Abstract:
Background: Screening of curable sexually transmitted infections is frequently oriented
towards the diagnosis of chlamydia, gonorrhea, syphilis and trichomoniasis, whereas
other pathogens, sometimes associated with similar urogenital syndromes, remain
undiagnosed and/or untreated. Some of these pathogens are associated with adverse
pregnancy outcomes.
Methods: In a nested case-control study, vaginal swabs from 79 pregnant women, i.e., 28
T. vaginalis-positive (cases) and 51 T. vaginalis-negative (controls), were screened by
quantitative PCR for Adenovirus 1 and 2, Cytomegalovirus, Herpes Simplex Virus 1 and
2, Chlamydia trachomatis, Escherichia coli, Haemophilus ducreyi, Mycoplasma
genitalium, M. hominis, candidatus M. girerdii, Neisseria gonorrhoeae, Streptococcus
agalactiae, Treponema pallidum, Ureaplasma parvum, U. urealyticum, and Candida
albicans. Additionally, we determined whether women with pathogens highly associated
with T. vaginalis had distinct clinical signs and symptoms compared to women with T.
vaginalis mono-infection.
Results: M. hominis was independently associated with T. vaginalis (adjusted odds ratio
= 6.8, 95% CI: 2.3-19.8). Moreover, M. genitalium and Ca M. girerdii were exclusively
detected in women with T. vaginalis (P = 0.002 and P = 0.001), respectively. Four of the
six women co-infected with T. vaginalis and Ca M. girerdii complained of vaginal
itching, compared to only 4 out of the 22 women infected with T. vaginalis without Ca
M. girerdii (P = 0.020).
Conclusion: We confirm M. hominis as a correlate of T. vaginalis in our population, and
the exclusive association of both M. genitalium and Ca. M. girerdii with T. vaginalis.
Screening and treatment of these pathogens should be considered.