34 results on '"Van Der Veer C"'
Search Results
2. Distributed Collaborative Learning in a Telematic Context. Telematic Learning Support and its Potential for Collaborative Learning with New Paradigms and Conceptual Mapping Tools.
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Kommers, Pam, Lenting, B. F., and van der Veer, C. G.
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Describes a recent computer-supported cooperative-learning (CSCL) project called TSCL (Telematic (and IT) Supported Co-operative Learning) which builds upon distributed knowledge and constructivism. It takes the opportunity of Internet-based communication tools to allow students to participate in nonschool environments such as expert discussions, socially engaged groups like peace organizations, environmental health, and technical discussions. (Author/AEF)
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- 1998
3. Trichomonas vaginalis and Mycoplasma genitalium
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van der Veer, C, van Rooijen, M S, Himschoot, M, de Vries, H J C, and Bruisten, S M
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- 2016
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4. In depth analysis of patients with severe SARS-CoV-2 in sub-Saharan Africa demonstrates distinct clinical and immunological profiles
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Morton, B, primary, Barnes, KG, additional, Anscombe, C, additional, Jere, K, additional, Kamng’ona, R, additional, Brown, C, additional, Nyirenda, J, additional, Phiri, T, additional, Banda, N, additional, Van Der Veer, C, additional, Mndolo, KS, additional, Mponda, K, additional, Rylance, J, additional, Phiri, C, additional, Mallewa, J, additional, Nyirenda, M, additional, Katha, G, additional, Kambiya, P, additional, Jafali, J, additional, Mwandumba, HC, additional, Gordon, SB, additional, Cornick, J, additional, and Jambo, KC, additional
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- 2021
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5. Effects of an over-the-counter lactic-acid containing intra-vaginal douching product on the vaginal microbiota
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van der Veer, C, Bruisten, S M, van Houdt, R, Matser, A A, Tachedjian, G, van de Wijgert, J H H M, de Vries, H J C, van der Helm, J J, van der Veer, C, Bruisten, S M, van Houdt, R, Matser, A A, Tachedjian, G, van de Wijgert, J H H M, de Vries, H J C, and van der Helm, J J
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- 2019
6. Effects of an over-the-counter lactic-acid containing intra-vaginal douching product on the vaginal microbiota
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Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Epi Infectieziekten Team 1, UMC Utrecht, van der Veer, C, Bruisten, S M, van Houdt, R, Matser, A A, Tachedjian, G, van de Wijgert, J H H M, de Vries, H J C, van der Helm, J J, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Epi Infectieziekten Team 1, UMC Utrecht, van der Veer, C, Bruisten, S M, van Houdt, R, Matser, A A, Tachedjian, G, van de Wijgert, J H H M, de Vries, H J C, and van der Helm, J J
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- 2019
7. Multilocus sequence typing ofTrichomonas vaginalisclinical samples from Amsterdam, the Netherlands
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van der Veer, C, primary, Himschoot, M, additional, and Bruisten, S M, additional
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- 2016
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8. P06.01 Women of dutch ethnic origin have lower prevalence of vaginal microbiome dysbiosis than women of other ethnic origin residing in amsterdam
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Borgdorff, H, primary, van der Veer, C, additional, van Houdt, R, additional, Alberts, CJ, additional, de Vries, HJ, additional, Bruisten, SM, additional, Snijder, MB, additional, Prins, M, additional, Geerlings, SE, additional, van der Loeff, MF Schim, additional, and Jhhm, van de Wijgert, additional
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- 2015
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9. P09.04 Trichomonas vaginalisandmycoplasma genitalium: age-specific prevalence and disease burden in men attending a sexually transmitted infections clinic in amsterdam, the netherlands
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van der Veer, C, primary, van Rooijen, MS, additional, de Vries, HJC, additional, Himschoot, M, additional, and Bruisten, SM, additional
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- 2015
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10. Trichomonas vaginalisandMycoplasma genitalium:age-specific prevalence and disease burden in men attending a sexually transmitted infections clinic in Amsterdam, the Netherlands: Table 1
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van der Veer, C, primary, van Rooijen, M S, additional, Himschoot, M, additional, de Vries, H J C, additional, and Bruisten, S M, additional
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- 2015
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11. Molecular Tools for Diagnosis of Visceral Leishmaniasis: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy
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de Ruiter, C. M., primary, van der Veer, C., additional, Leeflang, M. M. G., additional, Deborggraeve, S., additional, Lucas, C., additional, and Adams, E. R., additional
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- 2014
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12. Multilocus sequence typing of Trichomonas vaginalis clinical samples from Amsterdam, the Netherlands.
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van der Veer, C., Himschoot, M., and Bruisten, S. M.
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Objectives: In this cross-sectional epidemiological study we aimed to identify molecular profiles for Trichomonas vaginalis and to determine how these molecular profiles were related to patient demographic and clinical characteristics. Setting: Molecular typing methods previously identified two genetically distinct subpopulations for T. vaginalis; however, few molecular epidemiological studies have been performed. We now increased the sensitivity of a previously described multilocus sequence typing (MLST) tool for T. vaginalis by using nested PCR. This enabled the typing of direct patient samples. Participants: From January to December 2014, we collected all T. vaginalis positive samples as detected by routine laboratory testing. Samples from patients either came from general practitioners offices or from the sexually transmitted infections (STI) clinic in Amsterdam. Epidemiological data for the STI clinic patients were retrieved from electronic patient files. Primary and secondary outcome measures: The primary outcome was the success rate of genotyping direct T. vaginalis positive samples. The secondary outcome was the relation between T. vaginalis genotypes and risk factors for STI. Results: All 7 MLST loci were successfully typed for 71/87 clinical samples. The 71 typed samples came from 69 patients, the majority of whom were women (n=62; 90%) and half (n=34; 49%) were STI clinic patients. Samples segregated into a two population structure for T. vaginalis representing genotypes I and II. Genotype I was most common (n=40; 59.7%). STI clinic patients infected with genotype II reported more sexual partners in the preceding 6 months than patients infected with genotype I (p=0.028). No other associations for gender, age, ethnicity, urogenital discharge or co-occurring STIs with T. vaginalis genotype were found. Conclusions: MLST with nested PCR is a sensitive typing method that allows typing of direct (uncultured) patient material. Genotype II is possibly more prevalent in high-risk sexual networks. [ABSTRACT FROM AUTHOR]
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- 2016
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13. Ideologies in the news: On the measurement of ideological characteristics of news reports.
