This study primarily aimed to investigate the prevalence of human papillomavirus (HPV) and other common pathogens of sexually transmitted infections (STIs) in spermatozoa of infertile men and their effects on semen parameters. These pathogens included Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae, Pseudomonas aeruginosa , and Staphylococcus aureus . A total of 1951 men of infertile couples were recruited between 23 March 2023, and 17 May 2023, at the Department of Reproductive Medicine of The First People's Hospital of Yunnan Province (Kunming, China). Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping. Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs. The overall prevalence of HPV infection was 12.4%. The top five prevalent HPV subtypes were types 56, 52, 43, 16, and 53 among those tested positive for HPV. Other common infections with high prevalence rates were Ureaplasma urealyticum (28.3%), Ureaplasma parvum (20.4%), and Enterococcus faecalis (9.5%). The prevalence rates of HPV coinfection with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae , and Staphylococcus aureus were 24.8%, 25.4%, 10.6%, 6.4%, 2.4%, 7.9%, 5.9%, 0.9%, and 1.3%, respectively. The semen volume and total sperm count were greatly decreased by HPV infection alone. Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability. Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters, emphasizing the necessity of semen screening for STIs.
Humans ; Male ; Infertility, Male/epidemiology* ; Coinfection/microbiology* ; Papillomavirus Infections/virology* ; Adult ; Sexually Transmitted Diseases/complications* ; China/epidemiology* ; Staphylococcus aureus/isolation & purification* ; Chlamydia trachomatis/isolation & purification* ; Prevalence ; Mycoplasma genitalium/isolation & purification* ; Ureaplasma urealyticum/isolation & purification* ; Neisseria gonorrhoeae/isolation & purification* ; Enterococcus faecalis/isolation & purification* ; Streptococcus agalactiae/isolation & purification* ; Herpesvirus 2, Human/genetics* ; Pseudomonas aeruginosa/isolation & purification* ; Semen/virology* ; Sperm Motility ; Spermatozoa/microbiology* ; Human Papillomavirus Viruses

Aims: Maternal vaginal Group B Streptococcus (GBS) colonization is considered a risk factor for preterm delivery and, consequently, neonatal infections. Previous studies have portrayed the important roles of these virulence factors, including hemolytic pigment, hyaluronidase (HylB), serine-rich protein (Srr) and bacterial surface adhesion of GBS (BsaB) in mediating GBS colonization and intrauterine ascending infection, causing preterm delivery. This study aimed to investigate the association between mRNA expression of virulence genes in GBS isolates obtained from symptomatic pregnant women and preterm delivery. Methodology and results: GBS isolates were obtained from high vaginal swabs of 40 symptomatic pregnant women of gestational age of less than 37 weeks. RNA was extracted from these GBS isolates and RT-qPCR was performed to determine the relative mRNA expression of GBS virulence genes, including CylE (encode enzyme required for the biosynthesis of the hemolytic pigment), HylB, Srr-1 and BsaB. Socio-demographic details and obstetric history were not found to be associated with the delivery outcomes of these women. The GBS isolates from symptomatic pregnant women who delivered prematurely showed a higher expression of CylE gene and a trend towards an elevated expression of HylB gene compared to women with term delivery. Meanwhile the expression of both Srr-1 and BsaB genes was similar between symptomatic pregnant women who had term or preterm delivery. Conclusion, significance and impact of study The results suggest that following vaginal colonization, both CylE and HylB genes are likely to contribute to intrauterine ascending infection and inflammation, leading to preterm delivery in humans. These virulence factors may be targeted for the pre-clinical stages of vaccine development or therapeutic intervention.
Streptococcus agalactiae--isolation & ; purification ; Pregnant Women

Group B streptococcus (GBS) is one of the severe pathogenic bacteria during the perinatal period, both on pregnant women and newborns. GBS infection may lead to pneumonia, septicemia, meningitis or other severe disease, even death in neonates. Although only 1%-2% infections will develop into GBS disease among the neonates, the etiological mechanism of which is worth researching. This review summarizes the possible factors related to GBS infection or occurrence of the disease, including the risk in gestation period (for example, colonization of GBS on vagina of pregnant women, preterm birth or premature rupture of fetal membranes and so on), related pathogens (bacteria strains, loads or virulence), immune level (inflammatory factor or neutralizing anticytokine auto-Abs), gene defect or primary immunodeficiencies of the hosts.
Female ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious/urine* ; Premature Birth ; Streptococcal Infections/urine* ; Streptococcus agalactiae/isolation & purification* ; Vagina/microbiology*

OBJECTIVETo study neonatal Streptococcus agalactiae (GBS) infection in The Children's Hospital of Gansu Province through Polymerase Chain Reaction(PCR) Array.

