing these misconceptions using existing evidence is needed to ensure proper risk-benefit assessment and optimal utilization of this efficacious therapy. This review aims to provide a balanced perspective on the evidence-based cardiovascular and renal benefits of SGLT2is and the associated risk of GU infections. We also summarize and propose clinical practice considerations for SGLT2i-associated GU infections focusing on patients with cardiovascular disease. [Display omitted] • Treatment with SGLT2is is associated with an increased risk of GMI but not UTI or necrotizing fasciitis of the perineum (Fournier's gangrene). • The benefits of SGLT2is usually outweigh the risk of treatment-associated GU infections. • In most cases, patients developing mild-moderate or stable severe GU infections can continue SGLT2is. [ABSTRACT FROM AUTHOR]

The development of new approaches and drugs for effective control of the chronic and complicated forms of urogenital chlamydia caused by Chlamydia trachomatis, which is suspected to be one of the main causes of infertility in both women and men, is an urgent task. We used the technology of single-domain antibody (nanobody) generation both for the production of targeting anti-chlamydia molecules and for the subsequent acquisition of anti-idiotypic nanobodies (ai-Nbs) mimicking the structure of a given epitope of the pathogen (the epitope of the Chlamydial Type III Secretion System Needle Protein). In a mouse model, we have shown that the obtained ai-Nbs are able to induce a narrowly specific humoral immune response in the host, leading to the generation of intrinsic anti-Chlamydia antibodies, potentially therapeutic, specifically recognizing a given antigenic epitope of Chlamydia. The immune sera derived from mice immunized with ai-Nbs are able to suppress chlamydial infection in vitro. We hypothesize that the proposed method of the creation and use of ai-Nbs, which mimic and present to the host immune system exactly the desired region of the antigen, create a fundamentally new universal approach to generating molecular structures as a part of specific vaccine for the targeted induction of immune response, especially useful in cases where it is difficult to prepare an antigen preserving the desired epitope in its native conformation. [ABSTRACT FROM AUTHOR]

This article is presented in form of a current literature review on bacterial complications of the early post-liver transplantation period and promising areas for studying the effect of bacterial flora in patients after liver transplantation. The paper describes the problem of the emergence, spread, and pathogenesis of various bacterial complications, as well as current concepts of various bacterial complication’s impact on the results of liver transplantation. The results of ventilatorassociated pneumonia in patients after liver transplantation are given. A theoretical analysis of bacterial complications from the standpoint of microbiota effects on the biliary tree was carried out. The review also highlights a relatively new conceptual approach in examining the results of scientific research using the "Machine Learning Method”. The so-called CDC “Big Four” was chosen as the main infectious nomenclature in this article. However, catheter-associated bacterial complications, which pathogenesis has been sufficiently studied to date, have been replaced by a relatively new group of complications – bacteriobilia. This review also contains a brief statistical data collected in the frames of the NCT04281797 study. Own cohort data consisted of 57 patients who underwent orthotopic liver transplantation from a post-mortem donor. Surgical site infection was the most common bacterial complication of the early postoperative period. The most common causative agent of bacterial infection was Klebsiella pneumonia and Enterococcus.

Background: Tolerance enables bacteria to survive intermittent antibiotic exposure without an increase in antimicrobial susceptibility. In this study, we investigated the presence of tolerance to three antimicrobials, ceftriaxone, azithromycin and ciprofloxacin, in clinical isolates and the WHO (World Health Organization) reference panel of Neisseria gonorrhoeae. Methods: We used the modified tolerance disk (TD test) to assess for tolerance to ceftriaxone, azithromycin and ciprofloxacin in 14 WHO reference strains and 62 N. gonorrhoeae clinical isolates—evenly divided between anorectal and urogenital infections. The isolates underwent a three-step incubation process wherein the isolates were exposed to an antibiotic disk for 20 h of incubation (Step I), followed by the replacement of the antibiotic disk with a nutrient disk for overnight incubation (Step II) and additional overnight incubation with extra nutrients (Step III). Results: A total of 4 of the 62 clinical anorectal isolates and none of the urogenital isolates exhibited tolerance to azithromycin (p = 0.033). Tolerance to ceftriaxone and ciprofloxacin was observed in eight and four isolates, respectively, with no difference between infection sites. Tolerance was also detected in 8 (K, M, N, O, P, U, V, W) out of the 14 WHO reference strains, with varying patterns of tolerance to ceftriaxone (n = 8), ciprofloxacin (n = 2) and azithromycin (n = 1). Conclusions: This study identified ceftriaxone, azithromycin and ciprofloxacin tolerance in clinical and WHO reference N. gonorrhoeae isolates. Azithromycin tolerance was more common in anorectal than urogenital infections.

