Female Urogenital Diseases and Pregnancy Complications Commons^™

Evidentiary Standards For Newly Approved Antibiotics For Uncomplicated Urinary Tract Infections, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez, John H. Powers Iii

Pharmacy Faculty Articles and Research

Importance: Uncomplicated urinary tract infections (uUTIs) are among the most common bacterial infections and are typically treated with existing oral antibiotics. In 2024–2025, the FDA approved two new oral agents, sulopenem etzadroxil/probenecid and gepotidacin, via expedited review pathways, for the treatment of uUTIs. Objective: To assess the clinical significance and regulatory evidence supporting FDA approval of sulopenem/probenecid and gepotidacin for uUTI, and to analyze the adherence of pivotal phase III trials to regulatory standards for approval and FDA guidelines. Design, Setting, and Participants: Comparative descriptive analysis of publicly available data from phase 3 randomized, double-blind, active-controlled clinical …

A Modified Sir Model Used To Investigate The Relationship Between Congenital And Adult Syphilis, Kaleesta R. Waysman

Honors Thesis

A complex SIR model integrating the relationship between adult and congenital syphilis was developed. The goal of the project was to determine the specific population(s) or control strategies that should be enforced, altered, or removed to decrease the number of children experiencing clinical sequelae due to congenital syphilis. Early clinical sequelae include hydrops fetalis, preterm birth, central nervous system infection, hepatosplenomegaly, hyperbilirubinemia, cholestasis, hemolytic anemia, snuffles, osteochondritis, and lesions or rashes in the palms and soles. Late clinical sequelae include interstitial keratitis, hearing loss, Hutchinson teeth, saber shins, Clutton joints, mulberry molars, and saddle nose. After implementing real-world data into …

The Impact Of Testosterone Therapy On The Vaginal Microbiota Of Transgender Men And Non-Binary People: A Prospective Study, Olivia T. Van Gerwen, Kristal J. Aaron, Emma Sophia Kay, Krishmita Siwakoti, Angela Pontius, Saralyn Richter, Z Alex Sherman, Keonte J. Graves, Ashutosh Tamhane, Jacob H. Elnaggar, Meng Luo, Evelyn Toh, David E. Nelson, Nicholas J. Van Wagoner, Christopher M. Taylor, Christina A. Muzny

School of Medicine Faculty Publications

BACKGROUND: Understanding the impact of testosterone on the vaginal microbiota of transgender men (TGM) and non-binary people assigned female sex at birth over time is imperative as vaginal dysbiosis and incident bacterial vaginosis (iBV) may cause bothersome genital symptoms and increase HIV/STI acquisition risk. We investigated shifts in the composition of the vaginal microbiota over time in TGM initiating testosterone for gender-affirming hormone therapy, including development of vaginal dysbiosis and iBV.

METHODS: Participants ages ≥18 years, assigned female sex at birth and reporting TGM or non-binary identity, interested in starting injectable testosterone, demonstrating optimal vaginal microbiota, with no current STI(s) …

Emphysematous Cystitis In A 60-Year-Old Female Who Had Reported No Medical Care For Decades, Taylor O'Brien, Scott Scher, Brian Wexler, Daniel Breznau, Karen Joseph

West Florida Division GME Research Day 2025

No abstract provided.

Development Of A Proposed Selective Medium For The Isolation And Differentiation Of P. Sordellii, Dimyana Bottros

Honors Undergraduate Theses

Clostridium, a genus of anaerobic, spore-forming bacteria, includes clinically and ecologically significant species like Clostridium difficile and Paeniclostridium sordellii. C. difficile causes antibiotic-associated colitis, while P. sordellii is linked to fatal infections and spontaneous abortions. Recent studies found both species in marine sediments, suggesting their role in environmental and wildlife health disturbances, including the 2013 mass mortality of over 300 manatees in the Indian River Lagoon. However, isolating and differentiating P. sordellii is challenging due to the lack of selective media optimized for its growth. This thesis proposes a novel selective medium tailored to P. sordellii’s physiological …

An Epidemiological Approach To The Rise In Syphilis In The United States Between 2018 And 2022, Ashley Forrest, Erica Rankin, Lahana Maharjan, Cyril Blavo, Jyotsna Chawla

HCA-NSU MD Research Day

Objective. This study aimed to investigate the recent increase in syphilis rates from 2018 to 2022, utilizing publicly available data from the Centers for Disease Control and Prevention (CDC). Background. Syphilis has seen a dramatic resurgence since 2018, reaching levels not observed since the 1940s. While this increase has prompted significant discourse among healthcare professionals, a comprehensive demographic analysis remains limited. Methods. CDC public datasets from 2018 to 2022 were analyzed descriptively, followed by chi-squared tests and logistic regression modeling conducted using R. The analysis examined syphilis rates across different demographic and behavioral factors, including sex, race/ethnicity, and reported sexual …

Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano

School of Medicine Faculty Publications

Introduction: Tertiary syphilis, a late form of the disease with neurologic, cutaneous, and cardiovascular manifestations, is rarely seen in the United States in modern times. Also called the “great imitator,” syphilis tends to mimic other disease processes, which can lead to a delay in proper diagnosis and treatment. Case: We present the case of a 59-year-old woman who presented for evaluation of possible squamous cell carcinoma of the vulva. After multiple inconclusive biopsies and extensive workup with multiple providers, she was instead found to have cutaneous and neurologic tertiary syphilis. A correct diagnosis was delayed in this patient due to …

The Role Of Prevotella Species In Female Genital Tract Infections, Sheridan D. George, Olivia T. Van Gerwen, Chaoling Dong, Lúcia G. Sousa, Nuno Cerca, Jacob H. Elnaggar, Christopher M. Taylor, Christina A. Muzny

School of Graduate Studies Faculty Publications

Female genital tract infections (FGTIs) include vaginal infections (e.g., bacterial vaginosis [BV]), endometritis, pelvic inflammatory disease [PID], and chorioamnionitis [amniotic fluid infection]. They commonly occur in women of reproductive age and are strongly associated with multiple adverse health outcomes including increased risk of HIV/sexually transmitted infection acquisition and transmission, infertility, and adverse birth outcomes such as preterm birth. These FGTIs are characterized by a disruption of the cervicovaginal microbiota which largely affects host immunity through the loss of protective, lactic acid-producing spp. and the overgrowth of facultative and strict anaerobic bacteria. species (spp.), anaerobic Gram-negative rods, are implicated in the …

Impaired Neutrophil Extracellular Trap-Forming Capacity Contributes To Susceptibility To Chronic Vaginitis In A Mouse Model Of Vulvovaginal Candidiasis, Junko Yano, Paul L. Fidel

School of Dentistry Faculty Publications

Vulvovaginal candidiasis (VVC), caused by is characterized by aberrant inflammation by polymorphonuclear neutrophils (PMNs) in the vaginal lumen. Data from the established murine model shows that despite potent antifungal properties, PMNs fail to clear due to local heparan sulfate that inhibits the interaction between PMNs and , resulting in chronic vaginal immunopathology. To understand the role of neutrophil extracellular traps (NETs) in defense against at the vaginal mucosa, we investigated the NET-forming capacity of PMNs in chronic VVC-susceptible (CVVC-S/C3H) and -resistant (CVVC-R/CD-1) mouse strains. Immunofluorescence revealed the formation of NETs (release of DNA with PMN-derived antimicrobial proteins) in PMN cocultures …

Puerperal Group A Streptococcus Infection Mimicking Gastrointestinal Ileus, Juhi Singhal, Mollie Mcdonnold, Carol Wang, Clarissa Villareal

Central & West Texas GME Research Day 2024

No abstract provided.

Established Colonization Of Sneathia Vaginalis In A Mouse Model, Kailyn E. Turcios-Gonzalez

Theses and Dissertations

Sneathia vaginalis (Sv) is a gram-negative anaerobic bacterium associated with adverse reproductive outcomes. Sv can traverse the fetal membrane and damage epithelial cells in vitro by producing a pore-forming cytotoxin, cytopathogenic toxin A (CptA). To further understand the transition of Sv from normal flora to a pathogen, an animal in vivo model needs to be created to observe the preliminary ascending infection before we begin to study the effects on pregnancy. Experimentation was conducted to optimize mouse breed, bacteria administration methods, and other variables that arise when working in vivo. The C57BL/6 mouse strain displayed the most consistent …

A Preliminary Analysis Of Vaginal Microbial Changes Prior To Incident Bacterial Vaginosis As Determined By Qpcr And Inferred Absolute Abundance, Jacob H. Elnaggar, Christopher M. Taylor, Caleb M. Ardizzone, Kristal J. Aaron, Isaac C. Eastlund, Keonte J. Graves, Meng Luo, Alison J. Quayle, Nuno Cerca, Christina A. Muzny

School of Medicine Faculty Publications

Infectious Diseases Week, IDWeek 2023, October 11 - 15, 2023, Boston, MA

Outpatient Sexually Transmitted Infection Testing And Treatment Patterns In The United States: A Real-World Database Study, Rebecca Lillis, Louis Kuritzky, Zune Huynh, Rodney Arcenas, Avneet Hansra, Roma Shah, Baiyu Yang, Stephanie N. Taylor

