Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections.
Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections.
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DOI：
10.1186/s40779-016-0074-5
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发表时间：
2016
影响因子：
21.1
通讯作者：
Sanchez JL
中科院分区：
文献类型：
--
作者：
Bautista CT;Wurapa E;Sateren WB;Morris S;Hollingsworth B;Sanchez JL
细菌性阴道病（BV）是育龄妇女常见的阴道疾病。自 Leopoldo 于 1953 年以及 Gardner 和 Dukes 于 1955 年开展初步工作以来，研究人员一直未能确定 BV 的致病因素。然而，越来越多的证据表明，当健康阴道菌群中的主要菌种乳杆菌被厌氧菌（如阴道栀子、柯蒂斯动杆菌、穆氏分枝杆菌、其他厌氧菌和/或人型支原体）取代时，就会发生细菌性阴道炎。据估计，在世界范围内，到性传播感染 (STI) 诊所就诊的育龄妇女中有 20-30% 患有细菌性阴道炎，而在高危人群（例如从事商业性工作 (CSW) 的人群）中，其患病率可能高达 50-60%。流行病学数据显示，如果女性满足以下条件，则更有可能报告细菌性阴道炎：1) 一生中性伴侣数量较多； 2）未婚； 3) 第一次性交的年龄较年轻； 4) 进行过 CSW，并且 5) 进行定期冲洗。在过去的十年中，多项研究提供了性活动对细菌性阴道病的影响的证据。然而，在无法确定病原体的情况下，很难说 BV 是一种 STI。由于与其他性传播感染相关，细菌性阴道炎也已成为一个公共卫生问题，包括：人类免疫缺陷病毒 (HIV)、单纯疱疹病毒 2 型 (HSV-2)、沙眼衣原体 (CT) 和淋病奈瑟菌 (NG)。关于 BV 和 CT/NG 感染之间关联的最新证据来自对就诊于 STI 诊所的女性进行的队列数据的两次二次分析。根据这些研究，患有 BV 的女性 NG 和 CT 感染的风险分别增加 1.8 倍和 1.9 倍。综上所述，BV 可能是高危女性随后发生 NG 或 CT 感染的一个危险因素，或者至少是一个重要因素。需要进行更多研究来确定这种关联是否也存在于其他低风险性活跃人群中，例如美国军队中的女性。有必要进行大规模横断面或基于人群的病例对照研究，以调查 BV 作为 CT/NG 感染危险因素的作用。这些研究可能会导致制定旨在减轻全球细菌性传播感染相关负担的干预措施。
Bacterial vaginosis (BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20–30 % of women of reproductive age attending sexually transmitted infection (STI) clinics suffer from BV, and that its prevalence can be as high as 50–60 % in high-risk populations (e.g., those who practice commercial sex work (CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus (HIV), herpes simplex virus type 2 (HSV-2), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among women in the US military. It is essential to conduct large scale cross-sectional or population-based case-control studies to investigate the role of BV as a risk factor for CT/NG infections. These studies could lead to the development of interventions aimed at reducing the burden associated with bacterial STIs worldwide.