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VAN DEN BERG, H. and VAN DER VEER, C. G.
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CONTENT analysis ,COMMUNICATION education ,DISCOURSE analysis ,POLITICAL communication ,CONVERSATION analysis ,ORAL communication ,LITERARY discourse analysis ,STRUCTURAL analysis (Linguistics) - Abstract
In this article, we discuss recent developments within the field of text-analysis from a socio-cultural point of view. In the first part attention is paid to the relation between dominant research traditions in communication studies such as the tradition of content analysis and new approaches which are often labeled as discourse analysis. The main methodological and theoretical problems within the tradition of content analysis are exposed. Perspectives of discourse analysis to overcome these problems are evaluated. Common problem of different approaches seems to be the question whether adequate research tools can be designed to produce not only reliable and valid results but also theoretical relevant analyses of media-discourses. In the second part of this article we consider by way of example a new method of measuring ideological characteristics of news. This method is comparable to jurisdiction in several important respects: Like judges, the task of coders does not simply consist of applying rules of coding in a purely technical way. The coding of news articles, using general rules, is coupled to a further elaboration of the rules themselves. To test the validity of this procedure, we use a method of scaling derived from a theoretical model generally known as "the law of categorical judgement". We also analyze the reliability of the coding process. Finally, the value of the research tool is demonstrated by presenting some results of a content analysis of the news coverage of a renowned Dutch industrial dispute in the seventies. [ABSTRACT FROM AUTHOR]
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- 1989
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14. The aetiology and antimicrobial resistance of bacterial maternal infections in Sub-Saharan Africa-a systematic review and meta-analysis.
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Chapuma C, Twabi HH, Monk EJM, Jafali J, Weeks A, Beales E, Kulapani D, Selemani A, Nliwasa M, Gadama L, Nyirenda T, Msefula C, Dunlop C, Lissauer S, Feasey N, Van der Veer C, and Lissauer D
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- Humans, Africa South of the Sahara epidemiology, Female, Pregnancy, Bacteria drug effects, Bacteria isolation & purification, Bacteria classification, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Pregnancy Complications, Infectious microbiology, Pregnancy Complications, Infectious drug therapy, Pregnancy Complications, Infectious epidemiology, Drug Resistance, Bacterial, Bacterial Infections microbiology, Bacterial Infections drug therapy, Bacterial Infections epidemiology
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Background: Understanding the aetiological organisms causing maternal infections is crucial to inform antibiotic treatment guidelines, but such data are scarce from Sub-Saharan Africa (SSA). We performed this systematic review and meta-analysis to address this gap., Methods: Microbiologically confirmed maternal infection data were collected from PubMed, Embase, and African Journals online databases. The search strategy combined terms related to bacterial infection, pregnancy, postnatal period, observational studies, SSA. Exclusion criteria included colonization, asymptomatic infection, and screening studies. Pooled proportions for bacterial isolates and antimicrobial resistance (AMR) were calculated. Quality and completeness of reporting were assessed using the Newcastle-Ottawa and STROBE checklists., Findings: We included 14 papers comprising data from 2,575 women from four sources (blood, urine, surgical wound and endocervical). Mixed-growth was commonly reported at 17% (95% CI: 12%-23%), E. coli from 11%(CI:10%-12%), S. aureus from 5%(CI: 5%-6%), Klebsiella spp. at 5%(CI: 4%- 5%) and Streptococcus spp. at 2%(CI: 1%-2%). We observed intra-sample and inter-sample heterogeneity between 88-92% in all meta-analyses. AMR rates were between 19% -77%, the highest with first-line beta-lactam antibiotics. Convenience sampling, and limited reporting of laboratory techniques were areas of concern., Interpretation: We provide a comprehensive summary of microbial aetiology of maternal infections in SSA and demonstrate the paucity of data available for this region. We flag the need to review the current local and international empirical treatment guidelines for maternal bacterial infections in SSA because there is high prevalence of AMR among common causative bacteria., Funding: This research was supported by the NIHR-Professorship/NIHR300808 and the Wellcome-Strategic-award /206545/Z/17/Z., Trial Registration: Prospero ID CRD42021238515., (© 2024. The Author(s).)
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- 2024
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15. Prevalence of sexually transmitted infection in pregnancy and their association with adverse birth outcomes: a case-control study at Queen Elizabeth Central Hospital, Blantyre, Malawi.
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van der Veer C, Kondoni C, Kuyere A, Mtonga F, Nyasulu V, Shaba G, Morroni C, Gadama G, Gadama L, Kawaza K, Dube Q, French N, Lissauer D, and Freyne B
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Background: There are limited data on the epidemiology of sexually transmitted infections (STI) and their contribution to adverse birth outcomes (ABO) in sub-Saharan Africa (SSA). We performed a case-control study to assess the prevalence of STI and their association with ABO among women attending Queen Elizabeth Central Hospital, Blantyre, Malawi., Methods: A composite case definition for ABO included stillborn, preterm and low birthweight infants and infants admitted to neonatal intensive care unit within 24 hours of birth. Following recruitment of an infant with an ABO, the next born healthy infant was recruited as a control. Multiplex PCR for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) was performed on maternal vaginal swabs. HIV and syphilis status was determined on maternal and infant serum. For syphilis, we used combined treponemal/non-treponemal rapid point-of-care tests in parallel with rapid plasma reagin tests, PCR for Treponema pallidum and clinical parameters to diagnose and stage the infection. We compared STI positivity between cases and controls., Results: We included 259 cases and 251 controls. Maternal prevalence of STI was 3.1%, 2.7% and 17.1% for NG, CT and TV, respectively. Maternal prevalence of untreated syphilis was 2.0% and 6.1% for early stage and late/unknown stage, respectively; prevalence of treated syphilis was 2.7%. The HIV prevalence was 16.5%. HIV infection significantly increased the odds for ABO (OR=3.31; 95% CI 1.10 to 9.91) as did NG positivity (OR=4.30; 95% CI 1.16 to 15.99). We observed higher rates of ABO among women with untreated maternal syphilis (early: OR=7.13; 95% CI 0.87 to 58.39, late/unknown stage: OR=1.43; 95% CI 0.65 to 3.15). Maternal TV and CT infections were not associated with ABO., Conclusion: STI prevalence among pregnant women in Malawi is comparable to other SSA countries. HIV, NG and untreated syphilis prevalence was higher among women with ABO compared with women with healthy infants., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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- 2024
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16. A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study.
