what cellular features would you expect to be shared between c. albicans and t. vaginalis?

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Biomed Res Int. 2013; 2013: 281892.

Codetection of Trichomonas vaginalis and Candida albicans by PCR in Urine Samples in a Depression-Hazard Population Attended in a Dispensary First Level in Central Veracruz, Mexico

A. López-Monteon

^aneLADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico

ⁱⁱCentro de Investigaciones Biomédicas, Universidad Veracruzana, 91000 Xalapa, VER, Mexico

F. S. Gómez-Figueroa

¹LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, United mexican states

G. Ramos-Poceros

¹LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico

D. Guzmán-Gómez

¹LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, United mexican states

²Centro de Investigaciones Biomédicas, Universidad Veracruzana, 91000 Xalapa, VER, Mexico

A. Ramos-Ligonio

^aneLADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico

²Centro de Investigaciones Biomédicas, Universidad Veracruzana, 91000 Xalapa, VER, Mexico

Received 2013 Apr 17; Revised 2013 Jul 18; Accepted 2013 Jul 31.

Abstract

The aim of this study is to guess the prevalence of Trichomonas vaginalis and Candida albicans in depression-gamble patients treated at a first level clinic (main wellness care represents the commencement level of contact of individuals, families, and the community with the system national wellness). Using a cantankerous-exclusive study in patients treated in clinical laboratory of the Germ-free District no. seven of the city of Orizaba during the months June-July, 252 urine samples were collected for the identification of T. vaginalis and C. albicans by PCR. Furthermore, nosotros analyzed the sociodemographic characteristics of the studied population. We observed an overall prevalence of 23.41% (95% CI 22.10–24.72) for T. vaginalis and 38.88% (95% CI 37.73–40.03) for C. albicans. At that place was also presence of coinfection in 14.28% (95% CI 13.10–fifteen.46), which was associated with the presence of pain. Most of the positive cases were observed in women house-maker (80%, 95% CI l.36–48.98). The results of this study provide bear witness that the majority of positive cases observed in the studied population are presented in an asymptomatic form and usually are not associated with any hazard cistron.

ane. Introduction

Sexually transmitted infections (STIs) are the second leading cause of morbidity in immature women in developing countries, afterwards causes related to pregnancy and childbirth [1]. It is estimated that the number of people suffering from curable STIs in the earth per year is approximately 340 million. Amidst the STIs considered curable by World Wellness System (WHO) [2] stand out those caused by etiological agents Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis [3]. The impact of these STIs as a public health problem occurs not but for its high prevalence, but also due to the development of these infections in an astute phase and in a chronic phase with sequelae due to a lack of accurate diagnosis and appropriate treatment: the pelvic inflammatory processes, perinatal morbidity, and infertility [1]. T. vaginalis is a flagellated, parasitic protozoan, which causes trichomoniasis by infecting urogenital tract. Trichomoniasis is one of the virtually common causes of nonviral genitourinary sexually transmitted infection (STI) in humans, with a worldwide prevalence of 174 million cases annually. According to WHO interpretation, it accounts for almost half of all curable STIs [iii]. In spite of high prevalence, it is one of the poorly studied parasites with respect to virulence properties, pathogenesis, and immunopathogenesis. T. vaginalis infection is asymptomatic in about 50% of infected women and in over 90% of men; thus, re-infection and reexposure is problematic. Furthermore, coinfections among these three STIs are common [4].

