Trichomonas vaginalis, endometritis and sequelae among women with clinically suspected pelvic inflammatory disease
SEXUALLY TRANSMITTED INFECTIONS
Authors: Wiringa, Ann E.; Ness, Roberta B.; Darville, Toni; Beigi, Richard H.; Haggerty, Catherine L.
Abstract
Objective To ascertain the prevalence ofTrichomonas vaginalisand investigate associations between trichomoniasis, endometritis and sequelae among women with pelvic inflammatory disease (PID). Methods We assessed the prevalence of trichomoniasis identified via wet mount and its association with histologically confirmed endometritis, infertility and recurrent PID among 647 women in the PID Evaluation and Clinical Health (PEACH) study. Participants were treated for clinically suspected PID and followed for a mean of 84 months for incident sequelae. Analyses were adjusted for age, race,Chlamydia trachomatis,Neisseria gonorrhoeae,Mycoplasma genitaliumand bacterial vaginosis. Additional adjustments were incorporated for history of infertility (models of pregnancy and infertility), history of PID (recurrent PID), and self-reported partner treatment and intercourse between baseline and 30-day follow-up (persistent endometritis). Results T. vaginaliswas present in the vagina of 12.8% of women. The odds of having endometritis at baseline were twice as high among women with trichomoniasis as compared with those without (adjusted OR (AOR): 1.9, 95% CI 1.0 to 3.3). Persistent endometritis was highly prevalent at 30 days (52.1%) and more common among women with baseline trichomoniasis (AOR: 2.6, 95% CI 0.7 to 10.1), although non-significantly. Infertility and recurrent PID were more common among women with trichomoniasis, while rates of pregnancy and live birth were lower. Conclusions T. vaginaliswas frequently isolated from the vagina of women with PID in the PEACH cohort. Wet mount microscopy for the identification of motile trichomonads was standard practice at the time of the PEACH study, but likely resulted in an underestimation of trueT. vaginalisprevalence. Our findings of modest, although non-significant, prospective associations between trichomoniasis and sequelae are novel and underscore the need for additional investigation into whetherT. vaginalismay play an aetiological role in adverse reproductive and gynaecological outcomes.
Backbone and sidechain resonance assignments and secondary structure of Scc4 fromChlamydia trachomatis
BIOMOLECULAR NMR ASSIGNMENTS
Authors: Ukwaththage, Thilini O.; Tonelli, Marco; Macnaughtan, Megan A.
Abstract
Chlamydia trachomatisis an obligate intracellular bacterium that causes the most common sexually transmitted bacterial diseases in the world. With a biphasic developmental cycle, the bacteria utilize a type III secretion system (T3SS) to invade host cells as infectious elemental bodies, which then differentiate into actively dividing reticulate bodies. The regulation of the developmental cycle and the T3SS are linked by the bi-functional protein, specificChlamydiachaperone 4 (Scc4). Scc4 is a class I T3SS chaperone forming a heterodimer with specificChlamydiachaperone 1 (Scc1) to chaperone the essential virulence effector,Chlamydiaouter membrane protein N. Scc4 also functions as a transcription factor by binding to the RNA polymerase holoenzyme between the flap region of the beta subunit and region 4 of sigma(66). In order to investigate the mechanism behind Scc4's dual functions and target its protein-protein interactions as a route for drug development, the structure and dynamics of Scc4 are being pursued. In the course of this effort, we assigned 89.2% of the backbone and sidechain(1)H,N-15, and(13)C resonances of full-length Scc4. The assigned chemical shifts were used to predict the secondary structure and dynamic properties. The type and order of Scc4's determined secondary structure are consistent with the X-ray crystal structures of other bacterial T3SS chaperones.