Volume 15, Issue 6 (7-2017)                   IJRM 2017, 15(6): 357-366 | Back to browse issues page

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Nateghi Rostam M, Hossein Rashidi B, Habibi A, Nazari R, Dolati M. Genital infections and reproductive complications associated with Trichomonas vaginalis, Neisseria gonorrhoeae, and Streptococcus agalactiae in women of Qom, central Iran. IJRM. 2017; 15 (6) :357-366
URL: http://ijrm.ssu.ac.ir/article-1-829-en.html
1- Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran. , Rostami52@yahoo.com
2- Department of Obstetrics and Gynecology, Vali-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
3- Department of Microbiology, Science and Research Branch, Islamic Azad University, Arak, Iran
4- Department of Microbiology, Islamic Azad University, Qom Branch, Qom, Iran
5- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran
Abstract:   (2760 Views)
Background: Trichomonas vaginalis (T.vaginalis) and Neisseria gonorrhoeae (N.gonorrhoeae) are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran.
Objective: Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran.
Materials and Methods: Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler® real-time PCR (for N.gonorrhoeae) and ITS-PCR (for T.vaginalis).
Results: Of 420 volunteers, 277 (65.9%) had genital signs/symptoms, including 38.3% malodorous discharge, 37.9% dyspareunia, and 54.8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens (1.2%) in Thayer-Martin culture and 17 (4.1%) in real-time PCR were identified as N.gonorrhoeae. Fifty-four specimens (12.9%) in wet mount, 64 (15.2%) in Dorset’s culture, and 81 (19.3%) in ITS-PCR showed positive results for T.vaginalis. Five mixed infections of T.vaginalis+ N.gonorrhoeae were found. The risk of T.vaginalis infection was increased in women with low-birth-weight (p=0.00; OR=43.29), history of abortion (p=0.00; OR=91.84), and premature rupture of membranes (PROM) (p=0.00; OR=21.75). The probability of finding nuclear leukocytes (p=0.00; OR=43.34) in vaginal smear was higher in T.vaginalis infection.
Conclusion: The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women.
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1. World Health Organization. Sexually transmitted infections (STIs). Available at: http://www.who.int/ mediacentre/factsheets/fs110/en./
2. Da Ros CT, Schmitt Cda S. Global epidemiology of sexually transmitted diseases. Asian J Androl 2008; 10: 110-114. [DOI:10.1111/j.1745-7262.2008.00367.x]
3. World Health Organization. Global incidence and prevalence of selected curable sexually transmitted infections-2008. Available at: http://www.who.int/ reproductivehealth/publications/rtis/stisestimates/en/index.htlm.
4. Secor WE, Meites E, Starr MC, Workowski KA. Neglected parasitic infections in the United States: trichomoniasis. Am J Trop Med Hyg 2014; 90: 800-804. [DOI:10.4269/ajtmh.13-0723]
5. Silver BJ, Guy RJ, Kaldor JM, Jamil MS, Rumbold AR. Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis. Sex Transm Dis 2014; 41: 369-376. [DOI:10.1097/OLQ.0000000000000134]
6. Mielczarek E, Blaszkowska J. Trichomonas vaginalis: pathogenicity and potential role in human reproductive failure. Infection 2016; 44: 447-458. [DOI:10.1007/s15010-015-0860-0]
7. Cotch MF, Pastorek JG, Nugent RP, Hillier SL, Gibbs RS, Martin DH, et al. Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infections and Prematurity Study Group. Sex Transm Dis 1997; 24: 353-360. [DOI:10.1097/00007435-199707000-00008]
8. Lewis DA. Global resistance of Neisseria gonorrhoeae: when theory becomes reality. Curr Opin Infect Dis 2014; 27: 62-67. [DOI:10.1097/QCO.0000000000000025]
9. Stoll BJ, Schuchat A. Maternal carriage of group B streptococci in developing countries. Pediatr Infect Dis J 1998; 17: 499-503. [DOI:10.1097/00006454-199806000-00013]
10. Le Doare K, Heath PT. An overview of global GBS epidemiology. Vaccine 2013; 31 (Suppl.): D7-12. [DOI:10.1016/j.vaccine.2013.01.009]
11. Ahmadzia HK, Heine RP. Diagnosis and management of group B streptococcus in pregnancy. Obstet Gynecol Clin North Am 2014; 41: 629-647. [DOI:10.1016/j.ogc.2014.08.009]
12. Zaleznik DF, Rench MA, Hillier S, Krohn MA, Platt R, Lee ML, et al. Invasive disease due to group B Streptococcus in pregnant women and neonates from diverse population groups. Clin Infect Dis 2000; 30: 276-281. [DOI:10.1086/313665]
13. Nourollahpour Shiadeh M, Niyyati M, Fallahi S, Rostami A. Human parasitic protozoan infection to infertility: a systematic review. Parasitol Res 2016; 115: 469-477. [DOI:10.1007/s00436-015-4827-y]
14. Smith L, Angarone MP. Sexually Transmitted Infections. Urol Clin North Am 2015; 42: 507-518. [DOI:10.1016/j.ucl.2015.06.004]
15. Whiley DM, Buda PP, Freeman K, Pattle NI, Bates J, Sloots TP. A real-time PCR assay for the detection of Neisseria gonorrhoeae in genital and extragenital specimens. Diagn Microbiol Infect Dis 2005; 52: 1-5. [DOI:10.1016/j.diagmicrobio.2004.12.011]
16. Arbabi M, Fakhrieh Z, Delavari M, Abdoli A. Prevalence of Trichomonasvaginalis infection in Kashan city, Iran (2012-2013). Iran J Reprod Med 2014; 12: 507-512.