Background This study evaluated the distribution of macrolide-resistant Mycoplasma genitalium in multiple urogenital specimens collected from women enrolled in a prospective multicenter US clinical study. Methods Four female urogenital specimens (vaginal swab, urine, endocervical swab, ectocervical brush/spatula) collected from each subject were tested using a transcription-mediated amplification (TMA) assay for M. genitalium. TMA-positive specimens were evaluated by reverse transcription–polymerase chain reaction and bidirectional Sanger sequencing of M. genitalium 23S rRNA to identify the presence of macrolide-resistance–mediating mutations (MRMs) at base positions 2058/2059. Results Of 140 women with ≥1 TMA-positive specimens, 128 (91.4%) yielded M. genitalium 23S rRNA sequence. MRMs were found in 52% of vaginal specimens, 46.3% of urine specimens, 37.8% of endocervical specimens, and 46% of ectocervical specimens. There were 44 unique specimen type/sequence phenotype combinations of M. genitalium infection. Most (81; 63.3%) women had single specimen-sequence phenotype (macrolide-susceptible, MRM, or both) infections, while 24 (18.8%) women had multiple specimen-sequence phenotype concordant infections, and 23 (17.9%) women had multiple specimen-sequence phenotype discordant infections. The sensitivity for any single specimen type to detect overall urogenital tract macrolide-resistant M. genitalium infection status was 96.3% for vaginal swab samples, 82.6% for urine samples, 70.8% for endocervical swab samples, and 82.1% for ectocervical brush/spatula liquid Pap samples. Conclusions The distribution of M. genitalium infections in female urogenital tract specimens is highly complex, with multiple phenotypic combinations of the organism infecting a significant proportion of women at different anatomic specimen collection sites. Vaginal swab sampling yielded the highest sensitivity for identifying women with macrolide-resistant M. genitalium urogenital tract infections. [ABSTRACT FROM AUTHOR]

Testicular tuberculosis (TB) is a rare disease, and it tends to mimic other testicular diseases which are more common. We highlight the case of a 37-year-old male who presented to the emergency department with testicular torsion. Further investigations revealed evidence of TB.

Seventy five patients with urogenital chlamydial and mycoplasmic infections were enrolled in the trial. In the etiotropic therapy azithromycin was used in the standard dosage (1.0-1.5 g) depending on the infection. The treatment with azithromycin, in addition to the high eradication rates, was also evident of its effect on the cytokine levels in the patients, that was characteristic of a significant increase of the IFN-γ level and a decrease of the IL-β and IL-6 levels in the blood.

Testicular tuberculosis (TB) is a rare disease, and it tends to mimic other testicular diseases which are more common. We highlight the case of a 37-year-old male who presented to the emergency department with testicular torsion. Further investigations revealed evidence of TB. [ABSTRACT FROM AUTHOR]

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.