School of Medicine Faculty Publications

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common notifiable sexually transmitted infections (STIs) in the United States. Because symptoms of these infections often overlap with other urogenital infections, misdiagnosis and incorrect treatment can occur unless appropriate STI diagnostic testing is performed in clinical settings. The objective of this study was to describe STI diagnostic testing and antimicrobial treatment patterns and trends among adolescent and adult men and women with lower genitourinary tract symptoms (LGUTS). Methods: We analyzed insurance claims data from the IBM® MarketScan® Research Databases. Patients included were between 14 and 64 years old with …

A Novel Gardnerella, Prevotella, And Lactobacillus Standard That Improves Accuracy In Quantifying Bacterial Burden In Vaginal Microbial Communities, Jacob H. Elnaggar, Caleb M. Ardizzone, Nuno Cerca, Evelyn Toh, Paweł Łaniewski, Rebecca A. Lillis, Melissa M. Herbst-Kralovetz, Alison J. Quayle, Christina A. Muzny, Christopher M. Taylor

School of Graduate Studies Faculty Publications

Bacterial vaginosis (BV) is the most common vaginal dysbiosis. In this condition, a polymicrobial biofilm develops on vaginal epithelial cells. Accurately quantifying the bacterial burden of the BV biofilm is necessary to further our understanding of BV pathogenesis. Historically, the standard for calculating total bacterial burden of the BV biofilm has been based on quantifying Escherichia coli 16S rRNA gene copy number. However, E. coli is improper for measuring the bacterial burden of this unique micro-environment. Here, we propose a novel qPCR standard to quantify bacterial burden in vaginal microbial communities, from an optimal state to a mature BV biofilm. …

Purple Urine Bag Syndrome (Pubs) In A Patient With A Chronic Indwelling Foley, Kelsey Murray, Kishan B. Patel

Rowan-Virtua Research Day

Purple urine bag syndrome (PUBS) is a rare medical condition characterized by the appearance of purple discoloration in the urine collection bag of patients who use catheters for urinary drainage. PUBS is primarily seen in elderly, female, and institutionalized patients who have chronic indwelling catheters. The discoloration occurs due to the presence of certain bacteria that produce pigments, which react with the plastic materials of the catheter and urine collection bag, leading to the formation of a purple color. In addition to the aesthetic concerns, PUBS may also indicate an underlying urinary tract infection or other medical conditions that require …

The Vaginal Microbiome Post-Menopause And Urinary Tract Infections, Rifke Anolik, Julia Kiffel, Venkateswar Venkataraman

Rowan-Virtua Research Day

Background: Urinary Tract Infection (UTI) is a condition where pathogens invade the urinary tract and can travel up the urethra and into the bladder. UTIs occur more commonly in females compared to males and in the post-menopausal population this rate increases significantly. While these infections may be asymptomatic, they can also cause severe discomfort and lead to serious and even life threatening complications. Recent investigation into the vaginal microbiome has opened the doors to a possible mechanism behind the increased incidence of UTIs after menopause. Understanding the pathogenesis behind the increased risk of UTIs in the postmenopausal state will allow …

Diagnosis Of Urinary Tract Infections And Rapid Molecular Characterization Of Antibiotic Resistance, Mohammed Harris

All Dissertations

Urinary tract infections (UTIs) are one of the most common infectious clinical entities in both community and hospital settings. They have a broad range of clinical severity yet inflict large epidemiological burden of morbidity and mortality on patients and the healthcare system with billions of dollars in cost of treatment. Understanding what methods are optimal for diagnosing UTIs are critical to mitigate the marked impact and cost of these infections.

Chapter 1 and 2 in this work surveys the broad array of diagnostic modalities for UTIs and highlights their advantages and limitations in the context of the current standard of …

Sulopenem For The Treatment Of Complicated And Uncomplicated Bacterial Urinary Tract Infection (Uti), Aiyi Chen, Thanh-Liem Vu, Daniel J. Yang, Landon Olsen

Annual Research Symposium

No abstract provided.

Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge

Doctor of Nursing Practice Projects

Sexually transmitted infection (STI) prevention, education, screening, and management in pediatric primary care settings are of importance due to the increasing number of cases yearly. Almost half of the 26 million new STIs that occurred in 2018 were among young people 15-24. An opportunity existed in a rural pediatric primary clinic, for improved adherence to Centers for Disease Control and Prevention (CDC) or American Academy of Pediatrics (AAP) recommendations to screen/test patients. An evidence-based project (EBP) was developed to address this concern. Project objectives included: developing STI screening guidelines for pre-teen to young adults, developing a screening algorithm, providing alternative …

Genital Chlamydia Infection Is Influenced By The Female Sex Hormones Estrogen And Progesterone In Vivo, Amy Gail Gravitte

