Recently, detection of human papillomavirus (HPV)mRNA expression was made possible by in situ hybridization. We described a patient with cervical intraepithelial neoplasia (CIN) 3, showing a distinctive and rare form of co-infection with HPV type 16 and 18. HPV-16 was detected in high grade squamous intraepithelial neoplastic lesion (CIN 3) and HPV-18 was in low grade lesion just adjacent to the HPV-16 infected area. This case suggests that HPV infection may be one of the most responsible causative agents producing malignant transformation and two distinctive HPV types can also simultaneously infect the squamous epithelium of the uterine cervix.
Adult ; Cervical Intraepithelial Neoplasia/*microbiology ; Cervix Uteri/microbiology ; Female ; Humans ; In Situ Hybridization ; Papillomaviridae/genetics/*isolation & purification ; Papillomavirus Infections/*microbiology ; Tumor Virus Infections/complications/*microbiology ; Uterine Cervical Neoplasms/*microbiology

Adult ; Cervix Uteri ; microbiology ; Female ; Humans ; Middle Aged ; Peritonitis, Tuberculous ; diagnosis ; diagnostic imaging ; Recurrence ; Tomography, X-Ray Computed ; Treatment Outcome

Objective: To explore the characteristics and correlations of vaginal flora in women with cervical lesions. Methods: A total of 132 women, including 41 women diagnosed with normal cervical (NC), 39 patients with low-grade cervical intraepithelial neoplasia (CIN 1), 37 patients with high-grade cervical intraepithelial neoplasia (CIN 2/3) and 15 patients with cervical squamous cell carcinoma (SCC), who came from the gynecological clinic of Second Hospital of Shanxi Medical University during January 2018 to June 2018, were enrolled in this study according to the inclusive and exclusive criteria strictly. The vaginal flora was detected by 16S rDNA sequencing technology. Co-occurrence network analysis was used to investigate the Spearman correlations between different genera of bacteria. Results: The dominant bacteria in NC, CIN 1 and CIN 2/3 groups were Lactobacillus [constituent ratios 79.4% (1 869 598/2 354 098), 63.6% (1 536 466/2 415 100) and 58.3% (1 342 896/2 301 536), respectively], while Peptophilus [20.4% (246 072/1 205 154) ] was the dominant bacteria in SCC group. With the aggravation of cervical lesions, the diversity of vaginal flora gradually increased (Shannon index: F=6.39, P=0.001; Simpson index: F=3.95, P=0.012). During the cervical lesion progress, the ratio of Lactobacillus gradually decreased, the ratio of other anaerobes such as Peptophilus, Sneathia, Prevotella and etc. gradually increased, and the differential bacteria (LDA score >3.5) gradually evolved from Lactobacillus to other anaerobes. The top 10 relative abundance bacteria, spearman correlation coefficient>0.4 and P<0.05 were selected. Co-occurrence network analysis showed that Prevotella, Peptophilus, Porphyrinomonas, Anaerococcus, Sneathia, Atopobium, Gardnerella and Streptococcus were positively correlated in different stages of cervical lesions, while Lactobacillus was negatively correlated with the above anaerobes. It was found that the relationship between vaginal floras in CIN 1 group was the most complex and only Peptophilus was significantly negatively correlated with Lactobacillus in SCC group. Conclusions: The increased diversity and changed correlations between vaginal floras are closely related to cervical lesions. Peptophilus is of great significance in the diagnosis, prediction and early warning of cervical carcinogenesis.
Female ; Humans ; Vagina/microbiology* ; Uterine Cervical Neoplasms/genetics* ; Uterine Cervical Dysplasia ; Cervix Uteri ; Lactobacillus/genetics* ; Papillomavirus Infections

OBJECTIVETo explore the relationship between the colonization of group B streptococci (GBS), mycoplasma,and Chlamydia trachomatis (CT) infections and spontaneous abortion due to early embryonic death.

METHODSTotally 74 patients (study group) who experienced the missed abortion during their first or second trimester and 62 women (control group) who underwent induced termination of normal pregnancy during the first or second trimester were enrolled in this study. The vaginal secretions, intrauterine aspirates, and amniotic fluids were collected for GBS culture. Cervical mycoplasma (UU+MH) and CT were detected at the same time.