C. albicans is a dimorphic fungus that colonizes different areas of the body from the gastrointestinal tract to oral and vaginal mucosa. It is normally a commensal microorganism but in immunocompromised or otherwise debilitated hosts it can cause disseminated and mucosal candidiasis [v]. Candida species are the second about common cause of vulvovaginitis worldwide. The prevalence of vulvovaginal candidiasis (VVC) is increasing due to the all-encompassing utilization of wide-spectrum antibiotics as well equally increased cases of immunocompromised patients; C. albicans is the nearly mutual and clinically relevant species, that is, present in 85–ninety% of VVC [6]. However, there has been a significant tendency towards the emergence of other species, which ironically show more resistance to the commencement line antifungal treatments [vii]. Equally Trichomonas prevalence depends on factors such as historic period, number of sexual partners, and design of sexual activeness, a better understanding of the local epidemiology of the infection in women would exist useful in planning prevention strategies [8]. In 2010, 124,310 cases for T. vaginalis were reported in United mexican states and 293,530 candidiasis cases, with a higher incidence in 25- to 44-year-old persons and a national incidence charge per unit of 114.68/100,000 and 270.79/100,000 in habitants, respectively, where the state of Veracruz was ranked in showtime place in the number of cases for both infections, with an incidence charge per unit of 224.v/100,000 for trichomoniasis and 480.iv/100,000 for candidiasis [ix]. Shortages of basic data on the truthful incidence and prevalence of STIs practice not allow reliable information to estimate the bear on of the manual of these diseases. The aim of this study was to estimate by PCR the prevalence of T. vaginalis and C. albicans and to describe trends of positiveness in patients attention at a first level clinic in Orizaba, Veracruz, Mexico.

two. Materials and Methods

2.ane. Study

The cantankerous-sectional study was conducted on patients, who received attention in the clinical laboratories of the health jurisdiction Vii from Orizaba, Veracruz, between June nineteen, 2012 and July ten, 2012. Those who provided written informed consent were enrolled in this report. Patients treated at this dispensary come from various locations all belonging to the state of Veracruz (Figure 1). Sociodemographic characteristics and gynecological complaints were obtained in private using structured questionnaires applied by one investigator. Criteria for inclusion in this written report were belonging to the clinic population, being within the mentioned age group, and voluntariness of the patient. Exclusion criteria were patient refusal and inability to requite informed consent. All participants provided a sample of 10 mL urine collected in the morn. The samples were received in the laboratory of the sanitary jurisdiction and stored at −20°C and transported to LADISER Inmunología y Biología Molecular for further processing.

Mexico (bottom left), the state of Veracruz (center), and the study area (inset). Lines delimitating the respective municipalities. (1)–(21), bespeak the proper name of the villages in the different municipalities.

2.ii. Obtaining Dna of Urine Samples

252 urine samples were collected. The patient was also asked to provide 10 mL of urine which was pelleted in its entirety at 2,000 ×g for 10 min, the supernatant was removed, and the pellet was rinsed in ane mL of phosphate buffered saline (PBS (137 mM NaCl, 2.7 mM KCl, 4.3 mM Na₂HPO_iv, ane.4 mM KH₂PO_four, pH vii.4)) and repelleted at two,000 ×g for ten min. The supernatant was discarded, and the pellet was frozen at −20°C. Dna was extracted as previously described with some modification [x]. Briefly, thawed samples were resuspended in 600μL of lysis buffer (ane Thousand Tris, 0.5 M EDTA, ten% glucose, and lysozyme ii mg/mL), heated at 80°C for 5 min, and then cooled to room temperature. The samples were RNase treated (Promega, Madison, WI, USA) (0.5 mg/mL) for ane h at 37°C. Proteins were precipitated with 0.ii N NaOH, ane% sodium dodecyl sulfate, v Yard CH₃Melt (pH 4.eight) for 5 min on ice and and then centrifuged for iii min at 2,000 ×grand. DNA was precipitated with 600μL of isopropanol and then centrifuged for 3 min at 2,000 ×m, and then the DNA pellet was washed with 600μL of 70% ethanol and centrifuged for 3 min at 2,000 ×chiliad. The DNA pellet was stale, resuspended in lμL of 10 mM Tris (pH vii.4), 1 mM EDTA (pH 8.0), and heated at 65°C for 1 h. The presence of genomic DNA was confirmed in each sample by electrophoresis prior to PCR amplification.

