Sample Collection Transport And Dna Extraction
Midstream urine samples used for sequencing were immediately transferred to a urine collection and preservation tube holding 50 ml and stored at room temperature until further processing. DNA was extracted from 15 ml urine using the peqGOLD Tissue DNA Kit . Urine was centrifuged at 7000 rpm for 15 min, and DNA was extracted with pretreatment and modification as described . Briefly, urine was centrifuged at 7000 rpm for 15 min . Pellets were resuspended in 700 l lysis buffer, 15 l RNase and 20 l proteinase K. This suspension was then added to 0.5 g of silica beads which were covered with 500 l cooled phenol. For cell lysis, the bead-suspension mix was shaken at 5 m/s for 1 min in three intervals which were 2 min apart using the MO-BIO PowerLyzer . After centrifugation for 1 min at 13000 rpm, the upper phase containing the DNA was further processed according to the manufacturers instructions starting with DNA binding. The mean DNA yield was 5.9 ng/l and varied from 2 ng/l to 14.3 ng/l.
Ethics Approval And Consent To Participate
The study protocol was approved by the local ethics committees and written consent was obtained from all participants. The clinical study was conducted in accordance with the Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects. Principles and guidelines for good clinical practice were followed.
What Antibiotics Are Used To Treat Bacterial Utis
Once your physician has determined the location of your UTI and whether its complicated, he or she will likely suggest an antibiotic for treatment. Infections in the lower urinary tract are typically treated with oral medication , while upper-tract UTIs usually merit intravenous antibiotics.
All antibiotics require a prescription. This is, in part, to avoid the potential for antibiotic misuse, which can result in your body forming a dangerous resistance to antibiotics. Its also a way to ensure that you visit a healthcare provider when you have symptoms. If left untreated, even an uncomfortable but harmless lower-tract UTI can become more severe, particularly if its allowed to travel further up the urethra and take up residence in your kidneys.
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Treatment Length For All Utis
No matter what kind of bacterial infection you have and where its located, the best antibiotic treatment for UTI is generally the shortest one. This is to lower your odds of developing antibiotic resistance and to decrease your risk of a yeast infection or infectious diarrhea.
Still, its imperative that you take all the antibiotics prescribed, even after symptoms subside. Most UTIs resolve within three to 10 days. Stopping your antibiotics early, before the drugs eliminate all bacteria, can create a breeding ground for antibiotic-resistant bacteria, too.
What Is Bacterial Vaginosis Like
The main symptom of BV is a vaginal discharge. BV is the most common cause of vaginal discharge in women of childbearing age. Often, BV causes no symptoms. This is true in about half of the women who have the condition. This may be because the bacterial disturbance is only mild.
When BV causes symptoms, this is usually a change in vaginal discharge. Some women will also notice the characteristic smell.
- The discharge is often white-grey in colour and often has a fishy smell.
- The smell may be more noticeable during sex.
- The discharge tends to be heaviest just after a period, or after sex.
- The discharge does not usually cause itch or soreness around the vagina and vulva.
- STIs, such as chlamydia, may also cause vaginal discharge. See the separate leaflet called Chlamydia for more details.
We Asked An Obgyn And A Naturopath
Getty/Design by Cristina Cianci
Bacterial vaginosis, commonly known as BV, is the most common vaginal infection in the USwhich means it’s more prevalent than yeast infections. Affecting more than 21 million women between the ages of 14 and 49, according to the Centers for Disease Control , more likely than not, you’ve probably had BV at some point in your life. Caused by an overgrowth of vaginal bacteria, BV can be uncomfortable, with symptoms such as itching, odor, and discharge. Alternatively, sometimes BV doesn’t manifest symptoms, so people with the infection might not know they have it. Either way, treating BV is essential, especially if you’re pregnant. The CDC notes that left untreated, BV might lead to premature birth or low-birth-weight babies. Additionally, if left untreated in non-pregnant women, BV can increase the risk of other infections and cause a host of vaginal issues.
On that note, please note that the remedies provided ahead are meant to eliminate BV cases in conjunction with antibiotics, or to be used as preventative measures against the infection.
Meet the Expert
Antibiotics For Bacterial Vaginosis
Oral antibiotics are the first-choice treatment in pregnant women with BV.
Metronidazole tabletsA full course of metronidazole tablets is the common treatment. Metronidazole is an antibiotic. This clears BV in most cases. It is important to read the leaflet that comes with these tablets for the full list of possible side-effects and cautions. The main points to note about metronidazole include:
- The usual dose is 400-500 mg twice a day for 5-7 days. A single dose of 2 grams of metronidazole is an alternative, although this may be less effective and may cause more side-effects. It is important to finish the course you have been prescribed, and not to miss any tablets.
- Some people feel sick or may be sick when they take metronidazole. This is less likely to occur if you take the tablets straight after food. A metallic taste is also a common side-effect.
- Do not drink any alcohol while taking metronidazole, nor for 48 hours after stopping treatment. The interaction of metronidazole with alcohol can cause severe sickness and vomiting, and may also cause flushing and an increased pulse rate.