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Anscombe C, Lissauer S, Thole H, Rylance J, Dula D, Menyere M, Kutambe B, van der Veer C, Phiri T, Banda NP, Mndolo KS, Mponda K, Phiri C, Mallewa J, Nyirenda M, Katha G, Mwandumba H, Gordon SB, Jambo KC, Cornick J, Feasey N, Barnes KG, Morton B, and Ashton PM
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- Adult, Humans, SARS-CoV-2, Malawi, Cohort Studies, Data Accuracy, COVID-19
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Background: Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity of data from low-income countries. Our aim was to explore the relationship between viral lineage and patient outcome., Methods: We enrolled a prospective observational cohort of adult patients hospitalised with PCR-confirmed COVID-19 disease between July 2020 and March 2022 from Blantyre, Malawi, covering four waves of SARS-CoV-2 infections. Clinical and diagnostic data were collected using an adapted ISARIC clinical characterization protocol for COVID-19. SARS-CoV-2 isolates were sequenced using the MinION™ in Blantyre., Results: We enrolled 314 patients, good quality sequencing data was available for 55 patients. The sequencing data showed that 8 of 11 participants recruited in wave one had B.1 infections, 6/6 in wave two had Beta, 25/26 in wave three had Delta and 11/12 in wave four had Omicron. Patients infected during the Delta and Omicron waves reported fewer underlying chronic conditions and a shorter time to presentation. Significantly fewer patients required oxygen (22.7% [17/75] vs. 58.6% [140/239], p < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 0.001) in the Omicron wave compared with the other waves. Multivariable logistic-regression demonstrated a trend toward increased mortality in the Delta wave (OR 4.99 [95% CI 1.0-25.0 p = 0.05) compared to the first wave of infection., Conclusions: Our data show that each wave of patients hospitalised with SARS-CoV-2 was infected with a distinct viral variant. The clinical data suggests that patients with severe COVID-19 disease were more likely to die during the Delta wave., (© 2023. The Author(s).)
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- 2023
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17. A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study.
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Anscombe C, Lissauer S, Thole H, Rylance J, Dula D, Menyere M, Kutambe B, van der Veer C, Phiri T, Banda NP, Mndolo KS, Mponda K, Phiri C, Mallewa J, Nyirenda M, Katha G, Mwandumba H, Gordon SB, Jambo KC, Cornick J, Feasey N, Barnes KG, Morton B, and Ashton PM
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Background: Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity of data from low-income countries. Our aim was to explore the relationship between viral lineage and patient outcome., Methods: We enrolled a prospective observational cohort of adult patients hospitalised with PCR-confirmed COVID-19 disease between July 2020 and March 2022 from Blantyre, Malawi, covering four waves of SARS-CoV-2 infections. Clinical and diagnostic data were collected using an adapted ISARIC clinical characterization protocol for COVID-19. SARS-CoV-2 isolates were sequenced using the MinIONâ"¢ in Blantyre., Results: We enrolled 314 patients, good quality sequencing data was available for 55 patients. The sequencing data showed that 8 of 11 participants recruited in wave one had B.1 infections, 6/6 in wave two had Beta, 25/26 in wave three had Delta and 11/12 in wave four had Omicron. Patients infected during the Delta and Omicron waves reported fewer underlying chronic conditions and a shorter time to presentation. Significantly fewer patients required oxygen (22.7% [17/75] vs. 58.6% [140/239], p<0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p<0.001) in the Omicron wave compared with the other waves. Multivariable logistic-regression demonstrated a trend toward increased mortality in the Delta wave (OR 4.99 [95% CI 1.0-25.0 p=0.05) compared to the first wave of infection., Conclusions: Our data show that each wave of patients hospitalised with SARS-CoV-2 was infected with a distinct viral variant. The clinical data suggests that patients with severe COVID-19 disease were more likely to die during the Delta wave., Summary: We used genome sequencing to identify the variants of SARS-CoV-2 causing disease in Malawi, and found that each of the four waves was caused by a distinct variant. Clinical investigation suggested that the Delta wave had the highest mortality.
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- 2022
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18. Urine and vaginal microbiota compositions of postmenopausal and premenopausal women differ regardless of recurrent urinary tract infection and renal transplant status.
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Hugenholtz F, van der Veer C, Terpstra ML, Borgdorff H, van Houdt R, Bruisten S, Geerlings SE, and van de Wijgert JHHM
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- Adolescent, Adult, Aged, Bacteria genetics, Female, Humans, Microbiota genetics, Middle Aged, RNA, Ribosomal, 16S analysis, Young Adult, Kidney Transplantation adverse effects, Postmenopause urine, Premenopause urine, Urinary Tract Infections microbiology, Urine microbiology, Vagina microbiology
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Postmenopausal women and renal transplant recipients are at increased risk of recurrent urinary tract infections (RUTI). Urine and vaginal microbiota of premenopausal controls (N = 18) and RUTI cases (18), and of postmenopausal controls (30) and RUTI cases (20) with and without a renal transplant, were characterized using 16S rRNA sequencing. Participants did not have UTI symptoms at the time of sampling. Gram-negative uropathobionts (predominantly Escherichia/Shigella, Pseudomonas, Klebsiella, and Acinetobacter) had a much higher mean relative abundance in urine than vaginal samples, especially in premenopausal women. No statistically significant differences in mean relative abundances of bacterial groups were found within the premenopausal group or within the postmenopausal group by RUTI or renal transplant status without chronic antibiotic use. Comparing postmenopausal to premenopausal women, mean relative abundances of lactobacilli (especially L. crispatus) in urine and vaginal samples and of Gram-negative uropathobionts in urine were lower, and of BV-anaerobes and Gram-positive uropathobionts in urine and vaginal samples were higher. While RUTI in premenopausal women is predominantly caused by Escherichia, the causative organisms in postmenopausal women are likely more diverse. The relative importance of individual organisms is currently unknown. We recommend that future studies, including intervention studies, include longitudinal microbiota assessments., (© 2022. The Author(s).)