Electronic Theses and Dissertations

Chlamydia is the most common bacterial sexually transmitted infection in the United States and worldwide. It often goes unnoticed due to lack of symptoms and left untreated it can ascend the female genital tract to cause sequelae like pelvic inflammatory disease and irreversible tubal infertility. In reproductive-aged women, female sex hormones estrogen (E2) and progesterone (P4) concentrations fluctuate during the menstrual cycle and are influenced by hormonal contraceptives and hormone replacement therapy. E2 and P4 influence genital Chlamydia infection in women and mice, but these multifactorial interactions are not entirely mapped out. The complex interplay of E2 and P4 with …

Developing A Virus-Like Particle (Vlp)-Based Vaccine For Neisseria Gonorrhoeae, Ashvini Vaidya

Biomedical Sciences ETDs

Neisseria gonorrhoeae (Ng) is a sexually transmitted bacterium that infects human reproductive mucosal surfaces. Due to the risk of complications in untreated cases and evolving antibiotic resistance, a prophylactic vaccine is critical for preventing infection. There are four Ng outer-membrane proteins that contribute to Ng survival and resistance: PorB, BamA, TbpA, and MtrE. Each protein contains surface-exposed loops that are targets of bactericidal antibodies. Vaccines were developed by displaying Ng epitopes on the surface of bacteriophage virus-like particles (VLP). VLPs are immunogenic, multivalent, self-assembling complexes composed of viral structural proteins. Antigenic peptide sequences can be displayed on the surface …

Group A Beta-Hemolytic Streptococcus Toxic Shock Syndrome Following Elective Termination Of Pregnancy: A Review Of Current Literature And Recommendations, Shannon Alexa, Jandie Schwartz

Rowan-Virtua Research Day

Group A Streptococcal Toxic Shock Syndrome (STSS) occurs as a subset of invasive Group A Streptococcal (GAS) infections accounting for roughly 10% of cases yearly. Of those, Puerpural Streptococcal infections occur only 0.5/10,000 live births but has a mortality rate of nearly 38% if management does not occur early^1,3,4. Despite the overall lower incidence of disease when compared to noninvasive forms, infection rates have started to rise over the last 10 years making it a necessity that practitioners be able to efficiently diagnose and treat infection. Presented here is the case of a 30 year old female who …

Chat Expression In Chlamydia Muridarum-Infected Female Murine Genital Tract, Hallie Sartain

Undergraduate Honors Theses

Chlamydia trachomatis is the most prevalent agent of bacterial sexually transmitted infections in the world. However, a profuse number of cases are unreported, as the infection is often asymptomatic. Sequelae such as pelvic inflammatory disease, an increased risk of cervical cancer, premature birth, and perinatal infections in pregnant women can occur. Inflammation occurs in the body in response to infection or injury. Although inflammation can lead to some unwanted secondary effects, such as pain, it serves to return the body to homeostasis by restoring injured tissues and eliminating pathogens. One recently identified connection between the central nervous system and the …

Characterization Of Bacterial Pathogens Involved In Aerobic Vaginitis: Prevalence, Strain Characterization And Sequelae, Leslie A. Lafferty

Graduate School of Biomedical Sciences Theses and Dissertations

Aerobic vaginitis (AV) is a more recently defined infection that involves aerobic pathogenic bacteria that replace the normal flora of the vaginal tract. It is commonly mistaken for other vaginal infections, such as bacterial vaginosis (BV), because they share many common symptoms. AV leads to complications during pregnancy, such as premature delivery and amnion infection, and is diagnosed by indications that range from vaginal discharge to inflammation. Because this infection is difficult to diagnose differentially from other vaginal infections, it is important to determine what pathogens are involved in AV so that we may have the ability to detect them. …

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305) had …

Identification Of Transcription Factors Gzf3, Rfx1, Orf19.3928 As Being Implicated In Candida-Bacterial Interactions., Joni Watson

Undergraduate Honors Theses

Candida albicans is an opportunistic pathogen that is present in the normal flora in a majority of individuals. One key factor in C. albicans virulence is the ability to change its morphology from yeast to an elongated or hyphal form. The regulation of this morphogenesis relies in part upon quorum sensing (QS) molecules. C. albicans often exists as part of a mixed culture alongside other microbes and is influenced by their presence as well as the presence of QS molecules that they produce. In this study, a library of diploid homozygous transcriptional regulator knockout (TRKO) mutants were screened to identify …

Puerperal Fever From Hippocrates To Pasteur, Hunter A. Hammill

Houston History of Medicine Lectures (2006-2012)

The death of a mother in childbirth leaving a newborn deserted is a sort of a desecration. This was a frequent event for early physicians. It was felt to be caused by miasmas or punishment from the gods. DaVinci felt the cause was milk stasis, Hippocrates - lochia, Virchow - weather. Then came Semmelweis, Pasteur and Lister. They started a battle with ignorance, hospital administration, budget and academic politics. Ending with the murder of Semmelweis!