Open AccessA clinical study on the association of Trichomonas vaginalis and Mycoplasma hominis infections in women attending a sexually transmitted disease (STD) outpatient clinic
Author(s) -
Belkum Alex,
Schee Cindy,
Meijden Willem I,
Verbrugh Henri A,
Sluiters Hans J.F
Publication year - 2001
Publication title -
fems immunology & medical microbiology
Language(s) - English
Resource type - Journals
eISSN - 1574-695X
pISSN - 0928-8244
DOI - 10.1111/j.1574-695x.2001.tb00529.x
Subject(s) - trichomonas vaginalis , mycoplasma hominis , bacterial vaginosis , trichomoniasis , chlamydia trachomatis , vaginitis , outpatient clinic , chlamydia , vagina , mycoplasma genitalium , vaginal discharge , cervicitis , vaginal disease , sexually transmitted disease , medicine , trichomonas , gynecology , sex organ , biology , mycoplasma , immunology , microbiology and biotechnology , surgery , syphilis , genetics , human immunodeficiency virus (hiv)
Swabs from the posterior vaginal fornix were obtained from 804 consecutive female patients visiting a large Dutch sexually transmitted diseases (STD) outpatient clinic. A detailed clinical history was obtained and complaints concerning the lower genital tract, such as vaginal discharge or vulval and vaginal irritation, were recorded. Patients were examined and the presence of non‐physiological vaginal secretions was established by speculum examination. The swabs were monitored for bacterial vaginosis (BV) or Candida albicans infection. PCR diagnosis of Chlamydia trachomatis and Trichomonas vaginalis was performed as well. Four groups of patients ( n =14–21) with BV or single infections caused by one of these three pathogens and a control group with no pathogens were selected and Mycoplasma hominis PCR was performed additionally. At clinical presentation, controls and single‐infected patient groups were comparable with regard to complaints of the lower genital tract and sexual risk behavior defined as having prior STDs and/or admitted prostitution. Only in the T. vaginalis ‐positive group significantly more women reporting sexual risk behavior were found than in controls. In agreement with former in vitro observations, an in vivo association between the PCR‐detected presence of M. hominis and T. vaginalis was established. In 79% of all samples positive for T. vaginalis , M. hominis could be detected, as compared to only 6% in control samples ( P =0.0004 ). However, since single infections by either of the two pathogens were regularly observed, there does not seem to be an exclusive association between the species, as the bacterium is also more frequently found in cases of BV ( P =0.026 ). Co‐infection of M. hominis with C. albicans (11%) or C. trachomatis (0%) did not differ significantly from controls (6%). M. hominis did not associate with complaints of the lower genital tract. However, if all groups were combined there appears to be a very significant association between the presence of M. hominis and sexual risk behavior ( P =0.0004 ). M. hominis and sexual risk behavior were more closely associated than M. hominis and T. vaginalis . No indications were found for an enhanced pathogenicity by either of the symbionts.