RESULTSPositive results of GBS culture of vaginal secretions were detected in 9 patients (12.16%) in the study group, but in only 6 patients (9.68%) in control group (P=0.662). The intrauterine aspirate samples (as well as the amniotic fluid samples) of all cases were negative in GBS culture. The positive rates of UU and MH were 32.43% (24/74) and 16.22% (12/74) in the study group, but were only 10.35% (12/62) (P=0.0103) and 6.45 (4/62) (P=0.042) in the control group. The positive rate of CT was 8.11% (6/74) in the study group and 8.06 % (5/62) in the control group (P=0.905). The rate of concurrent infection of GBS and mycoplasma was 4.05% (3/74) in the study group and 6.45% (4/62) in the control group (P=0.743). The rate of concurrent infection of GBS and CT was 0 in the study group and 1.61% (1/62) in the control group (P=0.475). The rate of concurrent mycoplasma and CT infection was 2.70% (2/74) in the study group and 0 in the control group (P=0.325). Furthermore, no one was positive for poly infection of all these three pathogens.

CONCLUSIONSGBS may be positive in the genital tract of some pregnant women but is not related with early abortion. The mycoplasma infection may be one of the reasons leading to arrested intrauterine pregnancy.

Abortion, Spontaneous ; microbiology ; Adult ; Cervix Uteri ; microbiology ; Chlamydia trachomatis ; isolation & purification ; Female ; Humans ; Mycoplasma ; isolation & purification ; Pregnancy ; Streptococcus agalactiae ; isolation & purification ; Young Adult

OBJECTIVETo establish a methed of cleavage fragment length polymorphism (CFLP) analysis with a primer labeled at the 5'-end with digoxigenin for genotyping of Chlamydia trachomatis (Ct). The methods for detection of Ct by major outer membrane protein (MOMP) gene (ompl) with nested polymerase chain reaction (ompl-nPCR) were studied. The incidence of Ct infection in pregnant women, the common genotypes and vertical transmission rate of Ct in Chongqing area during the past one year was also investigated.

METHODSThe samples were taken from cervical scrapes of parturient women and nasopharygeal swabs of their neonates from April 2003 to Feb. 2004 in Chongqing Women and Children's Health Care Institute. Totally 300 pairs (605 specimens) were detected by using ompl-nPCR, ompl-PCR (inside pair of primers was used directly) and plasmid-PCR. The results were judged by the modified gold standard (MGS). The ompl-nPCR amplified DNA was purified by recovery of DNA from agarose gel electroelution into dialysis bags. The DNA amplified from ompl-nPCR was sequenced by ABI PRISM 377 DNA sequencer. CFLP assay with a primer labeled at the 5'-end with digoxigenin was created for genotyping of Ct, and was primarily applied.

RESULTSThe minimum detectable levels of ompl-nPCR and ompl-PCR corresponded to 2.5 elementary body (EB) and 25 EB, respectively. The sensitivity of ompl-nPCR was 10 times that of ompl-PCR. The positive rate of Ct in the samples from the pregnant women was 11% (33/300). The vertical transmission rate of Ct from mothers to their infants was 24.2% (8/33). The rate of Ct isolated from nasopharyngeal swabs 5 - 10 days after birth was 38.9% (7/18), which was significantly greater than that [3.0% (1/33)] detected within 24 hours after birth (chi(c)(2) = 8.79, P < 0.01). Of the 33 Ct-positive samples from pregnant women, 9 had vaginal delivery and 24 had caesarean section. The vertical transmission rates in vaginal delivery group and caesarean section group were 66.7% (6/9) and 8.3% (2/24), respectively (chi(c)(2) = 9.16, P < 0.01). Incidence of premature rupture of membrane in Ct-positive group was 30.3% (10/33), which was greater than that of Ct-negative groups (13.5%, 36/267, chi(2) = 6.40, P < 0.05). Four different patterns were observed in the 16 Ct-positive samples from 8 pregnant women and 8 matched maternal-infants by using CFLP, which were confirmed by DNA sequencing later. They were type E (3 pairs), type F (2 pairs), type H (2 pairs) and type D (1 pair). Each pair of matched maternal-infantile samples presented identical CFLP pattern.

CONCLUSIONSThis study revealed the infection rate of Ct in pregnant women, vertical transmission rate of Ct and the common genotypes of Ct in Chongqing Women and Children's Health Care Institute. The CFLP assay by using a primer labeled at the 5'-end with digoxigenin was first used for genotyping of Ct. The assay showed a good sensitivity and reproducibility, no radioactive contamination, and is simple. Therefore the assay is a potential new method for Ct genotyping.

Cervix Uteri ; microbiology ; Chlamydia Infections ; diagnosis ; Chlamydia trachomatis ; genetics ; DNA Primers ; Female ; Genes, Bacterial ; genetics ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Pregnancy ; Pregnancy Complications, Infectious ; diagnosis

OBJECTIVETo explore the significance of clue cells in the diagnosis of male urogenital infection.

