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Assessment of the relation between flow cytometry bacterial count and outcome of bacterial vaginosis treatment

Grant number: 13/01750-3
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): April 01, 2013
Effective date (End): December 31, 2013
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Camila Marconi
Grantee:Heloise Ranucci Luchiari
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Bacterial vaginosis (BV) is the most common type of abnormal vaginal flora of women in reproductive age. Several gynecologic and obstetrical complications are associated to BV, such as pelvic inflammatory disease, increased risk for HIV acquisition and premature deliveries. BV is characterized by the replacement of vaginal Lactobacillus sp. by other bacterial species, mostly anaerobes. Many bacterial species have been associated with BV and although many of them are uncultivable, they represent an expressive portion of the local microbiota. Despite most of BV-associated bacteria were identified, treatment of this condition remains as a challenge in routine practice. Currently BV treatment consists in a seven-days regimen with metronidazole despite the literature is consistent in showing an efficacy of only 60% one month after treatment. It was already described that higher loads of some BV-associated bacteria are related with therapeutic failure, however it remains undetermined the role of total bacterial load in vaginal environment in the response of BV treatment. Therefore the objective of this study is to evaluate if there is a relation between the BV treatment outcome and the total bacterial count assessed by flow cytometry. Women in reproductive age will be enrolled at the "Ambulatório de Saúde da Mulher da Unidade Básica de Saúde do Jardim Peabiru, Botucatu - SP". Endocercical samples will be taken for exclusion of the women positive for Chlamydia trachomatis and Neisseria gonorrhoeae. Those women with trichomoniasis and candidosis detected by microscopic evaluation on wet mount vaginal smears will also be excluded from the study. Vaginal smears will be Gram-stained for vaginal microbiota classification according to Nugent et al. (1991). Vaginal lavage samples will be obtained for total bacterial count by flow cytometry from 40 women with BV and 40 women with normal flora. BV-women will be oriented to return for new sampling procedures after 45 days of the end of treatment. The comparison between the total bacterial count in those women with treated and untreated BV will allow to determine the influence of the bacterial load in the treatment of this condition which will contribute for the development of new strategies for improving women's reproductive health.

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
LUCHIARI, HELOISE R.; FERREIRA, CAROLINA S. T.; GOLIM, MARJORIE A.; SILVA, MARCIA G.; MARCONI, CAMILA. Cervicovaginal bacterial count and failure of metronidazole therapy for bacterial vaginosis. International Journal of Gynecology & Obstetrics, v. 132, n. 3, p. 297-301, MAR 2016. Web of Science Citations: 1.

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