Douching cessation and molecular bacterial vaginosis: a reanalysis of archived specimens.
Douching cessation and molecular bacterial vaginosis: a reanalysis of archived specimens.
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停止冲洗和分子细菌性阴道病：对存档标本的重新分析。
DOI：
10.1136/sextrans-2022-055459
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发表时间：
2023
影响因子：
3.6
通讯作者：
Brotman,RebeccaM
中科院分区：
文献类型：
--
作者：
Brown,SarahElizabeth;He,Xin;Shardell,MichelleD;Ravel,Jacques;Ghanem,KhalilG;Zenilman,JonathanM;Brotman,RebeccaM
目的观察性研究证实阴道冲洗与革兰氏染色特征的细菌性阴道病（BV）之间存在相关性。我们试图描述冲洗停止干预对阴道微生物群和分子BV的组成和结构的影响，一种通过分子工具评估的低水平乳酸杆菌属的状态。方法33名妇女每周两次自我收集阴道中段拭子在马里兰州的巴尔的摩进行的2005年单交叉初步研究中，在冲洗观察期（4周）和冲洗停止期（12周）期间（982份样本）。通过16 S rRNA基因扩增子测序（V3-V4）表征阴道微生物群，并将其聚类为群落状态类型（CST）。条件logistic回归模型允许每个参与者作为自己的对照。使用Wilcoxon符号秩检验来评估阶段之间微生物群的变化。宽范围qPCR检测提供了冲洗前后7名参与者子样本中每个拭子的细菌绝对丰度估计值。分段线性混合效应模型被用来评估细菌绝对丰度的变化率之前和之后wouching.ResultsThere是没有统计学显着变化的几率分子BV versusLactobacillus-dominated CST比较冲洗停止间隔冲洗观察（调整OR 1.77，95%CI 0.89至3.55）。去除L.从结果来看，惯性主导的CST III并没有影响结果。四种乳酸杆菌的相对丰度没有显著变化，其他类群也没有显著变化。有一个参与者的样本收集3天前和冲洗后的细菌绝对丰度之间没有显着变化（p=0.46）conclusionsIn this pilot study，冲洗停止与阴道微生物群的重大变化无关。单独停止冲洗可能无法持久地改变阴道微生物群，可能需要额外的干预措施来恢复冲洗者的最佳阴道微生物群。
ObjectivesObservational studies demonstrate an association between vaginal douching and bacterial vaginosis (BV) characterised by Gram stain. We sought to describe the effect of a douching cessation intervention on the composition and structure of the vaginal microbiota and molecular-BV, a state defined by low levels ofLactobacillusspp evaluated by molecular tools.Methods33 women self-collected mid-vaginal swabs twice weekly (982 samples) during a douching observation phase (4 weeks) followed by a douching cessation phase (12 weeks) in a 2005 single crossover pilot study conducted in Baltimore, Maryland. Vaginal microbiota were characterised by16S rRNAgene amplicon sequencing (V3-V4) and clustered into community state types (CSTs). Conditional logistic regression modelling allowed each participant to serve as their own control. Wilcoxon signed-rank tests were used to evaluate changes in microbiota between phases. Broad-range qPCR assays provided estimates of bacterial absolute abundance per swab in a subsample of seven participants before and after douching. A piecewise linear mixed effects model was used to assess rates of change in bacterial absolute abundance before and after douching.ResultsThere was no statistically significant change in the odds of molecular-BV versusLactobacillus-dominated CSTs comparing the douching cessation interval to douching observation (adjusted OR 1.77, 95% CI 0.89 to 3.55). Removal ofL. iners-dominated CST III from the outcome did not affect the results. There were no significant changes in the relative abundance of fourLactobacillusspp and no meaningful changes in other taxa investigated. There was no significant change in bacterial absolute abundance between a participant’s sample collected 3 days prior to and following douching (p=0.46).ConclusionsIn this pilot study, douching cessation was not associated with major changes in vaginal microbiota. Douching cessation alone may not durably shift the vaginal microbiota and additional interventions may be needed to restore optimal vaginal microbiota among those who douche.