Type 2 diabetes mellitus (T2DM) in postmenopausal women is associated with a high incidence of urogenital infections, which negatively impact the quality of life and increase morbidity, mortality, and health-care costs. Glucosuria is a known risk factor for these infections; therefore, it is of interest to determine if increased glucosuria secondary to sodium-glucose cotransporter-2 inhibitors (SGLT2in) impacts the incidence and severity of urogenital infections in postmenopausal women with T2DM. The study was conducted at Gaffrée Guinle University Hospital on two groups of postmenopausal women with T2DM: with and without SGLT2in therapy (n = 80 in each group). Medical records and laboratory parameters (urinary dipstick test and culture; blood glucose, glycosylated hemoglobin, and creatinine; cervical cytologic study) of all subjects were carefully assessed at baseline and thrice during the 12-month study period. We observed a significant incidence of vulvovaginitis (relative risk [RR], 2.37; 95% confidence interval [CI], 1.10–5.10; P = 0.03) and asymptomatic bacteriuria (RR, 2.47; 95% CI, 1.09–5.60; P = 0.03), but not of urinary tract infections (RR, 2.08; 95% CI, 0.74–5.81; P = 0.16), secondary to SGLT2in therapy. Genital infection was severe enough to warrant treatment discontinuation in 57.89% of patients in group 1. All urinary tract infections were of mild intensity with a good response to antibiotic therapy. Glucosuria induced by SGLT2in therapy may lead to a high incidence of urogenital infections in postmenopausal women with T2DM and can be considered a risk factor for these infections. [ABSTRACT FROM AUTHOR]

This article presents biochemical markers and clinical laboratory reasons for predicting preterm labor in urogenital infections. Premature birth (PB) is one of the main pathologies in obstetrics and neonatology. Perinatal mortality and morbidity rates depend on preterm birth. According to numerous studies, almost half of the causes of preterm birth are due to infection, especially with urogenital infections. Prematurity, which affects almost 10% of pregnancies worldwide, is the most significant cause of perinatal mortality or morbidity, predicting their causes using biochemical markers and timely antibiotic therapy started, prevents purulent septic complications in the postpartum period, both in women and in newborns. [ABSTRACT FROM AUTHOR]

We performed an electron microscopic study of samples of urethral polyps obtained from 90 women (mean age 52.5±4.9 years). According to PCR and culture studies, the most common infectious agent in patients with urethral polyps is U. urealyticum (100% cases). In 70% cases, this infectious agent was present as monoinfection, of these, clinically significant concentration (>106 CFU/ml) were found in 53.3% cases. In 30% cases, associations with C. trachomatis, T. vaginalis, and M. genitalium were found. We observed significant ultrastructural heterogeneity of the epithelial cells in urethral polyps, which manifested in a combination of hyperplastic and metaplastic changes and signs of cytodestruction. Detection of mycoplasma-like bodies in connective tissue mononuclear cells and viral particles in epithelial cells during ultrastructural study, including cases with negative PCR results, indicates the pathogenetic role of latent infection in the formation of urethral polyps. [ABSTRACT FROM AUTHOR]

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.

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.

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.

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 crosssectional 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. [ABSTRACT FROM AUTHOR]

Given the growing use of electric bidet toilets in Japan and other countries, we assessed the relationship between bidet toilet use and haemorrhoids or urogenital infections. Data were collected using a web-based longitudinal survey. In total, 10 305 subjects randomly selected from panels of a Japanese website research company for the baseline survey in 2013 were asked about their frequency of bidet toilet use and receipt of a doctor's diagnosis or subjective symptom of haemorrhoids and urogenital infections. One- and three-year follow-up surveys were performed in 2014 and 2016, respectively, and information on newly diagnosed/experienced outcomes occurring during the follow-up period were collected. Cumulative incidence of haemorrhoids and urogenital infections was not significantly increased by habitual use of a bidet toilet. In men, more habitual users reported subjective symptoms of irritated skin around the anus, which were newly experienced during follow-up than non-habitual users (adjusted risk ratio 1.36 (95% confidence interval 1.06–1.75)). Further studies are needed to confirm this relationship. Several of the outcomes were significantly more prevalent in habitual users, but these results were probably explained by reverse causation. [ABSTRACT FROM AUTHOR]

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.

Abstract. 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.

Abstract. 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.

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.