METHODSUrethra swabs or prostatic fluid of 264 male outpatients were collected and smeared directly on the slice to find clue cells under the ultramicroscopy. Meanwhile, the positive patients' spouses were detected for bacterial vaginosis (BV).

RESULTSThe positive rates of the urethra swabs and the prostatic fluid were 5.1% (11/215 ) and 2.0% (1/49), respectively. Nine cases in 11 of the patients' spouses (81.8%) were diagnosed as BV.

CONCLUSIONBV pathogen can attack and attach to the epithelia of male genitals to form clue cells. Clue cells positive, along with clinical symptoms, contribute to the diagnosis of male urogenital bacterial infection.

Adult ; Bacterial Infections ; diagnosis ; microbiology ; pathology ; Cervix Uteri ; microbiology ; Epithelial Cells ; microbiology ; Female ; Gardnerella vaginalis ; isolation & purification ; Humans ; Male ; Middle Aged ; Mycoplasma hominis ; isolation & purification ; Prostate ; microbiology ; Sensitivity and Specificity ; Spouses ; Ureaplasma urealyticum ; isolation & purification ; Urethra ; microbiology ; Urinary Tract Infections ; diagnosis ; microbiology ; pathology ; Vagina ; microbiology

OBJECTIVETo test the antibiotic susceptibility and study mechanisms of macrolide resistance in group B streptococcus isolates (GBS).

METHODSThe GBS investigated in this study included 140 and 47 colonizing strains isolated from vaginal or cervical swabs from pregnant women in Beijing (from 1994 to 1999) and Guangzhou obstetrics and gynecology hospitals (from 1999) and 6 invasive strains isolated from infants in Beijing Children's Hospital. Susceptibility to ampicillin, penicillin G, erythromycin, lincomycin, cephazolin, cefuroxime, cefoperazone was assessed by K-B disc diffusion. The mechanisms, methylation or efflux, of macrolide resistant GBS isolates, were analyzed by PCR for ermB and mefA genes.

RESULTSSusceptibility testing revealed that none of the GBS isolates were resistant to beta-lactam drugs, but 17% isolates showed intermediate susceptibility to penicillin G and ampicillin. The rate of erythromycin resistance increased from 8% in 1998 to 16% in 1999 in Beijing, while the rate of lincomycin resistance increased from 20% to 28% in that period. However, 21 (45%) and 12 (26%) isolates were resistant to erythromycin and lincomycin, respectively in Guangzhou city where erythromycin resistance rate was higher than that in Beijing. Of 45 erythromycin resistant isolates, 20 (20/45, 44%) possessed the ermB gene and 13 (13/45, 29%) harbored the mefA gene; 6 isolates harbored both genes, 6 isolates had possessed neither ermB gene nor mefA gene.

CONCLUSIONThe susceptibility of GBS isolates to penicillin G and ampicillin suggests use of penicillin G or ampicillin as a first-line drug in prophylactic treatment regimes against early-onset neonatal GBS disease. Erythromycin and lincomycin should not be recommended as the second-line antimicrobial in Beijing and Guangzhou city. The clinical relevance of macrolide resistant GBS in women treated with macrolides for intrapartum prophylaxis needs to be assessed. Ribosomal modification by a methylase encoded by erm gene may play a major role in the mechanisms of macrolide resistance of GBS isolates in China.

Anti-Bacterial Agents ; pharmacology ; Cervix Uteri ; microbiology ; China ; Drug Resistance, Multiple, Bacterial ; genetics ; Female ; Humans ; Infant ; Macrolides ; pharmacology ; Microbial Sensitivity Tests ; Pregnancy ; Streptococcus agalactiae ; drug effects ; genetics ; Vagina ; microbiology

OBJECTIVEDiscussion of the relationship between Mycoplasma and chlamydia infection and lesions in the cervical tissue in high-risk HPV-positive infertile patients with cervical.

METHODSHPV-negative patients with cervical as the control, retrospective analysis the relationship of Mycoplasma hominis and chlamydia infection, cervical histological graded, and inflammation graded.

RESULTSThe rate of HPV infection in mycoplasma-positive and those with negative mycoplasma has significant difference (P < 0.01), The rate of HPV infection in chlamydia-positive and those with negative chlamydia has no significant difference (P > 0.05). CIN and the incidence of cervical erosion and CIN grade were higher in HPV-positive than HPV-negative group (P < 0.01). The cervical erosion of HPV-positive was no difference in the degree (P > 0.05). Compared with the simple HPV-positive group, CIN and the incidence of severe cervical erosion in mixed infection of Mycoplasma was no difference (P > 0.05).