METHODAfter obtaining the informed consent from parents or guardians, blood samples of 286 neonates were collected and studied in The Children's Hospital of Gansu Province from June 2011 to January 2012. DNA of the selected samples was extracted through the method of 5% Chelex-100 + 0.5% NP40 solution. Twenty-five genes were ultimately selected and then 25 pairs of primers were designed respectively through primer-BLAST tool of NCBI database.For every primer, PCR conditions were optimized through the identified GBS, and 25 pairs of primers were arrayed as to be used to study neonatal GBS infection.

RESULTThe results of PCR Array showed that the 14 samples were detected positive, accounting for 4.90% of all the selected specimens. As for neonatal GBS infection, the positive rate was 4.55% within 7 days after birth and 5.19% in those older than 7 days. The positive rate of 53 preterm infants was 5.66%. The follow-up survey showed that none of the cases died.

CONCLUSIONIn the Children's Hospital of Gansu Province neonatal GBS infection rate was 4.90%, which is similar to the previous domestic reports, but is lower than the reports from Europe and the United States.Studies have shown that the gene expression related to immune evasion has a higher frequency. The present study suggests that the strategy of GBS immune adaptation may play an important role in neonatal GBS infection.

Bacterial Proteins ; genetics ; China ; epidemiology ; DNA Primers ; DNA, Bacterial ; genetics ; Female ; Gene Amplification ; Hospitals, Pediatric ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; epidemiology ; microbiology ; Male ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Streptococcal Infections ; diagnosis ; epidemiology ; microbiology ; Streptococcus agalactiae ; genetics ; isolation & purification

BACKGROUND: Group B streptococcus (GBS) infection is a leading cause of neonatal morbidity and mortality worldwide. Here, we present the analytical and diagnostic usefulness of a new real-time PCR-based assay (Xpert GBS; Cepheid, USA) for rapid and accurate prenatal GBS screening. METHODS: We enrolled 175 pregnant women who were between 35 and 39 weeks of gestation. The analytical performance of the Xpert GBS assay was first tested using a reference GBS strain. Next, to test diagnostic performance, rectovaginal swabs were obtained from pregnant women who visited the hospital for regular antenatal screening after 34 weeks of gestation. The results of the Xpert GBS assay were compared to those of standard culture for the detection of prenatal GBS colonization. RESULTS: When any positive result from Xpert GBS or culture was considered a true positive, the sensitivity of the Xpert GBS assay and culture were 91% (20/22; 95% CI [confidence interval], 72-98) and 68% (15/22; 95% CI, 47-84), respectively. The specificity of both methods was 100% (153/153; 95% CI, 97-100). The sensitivity and specificity of the Xpert GBS assay, using the culture results as a reference, were 86.7% and 95.6%, respectively. In the Xpert GBS assay, the median threshold cycle of vaginally colonized samples was significantly lower than rectally colonized samples (P<0.01). CONCLUSIONS: The Xpert GBS assay is an accurate, rapid, easy-to-use test for the detection of maternal GBS colonization in prenatal screening that might be especially useful in clinical settings where standard culture is not feasible.
DNA, Bacterial/*analysis ; Female ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Complications, Infectious/*diagnosis/microbiology ; Prenatal Diagnosis ; Reagent Kits, Diagnostic ; Real-Time Polymerase Chain Reaction ; Rectum/microbiology ; Sensitivity and Specificity ; Streptococcal Infections/*diagnosis/microbiology ; Streptococcus agalactiae/*genetics/isolation & purification ; Vagina/microbiology

OBJECTIVETo realize the difference between China and France in the clinical manifestations, diagnosis and treatment of early-onset neonatal sepsis (EONS) and to provide basis to improve the level of our hospital in diagnosing and treating this disease.