17. Matini M, Rezaie S, Mohebali M, Maghsood A, Rabiee S, Fallah M, et al. Prevalence of Trichomonas vaginalis infection in Hamadan City, Western Iran. Iran J Parasitol 2012; 7: 67-72.
18. Matini M, Rezaie S, Mohebali M, Maghsood AH, Rabiee S, Fallah M, et al. Genetic identification of Trichomonas vaginalis by using the actin gene and molecular based methods. Iran J Parasitol 2014; 9: 329-335.
19. Nasirian M, Baneshi MR, Kamali K, Haghdoost AA. Estimation of prevalence and incidence of sexually transmitted infections in Iran; A model-based approach. J Res Health Sci 2015; 15: 168-174.
20. Hezarjaribi HZ, Fakhar M, Shokri A, Teshnizi SH, Sadough A, Taghavi M. Trichomonas vaginalis infection among Iranian general population of women: a systematic review and meta-analysis. Parasitol Res 2015; 114: 1291-300. [DOI:10.1007/s00436-015-4393-3]
21. Maraghi S, Khosravi A, Kardouni T, Razi T, Hadad M. Evaluation of an Immunochromatographic Strip (Xenostrip-Tv) test for diagnosis of vaginal trichomoniasis compared with wet mount and PCR assay. Iran J Parasitol 2008; 3: 11-17.
22. Patil MJ, Nagamoti JM, Metgud SC. Diagnosis of Trichomonas vaginalis from vaginal specimens by wet mount microscopy, In Pouch TV culture system, and PCR. J Glob Infect Dis 2012; 4: 22-25. [DOI:10.4103/0974-777X.93756]
23. Valadkhani Z, Kazemi F, Assmar M, Amirkhani A, Esfandeari B, Lotfi M, et al. Molecular diagnosis of trichomoniasis in negative samples examined by direct smear and culture. Iran J Parasitol 2010; 5: 31-36.
24. Manshoori A, Mirzaei S, Valadkhani Z, Kazemi Arababadi M, Rezaeian M, et al. A diagnostic and symptomatological study on trichomoniasis in symptomatic pregnant women in Rafsanjan, south centralIran in 2012-13. Iran J Parasitol 2015; 10: 490-497.
25. Gaydos C, Hardick J. Point of care diagnostics for sexually transmitted infections: perspectives and advances. Expert Rev Anti Infect Ther 2014; 12: 657-672. [DOI:10.1586/14787210.2014.880651]
26. Nakubulwa S, Kaye DK, Bwanga F, Tumwesigye NM, Mirembe FM. Genital infections and risk of premature rupture of membranes in Mulago Hospital, Uganda: a case control study. BMC Res Notes 2015; 8: 573. [DOI:10.1186/s13104-015-1545-6]
27. Afrasiabi S, Moniri R, Samimi M, Mousavi SG. The frequency of Neisseria gonorrhoeaeendocervical infection among female carrier and changing trends of antimicrobial susceptibility patterns in Kashan, Iran. Iran J Microbiol 2014; 6: 194-197.
28. Hossein Rashidi B, Chamani Tabriz L, Haghollahi F, Jeddi-Tehrani M, Ramezanzadeh F, Rahimi Foroushani A, et al. Prevalence of Neisseriagonorrhea in fertile and infertile women in Tehran. J Reprod Infertil 2009; 9: 379-383.
29. Cook RL, Hutchison SL, Østergaard L, Braithwaite RS, Ness RB. Systematic review: noninvasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Ann Intern Med 2005; 142: 914-925. [DOI:10.7326/0003-4819-142-11-200506070-00010]
30. de Cortina SH, Bristow CC, Davey DJ, Klausner JD. A systematic review of point of care testing for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Infect Dis Obst Gynecol 2016; 2016: 4386127.