- Metronidazole can get into breast milk in small amounts but will not harm your baby, although it may make the milk taste different. The manufacturer recommends that if you are breastfeeding you should take the 5- to 7-day lower dose course of metronidazole rather than the single large dose.
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Ask About Boric Acid Suppositories
Boric acid has been used to maintain vaginal health for centuries. Its available over-the-counter as a vaginal suppository.
Some recommend using it alongside antibiotic treatment. A on the use of boric acid shows its a promising effective treatment.
A clinical trial is also being conducted to determine whether vaginal boric acid suppositories are as effective at treating BV as antibiotics. The results are pending.
Boric acid poses some serious risks. If taken by mouth, it can lead to poisoning and even death. Pregnant people shouldnt take boric acid, as it can pose risks to a developing fetus.
Speak to your healthcare provider if youre considering this option to make sure its safe for you.
Bacterial Vaginosis Is An Std
While bacterial vaginosis can and does develop on its own without sexual contact, BV is most definitely also sexually transmitted by both men and women. Many of you will have developed BV after unprotected sex with a new partner.
Yes, it was them.
Women who have sex with women are at greater risk than women who have sex with men vagina-to-vagina transmission is oh-so-easy, but so is penis-to-vagina transmission. This is because biofilms are very infective, and while a penis isnt the natural home of these bacteria, with regular contact and especially in uncircumcised men, biofilms can and do exist.
Youll also be sad to know that you can get BV in your mouth. It might have a different name then, but its the same idea, same bacteria, and can result in gum disease. This is why some women report having received oral sex from someone with bad breath and developed BV afterward. Its not just regular p-in-v sex.
If you have a male sexual partner and have been having sex without a condom, he almost certainly has BV biofilms on his penis and will be reinfecting you and any other women he is coming into unprotected sexual contact with. Men should get a treatment as well, but antibiotics do not work in men and on biofilms, and frequently physicians do not even test men for BV bacteria.
If you have sex with women, the same principle applies. Remember, no symptoms doesnt mean no BV. You can still be infective.
Should Treatment Be Long Term
Melissa: Is this a short-term kind of treatment approach or should you be using the prebiotics for a long time?
Dr. Hlavinka: Well, I tell everybody I can about the value of probiotics, and probiotics are absolutely essential for immune system boosting. Weve got all those gut bacteria, theres all sorts of interplay between the gut microbiome and our immune system, our liver function.
Theres even a sort of, they call it a gut brain connection, between the microbiome and the brain and weve shown that things like depression and things like that, anxiety related, are related to changing the gut microbiome. So having a healthy constituted gut microbiome to me is an essential part of overall health and a simple thing to do, but we docs screw that up all the time by giving people antibiotics to destroy it immediately.
It can take weeks or months to rebuild, so I tell my patients they should be on 60, 80 billion of probiotics, 60 to 80 billion colonies per probiotics daily and then double that when youre on antibiotics. So thats basically what I tell them.
Indications For Specialist Referral
Most patients with recurrent uncomplicated UTI may be treated successfully by family physicians. Specialist referral for recurrent uncomplicated UTI is indicated when risk factors for complicated UTI are present . Referral is also indicated when a surgically correctable cause of UTI is suspected or the diagnosis of UTI as a cause for recurrent lower urinary tract symptoms is uncertain. Prior to referral, culture of the urine while symptomatic and 2 weeks after sensitivity-adjusted treatment may aid in confirming the diagnosis of UTI, as well as guiding further specialist evaluation and management.
Can I Prevent Recurrent Bacterial Vaginosis
If your symptoms come back and you did not have a test using a sample of your vaginal discharge taken initially, your doctor or nurse may suggest that they take swab tests now. This is to confirm that it is BV causing your symptoms.
BV may return if you did not complete your course of antibiotics. However, even if you have completed a full course of antibiotics, BV returns within three months in many women. If it does come back, a repeat course of antibiotics will usually be successful. A small number of women have repeated episodes of BV and need repeated courses of antibiotics.
Astodrimer sodium gel also prevents recurrent BV and associated symptoms. In a 2019 study astodrimer sodium significantly reduced BV recurrence rates. You can buy astodrimer sodium gel online and do not need a prescription.
If you have a copper coil for contraception – an IUCD – and have recurrent BV, your doctor or nurse may suggest that they remove your IUCD to see if this helps to improve your symptoms. You will need to consider alternative contraception measures.
If you have a same-sex partner then, even if they have no symptoms, treating both of you at the same time may reduce recurrence.
Can Doctors Treat Utis Via Telemedicine
Telemedicine is an increasingly popular method of treating UTIs. In addition to being convenient, its also discreet and frequently more affordable than an in-office visit.
Since doctors cant collect a urine specimen via telemedicine, they will typically make their diagnosis using a series of questions that identify and analyze your symptoms. Your telehealth provider will also want to know if you have a history of UTIs, as well as if there are any other factors that may complicate your UTI, such as pregnancy or a chronic health condition.
