DETECTION OF CAUSATIVE AGENTS OF SEXUALLY TRANSMITTED DISEASES IN SYMPTOMATIC INFERTILE WOMEN USING REAL TIME PCR TECHNIQUE
Keywords:
Causative agents, sexually transmitted diseases, Infertile women and PCR
Abstract
Sexually transmitted infections or venereal diseases constitute a major health problem especially in developing countries, including Iraq with complications like pelvic inflammatory disease, ectopic pregnancy, cervical cancer, infertility, and congenital infections. The main goal of current study is to detect the common bacterial causes of sexually transmitted infections among symptomatic infertile women using real time PCR technique. A cross-sectional study was conducted from February 2022 to February 2023. A total of 100 vaginal swabs were collected from symptomatic infertile women with ages ranging from 20 to 49 years (mean 23.97 years ±6.90 SD) who attended the private health centers in Duhok, Kurdistan Region, Iraq. The vaginal swabs were collected from each patient and processed by real time PCR to detect C. trachomatis, T. vaginalis, N. gonorrhoeae, M. genitalium, M. hominis, U. urealyticum and U. parvum. Out of 100 symptomatic infertile women, 68 were positive for one or more of the causative agents. The highest rate of infection was caused by U. parvum (50%), followed by M. homonis (21.0%), U. urealyticum (16.0%) and the lowest percentage was 1.00% for C. trachomatis, while all samples were negative for N. gonorrhoeae, T. vaginalis and M. genitalium. No significant association was found between C. trachomatis, M. hominis, U. urealyticum and U. parvum with age groups, duration of infertility and levels of education of studied symptomatic infertile women except C. trachomatis which showed significant association (p=0.001) with duration of infertility from 11-16 years. Prevalence of M. hominis, U. urealyticum and U. parvum in the birth canal of infertile women demands more studies because several studies in the world highlighted on the presence of association between these colonized bacteria and infertility due to the tubal damage or blockage
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References
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Adachi, K., Nielsen-Saines, K., & Klausner, J. D. (2016). Chlamydia trachomatis infection in pregnancy: the global challenge of preventing adverse pregnancy and infant outcomes in Sub-Saharan Africa and Asia. BioMed research international, 2016.
Al Saeed, W. M. (2011). Detection of Trichomonas vaginalis by different methods in women from Dohok province, Iraq. EMHJ-Eastern Mediterranean Health Journal, 17 (9), 706-709, 2011.
Alagouri, S. M. H., & Mohammad, M. (2013). Prevalence and Risk Factors of Bactieral Vaginosis, Trichomoniasis, Candidiasis and Chlamydial infections for women of child bearing age in Benghazi Libya (Doctoral dissertation, University of Benghazi).
Al-Fatlawy, Eman & Jabbar, Abdul & Al-Shammari, Abdul. (2019). Correlation between genital mycoplasma and infertility among Iraqi men and women: conventional and PCR methods. International Journal of Decision Sciences & Information Technology, USA. 14. 11-17.
Al-Kaisi, A. A. R., Al-Janabi, B., & Al-Tikriti, R. (2006). A Study on the Common Microorganisms Causing Vaginitis. Iraqi Academic Scientific Journal, 5(4), 426-430.
Al-khafaji, G. (2017). Molecular Study for Diagnosis of Ureaplasma parvum in Women with Recurrent Miscarriage. In Obstetrics. IntechOpen.
Choe, H. S., Lee, D. S., Lee, S. J., Hong, S. H., Park, D. C., Lee, M. K., ... & Cho, Y. H. (2013). Performance of Anyplex™ II multiplex real-time PCR for the diagnosis of seven sexually transmitted infections: comparison with currently available methods. International Journal of Infectious Diseases, 17(12), e1134-e1140.
Cole, M. J., Quinten, C., Jacobsson, S., Day, M., Amato-Gauci, A. J., Woodford, N., ... & Unemo, M. (2019). The European gonococcal antimicrobial surveillance programme (Euro-GASP) appropriately reflects the antimicrobial resistance situation for Neisseria gonorrhoeae in the European Union/European Economic Area. BMC infectious diseases, 19(1), 1-12.
De Francesco, M. A., Negrini, R., Pinsi, G., Peroni, L., & Manca, N. (2009). Detection of Ureaplasma biovars and polymerase chain reaction-based subtyping of Ureaplasma parvum in women with or without symptoms of genital infections. European journal of clinical microbiology & infectious diseases, 28(6), 641-646.