METHODData of 146 cases of EONS were retrospectively analyzed. All data were collected from our hospital and a French hospital. Bacterial spectrum, clinical manifestations, use of antibacterial drugs, occurrence of recording and screening of perinatal risk factors were compared between the two hospitals.

RESULTThe most common pathogenic bacteria in our hospital were coagulase-negative staphylococcus (69.2%) and Escherichia coli (15.4%) while in the French Hospital, group B streptococcus (33.3%) and Escherichia coli (33.3%). The most common pathogenic bacteria in gastric liquid and peripheral swabs of the French hospital were Escherichia coli (33.3%) and group B streptococcus (21.2%). Total days of antibacterial use 11.4 ± 7.2 (d), mean sorts of antibacterial drugs for single patient (3.1 ± 0.9) and proportion of patients who had antibacterial drug changes (70.2%) were greater than the French hospital 6.2 ± 2.5 (d), 2.2 ± 0.8(d), (9.9%). Both hospitals were inclined to combine 2 antibacterial drugs for the first dose (second-generation cephalosporins + semi-synthetic penicillin in our hospital vs. amoxicillin + amikacin in the French hospital). The common second and third line antibacterial drugs in our hospital are carbapenems and vancomycin vs. third-generation cephalosporins and vancomycin in the French hospital. The rates of occurrence of recording and screening perinatal risk factors (chorioamnionitis, maternal fever, prolonged rupture of membranes, screening results of vaginal swabs or urinary infection, amniotic fluid contamination, prenatal antibacterial prophylaxis, anamnesis of EONS) in our hospital was all lower than those of the French hospital. There was no significant difference in positive rate of perinatal risk factors between the two hospitals. For newborns hospitalized for immediate abnormalities after birth, the most common symptom was respiratory distress (96.5% vs. 88.2%). For those admitted after a period of time after birth, the proportion of abnormalities was different: in our hospital, the most common reasons were respiratory distress (44.4%) and lethargy (22.2%) while in the French hospital there were rise of C reactive proteins (78.2%) and fever (5.5%). The false negative rate of C reactive proteins in diagnosing EONS was not significantly different between the two hospitals.

CONCLUSIONThere was significant difference in diagnosing and treating EONS in the two hospitals. Emphasis on screening and recording perinatal risk factors, as well as strengthened surveillance on neonates in obstetric department could improve the accuracy of early diagnosis of EONS of our hospital. Positive attitude to gastric liquid and peripheral swabs culture, with drug susceptibility test may help pediatricians better select antibacterial drugs and reduce unnecessary changes and the total time of antibiotic use.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; C-Reactive Protein ; analysis ; China ; Drug Resistance, Microbial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; France ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; drug therapy ; microbiology ; Male ; Microbial Sensitivity Tests ; Neonatal Screening ; methods ; Pregnancy ; Pregnancy Complications ; diagnosis ; Prenatal Diagnosis ; methods ; Retrospective Studies ; Risk Factors ; Sepsis ; diagnosis ; drug therapy ; microbiology ; Staphylococcus ; drug effects ; isolation & purification ; Streptococcus agalactiae ; drug effects ; isolation & purification

BACKGROUND: To investigate the risk factors for vaginal infections and antimicrobial susceptibilities of vaginal microorganisms among women who experienced preterm birth (PTB), we compared the prevalence of vaginal microorganisms between women who experienced preterm labor (PTL) without preterm delivery and spontaneous PTB. METHODS: Vaginal swab specimens from 126 pregnant women who experienced PTL were tested for group B streptococcus (GBS), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex virus (HSV) I and II, and bacterial vaginosis. A control group of 91 pregnant women was tested for GBS. Antimicrobial susceptibility tests were performed for GBS, M. hominis, and U. urealyticum. RESULTS: The overall detection rates for each microorganism were: U. urealyticum, 62.7%; M. hominis, 12.7%; GBS, 7.9%; C. trachomatis, 2.4%; and HSV type II, 0.8%. The colonization rate of GBS in control group was 17.6%. The prevalence of GBS, M. hominis, and U. urealyticum in PTL without preterm delivery and spontaneous PTB were 3.8% and 8.7% (relative risk [RR], 2.26), 3.8% and 17.3% (RR, 4.52), and 53.8% and 60.9% (RR, 1.13), respectively, showing no significant difference between the 2 groups. The detection rate of M. hominis by PCR was higher than that by culture method (11.1% vs. 4.0%, P=0.010). The detection rates of U. urealyticum by PCR and culture method were 16.7% and 57.1%, respectively. CONCLUSIONS: There was no significant difference in the prevalence of GBS, M. hominis, and U. urealyticum between the spontaneous PTB and PTL without preterm delivery groups.
Female ; Humans ; Microbial Sensitivity Tests ; Mycoplasma Infections/complications/microbiology ; Mycoplasma hominis/isolation & purification ; Obstetric Labor, Premature/*epidemiology/etiology ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology/microbiology ; Premature Birth/*epidemiology/etiology ; Prevalence ; Risk Factors ; Streptococcal Infections/complications/microbiology ; Streptococcus agalactiae/isolation & purification ; Ureaplasma Infections/complications/microbiology ; Ureaplasma urealyticum/isolation & purification ; Vagina/*microbiology

