Molecular analysis of the relationship between specific vaginal bacteria and bacterial vaginosis metronidazole therapy failure
Molecular analysis of the relationship between specific vaginal bacteria and bacterial vaginosis metronidazole therapy failure
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特定阴道细菌与细菌性阴道病甲硝唑治疗失败关系的分子分析
DOI：
10.1007/s10096-014-2128-5
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发表时间：
2014-10-01
影响因子：
4.5
通讯作者：
Liao, Q.
中科院分区：
文献类型：
--
作者：
Wang, B.;Xiao, B. B.;Liao, Q.
细菌性阴道病经常持续存在，即使在治疗后也是如此。与细菌性阴道病治疗失败相关的一些细菌菌株的作用仍不清楚。我们研究的目的是确定细菌性阴道病治疗失败的风险，包括治疗前对特定阴道细菌的检测。当Nugent评分为7分且改良的Amsel标准为阳性时，即为细菌性阴道病。对细菌性阴道病患者每晚用甲硝唑凝胶阴道内注射治疗，疗程5晚。用454焦磷酸测序法检测阴道液中的细菌。通过单因素分析，细菌性阴道病病史、宫内节育器的使用以及法克拉米亚、棒状杆菌和韦隆杆菌的存在与细菌性阴道病治疗失败显著相关。卷曲乳杆菌、戊糖乳杆菌和巨型乳杆菌与细菌性阴道病的治疗密切相关。经过Logistic回归分析和对这些细菌的检测进行治愈测试，我们发现有细菌性阴道病病史的妇女治疗失败的发生率较高，而患有皱纹伊蚊的妇女治疗失败的发生率较低。治疗后的性行为与治疗效果无关。我们的数据表明，治疗失败可能不是由耐药性引起的。相反，它与乳酸菌修复失败有更密切的关系。
Bacterial vaginosis frequently persists, even after treatment. The role of some strains of bacteria associated with bacterial vaginosis treatment failure remains poorly defined. The aim of our study was to define the risk of bacterial vaginosis treatment failure, including pre-treatment detection of specific vaginal bacteria. Bacterial vaginosis is present when the Nugent score is >= 7 and the modified Amsel criteria is positive. Women with bacterial vaginosis were treated with intravaginal metronidazole gel nightly for 5 nights. The 454 pyrosequencing method was used to detect bacteria in vaginal fluid. By univariate analysis, a history of bacterial vaginosis, intrauterine device use and the presence of Facklamia, Corynebacterium and Veillonella were significantly associated with bacterial vaginosis treatment failure. Lactobacillus crispatus, Lactobacillus pentosus and Megasphaera were significantly associated with curing bacterial vaginosis. After logistic regression analysis and detection of these bacteria for test-of-cure, we found that women who had a history of bacterial vaginosis had a higher incidence of bacterial vaginosis treatment failure, whereas women with L. crispatus had a lower incidence of treatment failure. Post-treatment sexual activity was not associated with the treatment effect. Our data suggested that treatment failure may be not caused by drug resistance. Rather, it has a closer relationship with the failed restoration of lactobacilli.