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- 2022
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19. Enhanced IgA coating of bacteria in women with Lactobacillus crispatus-dominated vaginal microbiota.
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Breedveld AC, Schuster HJ, van Houdt R, Painter RC, Mebius RE, van der Veer C, Bruisten SM, Savelkoul PHM, and van Egmond M
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- Bacteria, Female, Humans, Immunoglobulin A, Vagina microbiology, Lactobacillus crispatus, Microbiota
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Background: Immunoglobulin A (IgA) plays an important role in maintaining a healthy intestinal microbiome, but little is known about the interaction between local immunoglobulins and the vaginal microbiome. We assessed immunoglobulins (unbound and bound to bacteria), their association with vaginal microbiota composition and the changes over time in 25 healthy women of reproductive age., Results: In both Lactobacillus crispatus-dominated and non-L. crispatus-dominated microbiota, IgA and IgG (unbound and bound to bacteria) were higher during menses (T = 1) compared to day 7‑11 (T = 2) and day 17‑25 (T = 3) after menses onset. The majority of vaginal bacteria are coated with IgA and/or IgG. Women with L. crispatus-dominated microbiota have increased IgA coating of vaginal bacteria compared to women with other microbiota compositions, but contained less IgA per bacterium. Presence of a dominantly IgA-coated population at T = 2 and/or T = 3 was also strongly associated with L. crispatus-dominated microbiota. In women with non-L. crispatus-dominated microbiota, more bacteria were uncoated. Unbound IgA, unbound IgG, and bound IgG levels were not associated with microbiota composition., Conclusions: In conclusion, L. crispatus-dominated vaginal microbiota have higher levels of bacterial IgA coating compared to non-L. crispatus-dominated vaginal microbiota. Similar to its regulating function in the intestinal tract, we hypothesize that IgA is involved in maintaining L. crispatus-dominated microbiota in the female genital tract. This may play a role in L. crispatus-associated health benefits. Video abstract., (© 2022. The Author(s).)
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- 2022
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20. The Two-Way Interaction between the Molecules That Cause Vaginal Malodour and Lactobacilli: An Opportunity for Probiotics.
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Puebla-Barragan S, Akouris PP, Al KF, Carr C, Lamb B, Sumarah M, van der Veer C, Kort R, Burton J, and Reid G
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- Dysbiosis drug therapy, Female, Humans, Probiotics therapeutic use, Vaginosis, Bacterial drug therapy, Dysbiosis immunology, Lactobacillus classification, Lactobacillus growth & development, Lactobacillus isolation & purification, Vagina microbiology, Vaginosis, Bacterial microbiology
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Vaginal malodour is a sign of dysbiosis. The biogenic amines (BAs) cadaverine, putrescine and tyramine are known to be causative compounds. Recent reports suggest these compounds produced by pathogens might have a role beyond causing malodour; namely inhibiting the growth of lactobacilli bacteria that are crucial in the maintenance of vaginal homeostasis. The aim of this study was to identify whether certain lactobacilli strains could reduce BAs and to evaluate how Lactobacillus species were affected by these compounds. Using LC-MS and HPLC-UV, five Lactobacillus crispatus strains were identified as being capable of significantly reducing BAs from the media under in vitro conditions. Through 16S rRNA gene sequencing of vaginal swabs exposed to Bas, cadaverine was found to reduce the relative abundance of lactobacilli. When L. crispatus was exposed to media supplemented with BAs with an HCl adjusted lower pH, its growth was enhanced, demonstrating the relevance of the maintenance of an acidic vaginal environment. If strains are to be developed for probiotic application to alleviate bacterial vaginosis and other conditions affecting large numbers of women worldwide, their ability to adapt to Bas and regulate pH should be part of the experimentation.
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- 2021
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21. Interstrain Variability of Human Vaginal Lactobacillus crispatus for Metabolism of Biogenic Amines and Antimicrobial Activity against Urogenital Pathogens.
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Puebla-Barragan S, Watson E, van der Veer C, Chmiel JA, Carr C, Burton JP, Sumarah M, Kort R, and Reid G
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- Candida albicans metabolism, Dysbiosis metabolism, Dysbiosis microbiology, Enterococcus faecium metabolism, Escherichia coli metabolism, Female, Genomics methods, Humans, Lactobacillus crispatus classification, Lactobacillus crispatus genetics, Metabolome, Metabolomics methods, Phylogeny, Prevotella metabolism, Probiotics metabolism, Anti-Infective Agents metabolism, Biogenic Amines metabolism, Female Urogenital Diseases metabolism, Female Urogenital Diseases microbiology, Lactobacillus crispatus metabolism, Microbiota, Vagina microbiology
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Lactobacillus crispatus is the dominant species in the vagina of many women. With the potential for strains of this species to be used as a probiotic to help prevent and treat dysbiosis, we investigated isolates from vaginal swabs with Lactobacillus -dominated and a dysbiotic microbiota. A comparative genome analysis led to the identification of metabolic pathways for synthesis and degradation of three major biogenic amines in most strains. However, targeted metabolomic analysis of the production and degradation of biogenic amines showed that certain strains have either the ability to produce or to degrade these compounds. Notably, six strains produced cadaverine, one produced putrescine, and two produced tyramine. These biogenic amines are known to raise vaginal pH, cause malodour, and make the environment more favourable to vaginal pathogens. In vitro experiments confirmed that strains isolated from women with a dysbiotic vaginal microbiota have higher antimicrobial effects against the common urogenital pathogens Escherichia coli and Enterococcus faecium . The results indicate that not all L. crispatus vaginal strains appear suitable for probiotic application and the basis for selection should not be only the overall composition of the vaginal microbiota of the host from which they came, but specific biochemical and genetic traits.
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- 2021
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22. Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa.