CONCLUSIONMycoplasma infection increases the rate of high risk HPV infection, high-risk HPV infection increased cervical pathological damage, Mycoplasma infection might be the factor of persistent infection with high risk HPV, the degree of cervical pathological is the factor of cervical infertility which can not be ignored.

Adult ; Alphapapillomavirus ; genetics ; isolation & purification ; Cervix Uteri ; microbiology ; pathology ; virology ; Chlamydia ; isolation & purification ; Chlamydia Infections ; complications ; microbiology ; pathology ; virology ; Female ; Humans ; Infertility, Female ; etiology ; microbiology ; pathology ; virology ; Mycoplasma ; isolation & purification ; Mycoplasma Infections ; complications ; microbiology ; pathology ; virology ; Papillomavirus Infections ; complications ; microbiology ; pathology ; virology ; Retrospective Studies ; Risk Factors ; Young Adult

BACKGROUND: Fitz-Hugh-Curtis (FHC) syndrome is inflammation of the liver capsule associated with pelvic inflammatory disease. We measured Chlamydia trachomatis antibodies in 30 female patients with acute abdominal pain for diagnosis of FHC-syndrome, and the results were compared with other tests. METHODS: A dual-polymerase chain reaction was used for the detection of C. trachomatis in the cervix, and a micro-immunofluorescence test was performed to measure the antibody to C. trachomatis in serum. Cervical specimens were stained with Gram stain and cultured on chocolate agar for detection of Neisseria gonorrhoeae, and abdominal computed tomography (CT) and pelvic examinations were performed. RESULTS: Of the 30 patients examined, 19 were diagnosed as having FHC-syndromes and 11 abdominal pains without FHC-syndrome. C. trachomatis was detected from one of the five patients studied, and no N. gonorrhoeae was isolated from the patients with FHC-syndrome. High titers of IgG antibody (1:512-1:1,024) to C. trachomatis were demonstrated in all patients with FHC-syndrome. The CT scan revealed perihepatitis in 14 patients with FHC-syndrome. CONCLUSIONS: All patients with FHC-syndrome are associated with C. trachomatis infections, and a high titer of C. trachomatis antibody (IgG) is a very useful marker for FHC-syndrome.
Adolescent ; Adult ; Aged ; Antibodies, Bacterial/*analysis ; Cervix Uteri/chemistry ; Chlamydia Infections/*diagnosis/microbiology ; Chlamydia trachomatis/*immunology/isolation & purification ; Female ; Hepatitis/diagnosis ; Humans ; Immunoglobulin G/analysis ; Immunoglobulin M/analysis ; Middle Aged ; Pelvic Inflammatory Disease/complications/*diagnosis ; Syndrome ; Tomography Scanners, X-Ray Computed ; Young Adult

The aims of this study were to determine whether sonographically measured cervical length is of value in the identification of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes (PPROM) and to compare its performance with maternal blood C-reactive protein (CRP), white blood cell count (WBC), and amniotic fluid (AF) WBC. This prospective observational study enrolled 50 singleton pregnancies with PPROM. Transvaginal ultrasound for measurement of cervical length was performed and maternal blood was collected for the determination of CRP and WBC at the time of amniocentesis. AF obtained by amniocentesis was cultured and WBC determined. The prevalence of a positive amniotic fluid culture was 26% (13/50). Patients with positive amniotic fluid cultures had a significantly shorter median cervical length and higher median CRP, WBC, and AF WBC than did those with negative cultures. Multiple logistic regression indicated that only cervical length had a significant relationship with the log odds of a positive AF culture. Transvaginal sonographic measurement of cervical length is valuable in the identification of microbial invasion of amniotic cavity in women with PPROM. Cervical length performs better than AF WBC, maternal blood CRP, and WBC in the identification of a positive amniotic fluid culture.
Adult ; Amniocentesis/methods ; Amniotic Fluid/*microbiology ; Bacterial Infections/*complications ; C-Reactive Protein/metabolism ; Cervix Uteri/*ultrasonography ; Female ; Fetal Membranes, Premature Rupture/etiology/*ultrasonography ; Gestational Age ; Humans ; Leukocyte Count ; Logistic Models ; Maternal Age ; Pregnancy ; Pregnancy Complications, Infectious/blood/etiology/ultrasonography ; Prospective Studies ; Risk Factors ; Ultrasonography/methods