Dhawan, B., Rawre, J., Ghosh, A., Malhotra, N., Ahmed, M. M., Sreenivas, V., & Chaudhry, R. (2014). Diagnostic efficacy of a real time-PCR assay for Chlamydia trachomatis infection in infertile women in north India. The Indian journal of medical research, 140(2), 252.
Edberg, A. (2010). PCR detection and prevalence of Mycoplasma genitalium (Doctoral dissertation, Karlstad University).
Fattah, C. O., & Kadir, M. A. (2010). Trichomonas vaginalis among women in Sulaimania governorate-Iraq. Tikrit Journal of Pharmaceutical Sciences, 6(1), 1-9.
Fenkci, V., Yilmazer, M., & Aktepe, O. C. (2002). Have Ureaplasma urealyticum and Mycoplasma hominis infections any significant effect on female fertility. Infezioni in Medicina, 10(4), 220-223.
Grześko, J., Elias, M., Mączyńska, B., Kasprzykowska, U., Tłaczała, M., & Goluda, M. (2009). Occurrence of Mycoplasma genitalium in fertile and infertile women. Fertility and sterility, 91(6), 2376-2380.
Haydar, S. O., & Naqid, I. (2022). A Study of Bacterial Vaginosis and Associated Risk Factors among Married Women in Zakho City, Kurdistan Region, Iraq. Journal of Life and Bio Sciences Research, 3(02), 33-39.
Hasani, S., Aung, E., & Mirghafourvand, M. (2021). Low self-esteem is related to depression and anxiety during recovery from an ectopic pregnancy. BMC Women's Health, 21(1), 1-8.
Hu, H., Zhou, Y., Shi, L., Lu, J., Zhang, Z., Xu, X., ... & Fu, G. (2021). High prevalence of Chlamydia trachomatis infection among women attending STD and gynecology clinics in Jiangsu province, China: A cross-sectional survey. Medicine, 100(46).
Javadinia, S., Movahedi, Z., Shokrollahi, M. R., Naghdalipour, M., Tabatabaee, A., Asgarian, R., & Jamei, M. (2017). Prevalence of Mycoplasma genitalium and Ureaplasma urealyticum in pregnant women of Tehran by duplex PCR. Curr Pediatr Res, 21(4), 680-685.
Johnson, R. E., Newhall, W. J., Papp, J. R., Knapp, J. S., Black, C. M., Gift, T. L., ... & Berman, S. M. (2002). Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections—2002. MMWR Recomm Rep, 51(RR-15), 1-38.
Kadir, M., Sulyman, M., Dawood, I., & Shams-Eldin, S. (2014). Trichomonas vaginalis and associated microorganisms in women with vaginal discharge in Kerkuk-Iraq. Ankara Medical Journal, 14(3), 91-99.
Karim, S., Bouchikhi, C., Banani, A., Fatemi, H. E., Souho, T., Erraghay, S., & Bennani, B. (2020). Detection of Ureaplasma Biovars and Subtyping of Ureaplasma parvum among Women Referring to a University Hospital in Morocco. Infectious Diseases in Obstetrics and Gynecology, 2020.
Kim Y, Kim J, Lee KA (2015). Analytical performance of multiplex real-time PCR for six sexually transmitted pathogens. Europe PMC Clinical Laboratory; 61(11): 1749-54.
Kimberly AW, Gail AB; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64 (RR-03): 1-137.
Koval, H. D., Chopyak, V. V., Kamyshnyi, O. M., & Kurpisz, M. K. (2018). Transcription regulatory factor expression in T-helper cell differentiation pathway in eutopic endometrial tissue samples of women with endometriosis associated with infertility. Central European Journal of Immunology, 43(1), 90-96.
Mabaso, N., Ngobese, B., Tinarwo, P., & Abbai, N. (2022). Prevalence of Chlamydia trachomatis infection in pr
Madani, T. A. (2006). Sexually transmitted infections in Saudi Arabia. BMC infectious diseases, 6, 1-6.
Majhi, J., Mohapatra, D., & Chayani, N. (2022). The prevalence of Mycoplasma hominis in Outpatients at a Tertiary Care Hospital in East India. Cureus, 14(11).
Mawak, J. D., Dashe, N., Agabi, Y. A., & Panshak, B. W. (2011). Prevalence of genital Chlamydia trachomatis infection among Gynaecologic clinic attendees in Jos, Nigeria.
Mohammed, I. H., Al-Awadei, S. J., & Saadedin, S. M. (2017). Molecular diagnosis of Chlamydia trachomatis in infertile Iraqi women using Real time-PCR and comparison with other methods. Iraqi Journal of Science, 1437-1446.