This study evaluated the annual prevalence of anogenital warts (AGW) caused by human papillomavirus (HPV) and analysed the trend in annual per cent changes (APC) by using national claims data from the Health Insurance Review and Assessment of Korea, 2007-2015. We also estimated the socio-economic burden and co-morbidities of AGW. All analyses were performed based on data for primary A63.0, the specific diagnosis code for AGW. The socioeconomic cost of AGW was calculated based on the direct medical cost, direct non-medical cost and indirect cost. The overall AGW prevalence and socio-economic burden has increased during the last 9 years. However, the prevalence of AGW differed significantly by sex. The female prevalence increased until 2012, and decreased thereafter (APC + 3·6%). It would fall after the introduction of routine HPV vaccination, principally for females, in Korea. The male prevalence increased continuously over time (APC + 11·6%), especially in those aged 20-49 years. Referring to the increasing AGW prevalence and its disease burden, active HPV infection control surveillance and prevention in males are worth consideration. [ABSTRACT FROM AUTHOR]

We isolated a cryptic genospecies of Haemophilus influenzae referred to as ‘ Haemophilus quentini ’ in the urethra of 3 men complaining of urethritis symptoms. H. influenzae strains, which had been isolated from the urethra in 77 of 1518 men complaining of urethritis symptoms, identified by the conventional test, and stored, were re-cultured for this study. Sixty-seven strains surviving storage were screened by a PCR-based assay specific for the cryptic genital Haemophilus genospecies. Three strains (HI09003, HI11006, and HI14016) were screened by PCR and identified as ‘ H. quentini ’ by 16S rRNA sequencing. The men positive for HI09003 and HI11006 were diagnosed as having non-chlamydial non-gonococcal urethritis (NGU), and their demographic and clinical features were similar to those of NGU caused by other pathogens. The man positive for HI14016 was ultimately diagnosed as having condyloma acuminatum on the glans. The 3 strains of ‘ H. quentini ’ produced no β-lactamase and were susceptible to ampicillin and other antimicrobial agents, including cephalosporins, fluoroquinolones, tetracyclines, and macrolides, recommended for treatment for urethritis. ‘ H. quentini ’ would be an uncommon pathogen in men with urogenital infections. Based on the clinical features of the two patients with ‘ H. quentini ’-positive NGU, it would be difficult to predict the presence of ‘ H. quentini ’ in the urethra. The 3 strains of ‘ H. quentini ’ were susceptible to a variety of antimicrobial agents. Further accumulation of data regarding ‘ H. quentini ’ infections is needed to characterize the pathogenic roles of this genospecies in urogenital infections and to establish appropriate management of ‘ H. quentini ’ infections. [ABSTRACT FROM AUTHOR]

Ureaplasma urealyticum and U. parvum have been associated with genital infections. The purpose of this study was to detect the presence of ureaplasmas and other sexually transmitted infections in sexually active women from Brazil and relate these data to demographic and sexual health, and cytokines IL-6 and IL-1β. Samples of cervical swab of 302 women were examined at the Family Health Units in Vitória da Conquista. The frequency of detection by conventional PCR was 76·2% for Mollicutes. In qPCR, the frequency found was 16·6% for U. urealyticum and 60·6% U. parvum and the bacterial load of these microorganisms was not significantly associated with signs and symptoms of genital infection. The frequency found for Trichomonas vaginalis, Neisseria gonorrhoeae, Gardnerella vaginalis and Chlamydia trachomatis was 3·0%, 21·5%, 42·4% and 1·7%, respectively. Higher levels of IL-1β were associated with control women colonized by U. urealyticum and U. parvum. Increased levels of IL-6 were associated with women who exhibited U. parvum. Sexually active women, with more than one sexual partner in the last 3 months, living in a rural area were associated with increased odds of certain U. parvum serovar infection. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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.

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 <37 weeks (1.27; (1.12-1.44); 5.33; (1.84-15.41); 6.95; (1.58-30.54), respectively). Conclusion: Presence or treatment of BV did not influence rates of PTB. The probability of PPROM would be higher in patients who are BV positive both in the first and second trimesters. [ABSTRACT FROM AUTHOR]

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 4 °C for 360 d. 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 d. 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. [ABSTRACT FROM AUTHOR]

