Prevalence and polymicrobial patterns of genital tract microorganisms among women with genital symptoms in Northern Cyprus: a cross-sectional study
DOI:
https://doi.org/10.5327/DST-2177-8264-1501%20Keywords:
sexually transmitted disease (STD), PCR, Genital microbiota, EpidemiologyAbstract
Introduction: Recent advances in molecular diagnostics have shown that interactions between polymicrobial infections are increasingly influencing the epidemiology of sexually transmitted and genital infections. Despite the evident importance of this information to world health, no specific information is available regarding Northern Cyprus. Objective: To analyse the presence of multi-microbial pathogens and classic sexually transmitted infections in the genitourinary system. Methods: A total of 1,000 vaginal swab samples from symptomatic women were included in this study and analysed for 12 different sexually transmitted and genital tract-associated microorganisms by multiplex real-time polymerase chain reaction. Prevalence, co-detection, and age distribution were investigated. Results: At least one microorganism was detected in 39.0% (390/1,000) of the study population. Microbiota-associated organisms were the most prevalent, including Gardnerella vaginalis (28.2%), Ureaplasma parvum (17.7%), and Candida albicans (11.6%), followed by Mycoplasma hominis (3.3%) and Ureaplasma urealyticum (1.5%). Classical sexually transmitted infections, such as Chlamydia trachomatis (2.3%) and Neisseria gonorrhoeae (0.6%) were found at lower rates, while Mycoplasma genitalium (0.7%), herpes simplex virus type 2 (0.3%), Treponema pallidum (0.1%), and Trichomonas vaginalis (0.1%) were detected at very low rates; herpes simplex virus type 1 was not detected. Infections were most frequently observed in women aged 20–29 years, though no statistically significant age difference was found between microbiota-associated and classical sexually transmitted pathogen groups (p=0.95). Co-detection of multiple microorganisms was frequent, occurring in 49.5% of positive cases, particularly among G. vaginalis, U. parvum, and C. albicans, which showed the strongest pairwise associations (phi coefficients 0.27–0.40, all p<0.001), highlighting strong polymicrobial interactions. Conclusion: Genital tract infection for this demographic group is mainly mediated by microbiota-associated pathogens, with a substantial tendency toward co-detection. This first comprehensive molecular data set from Northern Cyprus underscores the importance of microbiota-focused diagnostic approaches and encourages a paradigm shift beyond traditional STI-centric frameworks.8
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