Mortazavi, S. M., Tarinjoo, A., Dastani, S., Niyazpour, M., Dahaghin, S., & Mirnejad, R. (2021). Molecular Detection of Sexually Transmitted Infections in Women with and without Human Papillomaviruses Infection Who Referred to Tehran West Hospitals in Iran. Reports of Biochemistry & Molecular Biology, 10(3), 387.
Muralidhar, S. (2015). Molecular methods in the laboratory diagnosis of sexually transmitted infections. Indian journal of sexually transmitted diseases and AIDS, 36(1), 9.
Peerayeh, S. N., & Sattari, M. (2006). Detection of Ureaplasma urealyticum and Mycoplasma hominis in endocervical specimens from infertile women by polymerase chain reaction. Middle East Fertility Society Journal, 11(2), 104-108.
Quaas, A., & Dokras, A. (2008). Diagnosis and treatment of unexplained infertility. Reviews in obstetrics and gynecology, 1(2), 69.
Rajabpour, M., Emamie, A. D., Pourmand, M. R., Goodarzi, N. N., Asbagh, F. A., & Whiley, D. M. (2020). Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among women with genitourinary infection and pregnancy-related complications in Tehran: A cross-sectional study. International journal of STD & AIDS, 31(8), 773-780.
Shamkhi, G. J., Alkhuzai, R. A., & Al-Shukr, N. M. (2022). Molecular Genotyping of Chlamydia trachomatis in Iraqi married pregnant and non-pregnant women. Archives of Razi Institute, 77(2), 761-769.
Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American journal of obstetrics and gynecology, 216(1), 1-9.
Urszula, K., Joanna, E., Marek, E., Beata, M., & Magdalena, S. B. (2014). Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study. Archives of gynecology and obstetrics, 289, 1129-1134.
Workowski, K. A., & Berman, S. M. (2011). Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines. Clinical infectious diseases, 53(suppl_3), S59-S63.
Yazar, S., Dagci, H., Aksoy, U., Ustun, S., Akisu, C., Ak, M., & Daldal, N. (2002). Frequency of Trichomonas Vaginalis Among Women Having Vaginal Discharge, in Izmir, Turkey.
Yuan, D., Chen, W., Qin, J., Shen, D., Qiao, Y., & Kong, B. (2021). Associations between bacterial vaginosis, candida vaginitis, trichomonas vaginalis, and vaginal pathogenic community in Chinese women. American journal of translational research, 13(6), 7148.
Zdrodowska-Stefanow, B., Kłosowska, W. M., Ostaszewska-Puchalska, I., Bułhak-Kozioł, V., & Kotowicz, B. (2006). Ureaplasma urealyticum and Mycoplasma hominis infection in women with urogenital diseases. Adv Med Sci, 51(1), 250-253
Aboulghar, M. M., Aboushady, O. M., Ahmed, J. A., & Hanafy, N. A. (2009). Diagnosis of Trichomonas vaginalis infection in women of childbearing age at a university setting using OSOM anew diagnostic technique. Egyptian Journal of Medical Microbiology, 18(3).
Adachi, K., Nielsen-Saines, K., & Klausner, J. D. (2016). Chlamydia trachomatis infection in pregnancy: the global challenge of preventing adverse pregnancy and infant outcomes in Sub-Saharan Africa and Asia. BioMed research international, 2016.
Al Saeed, W. M. (2011). Detection of Trichomonas vaginalis by different methods in women from Dohok province, Iraq. EMHJ-Eastern Mediterranean Health Journal, 17 (9), 706-709, 2011.
Alagouri, S. M. H., & Mohammad, M. (2013). Prevalence and Risk Factors of Bactieral Vaginosis, Trichomoniasis, Candidiasis and Chlamydial infections for women of child bearing age in Benghazi Libya (Doctoral dissertation, University of Benghazi).
Al-Fatlawy, Eman & Jabbar, Abdul & Al-Shammari, Abdul. (2019). Correlation between genital mycoplasma and infertility among Iraqi men and women: conventional and PCR methods. International Journal of Decision Sciences & Information Technology, USA. 14. 11-17.
Al-Kaisi, A. A. R., Al-Janabi, B., & Al-Tikriti, R. (2006). A Study on the Common Microorganisms Causing Vaginitis. Iraqi Academic Scientific Journal, 5(4), 426-430.
Al-khafaji, G. (2017). Molecular Study for Diagnosis of Ureaplasma parvum in Women with Recurrent Miscarriage. In Obstetrics. IntechOpen.