2.three. PCR for T. vaginalis and C. albicans

T. vaginalis-specific primers TV3 (5′-ATT GTC GAA CAT TGG TCT TAC CCT C-3′) and TV7 (5′-TCT GTG CCG TCT TCA AGT ATG C-3′) [11] and C. albicans-specific primers Calb-one (5′-AAG TAT TTG GGA GAA GGG AAA GGG-3′) and Calb-ii (five′-AAA ATG GGC ATT AAG GAA AAG AGC-iii′) [12] were used for PCR distension. The PCR mixture consisted of fiveμL of 10 ten PCR buffer, ivμ50 of deoxynucleoside triphosphates (2.5 mM each), 0.5μL of each primer pair (x pmol/μL), 0.vμ50 of Taq DNA polymerase (Promega) (v U/mL), 10μFifty of sample (5 to x ng/mL), and 29.5μL of distilled h2o. Positive and negative controls were included in all PCR runs. The positive command consisted of DNA from ATCC T. vaginalis isolate 30184 and ATCC C. albicans isolate 18804. Negative controls included Dna from T. cruzi MHOM/MX/1994/INC-1 strain, PCR mix with primers only no Deoxyribonucleic acid, and man genomic DNA. PCR amplification consisted of 30 cycles of ane min at ninety°C, 30 s at 60°C, and ii min at 72°C for T. vaginalis, and 40 cycles of sixty s at 94°C, thirty s at 55°C, and 45 s at 62°C for C. albicans. After amplification, there was an additional extension step at 72°C for 7 min, and then the samples were cooled to 4°C. 5 microliters of amplified production was electrophoresed on a 1.viii% agarose, 0.v mg/mL ethidium bromide gel, viewed on a UV lite box, and photographed. Samples containing a 300 bp fragment were considered positive for T. vaginalis, and samples containing a 310 bp fragment were considered positive for C. albicans.

2.4. Statistical Methods

Frequency distribution of demographic data, characteristics of the population, sexual history, and clinical manifestations were analyzed. The relationship betwixt selected risk factors and the prevalence of trichomoniasis and candidiasis were compared using χ ² or Fisher'south exact test when appropriate. Ninety-five percent conviction intervals were calculated to evaluate statistically significant differences between collection methods. The relationship between age and seroprevalence charge per unit was assessed past chi-square examination and by regression analysis. All municipalities were referenced and the data were entered into a geographical data system database in Qgis version ane.eight to generate maps.

three. Results

The 252 samples were divided into 7 historic period groups (Table 1), age of the participants ranged from 14 to 90 years sometime, the group between 21 and xxx years had more number of samples: 46 samples (18.25%); instruction level showed that from the total studied population, 34.52% (CI 95% 33.01–36.03) take unproblematic school, 27.77% (CI 95% 25.97–29.57) have secondary pedagogy, 20.23% (CI 95% xviii.31–22.xviii) have loftier school education, iv.36% (CI 95% three.05–5.67) take university studies, and 0.39% (CI 95% −0.35–1.09) have postgraduate studies. In relation to marital status, 33.73% (CI 95% 32.82–34.64) declared to remain unmarried, 35.31% (CI 95% 34.02–36.6) reported beingness married, and 30.95% (CI 95% 29.86–32.04) said that they are living together, being divorced, or widowed.

Table 1

Socioeconomic characteristics and sexual behavior of the studied population.

