Assessment of the Lower Urinary Tract Microbiota during Symptom Flare in Women with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study.
Assessment of the Lower Urinary Tract Microbiota during Symptom Flare in Women with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study.
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泌尿科慢性盆腔疼痛综合征女性症状发作期间下尿路微生物群的评估：MAPP 网络研究。
DOI：
10.1016/j.juro.2015.09.075
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
MAPP Research Network
中科院分区：
文献类型：
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作者：
Nickel JC;Stephens A;Landis JR;Mullins C;van Bokhoven A;Lucia MS;Ehrlich GD;MAPP Research Network
我们比较了标准培养阴性的泌尿系统慢性盆腔疼痛综合征女性患者的下尿路微生物群的独立评估，这些患者报告了症状发作与未报告发作的患者。采用Ibis T-5000通用生物传感器系统技术对233例泌尿系慢性盆腔疼痛综合征患者的初流（VB 1）和中段（VB 2）尿液标本进行微生物菌种的全面鉴定。耀斑和nonflare组的存在或数量的不同物种在一个更高的水平组（丰富度）之间的差异进行了检查，排列多变量方差分析和logistic回归。在VB 1和VB 2中分别检测到81种（35属）和73种（33属）。86例发作病例的平均（SD）VB 1和VB 2物种计数分别为2.6（1.5）和2.4（1.5），127例非发作病例的平均（SD）VB 1和VB 2物种计数分别为2.8（1.3）和2.5（1.5）。总体而言，在多变量丰富度分析中，在任何水平上，耀斑和非耀斑病例之间的物种组成均无显著差异（VB 1和VB 2中分别为p =0.14种，p=0.95属）。未经调整和调整的单变量分析证实，在VB 2中，耀斑组（15.7%）的真菌（念珠菌和酵母菌）患病率显着高于非耀斑组（3.9%）（p=0.01）。当调整抗生素使用和月经期时，报告发作的女性更有可能在VB 2标本中存在真菌（OR 8.3，CI 1.7-39.4）。在患有泌尿系统慢性盆腔疼痛综合征的女性中，真菌（念珠菌和酵母菌属）的患病率与未报告发作的患者相比，报告发作的患者的平均心率显著更高。
We compared culture independent assessment of microbiota of the lower urinary tract in standard culture negative female patients with urological chronic pelvic pain syndrome who reported symptom flare vs those who did not report a flare. Initial stream (VB1) and midstream (VB2) urine specimens (233 patients with urological chronic pelvic pain syndrome) were analyzed with Ibis T-5000 Universal Biosensor system technology for comprehensive identification of microorganism species. Differences between flare and nonflare groups for presence or number of different species within a higher level group (richness) were examined by permutational multivariate analysis of variance and logistic regression. Overall 81 species (35 genera) were detected in VB1 and 73 (33) in VB2. Mean (SD) VB1 and VB2 species count per person was 2.6 (1.5) and 2.4 (1.5) for 86 flare cases and 2.8 (1.3) and 2.5 (1.5) for 127 nonflare cases, respectively. Overall the species composition did not significantly differ between flare and nonflare cases at any level (p=0.14 species, p=0.95 genus in VB1 and VB2, respectively) in multivariate analysis for richness. Univariate analysis, unadjusted as well as adjusted, confirmed a significantly greater prevalence of fungi (Candida and Saccharomyces) in the flare group (15.7%) compared to the nonflare group in VB2 (3.9%) (p=0.01). When adjusted for antibiotic use and menstrual phase, women who reported a flare remained more likely to have fungi present in VB2 specimens (OR 8.3, CI 1.7–39.4). Among women with urological chronic pelvic pain syndrome the prevalence of fungi (Candida and Saccharomyces sp.) was significantly greater in those who reported a flare compared to those who did not.