Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis
Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis
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DOI：
10.1111/j.1471-0528.2002.00432.x
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发表时间：
2002-01-01
影响因子：
5.8
通讯作者：
Spitz, B
中科院分区：
文献类型：
--
作者：
Donders, GGG;Vereecken, A;Spitz, B
目的定义一种阴道菌群异常的实体：有氧阴道炎。设计观察性研究。比利时鲁汶Gasthuisberg大学医院。样本631名参加常规产前护理或参加阴道炎门诊的妇女。方法对阴道液进行新鲜湿片镜检和阴道培养，测定阴道液中乳酸、琥珀酸和细胞因子水平。乳酸菌缺乏和线索细胞阳性的涂片被认为是细菌性阴道病的诊断。如果涂片缺乏乳酸菌，球菌或粗杆菌阳性，基底旁上皮细胞阳性，和/或阴道白细胞阳性（加上它们的颗粒状外观），则诊断为需氧性阴道炎。结果外阴主诉包括红色炎症、黄色分泌物、阴道性交困难。常培养B群链球菌、大肠杆菌、金黄色葡萄球菌和阴道毛滴虫。与细菌性阴道病一样，需氧阴道炎患者阴道乳酸浓度严重降低，但不产生阴道琥珀酸盐。与细菌性阴道炎不同，有氧阴道炎产生宿主免疫反应，导致阴道液中白细胞介素-6、白细胞介素-1- β和白血病抑制因子的大量产生。结论需氧性阴道炎与需氧微生物有关，以B群链球菌和大肠杆菌为主。其特点不同于细菌性阴道病，引起重要的宿主反应。有氧阴道炎最严重的形式是脱屑性炎症性阴道炎。理论上，有氧阴道炎可能比细菌性阴道病更适合作为妊娠并发症的病因，如绒毛膜上升性羊膜炎、胎膜早破和早产。
Objective To define an entity of abnormal vaginal flora: aerobic vaginitis.Design Observational study.Setting University Hospital Gasthuisberg, Leuven, Belgium. Sample 631 women attending for routine prenatal care or attending vaginitis clinic.Methods Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect).Results Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured. Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-beta and leukaemia inhibitory factor in the vaginal fluid.Conclusion Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.