Background Bacterial vaginosis and genital mycoplasmas are reproductive tract infections that are associated with several infections and adverse pregnancy outcomes, such as pelvic inflammatory disease, preterm birth and spontaneous abortions in affected women. Bacterial vaginosis (BV), a polymicrobial condition, is reported to be prevalent in 15% to 20% of pregnant women while mycoplasmas colonise up to about 70% of sexually active women and antenatal patients.
Methods Self-collected vaginal swabs were obtained from 221 pregnant women. Bacteria vaginosis was diagnosed using the Nugent scoring system and a multiplex PCR assay was performed to detect genital mycoplasmas. Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum and U. parvum were targeted, respectively, for the 16S rRNA gene, 140-kDa adhesion protein and the multiple-banded antigen genes.
Results The prevalence of bacterial vaginosis was 17.6% (39/221) with a total of 23.1% (9/39) of all BV-positive cases (score 7 to 10) being HIV positive. An intermediate grading according to the Nugent system (score 4 to 6) was given to 14.9% (33/221) of samples. Ureaplasma parvum was isolated from the majority of samples with a prevalence of 72.4% (160/221) followed by M. hominis, which was present in 50.7% (112/221) of all samples. The prevalence of M. genitalium and U. urealyticum was 14.5% (32/221) and 2.3% (5/221), respectively. Mycoplasma hominis was detected in 75% (27/36) of all HIV positive cases with U. parvum also present in 75% (27/36) of these cases.
Conclusions The overall prevalence of genital mycoplasmas in antenatal patients was relatively high when compared to previous studies, while BV prevalence correlated with other reports. Ureaplasma parvum and M. hominis were notably present in HIV positive patients. The diagnosis of genital mycoplasmas and BV in pregnant women in HIV-prevalent South Africa is vital to allow early intervention and minimise complications, such as undesirable pregnancy outcomes.
- bacterial vaginosis
- genital mycoplasmas
- pregnant women
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