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Morton B, Barnes KG, Anscombe C, Jere K, Matambo P, Mandolo J, Kamng'ona R, Brown C, Nyirenda J, Phiri T, Banda NP, Van Der Veer C, Mndolo KS, Mponda K, Rylance J, Phiri C, Mallewa J, Nyirenda M, Katha G, Kambiya P, Jafali J, Mwandumba HC, Gordon SB, Cornick J, and Jambo KC
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- Adult, Africa South of the Sahara epidemiology, Anti-Bacterial Agents administration & dosage, Antibodies blood, COVID-19 blood, COVID-19 epidemiology, Coinfection immunology, Cytokines blood, Dexamethasone administration & dosage, Female, Humans, Immunoglobulin G blood, Immunoglobulin M blood, Male, Middle Aged, Pandemics, SARS-CoV-2 isolation & purification, COVID-19 Drug Treatment, COVID-19 immunology
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Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we characterise patients hospitalised with suspected (PCR-negative/IgG-positive) or confirmed (PCR-positive) COVID-19, and healthy community controls (PCR-negative/IgG-negative). PCR-positive COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-negative/IgG-positive and PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants exhibited a nasal and systemic cytokine signature analogous to PCR-positive COVID-19 participants, predominated by chemokines and neutrophils and distinct from PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants had increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. PCR-negative/IgG-positive individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies.
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- 2021
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23. In depth analysis of patients with severe SARS-CoV-2 in sub-Saharan Africa demonstrates distinct clinical and immunological profiles.
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Morton B, Barnes KG, Anscombe C, Jere K, Kamng'ona R, Brown C, Nyirenda J, Phiri T, Banda N, Van Der Veer C, Mndolo KS, Mponda K, Rylance J, Phiri C, Mallewa J, Nyirenda M, Katha G, Kambiya P, Jafali J, Mwandumba HC, Gordon SB, Cornick J, and Jambo KC
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Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we comprehensively characterise patients hospitalised with suspected or confirmed COVID-19, and healthy community controls. PCR-confirmed COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-/IgG+ and PCR-/IgG-participants. PCR-/IgG+ participants exhibited a nasal and systemic cytokine signature analogous to PCR-confirmed COVID-19 participants, but increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. We did not find evidence that HIV co-infection in COVID-19 participants was associated with mortality or altered cytokine responses. The nasal immune signature in PCR-/IgG+ and PCR-confirmed COVID-19 participants was distinct and predominated by chemokines and neutrophils. In addition, PCR-/IgG+ individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies.
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- 2021
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24. Pathobionts in the Vaginal Microbiota: Individual Participant Data Meta-Analysis of Three Sequencing Studies.
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van de Wijgert JHHM, Verwijs MC, Gill AC, Borgdorff H, van der Veer C, and Mayaud P
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- Female, Humans, Infant, Newborn, Netherlands, South Africa, Vagina, Microbiota, Vaginosis, Bacterial
- Abstract
Sequencing studies have shown that optimal vaginal microbiota (VMB) are lactobacilli-dominated and that anaerobes associated with bacterial vaginosis (BV-anaerobes) are commonly present. However, they overlooked a less prevalent but more pathogenic group of vaginal bacteria: the pathobionts that cause maternal and neonatal infections and pelvic inflammatory disease. We conducted an individual participant data meta-analysis of three VMB sequencing studies that included diverse groups of women in Rwanda, South Africa, and the Netherlands (2,044 samples from 1,163 women in total). We identified 40 pathobiont taxa but only six were non-minority taxa (at least 1% relative abundance in at least one sample) in all studies: Streptococcus (54% of pathobionts reads) , Staphylococcus, Enterococcus, Escherichia/Shigella, Haemophilus , and Campylobacter . When all pathobionts were combined into one bacterial group, the VMB of 17% of women contained a relative abundance of at least 1%. We found a significant negative correlation between relative abundances (ρ = -0.9234), but not estimated concentrations ( r = 0.0031), of lactobacilli and BV-anaerobes; and a significant positive correlation between estimated concentrations of pathobionts and BV-anaerobes ( r = 0.1938) but not between pathobionts and lactobacilli ( r = 0.0436; although lactobacilli declined non-significantly with increasing pathobionts proportions). VMB sequencing data were also classified into mutually exclusive VMB types. The overall mean bacterial load of the ≥20% pathobionts VMB type (5.85 log
10 cells/μl) was similar to those of the three lactobacilli-dominated VMB types (means 5.13-5.83 log10 cells/μl) but lower than those of the four anaerobic dysbiosis VMB types (means 6.11-6.87 log10 cells/μl). These results suggest that pathobionts co-occur with both lactobacilli and BV-anaerobes and do not expand as much as BV-anaerobes do in a dysbiotic situation. Pathobionts detection/levels were increased in samples with a Nugent score of 4-6 in both studies that conducted Nugent-scoring. Having pathobionts was positively associated with young age, non-Dutch origin, hormonal contraceptive use, smoking, antibiotic use in the 14 days prior to sampling, HIV status, and the presence of sexually transmitted pathogens, in at least one but not all studies; inconsistently associated with sexual risk-taking and unusual vaginal discharge reporting; and not associated with vaginal yeasts detection by microscopy. We recommend that future VMB studies quantify common vaginal pathobiont genera., (Copyright © 2020 van de Wijgert, Verwijs, Gill, Borgdorff, van der Veer and Mayaud.)- Published
- 2020
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25. Vaginal herb use and Chlamydia trachomatis infection: cross-sectional study among women of various ethnic groups in Suriname.