Choe, H. S., Lee, D. S., Lee, S. J., Hong, S. H., Park, D. C., Lee, M. K., ... & Cho, Y. H. (2013). Performance of Anyplex™ II multiplex real-time PCR for the diagnosis of seven sexually transmitted infections: comparison with currently available methods. International Journal of Infectious Diseases, 17(12), e1134-e1140.
Cole, M. J., Quinten, C., Jacobsson, S., Day, M., Amato-Gauci, A. J., Woodford, N., ... & Unemo, M. (2019). The European gonococcal antimicrobial surveillance programme (Euro-GASP) appropriately reflects the antimicrobial resistance situation for Neisseria gonorrhoeae in the European Union/European Economic Area. BMC infectious diseases, 19(1), 1-12.
De Francesco, M. A., Negrini, R., Pinsi, G., Peroni, L., & Manca, N. (2009). Detection of Ureaplasma biovars and polymerase chain reaction-based subtyping of Ureaplasma parvum in women with or without symptoms of genital infections. European journal of clinical microbiology & infectious diseases, 28(6), 641-646.
Dhawan, B., Rawre, J., Ghosh, A., Malhotra, N., Ahmed, M. M., Sreenivas, V., & Chaudhry, R. (2014). Diagnostic efficacy of a real time-PCR assay for Chlamydia trachomatis infection in infertile women in north India. The Indian journal of medical research, 140(2), 252.
Edberg, A. (2010). PCR detection and prevalence of Mycoplasma genitalium (Doctoral dissertation, Karlstad University).
Fattah, C. O., & Kadir, M. A. (2010). Trichomonas vaginalis among women in Sulaimania governorate-Iraq. Tikrit Journal of Pharmaceutical Sciences, 6(1), 1-9.
Fenkci, V., Yilmazer, M., & Aktepe, O. C. (2002). Have Ureaplasma urealyticum and Mycoplasma hominis infections any significant effect on female fertility. Infezioni in Medicina, 10(4), 220-223.
Grześko, J., Elias, M., Mączyńska, B., Kasprzykowska, U., Tłaczała, M., & Goluda, M. (2009). Occurrence of Mycoplasma genitalium in fertile and infertile women. Fertility and sterility, 91(6), 2376-2380.
Haydar, S. O., & Naqid, I. (2022). A Study of Bacterial Vaginosis and Associated Risk Factors among Married Women in Zakho City, Kurdistan Region, Iraq. Journal of Life and Bio Sciences Research, 3(02), 33-39.
Hasani, S., Aung, E., & Mirghafourvand, M. (2021). Low self-esteem is related to depression and anxiety during recovery from an ectopic pregnancy. BMC Women's Health, 21(1), 1-8.
Hu, H., Zhou, Y., Shi, L., Lu, J., Zhang, Z., Xu, X., ... & Fu, G. (2021). High prevalence of Chlamydia trachomatis infection among women attending STD and gynecology clinics in Jiangsu province, China: A cross-sectional survey. Medicine, 100(46).
Javadinia, S., Movahedi, Z., Shokrollahi, M. R., Naghdalipour, M., Tabatabaee, A., Asgarian, R., & Jamei, M. (2017). Prevalence of Mycoplasma genitalium and Ureaplasma urealyticum in pregnant women of Tehran by duplex PCR. Curr Pediatr Res, 21(4), 680-685.
Johnson, R. E., Newhall, W. J., Papp, J. R., Knapp, J. S., Black, C. M., Gift, T. L., ... & Berman, S. M. (2002). Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections—2002. MMWR Recomm Rep, 51(RR-15), 1-38.
Kadir, M., Sulyman, M., Dawood, I., & Shams-Eldin, S. (2014). Trichomonas vaginalis and associated microorganisms in women with vaginal discharge in Kerkuk-Iraq. Ankara Medical Journal, 14(3), 91-99.
Karim, S., Bouchikhi, C., Banani, A., Fatemi, H. E., Souho, T., Erraghay, S., & Bennani, B. (2020). Detection of Ureaplasma Biovars and Subtyping of Ureaplasma parvum among Women Referring to a University Hospital in Morocco. Infectious Diseases in Obstetrics and Gynecology, 2020.
Kim Y, Kim J, Lee KA (2015). Analytical performance of multiplex real-time PCR for six sexually transmitted pathogens. Europe PMC Clinical Laboratory; 61(11): 1749-54.
Kimberly AW, Gail AB; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64 (RR-03): 1-137.
