The thesis covered validation of quantitative polymerase chain reaction (qPCR) assays for the detection of the genital Mollicutes - M.genitalium, M.hominis, U.urealyticum, U.parvum, and relevant non Mollicute organisms found in the urogenital tract specifically T. vagina lis, G. vaginalis and S.agalactiae; a novel qPCR was developed for G.vaginalis. The assays were applied to (a) residual anonymised specimens from a Genitourinary Medicine clinic and (b) placental specimens collected with informed consent in pregnancies presenting in preterm labour; both approaches had appropriate ethical approval. The analysis allowed the prevalence, clinical significance and synergistic relationships of genital Mollicutes to be assessed in different anatomical sites (urethra, vagina, rectum) and different clinical conditions. The qPCR assays were highly reproducible, provided new observations and allowed novel findings to emerge from the overlapping stUdies. Mollicute infections are common and therefore commonly missed by current testing algorithms for STls. M.genitalium and U.parvum were significantly associated (p<0.001 and p=0.03 respectively) with non-chlamydial non-gonococcal urethritis in men attending GUM. U.parvum, which is a bacterial commensal of the vaginal micro-flora, showed a significant association with chorioamnionitis (p=0.002) in women delivering preterm and also demonstrated growth synergy (p=0.017) with G.vaginalis in bacterial vaginosis. A further synergy involving M.hominis and G.va!~inalis (p <0.0001 ) was also demonstrated in bacterial vaginosis and in the rectum of men who have sex with men. The association with preterm labour and with bacterial vaginosis suggests that disruption of the vaginal micro-flora in pregnancy could trigger serious obstetric complications involving commensal bacteria. It could also be speculated that the synergistic bacterial overgrowth seen in samples from the rectal mucosa is a factor in HIV transmission across an inflamed surface. The prevalence data and associations with important clinical conditions would support the need for more research on the role of Mollicutes and co-infection in both STls and infections in pregnancy.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:680173 |
| Date | January 2015 |
| Creators | Cox, Ciara |
| Publisher | Queen's University Belfast |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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