Ultimately, the fact that UTIs are extremely common assists physicians in their ability to accurately diagnose and treat UTIs online. In the event that your UTI symptoms present themselves as more severe or as something else entirely, your telemedicine professional will instruct you to visit another physician in the office for a follow-up or to perform a urinalysis. Most of the time, however, your telehealth provider can diagnose your infection and prescribe antibiotics via video alone. Certain telehealth providers may be able to fill your prescription as well, which can save you the expense of going through a pharmacy.
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Do You Have Cystitis Or A Uti
You may have UTI in your bladder, which leads to bacterial cystitis. However, UTI doesnt have to occur in your bladder in which case you would not have bacterial cystitis.
You may have interstitial cystitis if youre experiencing cystitis symptoms without any bacteria in your urine. Interstitial cystitis is sometimes called non-infectious cystitis because it is bladder inflammation that is not caused by a bacterial infection.
What is the difference between cystitis and UTI? There are 3 main differences between cystitis and UTI:
Can a UTI cause cystitis? UTI can directly cause bacterial cystitis, or indirectly cause interstitial cystitis. If UTI is left untreated, it can lead to chronic bladder inflammation, which is the underlying cause of interstitial cystitis.
UTI and interstitial cystitis are interconnected, yet they are different. Below, we list what differentiates the two.
How Do You Get Bacterial Vaginosis
Bacterial vaginosis is a common condition of the vagina caused by an overgrowth of various germs. It is not one infection, caused by one type of germ.
The vagina normally has a mix of germs , including anaerobic bacteria and lactobacilli, but in bacterial vaginosis the balance changes. As a result, the anaerobic bacteria multiply and thrive much more than usual. In other words, they are bacteria which are normally present, just not in the same balance.
BV is not caused by poor hygiene. In fact, excessive washing of the vagina may alter the normal balance of bacteria in the vagina even more, which may make BV more likely to develop or worsen.
We don’t really know what triggers the bacterial balance to ‘swing’ away from normal. We know that it’s more likely to happen if something disturbs the acidity of the vagina, , which then allows the anaerobic bacteria to overgrow.
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What Is Bacterial Vaginosis
Bacterial vaginosis can be termed as a bacterial infection. So, it is an infection that is more common than you think. It happens when the healthy bacteria are replaced by the bad bacteria in your vagina.
Dr Gaikwad says, It is seen due to different types of healthy bacteria in the vagina that tend to get out of balance and grow too much. BV is mostly seen due to Gardnerella vaginalis, the most common type of bacteria in ones vagina.
If left untreated, this infection can be dangerous because it can cause multiple complications including infertility. If we talk about it causes douching, using vaginal deodorants and other irritating products down there can be the reasons behind the occurrence of BV. Along with this, if youre sexually active and pregnant youre at a high risk of getting BV.
Is There Any Other Way To Prevent A Uti
While theres no foolproof way to ensure you never have a UTI, there are strategies and behaviors that may lower your risk:
- Stay hydrated.
- Women should wipe from front to back to stop the spread of bacteria.
- Avoid using douches, powders, sprays or other materials in the genital area.
Some physicians have begun recommending that patients add probiotics to their diet such as kefir, yogurt, various fermented foods, etc. as a form of prevention. No evidence indicates that probiotics can prevent a UTI on their own, but they do promote the growth of helpful bacteria in the vagina and bowels, which is beneficial for your overall health and may lower your risk of infection.
UTIs are commonplace so commonplace, in fact, that theyre one of the most frequently treated issues by telehealth professionals. If youre experiencing symptoms consistent with a UTI, dont wait until your schedule clears up to make an appointment with a physician. Dont wait for your doctors next in-office opening six weeks from now, either.
Can Bacterial Vaginosis Be Treated And Cured With Home Remedies
There are no home remedies or natural remedies for bacterial vaginosis. Antibiotics are the only treatment. It is important to note that douching will not help with BV, and there is no proven medical benefit of douching. In fact, douching may flush bacteria farther up the genital tract into the uterus or Fallopian tubes, potentially worsening the condition.
Studies of yogurt/lactobacilli probiotic preparations , which are designed to help reestablish the lactobacilli population in the vagina, have not shown consistent results in treating bacterial vaginosis.
What Is A Bacterial Vaginosis Test
Bacterial vaginosis is an infection of the vagina. A healthy vagina contains a balance of both “good” and “bad” bacteria. Normally, the good type of bacteria keeps the bad type under control. A BV infection happens when the normal balance is upset and more bad bacteria grow than good bacteria.
Most BV infections are mild and sometimes go away on their own. Some women get BV and recover without even knowing they were infected. But BV infections can be more serious and may not clear up without treatment. Untreated BV may increase your risk of getting a sexually transmitted disease , such as chlamydia, gonorrhea, or HIV.
If you are pregnant and have a BV infection, it can increase your risk of having a premature delivery or having a baby with a lower than normal birth weight . Low birth weight can cause serious health problems in a baby, including infections, breathing difficulties, and troubles with feeding and gaining weight.
A BV test can help you get diagnosed and treated so you can avoid these serious health problems.
Other names: vaginal pH test, KOH test, wet mount test
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