	Age groups (years)
	14–20		21–30		31–twoscore		41–50		51–60		61–70		>71		Total
	N	(%)	Due north	(%)	N	(%)	Due north	(%)	N	(%)	N	(%)	North	(%)	Northward	(%)
Schooling
No study	0	—	ii	0.793	2	0.793	six	2.380	7	2.574	8	2.941	seven	two.778	32	12.698
Elementary	1	0.397	9	three.571	12	four.761	13	five.159	18	vi.618	24	viii.823	x	3.968	87	34.524
Secondary	25	nine.921	xi	4.365	11	4.365	10	3.968	eight	ii.941	5	1.838	0	—	seventy	27.778
High school	17	six.746	17	6.746	vi	ii.380	4	1.587	6	2.206	0	—	1	0.397	51	20.238
University	i	0.397	6	two.381	three	ane.190	ane	0.397	0	—	0	—	0	—	11	4.365
Postgraduate	0	—	1	0.397	0	—	0	—	0	—	0	—	0	—	1	0.397
Total	44	17.460	46	18.253	34	thirteen.492	34	13.492	39	fifteen.476	37	fourteen.682	18	seven.142	252	100
Marital status
Single	twenty	seven.936	ten	3.968	eleven	4.365	13	5.158	eleven	4.365	14	5.556	6	2.380	85	33.730
Married	eight	3.174	17	six.746	15	five.952	xi	four.365	23	9.126	11	4.365	4	i.587	89	35.317
Other	16	vi.349	xix	7.539	viii	3.174	10	3.968	5	1.984	12	4.761	8	3.174	78	30.952
Total	44	17.460	46	18.253	34	xiii.492	34	xiii.492	39	15.476	37	14.682	xviii	7.142	252	100
History of STIs
Yes	ane	0.396	1	0.396	1	0.396	1	0.396	four	1.587	0	—	1	0.396	ix	iii.571
No	43	17.063	45	17.857	33	13.095	33	13.095	35	thirteen.888	37	14.682	17	6.746	243	96.428
Total	44	17.460	46	18.253	34	13.492	34	13.492	39	15.476	37	14.682	eighteen	7.142	252	100
Smoking
Smoker	0	—	3	ane.190	ane	0.396	3	one.190	ane	0.396	0	—	0	—	viii	3.174
Ex-smoker	vi	2.380	vi	2.380	1	0.396	iv	1.587	five	1.984	vii	2.777	7	two.777	36	xiv.285
Nonsmoker	37	14.682	38	xv.079	32	12.698	30	11.904	31	12.301	29	11.507	11	4.365	208	82.539
Total	44	17.460	46	18.253	34	13.492	34	13.492	39	15.476	37	fourteen.682	18	7.142	252	100
Consumption of booze
Yes	21	8.333	21	8.333	12	four.761	13	v.158	12	iv.761	14	5.556	6	2.380	99	39.285
No	23	9.126	25	nine.920	22	eight.730	21	viii.333	27	10.714	23	9.126	12	4.761	153	60.714
Total	44	17.460	46	xviii.253	34	13.492	34	thirteen.492	39	15.476	37	fourteen.682	18	7.142	252	100
Sexual partners
1	20	seven.936	23	ix.126	eighteen	7.142	14	five.556	23	9.126	21	8.333	viii	three.174	127	50.396
Two	eleven	4.365	14	5.556	4	1.587	nine	iii.571	6	2.380	7	2.777	3	1.190	54	21.428
More than than two	7	2.777	8	3.174	nine	iii.571	10	3.968	eight	iii.174	nine	3.571	seven	2.777	58	23.015
None	1	0.397	0	—	one	0.397	0	—	0	—	0	—	0	—	two	0.793
Total	44	17.460	46	18.253	34	13.492	34	13.492	39	15.476	37	14.682	eighteen	7.142	252	100
Condom employ
Yes	5	1.984	4	1.587	three	1.190	ane	0.397	1	0.397	0	—	0	—	14	v.556
No	39	xv.476	42	sixteen.666	31	12.302	33	13.095	38	15.079	37	14.683	18	seven.143	238	94.444
Total	44	17.460	46	18.253	34	13.492	34	xiii.492	39	15.476	37	14.682	xviii	7.142	252	100

In gild to institute a history about the presence of STIs in this written report grouping, they were questioned whether they had e'er suffered at least one STI in their lives; 96.42% (CI 95% 73.81–119.02) reported not having had an STI; the remaining 9 participants (3.57%, CI 95% two.76–4.38) agreed to have suffered at to the lowest degree one STI merely did non reveal the causal agent of it. Similarly, they were asked whether they regularly used condoms in their sexual relations; 5.55% (9/252, CI 95% 4.51–6.59) take indicated consistent condom use. In relation to smoking and consumption of alcohol, three.17% (8/252, CI 95% two.24–4.10) of the studied population is smokers, and 99/252 of them (39.28%, CI 95% 38.23–twoscore.33) consume alcohol.