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

PURPOSE: Erythromycin-resistant beta-hemolytic streptococci (BHS) has recently emerged and quickly spread between and within countries throughout the world. In this study, we evaluate the antimicrobial susceptibility patterns and erythromycin resistance mechanisms of BHS during 2003-2004. MATERIALS AND METHODS: The MICs of seven antimicrobials were determined for 204 clinical isolates of BHS from 2003 to 2004. Resistance mechanisms of erythromycin-resistant BHS were studied by the double disk test as well as by polymerase chain reaction (PCR). RESULTS: Compared with our previous study, resistance among Streptococcus pyogenes isolates to a variety of drugs decreased strikingly: from 25.7% to 4.8% in erythromycin; 15.8% to 0% in clindamycin; and 47.1% to 19.0% in tetracycline. The prevalent phenotypes and genotypes of macrolide-lincosamide-streptograminB (MLSB) resistance in Streptococcus pyogenes isolates have been changed from the constitutive MLSB phenotype carrying erm(B) to the M phenotype with mef(A) gene. In contrast with Streptococcus pyogenes, resistance rates to erythromycin (36.7%), clindamycin (43.1%), and tetracycline (95.4%) in Streptococcus agalactiae isolates did not show decreasing trends. Among the Streptococcus dysgalactiae subsp. equisimilis isolates (Lancefield group C, G), resistance rates to erythromycin, clindamycin, tetracycline and chloramphenicol were observed to be 9.4%, 3.1%, 68.8%, and 9.4%, respectively. CONCLUSION: Continual monitoring of antimicrobial resistance among large-colony-forming BHS is needed to provide the medical community with current data regarding the resistance mechanisms that are most common to their local or regional environments.
Anti-Bacterial Agents/*pharmacology ; Drug Resistance, Multiple, Bacterial ; Erythromycin/*pharmacology ; Genes, Bacterial ; Genotype ; Hospitals ; Humans ; Incidence ; Korea ; Microbial Sensitivity Tests ; Streptococcus/*drug effects/genetics/isolation & purification ; Streptococcus agalactiae/drug effects/genetics/isolation & purification ; Streptococcus pyogenes/drug effects/genetics/isolation & purification

During a four-week period, four healthy term newborn infants born at a regional maternity hospital in Korea developed late-onset neonatal group B Streptococcus (GBS) infections, after being discharged from the same nursery. More than 10 days after their discharge, all of the infants developed fever, lethargy, and poor feeding behavior, and were subsequently admitted to the Korea University Medical Center, Ansan Hospital. GBS was isolated from the blood cultures of three babies; furthermore, GBS was isolated from 2 cerebral spinal fluid cultures. Three babies had meningitis, and GBS was isolated from their cerebral spinal fluid cultures. This outbreak was believed to reflect delayed infection after early colonization, originating from nosocomial sources within the hospital environment. This report underlines the necessity for Korean obstetricians and pediatricians to be aware of the risk of nosocomial transmissions of GBS infection in the delivery room and/or the nursery.
Time Factors ; *Streptococcus agalactiae/isolation & purification ; Streptococcal Infections/*epidemiology/microbiology/transmission ; Pregnancy ; Meningitis, Bacterial/epidemiology/microbiology/transmission ; Male ; Korea/epidemiology ; Infant, Newborn ; Humans ; Hospitals, Maternity ; Female ; *Disease Outbreaks ; Cross Infection/*epidemiology/microbiology/transmission