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Infectious Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Susanna J. Dunachie, Hanif Esmail, Ruth Corrigan, Maria Dudareva
PID is most commonly a complication of Chlamydia trachomatis and N. gonorrhoeae infection. Mycoplasma genitalium may also be a causative agent. Other possible causes include Gardnerella vaginalis and other anaerobic species.
The Uterine Microbiota
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Jonah Bardos, Carlos Simón, Inmaculada Moreno
Landmark studies by Moreno and collaborators demonstrated that the presence of pathogens in the endometrium during the window of implantation was associated with poor reproductive outcomes, whereas Lactobacillus dominance conferred a protective benefit, resulting in increasing implantation rates.4,79 However, given that 16S rRNA methodology only allows for taxonomic identification at the genus level, it is unclear whether certain species or subspecies of Lactobacillus may be capable of conferring this benefit, or whether the presence of any type of Lactobacillus prevents the growth of pathogenic bacteria, leading to a normal or healthy microbiota. A recent study on the endometrial microbiota and chronic endometritis reported that Lactobacillus crispatus was less abundant in patients with CE, suggesting that there may be certain Lactobacillus spp. that are protective.80 Another study in 2019 by Garcia-Grau et al. found Gardnerella vaginalis causing uterine dysbiosis after repeated sampling over an 18-month period in a patient with recurrent reproductive failure.
Clindamycin
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Clindamycin is a semisynthetic broad-spectrum antibiotic produced by chemical modification of the parent compound lincomycin. This agent dissociates peptidyl-tRNA from the bacterial ribosome, thereby disrupting bacterial protein synthesis. Clindamycin is indicated for the treatment of serious infections caused by susceptible anaerobic bacteria, including Bacteroides spp., Peptostreptococcus, anaerobic streptococci, Clostridium spp., and microaerophilic streptococci. The antibiotic may be useful in polymicrobial infections such as intra-abdominal or pelvic infections, osteomyelitis, diabetic foot ulcers, aspiration pneumonia and dental infections. Another use of clindamycin is vaginally to treat vaginosis caused by Gardnerella vaginosa. Clindamycin reduces the toxin-producing effects of S. aureus and S. pyogenes and as such, may be particularly useful for treating necrotizing fasciitis. In topical preparations, clindamycin is widely used in the treatment of inflammatory acne vulgaris (1).
Alteration of vaginal microbiota in patients with recurrent miscarriage
Published in Journal of Obstetrics and Gynaecology, 2022
Xuejuan Jiao, Lanling Zhang, Danli Du, Lingling Wang, Qianqian Song, Shuyu Liu
As previously reported, human vaginal microbiota play a crucial role in guarding various urogenital diseases, such as bacterial vaginosis, sexually transmitted infections and urinary tract infections (Ravel et al. 2011). Nevertheless, there are finite studies demonstrating a direct association between RM and vaginal microbiota. Vaginal microbiota species has less diversity compared with the intestinal microbiota, there were about 40 species of bacteria and facultative anaerobic in women of childbearing including Bacteroides, Gardneria, Lactobacillus, Coccidioides, Corynebacterium, Escherichia coli and Velveti (Raphael et al. 2011). Bacterial vaginosis is characterised by a complete loss of lactobacilli and a concomitant increase in Gram-variable and Gram-negative rods, primary among them Gardnerella vaginalis, as well as Bacteroides, Prevotella and Mobiluncus species. The presence of an abnormal vaginal microbiota in early pregnancy is a recognised risk factor for preterm delivery and low birth weight (Petricevic et al. 2015).
Current and emerging pharmacotherapy for recurrent bacterial vaginosis
Published in Expert Opinion on Pharmacotherapy, 2021
Already extensive studies of Gardnerella vaginalis clades have shown striking differences in virulence capacity and in vitro/susceptibility, although not yet correlated with clinical resistance. There are yet unproven benefits of high-dose vaginal metronidazole use that may be related to in vivo resistance. In vitro resistance documented by increased MICs should be separated from in vivo antimicrobial resistance. Most importantly, since the discovery of the ubiquitous vaginal biofilm incorporating G.vaginalis and numerous other potential pathogenic microorganisms, non-sessile bacteria so enclosed appear relatively inaccessible to antibiotics and independent of the reduced penetration, biofilm contained organisms are thought to experience gene initiated reduced drug sensitivity [24,61,62].
Bacterial vaginosis: a primer for clinicians
Published in Postgraduate Medicine, 2019
Suzanne Reiter, Susan Kellogg Spadt
Recent, nonculture-based studies have demonstrated the diversity of the vaginal microbiome, especially its variability across race/ethnicity groups, leading researchers to reconsider the idea of a ‘healthy’ or ‘normal’ vaginal microbial community [20]. Clinical research on the human microbiome led to the inclusion of Gardnerella, Atopobium, Prevotella, Peptostreptococcus, Mobiluncus, Sneathia, Leptotrichia, Mycoplasma, and BV-associated bacterium 1 (BVAB1) to BVAB3 in BV pathology [4]. Four distinct clades of Gardnerella [21] have been identified, and studies are ongoing to differentiate pathogenic strains of Gardnerella from nonpathogenic strains, especially among strains that may be resistant to one of the primary antibiotic treatments for BV – metronidazole [22].