Finally, in relation to the number of sexual partners, 50.39% (127/252, CI 95% 49.45–51.33) mentioned to accept only one partner, 21.42% (54/252, CI 95% 20.38–22.46) mentioned to have two sexual partners, 23.01% (58/252, CI 95% 22.73–23.29) mentioned to have more than than two sexual partners, and 0.79% (two/252, CI 95% 0.12–1.46) did non mention sexual partners. 18.65% (47/252, CI 95% 17.87–19.43) mentioned a family history of cancer, and only 23.41% (59/252, CI 95% 22.22–24.60) of the patients have expressed discomfort (burning, itching, and vaginal secretion).

All 252 samples were used to identify the presence of T. vaginalis and C. albicans by PCR; molecular diagnosis of T. vaginalis showed an overall prevalence of 23.41% (59/252, CI 95% 22.ten–24.72) (Table 2); all positive samples showed an amplification of 300 bp, finding a mean age of 43.3 years for patients positive for T. vaginalis. When we analyzed the presence of C. albicans genomic cloth in the 252 studied samples, 38.88% (98/252, CI 95% 37.73–40.03) (Table ii) samples resulted positive for amplification of 310 bp fragment specific for C. albicans, with an average age of 41.nine years, for patients who tested positive for the presence of C. albicans. When we analyzed the presence of coinfections, xiv.28% (36/252, CI 95% thirteen.10–15.46) of the samples resulted positive, where 11.11% (28/252, CI 95% 10.sixteen–12.06) turned out to be women devoted to housework and 3.17% (8/252, CI 95% ii.01–iv.33) of co-infections were establish in samples from men. The presence of co-infection (18/82) was associated with the presence of hurting (32.v% versus 67.four%) (χ ² = four.942, degrees  of  freedom = two, P = 0.026 with Yate's corrections). Moreover, of the full number of samples analyzed, 83.iii% (210/252) correspond to samples of women, from which fourscore% (168/210, CI 95% 79.30–lxxx.69) accept as occupation housework. Surprisingly, in this grouping there are 41 samples of the 59 cases positive for T. vaginalis and 62 of the 98 cases positive for C. albicans, existence a high percentage of the total positive samples, 16.26% (41/252, CI 95% fifteen.18–17.34) and 24.6% (62/252, CI 95% 23.77–25.43) for T. vaginalis and C. albicans, respectively, in an age range betwixt 51 and 60 years, while ii.77% (7/252) of T. vaginalis positive cases and half dozen.34% (sixteen/252) of the cases for C. albicans from the women grouping who are predominantly students in an age range of fourteen to 20 years. However, during the association analysis between the occupation and the presence of infection, there existed no significant correlation with infection with T. vaginalis (P = 0.410, by Fisher's verbal test) or infection with C. albicans (P = 1.0, by Fisher's exact test). It is noteworthy that positive male samples for T. vaginalis (xi/59), representing 4.three% (xi/252, 95% CI 3.14–five.58) of the total studied population, are at an age range above 42 years. Of the total female population (210/252), the 35.71% (75/210, CI 95% 32.24–39.07) were meaning, of which 7.14% (15/210, CI 95% 5.79–8.49) were positive to T. vaginalis, 10.95% (23/210, CI 95% 9.06–12.84) were positive to C. albicans, and five.23% (11/210, CI 95% iii.79–six.67) with a codetection of both pathogens; withal, the presence of infection did not correlate with whatever adventure factors.

Table 2

Age groups and positivity to T. vaginalis and C. albicans by PCR in urine samples.