- Author
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Van der Helm JJ, Schim van der Loeff MF, de Vries E, van der Veer C, Grünberg AW, Mans D, and de Vries HJC
- Subjects
- Administration, Intravaginal, Administration, Topical, Adult, Cross-Sectional Studies, Ethnicity, Female, Humans, Microbiota immunology, Phytotherapy, Plant Extracts administration & dosage, Suriname epidemiology, Vagina immunology, Vaginal Douching methods, Women's Health ethnology, Chlamydia Infections epidemiology, Immunity, Mucosal drug effects, Plant Extracts adverse effects, Vagina microbiology, Vaginal Douching adverse effects
- Abstract
Objective: Vaginal steam baths with herb leaves (herb use) is practised by some Surinamese women. We assessed herb use among women from the five most prevalent ethnic groups, and if herb use is associated with Chlamydia trachomatis infection., Setting: Participants were recruited at a sexually transmitted infection (STI) clinic and a family planning clinic (FP) in Paramaribo, Suriname., Participants: 1040 women were included subsequently, comprising the following ethnic groups: Creole (26.7%), Hindustani (24.6%), Javanese (15.7%), Maroon (13.3%) and mixed descent (19.7%)., Methods: Nurses collected a questionnaire and vaginal swabs for nucleic acid amplification C. trachomatis testing., Primary Outcomes: Determinants of vaginal herb use and C. trachomatis infection via univariable and multivariable logistic regression., Results: Herb use was most common among Maroon (68.8%) and Creole women (25.2%). In multivariable analysis including only Maroon and Creole women, determinants significantly associated with vaginal herb use were (OR; 95% CI): Maroon ethnic descent (5.33; 3.26 to 8.71 vs Creole), recruitment at the STI clinic (2.04; 1.24 to 3.36 vs FP), lower education levels (3.80; 1.68 to 8.57 lower vs higher, and 2.02; 0.90 to 4.51 middle vs higher). Lower age and recruitment at the STI clinic were associated with C. trachomatis infection, but not vaginal herb use., Conclusion: In Suriname, vaginal herb use is common among Maroon and Creole women. Education, ethnic group and recruitment site were determinants for herb use. Vaginal herb use was not a determinant of C. trachomatis infection. Future research should focus on the effect of herb use on the vaginal microbiome and mucosal barrier., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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26. Comparative genomics of human Lactobacillus crispatus isolates reveals genes for glycosylation and glycogen degradation: implications for in vivo dominance of the vaginal microbiota.
- Author
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van der Veer C, Hertzberger RY, Bruisten SM, Tytgat HLP, Swanenburg J, de Kat Angelino-Bart A, Schuren F, Molenaar D, Reid G, de Vries H, and Kort R
- Subjects
- Bacterial Proteins genetics, Female, Genome, Bacterial, Glycosylation, Glycosyltransferases genetics, Humans, Lactobacillus crispatus genetics, Lactobacillus crispatus metabolism, Neisseria gonorrhoeae growth & development, Phenotype, Phylogeny, Sequence Analysis, DNA, Dysbiosis microbiology, Genomics methods, Glycogen metabolism, Lactobacillus crispatus isolation & purification, Vagina microbiology
- Abstract
Background: A vaginal microbiota dominated by lactobacilli (particularly Lactobacillus crispatus) is associated with vaginal health, whereas a vaginal microbiota not dominated by lactobacilli is considered dysbiotic. Here we investigated whether L. crispatus strains isolated from the vaginal tract of women with Lactobacillus-dominated vaginal microbiota (LVM) are pheno- or genotypically distinct from L. crispatus strains isolated from vaginal samples with dysbiotic vaginal microbiota (DVM)., Results: We studied 33 L. crispatus strains (n = 16 from LVM; n = 17 from DVM). Comparison of these two groups of strains showed that, although strain differences existed, both groups degraded various carbohydrates, produced similar amounts of organic acids, inhibited Neisseria gonorrhoeae growth, and did not produce biofilms. Comparative genomics analyses of 28 strains (n = 12 LVM; n = 16 DVM) revealed a novel, 3-fragmented glycosyltransferase gene that was more prevalent among strains isolated from DVM. Most L. crispatus strains showed growth on glycogen-supplemented growth media. Strains that showed less-efficient (n = 6) or no (n = 1) growth on glycogen all carried N-terminal deletions (respectively, 29 and 37 amino acid deletions) in a putative pullulanase type I protein., Discussion: L. crispatus strains isolated from LVM were not phenotypically distinct from L. crispatus strains isolated from DVM; however, the finding that the latter were more likely to carry a 3-fragmented glycosyltransferase gene may indicate a role for cell surface glycoconjugates, which may shape vaginal microbiota-host interactions. Furthermore, the observation that variation in the pullulanase type I gene is associated with growth on glycogen discourages previous claims that L. crispatus cannot directly utilize glycogen.
- Published
- 2019
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27. Accuracy of a commercial multiplex PCR for the diagnosis of bacterial vaginosis.
- Author
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van der Veer C, van Houdt R, van Dam A, de Vries H, and Bruisten S
- Subjects
- Adult, Bacteria classification, Bacteria genetics, Female, Humans, Microbiota, Multiplex Polymerase Chain Reaction economics, Multiplex Polymerase Chain Reaction instrumentation, Vagina microbiology, Vaginosis, Bacterial microbiology, Young Adult, Bacteria isolation & purification, Multiplex Polymerase Chain Reaction methods, Vaginosis, Bacterial diagnosis
- Abstract
Purpose: Bacterial vaginosis (BV) is a common clinical condition characterized by odorous vaginal discharge, vaginal itching and/or burning. BV can occur when vaginal lactobacilli are depleted and replaced by diverse anaerobic bacteria. We evaluated a commercial multiplex PCR (ATRiDA) for the diagnosis of BV., Methods: Cervicovaginal samples were included from women reporting urogenital symptoms and from women notified for sexually transmitted infections (STI) - who were not (necessarily) symptomatic. Clinical BV diagnoses were obtained from electronic patient files. The ATRiDA test measures the loads of Gardnerella vaginalis, Atopobium vaginae and Lactobacillus species in relation to overall bacterial load. The ATRiDA test outcome was compared to the clinical BV diagnosis and to vaginal microbiota composition, determined by 16SrRNA gene sequencing., Results: We included samples from 185 women reporting urogenital symptoms, of whom 81 had BV and 93 women who were notified for an STI, of whom 16 had BV. Overall, compared to the clinical BV diagnosis, the ATRiDA test demonstrated high sensitivity (96.9 %) and moderate specificity (70.2 %). The negative predictive value was high (>97.3). The positive predictive value differed by study group and was highest in women reporting urogenital symptoms (78.2 %). Sequencing showed that 54 % of women who had an ATRiDA BV-positive test outcome, but who were not clinically diagnosed with BV, had diverse anaerobic vaginal microbiota (asymptomatic vaginal dysbiosis)., Conclusion: The ATRiDA test is a sensitive method for the detection of BV but, given the high occurrence of asymptomatic vaginal dysbiosis, a positive test outcome should be interpreted together with clinical symptoms.
- Published
- 2018
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28. Promising Prebiotic Candidate Established by Evaluation of Lactitol, Lactulose, Raffinose, and Oligofructose for Maintenance of a Lactobacillus-Dominated Vaginal Microbiota.