31. Chigbu L, Aluka C, Eke R. Trichomoniasis as an indicator for existing sexually transmitted infections in women in Aba, Nigeria. Ann Afr Med 2006; 5: 1-5.
32. Namavar Jahromi B, Poorarian S, Poorbarfehee S. The prevalence and adverse effects of group B streptococcal colonization during pregnancy. Arch Iran Med 2008; 11: 654-657.
33. Fatemi F, Chamani-Tabriz L, Pakzad P, Zeraati H, Rabbani H, Asgari S. Colonization rate of group B Streptococcus (GBS) in pregnant women using GBS agar medium. Acta Med Iran 2009; 47: 25-30.
34. Tajbakhsh S, Norouzi Esfahani M, Emaneini M, Motamed N, Rahmani E, Gharibi S. Identification of Streptococcus agalactiae by fluorescent in situ hybridization compared to culturing and the determination of prevalence of Streptococcus agalactiaecolonization among pregnant women in Bushehr, Iran. BMC Infect Dis 2013; 13: 420. [DOI:10.1186/1471-2334-13-420]
35. Arisoy AS, Altinisik B, Tunger O, Kurutepe S, Ispahi C. Maternal carriage and antimicrobial resistance profile of group B Streptococcus. Infection 2003; 31: 244-246.
36. Al-Sweih N, Maiyegun S, Diejomaoh M, Rotimi V, Khodakhast F, Hassan N, et al. Streptococcus agalactiae (Group B Streptococci) carriage in late pregnancy in Kuwait. Med Princ Pract 2004; 13: 10-14. [DOI:10.1159/000074044]
37. Khan SA, Amir F, Altaf S, Tanveer R. Evaluation of common organisms causing vaginal discharge. J Ayub Med Coll Abbottabad 2009; 21: 90-93.
38. Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010; 59: 1-36.
39. Absalan M, Eslami G, Zandi H, Mosaddegh A, Vakili M, Khalili M. Prevalence of recto-vaginal colonization of Group B Streptococcus in pregnant women. J Isfahan Med Sch 2013; 30: 2367-2375.
40. Habibzadeh S, Arzanlou M, Jannati E, Asmar M, Azari M, Fardiazar Z. Maternal carriage of Group B Streptococcus in Ardabil, prevalence and antimicrobial resistance. J Ardabil Univ Med Sci 2011; 10: 14-20.
41. Nazari N, Zangeneh M, Moradi F, Bozorgomid A. Prevalence of Trichomoniasis among women in Kermanshah, Iran. Iran Red Crescent Med J 2015; 17: e23617. [DOI:10.5812/ircmj.23617]
42. Rabiee S, Fallah M, Zahabi F. Frequency of trichomoniasis in patients admitted to outpatient clinics in Hamadan (2007) and relationship between clinical diagnosis and laboratory findings. J Res Health Sci 2010; 10: 31-35.
43. Azargoon A, Darvishzadeh S. Association of bacterial vaginosis, Trichomonas vaginalis, and vaginal acidity with outcome of pregnancy. Arch Iran Med 2006; 9: 213-217.
44. Al-Saeed WM. Detection of Trichomonas vaginalis by different methods in women from Dohok province, Iraq. East Mediterr Health J 2011; 17: 706-709.
45. Mahdi NK, Gany ZH, Sharief M. Risk factors for vaginal trichomoniasis among women in Basra, Iraq. East Mediterr Health J 2001; 7: 918-924.
46. Değerli S, Şalk S, Malatyalı E. [Incidence in Sivas of Trichomonas vaginalis in patients with vaginitis]. Turkiye Parazitol Derg 2011; 35: 145-147. (In Turkish) [DOI:10.5152/tpd.2011.36]
47. Culha G, Hakverdi AU, Zeteroğlu S, Duran N. [Investigation of the prevalence of Trichomonas vaginalis in women with complaints of vaginal discharge and itching]. Turkiye Parazitol Derg 2006; 30: 16-18. (In Turkish)
48. Khan MS, Unemo M, Zaman S, Lundborg CS. HIV, STI prevalence and risk behaviours among women selling sex in Lahore, Pakistan. BMC Infect Dis 2011; 11: 119. [DOI:10.1186/1471-2334-11-119]
49. Alzanbagi NA, Salem HS, Al Braiken F. Trichomoniasis among women with vaginal discharge in Jeddah city, Saudi Arabia. J Egypt Soc Parasitol 2005; 35: 1071-1080.
50. Al-Zanbagi NA, Al-Jehani EF. Recent diagnostic study for the flagellate protozoan Trichomonas vaginalis. J Egypt Soc Parasitol 2007; 37: 361-370.

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