title: The correlation of the lifestyle and medical conditions with the vaginal infections and production of 2-phenylethanol.
abstract: OBJECTIVE
  The objective of this study was determination of causative factors of the genital infections and their correlation with various predictor variables. Secondary objectives included: (1) determination of the presence and the type of low molecular weight metabolites in the samples of vaginal secretion formed in vivo, (2) determination of the concentration of 2-phenylethanol formed in vitro for each Candida species, (3) determination of the relationship between fungal/bacterial/viral infections with the metabolites formed in vivo using multivariate analysis.
  
  
  METHODS
  One hundred and ninety-seven women in the age range from 18 to 65 years were included in the study. After the completion of questionnaire, all the patients were subjected to Pap test, cervical swabs for the presence of aerobic bacteria, yeasts, Ureaplasma urealyticum, Chlamydia trachomatis,                            Mycoplasma, and hrHPV DNA. The presence and the concentration of low-molecular weight metabolites in vitro and in vivo were determined by gas chromatography-mass spectrometry (GC-MS) method. Multivariate analysis methods were used for statistical evaluation.
  
  
  RESULTS
  The most important risk factors of fungal/bacterial/viral infections were determined. The presence of 2-phenylethanol in vivo was confirmed in 14 of 74 tested samples and connected with the Candida species. The presence of symptoms, hrHPV DNA and Ureaplasma urealyticum are the predictor variables with the highest influence on the formation of the metabolite in vivo. The results in vitro confirmed that various Candida species produced 2-phenylethanol with the concentrations ranging from 0.6 to 4.64 μg/mL.
  
  
  CONCLUSIONS
  The medical exposure to irradiation, marital status, and number of partners as well as stress factors (miscarriages, chronic, viral, or tumor illnesses) had the highest influence on the development of the bacterial/fungal/viral infections. The formation of 2-phenylethanol, both in vivo and in vitro, was confirmed and connected with Candida species. Besides, according to statistical tests, it seems that presence of symptoms, hrHPV DNA, and Ureaplasma urealyticum had also significant role on the formation of 2-phenylethanol in vivo.
authors.affiliation: Findri-Guštek Ltd, Ninska 5A, Sesvete, Zagreb, Croatia.
authors.forename: Stefica
authors.initials: S
authors.lastname: Findri-Guštek
authors.forename: Maja Jelena
authors.initials: MJ
authors.lastname: Petek
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Sarajlija
authors.forename: Gordan
authors.initials: G
authors.lastname: Mršić
authors.forename: Ana Mlinarić
authors.initials: AM
authors.lastname: Džepina
authors.forename: Višnja
authors.initials: V
authors.lastname: Oreščanin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002175:Candida / Q000378:metabolism*; D016022:Case-Control Studies; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010626:Phenylethyl Alcohol / Q000032:analysis*; D014621:Vagina / Q000382:microbiology*; D014626:Vaginal Smears; D014627:Vaginitis / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D010626:Phenylethyl Alcohol