- Author
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Collins SL, McMillan A, Seney S, van der Veer C, Kort R, Sumarah MW, and Reid G
- Subjects
- Dysbiosis drug therapy, Female, Humans, Lactobacillus genetics, Mass Spectrometry methods, RNA, Bacterial analysis, RNA, Ribosomal, 16S analysis, Sequence Analysis, RNA methods, Lactobacillus physiology, Metabolomics methods, Microbiota drug effects, Oligosaccharides analysis, Prebiotics analysis, Sugar Alcohols analysis, Vagina microbiology
- Abstract
Perturbations to the vaginal microbiota can lead to dysbiosis, including bacterial vaginosis (BV), which affects a large portion of the female population. In a healthy state, the vaginal microbiota is characterized by low diversity and colonization by Lactobacillus spp., whereas in BV, these species are displaced by a highly diverse population of bacteria associated with adverse vaginal health outcomes. Since prebiotic ingestion has been a highly effective approach to invigorate lactobacilli for improved intestinal health, we hypothesized that these compounds could stimulate lactobacilli at the expense of BV organisms to maintain vaginal health. Monocultures of commensal Lactobacillus crispatus , Lactobacillus vaginalis , Lactobacillus gasseri , Lactobacillus johnsonii , Lactobacillus jensenii , and Lactobacillus iners , in addition to BV-associated organisms and Candida albicans , were tested for their ability to utilize a representative group of prebiotics consisting of lactitol, lactulose, raffinose, and oligofructose. The disaccharide lactulose was found to most broadly and specifically stimulate vaginal lactobacilli, including the strongly health-associated species L. crispatus , and importantly, not to stimulate BV organisms or C. albicans Using freshly collected vaginal samples, we showed that exposure to lactulose promoted commensal Lactobacillus growth and dominance and resulted in healthy acidity partially through lactic acid production. This provides support for further testing of lactulose to prevent dysbiosis and potentially to reduce the need for antimicrobial agents in managing vaginal health. IMPORTANCE Bacterial vaginosis (BV) and other dysbioses of the vaginal microbiota significantly affect the quality of life of millions of women. Antimicrobial therapy is often poorly effective, causes side effects, and does not prevent recurrences. We report one of very few studies that have evaluated how prebiotics-compounds that are selectively fermented by beneficial bacteria such as Lactobacillus spp.-can modulate the vaginal microbiota. We also report use of a novel in vitro polymicrobial model to study the impact of prebiotics on the vaginal microbiota. The identification of prebiotic lactulose as enhancing Lactobacillus growth but not that of BV organisms or Candida albicans has direct application for retention of homeostasis and prevention of vaginal dysbiosis and infection., (Copyright © 2018 Collins et al.)
- Published
- 2018
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29. Direct detection of Trichomonas vaginalis virus in Trichomonas vaginalis positive clinical samples from the Netherlands.
- Author
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Jehee I, van der Veer C, Himschoot M, Hermans M, and Bruisten S
- Subjects
- Adult, DNA Primers, Female, Genome, Viral, Genotype, Humans, Male, Multilocus Sequence Typing, Netherlands epidemiology, Phylogeny, RNA, Double-Stranded, Totiviridae genetics, Trichomonas Vaginitis epidemiology, Polymerase Chain Reaction methods, Totiviridae isolation & purification, Trichomonas Vaginitis parasitology, Trichomonas vaginalis virology
- Abstract
Trichomonas vaginalis is the most common sexually transmitted parasitical infection worldwide. T. vaginalis can carry a virus: Trichomonas vaginalis virus (TVV). To date, four TVV species have been described. Few studies have investigated TVV prevalence and its clinical importance. We have developed a nested reverse-transcriptase PCR, with novel, type specific primers to directly detect TVV RNA in T. vaginalis positive clinical samples. A total of 119T. vaginalis positive clinical samples were collected in Amsterdam and "s-Hertogenbosch, the Netherlands, from 2012 to 2016. For all samples T. vaginalis was genotyped using multi-locus sequence typing. The T. vaginalis positive samples segregated into a two-genotype population: type I (n=64) and type II (n=55). All were tested for TVV with the new TVV PCR. We detected 3 of the 4 TVV species. Sequencing of the amplified products showed high homology with published TVV genomes (82-100%). Half of the T. vaginalis clinical samples (n=60, 50.4%) were infected with one or more TVV species, with a preponderance for TVV infections in T. vaginalis type I (n=44, 73.3%). Clinical data was available for a subset of samples (n=34) and we observed an association between testing positive for (any) TVV and reporting urogenital symptoms (p=0.023). The nested RT-PCR allowed for direct detection of TVV in T. vaginalis positive clinical samples. This may be helpful in studies and clinical settings, since T. vaginalis disease and/or treatment outcome may be influenced by the protozoa"s virus., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
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30. The association between ethnicity and vaginal microbiota composition in Amsterdam, the Netherlands.