Koval, H. D., Chopyak, V. V., Kamyshnyi, O. M., & Kurpisz, M. K. (2018). Transcription regulatory factor expression in T-helper cell differentiation pathway in eutopic endometrial tissue samples of women with endometriosis associated with infertility. Central European Journal of Immunology, 43(1), 90-96.
Mabaso, N., Ngobese, B., Tinarwo, P., & Abbai, N. (2022). Prevalence of Chlamydia trachomatis infection in pr
Madani, T. A. (2006). Sexually transmitted infections in Saudi Arabia. BMC infectious diseases, 6, 1-6.
Majhi, J., Mohapatra, D., & Chayani, N. (2022). The prevalence of Mycoplasma hominis in Outpatients at a Tertiary Care Hospital in East India. Cureus, 14(11).
Mawak, J. D., Dashe, N., Agabi, Y. A., & Panshak, B. W. (2011). Prevalence of genital Chlamydia trachomatis infection among Gynaecologic clinic attendees in Jos, Nigeria.
Mohammed, I. H., Al-Awadei, S. J., & Saadedin, S. M. (2017). Molecular diagnosis of Chlamydia trachomatis in infertile Iraqi women using Real time-PCR and comparison with other methods. Iraqi Journal of Science, 1437-1446.
Mortazavi, S. M., Tarinjoo, A., Dastani, S., Niyazpour, M., Dahaghin, S., & Mirnejad, R. (2021). Molecular Detection of Sexually Transmitted Infections in Women with and without Human Papillomaviruses Infection Who Referred to Tehran West Hospitals in Iran. Reports of Biochemistry & Molecular Biology, 10(3), 387.
Muralidhar, S. (2015). Molecular methods in the laboratory diagnosis of sexually transmitted infections. Indian journal of sexually transmitted diseases and AIDS, 36(1), 9.
Peerayeh, S. N., & Sattari, M. (2006). Detection of Ureaplasma urealyticum and Mycoplasma hominis in endocervical specimens from infertile women by polymerase chain reaction. Middle East Fertility Society Journal, 11(2), 104-108.
Quaas, A., & Dokras, A. (2008). Diagnosis and treatment of unexplained infertility. Reviews in obstetrics and gynecology, 1(2), 69.
Rajabpour, M., Emamie, A. D., Pourmand, M. R., Goodarzi, N. N., Asbagh, F. A., & Whiley, D. M. (2020). Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among women with genitourinary infection and pregnancy-related complications in Tehran: A cross-sectional study. International journal of STD & AIDS, 31(8), 773-780.
Shamkhi, G. J., Alkhuzai, R. A., & Al-Shukr, N. M. (2022). Molecular Genotyping of Chlamydia trachomatis in Iraqi married pregnant and non-pregnant women. Archives of Razi Institute, 77(2), 761-769.
Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American journal of obstetrics and gynecology, 216(1), 1-9.
Urszula, K., Joanna, E., Marek, E., Beata, M., & Magdalena, S. B. (2014). Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study. Archives of gynecology and obstetrics, 289, 1129-1134.
Workowski, K. A., & Berman, S. M. (2011). Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines. Clinical infectious diseases, 53(suppl_3), S59-S63.
Yazar, S., Dagci, H., Aksoy, U., Ustun, S., Akisu, C., Ak, M., & Daldal, N. (2002). Frequency of Trichomonas Vaginalis Among Women Having Vaginal Discharge, in Izmir, Turkey.
Yuan, D., Chen, W., Qin, J., Shen, D., Qiao, Y., & Kong, B. (2021). Associations between bacterial vaginosis, candida vaginitis, trichomonas vaginalis, and vaginal pathogenic community in Chinese women. American journal of translational research, 13(6), 7148.
Zdrodowska-Stefanow, B., Kłosowska, W. M., Ostaszewska-Puchalska, I., Bułhak-Kozioł, V., & Kotowicz, B. (2006). Ureaplasma urealyticum and Mycoplasma hominis infection in women with urogenital diseases. Adv Med Sci, 51(1), 250-253
Published
2023-10-24
How to Cite
QASIM , V. Q., & SAEED, A. Y. (2023). DETECTION OF CAUSATIVE AGENTS OF SEXUALLY TRANSMITTED DISEASES IN SYMPTOMATIC INFERTILE WOMEN USING REAL TIME PCR TECHNIQUE. Journal of Duhok University, 26(2), 308-315. https://doi.org/10.26682/sjuod.2023.26.2.27
Section
Pure and Engineering Sciences
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