Background: The role of Mycoplasma hominis and M. genitalium in urogenital tract infections remains unknown. Furthermore these mollicutes present a complex relationship with the host immune response. The role of inflammatory cytokines in infections also makes them good candidates to investigate bacterial vaginosis and mycoplasma genital infections. Therefore, the aim of this study was to detect the above-mentioned mollicutes by quantitative Polymerase Chain Reaction (qPCR) methodologies in vaginal swabs and dosage of cytokines. Methods: Vaginal swabs and peripheral blood were collected from 302 women, including healthy individuals. The molecular findings were correlated with some individual behavioral variables, clinical and demographic characteristics, presence of other important microorganisms in vaginal swabs, and levels of interleukin (IL)-1β and IL-6. Results: M. hominis and M. genitalium were detected in 31.8% and 28.1% of samples, respectively. The qPCR results were associated with clinical signs and symptoms of the infections studied. The frequency of Trichomonas vaginalis, Gardnerella vaginalis, Neisseria gonorrhoeae and Chlamydia trachomatis was 3.0%, 21.5%, 42.4%, and 1.7% respectively. Increased levels of IL-1β were associated with the presence of M. hominis and signs and/or symptoms of the genital infection of women studied. Conclusion: IL-1β production was associated with the detection of M. hominis by qPCR. The sexual behavior of women studied was associated with the detection of mycoplasma and other agents of genital infections. [ABSTRACT FROM AUTHOR]

Purpose: Preterm labor is a leading cause of neonatal morbidity and mortality. Ascending lower genital tract infection leads to preterm labor and adverse pregnancy outcomes. This prospective case-control study was performed to see the association between preterm labor and urogenital infections. Methods: A total of 104 women were observed for urogenital infections and their association with preterm labor. Case Group I included 52 women with preterm labor after 26 weeks and before 37 completed weeks of gestation with or without rupture of membranes. Control Group II included 52 women at completed or more than 37 weeks of gestation with no history of preterm labor, matched to the case group with respect to age and parity. Midstream urine was sent for cytology and culture sensitivity. Samples from posterior fornix of vagina were taken with two sterilized swabs under direct vision using Cusco/Sims speculum before first vaginal examination and were studied for gram stain characteristics and culture sensitivity by standard methods. Microorganisms isolated on culture were noted, and antibiotics were given according to sensitivity. Data collected were analyzed according to the groups by χ test for categorical variables. Results: In our study, urogenital infection was seen in 19 women in Case Group I (36.54 %) compared with 9 women in Control Group (17.3 %), and the difference was statistically significant ( p 0.027). Conclusion: Recognizing and treating the women having urogenital infections at a stage, when it has not become clinically evident, will decrease the percentage of women going into preterm labor and will improve the perinatal outcome. [ABSTRACT FROM AUTHOR]

Problem Interleukin (IL)-18 is a novel cytokine, previously known as interferon (IFN)- γ inducing factor. We evaluated the levels of IL-18 and IFN- γ in seminal plasma (SP) of fertile and infertile men. Method of study Semen samples were obtained by masturbation from 80 men, and were examined for the levels of IL-18 and IFN- γ by enzyme-linked immunosorbent assay. Seven groups were included: (i) fertile men ( n = 18), (i) infertile men with genital tract infections ( n = 17), (iii) with varicocele ( n = 15), (iv) with Klinefelter syndrome ( n = 6), (v) with cryptorchidism ( n = 7), (vi) with mumps orchitis ( n = 7), and (vii) with idiopathic testicular lesions ( n = 10). Results Mean levels of IL-18 were higher in SP from infertile men with genital tract infections compared with SP from other groups except Klinefelter syndrome ( P < 0.05). However, no significant differences could be detected for IFN- γ. A significant positive correlations was found between IL-18 and IFN- γ in total patient population ( P < 0.001). Moreover, a negative correlation was observed between IL-18 and sperm concentrations, and motility ( P < 0.01 and <0.03, respectively). Furthermore, there was a positive and statistically significant association between IL-18 and IFN- γ levels in SP of infertile men with genital tract infections ( P < 0.0001). However, there was no relationship between IL-18 and IFN- γ, and semen parameters in the same group. Conclusion SP IL-18 levels were increased in men with urogenital infections. Thus, the elevated expression of IL-18 in SP may be used as a diagnostic marker in the male genital tract infections. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

