Investigation of cytokines changes associated with genotype of Escherichia coli strains and Cytomegalovirus isolated from in women with vaginitis in Misan province, Iraq

The investigation of cytokine changes associated with the genotype of Escherichia coli (E. coli) strains and Cytomegalovirus (CMV) isolated from women with vaginitis in Misan Province, Iraq, represents a critical exploration into the intricate interplay of microorganisms and the immune response in the context of vaginal infections. Vaginitis, a common gynecological condition, can be caused by a variety of pathogens, including E. coli and CMV. Understanding how specific genotypes of E. coli and strains of CMV impact the cytokine profiles of affected individuals is pivotal in advancing our knowledge of the immunological dynamics in vaginal infections. The study aims to detect E. coli using biochemical tests and molecular techniques. Identification of virulence genes of E. coli. Immunological detection of Cytomegalovirus IgM and IgG. Cytokine changes which associated with the virulence genes of E.coli in vaginitis women. The study was carried out in the obstetrics and gynecology department of AL-Sadder Teaching Hospital in Maysan governorate and under the supervision of competent staff during the period March 2022–August 2022. the number of samples were collected 200 samples divided into high vaginal swabs (125) and serum (75%). All study samples were taken from women with vaginitis in 15–69 years. In the study, pathogenic microorganisms in Vaginitis Women were found to had a high rate of mixed infection (72%). CMV was the second most common outcome, occurring in 53 cases (26.5%). E. coli was prevalent in the age groups 20–29 years (30%) and 30-39 years (30%), while Cytomegalovirus had a high rate in the 20-29 years age group (32.1%). Among women aged 20-29 years, mixed infection had a high rate (43.1%), while E. coli was more prevalent in the age group 20-29 years to 30-39 years (30%). In cases where abortion did not occur, mixed infection had a high rate (29.2%) compared to Cytomegalovirus (32.1%). However, in cases of abortion, mixed infection had a high rate (70.8%), while E. coli had a lower rate (64%). Abortion with Cytomegalovirus was recorded in 36 cases (67.9%). Regarding virulence genes in E. coli in Vaginitis women, PCR technology revealed that DNA was found in all E. coli strains, with a high percentage rate (100%). Among the four genes of E. coli (16srRNA, Tra t, Vat, Fim H), gene 16srRNA had a high rate (100%), while gene Vat had a lower percentage (18%). In terms of antibiotic resistance, E. coli strains showed the highest resistance to Ampicillin (80%) and the lowest resistance to Meropenem, Piperacillin, Ceftazidime, Cefepime, Ertapenem, Imipenem, Meropenem, and Amikacin. Intermediate antibiotic resistance was highest for Fosfomycin (4%). Moreover, all E. coli strains were most sensitive to Meropenem (100%), while Ampicillin had the lowest sensitivity (18%). Regarding immunoglobulins of Cytomegalovirus in Vaginitis women, those who tested positive for IgM had previously contracted the virus or had it reactiVated, while those who tested positive for IgG had recently contracted CMV. In positive cases, IgG had a high rate (100%), while IgM had a low rate (0%). In negative cases, IgM had a high rate (100%), and IgG had a low percentage (0%). The study also recorded interleukin levels for Cytomegalovirus, with IL-6 at 0.79730±0.245659, IL-8 at 0.69881±0.281192, IL-10 at 0.81726±0.307895, and TNF-α at 0.54758±0.284395.