Colonization of the upper genital tract by vaginal bacterial species in nonpregnant women.
Colonization of the upper genital tract by vaginal bacterial species in nonpregnant women.
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DOI：
10.1016/j.ajog.2014.11.043
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发表时间：
2015-05
影响因子：
9.8
通讯作者：
Eschenbach D
中科院分区：
文献类型：
--
作者：
Mitchell CM;Haick A;Nkwopara E;Garcia R;Rendi M;Agnew K;Fredricks DN;Eschenbach D
使用能够检测挑剔细菌性阴道病 (BV) 相关细菌的敏感分子方法评估上生殖道 (UGT) 阴道细菌种类的存在。在子宫切除术之前收集阴道拭子。无菌地打开切除的子宫并从子宫内膜和上宫颈内膜收集拭子。在 11 种定量 PCR (qPCR) 检测中对 12 种细菌进行了 DNA 检测：惰性乳杆菌、卷曲乳杆菌、詹氏乳杆菌、阴道加德纳菌、阴道阿托波菌、巨球菌属、普氏菌属、细毛菌/Sneathia、BVAB1、BVAB2、BVAB3 和宽范围 16S rRNA 基因测定。使用 Luminex 和 ELISA 测试子宫内膜液中的细胞因子和防御素，并测试组织中防御素和抗菌素的基因表达。我们招募了 58 名女性：平均年龄 43 + 7 岁，大多数是白人 (n = 46; 79%) 和 BV 阴性 (n = 43; 74%)。通过物种特异性 qPCR，55 个 (95%) 的 UGT 定植于至少一种物种 (n = 52)，或通过 16S PCR 检测呈阳性 (n = 3)。最常见的物种是 L. iners（45% UGT，61% 阴道）、Prevotella spp。 （33% UGT，76% 阴道）和卷曲乳杆菌（33% UGT，56% 阴道）。 UGT 中细菌的中位数量比阴道水平低 2-4 log10 rRNA 基因拷贝数/拭子。 UGT 中没有细菌、仅有乳酸菌或任何 BV 相关菌种的女性之间的子宫内膜炎症标志物没有差异。我们的数据表明，大多数接受子宫切除术的女性的子宫内膜腔并不是无菌的，并且子宫中低水平细菌的存在与明显的炎症无关。
Evaluate upper genital tract (UGT) presence of vaginal bacterial species using sensitive molecular methods capable of detecting fastidious bacterial vaginosis (BV)-associated bacteria. Vaginal swabs were collected prior to hysterectomy. The excised uterus was sterilely opened and swabs collected from endometrium and upper endocervix. DNA was tested in 11 quantitative PCR (qPCR) assays for 12 bacterial species: Lactobacillus iners, L. crispatus, L. jensenii, Gardnerella vaginalis, Atopobium vaginae, Megasphaera spp., Prevotella spp., Leptotrichia/Sneathia, BVAB1, BVAB2, BVAB3 and a broad-range16S rRNA gene assay. Endometrial fluid was tested with Luminex and ELISA for cytokines and defensins, and tissue for gene expression of defensins and cathelicidin. We enrolled 58 women: mean age 43 + 7 years, mostly white (n = 46; 79%) and BV-negative (n = 43; 74%). By species-specific qPCR, 55 (95%) had UGT colonization with at least one species (n = 52), or were positive by 16S PCR (n = 3). The most common species were L. iners (45% UGT, 61% vagina), Prevotella spp. (33% UGT, 76% vagina) and L. crispatus (33% UGT, 56% vagina). Median quantities of bacteria in the UGT were lower than vaginal levels by 2–4 log10 rRNA gene copies/swab. There were no differences in endometrial inflammatory markers between women with no bacteria, Lactobacillus only or any BV-associated species in the UGT. Our data suggest that the endometrial cavity is not sterile in most women undergoing hysterectomy, and that the presence of low levels of bacteria in the uterus is not associated with significant inflammation.