Age (years)	Samples		Positive T. vaginalis		Negative T. vaginalis		Positive C. albicans		Negative C. albicans		Double positive
	N	%	N	%	N	%	N	%	North	%	Northward	%
14–20	44	17.460	8	3.175	36	14.286	21	8.333	23	9.127	seven	2.778
21–30	46	xviii.254	eleven	iv.365	35	13.889	12	4.762	34	13.492	5	1.984
31–xl	34	13.492	5	one.984	29	11.509	eleven	4.365	23	9.127	2	0.794
41–50	34	13.492	6	2.381	28	11.111	nineteen	7.540	15	5.952	iv	one.587
51–60	39	15.476	17	6.746	22	eight.730	eighteen	7.143	21	eight.333	11	4.365
61–seventy	37	14.683	eleven	4.365	26	x.317	13	5.159	24	ix.524	7	2.778
>71	18	seven.143	one	0.397	17	6.746	4	one.587	14	5.556	0	—
Full	252	100	59	23.413	193	76.587	98	38.889	154	61.111	36	14.286

The stratification of patients indicated a significant difference in infection rate (T. vaginalis) according to historic period (χ ² = 32.8, degrees  of  freedom = six, P = 0.0001), too equally for C. albicans (χ ⁱⁱ = l.four, degrees  of  freedom = 6, P = 0.0001); however, prevalence rate was not significantly correlated with age (r ² = 0.207, P = 0.97, by second-social club polynomial regression) for T. vaginalis infection, every bit well equally (r ⁱⁱ = 0.234, P = 0.55 by second-order polynomial regression) for C. albicans infection; for both infections at that place was no association with marital condition of participants (single versus married) (P = 0.729 for T. vaginalis infection, P = 0.466 for C. albicans infection, by Fisher'due south verbal tests); there was no statistically significant clan betwixt the presence of infection with booze consumption (P = 0.761 for T. vaginalis infection, P = ane.000 for C. albicans infection, by Fisher'southward exact tests); when smoking was analyzed as a risk factor in this population, the results showed that the consumption of snuff (smoker, ex-smoker, and nonconsumer of snuff) had no association with the presence of infection for T. vaginalis (χ ^two = 0.906, degrees  of  freedom = 2, P = 0.636), as well equally (χ ² = 0.674, degrees  of  freedom = 2, P = 0.714) for C. albicans infection. Moreover, the presence of discomfort (called-for, itching, and vaginal secretion) had no association with the presence of infections (P = 0.169 for T. vaginalis infection, P = 0.761 for C. albicans infection, by Fisher's verbal tests). Finally, a pregnant association in the number of sexual partners (two versus more than two) was observed for T. vaginalis infection (P = 0.047, by Fisher's verbal test) only not for C. albicans infection (P = 0.248, past Fisher'southward exact test).

4. Discussion

The diagnosis of Candida spp is difficult, existing up to 50% of asymptomatic cases, moreover, Candida spp, is considered endogenous flora normal of the vagina, in growth express weather condition [xiii]; on the other hand, the presence and trichomoniasis symptoms depend on local amnesty and the amount of parasites inoculated, and transit may be asymptomatic in fifty% of cases [14]. T. vaginalis and C. albicans are considered the pathogens found in a more frequent in vaginal infections. The culture is the gold standard test for diagnosis of C. albicans and T. vaginalis infections in cases of vaginitis [xv]; however, PCR is currently used for diagnosis of T. vaginalis and C. albicans obtaining a sensitivity and specificity of 100% [16, 17].

Equally it is known, the frequency of cases of candidiasis and trichomoniasis varies according to the studied population [18]. In this study, nosotros found a high prevalence rate in cases of trichomoniasis and candidiasis considering that the report was conducted in a low-risk population and that near women were homemakers, in relation to the information reported in United mexican states in 2010 for cases of trichomoniasis and candidiasis [9], and compared with different work in different studied populations [19–22], even in high-gamble populations such as sex workers [23]. Moreover, unlike other reports, this study found cases in all age groups, with a larger number of cases for T. vaginalis in people over 50 years old, and cases of candidiasis were observed in almost the aforementioned mode in all groups with a slight increase in the grouping of 21–30 years.