- Author
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Borgdorff H, van der Veer C, van Houdt R, Alberts CJ, de Vries HJ, Bruisten SM, Snijder MB, Prins M, Geerlings SE, Schim van der Loeff MF, and van de Wijgert JHHM
- Subjects
- Adolescent, Adult, Bifidobacterium genetics, Bifidobacterium physiology, Corynebacterium genetics, Corynebacterium physiology, Enterobacteriaceae genetics, Enterobacteriaceae physiology, Female, Humans, Lactobacillus genetics, Lactobacillus physiology, Microbiota genetics, Netherlands, Proteus genetics, Proteus physiology, RNA, Ribosomal, 16S genetics, Staphylococcus genetics, Staphylococcus physiology, Streptococcus genetics, Streptococcus physiology, Young Adult, Microbiota physiology, Vagina microbiology
- Abstract
Objective: To evaluate whether ethnicity is independently associated with vaginal microbiota (VMB) composition in women living in Amsterdam, the Netherlands, as has been shown for American women., Methods: Women (18-34 years, non-pregnant, N = 610) representing the six largest ethnic groups (Dutch, African Surinamese, South-Asian Surinamese, Turkish, Moroccan, and Ghanaian) were sampled from the population-based HELIUS study. Sampling was performed irrespective of health status or healthcare seeking behavior. DNA was extracted from self-sampled vaginal swabs and sequenced by Illumina MiSeq (16S rRNA gene V3-V4 region)., Results: The overall prevalence of VMBs not dominated by lactobacilli was 38.5%: 32.2% had a VMB resembling bacterial vaginosis and another 6.2% had a VMB dominated by Bifidobacteriaceae (not including Gardnerella vaginalis), Corynebacterium, or pathobionts (streptococci, staphylococci, Proteus or Enterobacteriaceae). The most prevalent VMB in ethnically Dutch women was a Lactobacillus crispatus-dominated VMB, in African Surinamese and Ghanaian women a polybacterial G. vaginalis-containing VMB, and in the other ethnic groups a L. iners-dominated VMB. After adjustment for sociodemographic, behavioral and clinical factors, African Surinamese ethnicity (adjusted odds ratio (aOR) 5.1, 95% confidence interval (CI) 2.1-12.0) and Ghanaian ethnicity (aOR 4.8, 95% CI 1.8-12.6) were associated with having a polybacterial G. vaginalis-containing VMB, and African Surinamese ethnicity with a L. iners-dominated VMB (aOR 2.8, 95% CI 1.2-6.2). Shorter steady relationship duration, inconsistent condom use with casual partners, and not using hormonal contraception were also associated with having a polybacterial G. vaginalis-containing VMB, but human papillomavirus infection was not. Other sexually transmitted infections were uncommon., Conclusions: The overall prevalence of having a VMB not dominated by lactobacilli in this population-based cohort of women aged 18-34 years in Amsterdam was high (38.5%), and women of sub-Saharan African descent were significantly more likely to have a polybacterial G. vaginalis-containing VMB than Dutch women independent of modifiable behaviors.
- Published
- 2017
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31. A33 The cervico-vaginale microbiota in chlamydia trachomtais notified women: a case-control study at the sexually transmitted infection outpatient clinic in Amsterdam.
- Author
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van der Veer C, Bruisten SM, van der Helm JJ, de Vries HJC, and van Houdt R
- Published
- 2017
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32. The Cervicovaginal Microbiota in Women Notified for Chlamydia trachomatis Infection: A Case-Control Study at the Sexually Transmitted Infection Outpatient Clinic in Amsterdam, The Netherlands.
- Author
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van der Veer C, Bruisten SM, van der Helm JJ, de Vries HJ, and van Houdt R
- Subjects
- Adult, Case-Control Studies, Disease Notification, Female, High-Throughput Nucleotide Sequencing, Humans, Netherlands epidemiology, Phylogeny, Public Health Surveillance, RNA, Ribosomal, 16S genetics, Risk Factors, Sexual Behavior, Sexually Transmitted Diseases, Young Adult, Cervix Uteri microbiology, Chlamydia Infections epidemiology, Chlamydia Infections microbiology, Chlamydia trachomatis classification, Chlamydia trachomatis genetics, Microbiota, Vagina microbiology
- Abstract
Background: Increasing evidence suggests that the cervicovaginal microbiota (CVM) plays an important role in acquiring sexually transmitted infections (STIs). Here we study the CVM in a population of women notified by a sex partner for Chlamydia trachomatis infection., Methods: We included 98 women who were contact-traced by C. trachomatis-positive sex partners at the STI outpatient clinic in Amsterdam, the Netherlands, and analyzed their cervicovaginal samples and clinical data. CVMs were characterized by sequencing the V3/V4 region of the 16S ribosomal RNA gene and by hierarchical clustering. Characteristics associating with C. trachomatis infection were examined using bivariable and multivariable logistic regression analysis., Results: The CVM was characterized for 93 women, of whom 52 tested C. trachomatis positive and 41 C. trachomatis negative. We identified 3 major CVM clusters. Clustered CVM predominantly comprised either diverse anaerobic bacteria (n = 39 [42%]), Lactobacillus iners (n = 32 [34%]), or Lactobacillus crispatus (n = 22 [24%]). In multivariable analysis, we found that CVM was significantly associated with C. trachomatis infection (odds ratio [OR], 4.2 [95% confidence interval {CI}, 1.2-15.4] for women with diverse anaerobic CVM and OR, 4.4 [95% CI, 1.3-15.6], for women with L. iners-dominated CVM, compared with women with L. crispatus-dominated CVM), as was younger age (OR, 3.1 [95% CI, 1.1-8.7] for those ≤21 years old) and reporting a steady sex partner (OR, 3.6 [95% CI, 1.4-9.4])., Conclusions: Women who tested positive for Chlamydia trachomatis infection after having been contact-traced by a chlamydia-positive partner were more likely to have CVM dominated by L. iners or by diverse anaerobic bacteria, than by L. crispatus., (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.)
- Published
- 2017
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33. First case of cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis in Suriname.
- Author
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Hu RV, Kent AD, Adams ER, van der Veer C, Sabajo LO, Mans DR, de Vries HJ, Schallig HD, and Lai A Fat RF
- Subjects
- Adult, DNA, Protozoan genetics, Humans, Leishmania braziliensis genetics, Leishmania braziliensis pathogenicity, Leishmania guyanensis genetics, Leishmania guyanensis pathogenicity, Leishmaniasis, Mucocutaneous drug therapy, Leishmaniasis, Mucocutaneous physiopathology, Male, Pentamidine therapeutic use, Suriname, Treatment Outcome, Leishmania braziliensis isolation & purification, Leishmania guyanensis isolation & purification, Leishmaniasis, Mucocutaneous diagnosis
- Abstract
The main causative agent of cutaneous leishmaniasis (CL) in Suriname is Leishmania (Viannia) guyanensis. This case report presents a patient infected with Leishmania (Viannia) braziliensis, a species never reported before in Suriname. This finding has clinical implications, because L. braziliensis has a distinct clinical phenotype characterized by mucocutaneous leishmaniasis, a more extensive and destructive form of CL that requires different treatment. Clinicians should be aware that chronic cutaneous ulcers in patients from the Guyana region could be caused by L. braziliensis.
- Published
- 2012
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34. Surgical management of patients with sports-related spinal injuries.
- Author
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Bailes JE Jr and Van der Veer CA
- Subjects
- Humans, Lumbar Vertebrae surgery, Magnetic Resonance Imaging, Spinal Cord Injuries classification, Spinal Cord Injuries pathology, Neurosurgical Procedures methods, Spinal Cord Injuries surgery, Sports
- Published
- 2001
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