A total of 196 patients attending the Center of Dermatology and Andrology, Giessen, Germany, were examined for fertility problems. Polymorphonuclear elastase, reactive oxygen species (ROS and the number of round and peroxidase-positive cells were investigated in addition to routine semen analysis. The ejaculates were also analysed before and after sperm separation by means of swim-up or glass wool filtration. In 20 cases of leukocvtospermia, sperm concentration, motility, viability, production of reactive oxygen species. and the number of peroxidase- positive cells were evaluated before and after glass wool filtration. The results show that ROS production by viable spermatozoa is highly correlated with the concentration of PMN elastase and the number of both peroxidase-positive and round cells. Multiple regression analysis with motility as dependent parameter showed the number of round cells (n=91; r= -0.332; P=0.0030) to be the most important parameter affecting motility, while ROS mainly affects the viability of spermatozoa (n=69; r=0.250; P=0.0107). In the ease of leukocytospermia, glass wool filtration significantly reduced the number of peroxidase-positive cells and ROS production (P=0.0098 and P=0.0005, respectively). Receiver operating characteristic (ROC) curve analysis for ROS production in the ejaculate using a concentration of 1.000 ng ml -1 PMN elastase as decisive parameter resulted in a rut-off value of 49,489.9 counts 10-7 viable spermatozoa. The statistical parameters were: Sensitivity: 63.2%, specificity: 100%, positive predictive value: 100%, negative predictive value: 36.1%. [ABSTRACT FROM AUTHOR]

Prostatic inflammation is associated with infections penetrating through the urethra. This inflammation is treated by long courses of wide-spectrum antibiotics. However, the most frequent cause of prostatitis is Escherichia coli and other enteric flora. Electron microscopy of biopsy specimens from the prostate detected gaps in the prostatic epithelium basement membrane, their size explaining the penetration of enteric flora into the prostate. These data suggest another view on the pathogenesis of prostatitis and approaches to improvement of therapy for this disease. [ABSTRACT FROM AUTHOR]

Urogenital infections with Chlamydia trachomatis belong to the most prevalent sexually-transmitted bacterial diseases. In women, they can cause chronic salpingitis with subsequent tubal infertility and ectopic pregnancies. In men, C. trachomatis can cause urethritis, prostatitis and epididymitis. Urogenital infections can be symptomatic or asymptomatic. Symptomatic urogenital infections might impair male fertility. In vitro, C. trachomatis affects sperm motility and viability. However, there is no clear evidence that asymptomatic urogenital infections have an adverse effect on male fertility. Because C. trachomatis can be sexually transmitted and lead to female infertility, it is also of significance in male infertility work-up. Because of their high sensitivity, nucleic acid amplification tests should be used to examine first-void urine specimens. Both partners should be treated. The role of Ureaplasma urealyticum in reproductive medicine has been discussed controversially. There is no evidence that U. urealyticum has a significant impact on female or male infertility. [ABSTRACT FROM AUTHOR]

Objective This study is to investigate the functions of newly discovered genes in Chlamydia muridarum (C. muridarum) strains with single gene differences. Methods Using whole genome sequencing and plaque formation assays, C. muridarum parental and passaging strains were established, and the isogenic clones expressing certain genotypes were isolated. Strains with single gene differences were obtained. Based on prediction, the valuable strains with single gene differences of tc0412, tc0668 or tc0237 were subjected to the in vitro and in vivo experiments for biological characterization and virulence analysis. Results Insertional -472840T mutation of the tc0412 gene (T28T/B3 type) matching with the nonmutant tc0668 gene and tc0237 gene with point mutations G797659T (Q117E) might slow the growth of Chlamydia due to the lack of a plasmid. The nonmutant tc0668 in the strain might induce a high incidence of hydrosalpinx in mice, while tc0668 with a G797659T point mutation was significantly attenuated. Compared with the nonmutant tc0237, the strains containing mutant tc0237 were characterized by reduced centrifugation dependence during infection. Conclusion The identification and characterization of these genes might contribute to the comprehensive understanding of the pathogenic mechanism of Chlamydia. [ABSTRACT FROM AUTHOR]