Hazard factors for acquisition, the clinical characteristics, and significance of candiduria accept been published primarily in relation to intensive care unit and immunocompromised. Diabetes mellitus, prolonged use of antibacterial agents, indwelling urinary catheter, genitourinary tuberculosis, chronic renal failure, malignancy, neutropenia, immunosuppressive therapy, urinary tract instrumentation, surgery, renal graft, female sex, and extremes of age are known hazard factors of acquisition of candiduria [24]. Moreover, the presence of Candida in urine may represent contagion of clinical sample, actual colonization of the lower urinary tract, or may be a truthful indicator of invasive infection of lower and/or upper urinary tract [25]; too, the epidemiology of Candida infections has changed over the terminal two decades. The number of patients suffering from such infections has increased dramatically and the Candida species involved have become more numerous [26].

A feature of this study is that the majority of participants reported no history of STIs submitted; furthermore, there was no human relationship between the presence of positive case and the presence of symptoms, but in the case of coinfections (xiv%) where a pregnant clan with the presence of pain was observed, these results indicated that the bulk of private infections with T. vaginalis and/or C. albicans remain in an asymptomatic form; presumably because pathogens can remain in low concentrations. These results strongly advise that the symptoms not e'er must be a secure evidence of affliction [27]. A limitation of this study was that most of the participants were women; only 16.6% of the population were males, a population where infection with T. vaginalis and generally any STI has been difficult to narrate [28]. But despite the low participation of the population, samples were positive for both pathogens, and in some cases in the presence of co-infections, these findings reinforced the absence of symptoms plus the presence of asymptomatic cases of this type of infection. Perhaps the lack of laboratory techniques for an authentic diagnosis, as well every bit early on confirmation, is what affects the permanence of the infection too as the likelihood of having any of the serious and of import consequences caused by these pathogens.

The sociocultural and educational levels are crucial in sexual behavior and the risk of STIs, if you consider this attribute to be able to identify run a risk factors for use in these populations in intervention programs to change the sexual beliefs of these people [29]. Yet, in this studied population not determining factors for the presence of infections was nowadays. In improver, there is some degree of promiscuity not clearly detected in the survey because the partner or hubby could not be interviewed; nevertheless, possessing more than one partner was significant in the presence of infection every bit previously reported [30].

Ane of the about common associations with T. vaginalis is the presence of bacteria and Candida spp [31], and the data obtained in the group of significant women showed no clan with the presence of infection risk factors analyzed (pain, history of STIs, itching and vaginal secretion, smoking, alcohol, etc.), just the clan was observed with C. albicans. It is known that environmental changes such every bit increased glycogen production during pregnancy and altered levels of estrogen and progesterone, past the apply of oral contraceptives, permit adherence of C. albicans to vaginal epithelial cells and facilitate germination of yeast [32]. These changes tin transform asymptomatic colonization in symptomatic infection. Patients with changes in the level of estrogens and progesterone, too as raising the pH and glycogen, can cause the growth and virulence of T. vaginalis [32, 33]. Hormone changes produced during pregnancy predispose a higher incidence of infections of the lower genital tract. This leads to maternal and perinatological complications. The diagnosis of T. vaginalis infection during pregnancy is of bully importance as such infections are related to premature rupture of membranes, preterm delivery, and low birth weight [34].

5. Conclusion

In conclusion, the codetection of T. vaginalis and C. albicans by PCR in urine samples in a depression-risk population attended in a clinic first level in fundamental Veracruz, Mexico, is of great importance because the diversity of results observed in this study enrich the testify that the etiology of this type of infection is variable and requires the individual studies to know the characteristics of the population with which they are working.

Acknowledgment

The authors appreciate the support provided past Jurisdicción Sanitaria no. 7 for obtaining samples.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773406/