Impact of oral metronidazole treatment on the vaginal microbiota and correlates of treatment failure
Impact of oral metronidazole treatment on the vaginal microbiota and correlates of treatment failure
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DOI：
10.1016/j.ajog.2019.08.008
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发表时间：
2020-02-01
影响因子：
9.8
通讯作者：
van de Wijgert, Janneke H. H. M.
中科院分区：
文献类型：
--
作者：
Verwijs, Marijn C.;Agaba, Stephen K.;van de Wijgert, Janneke H. H. M.
背景技术背景：甲硝唑是细菌性阴道病的一线治疗药物，但治愈率不理想，复发率高。结论：评价口服甲硝唑标准疗程的影响使用显微镜检查和16 S rRNA基因测序对卢旺达细菌性阴道病患者的阴道微生物群进行研究（500 mg，每天两次，持续7天），并评估治疗失败的相关性。在甲硝唑治疗前后，对患有细菌性阴道病和/或阴道毛滴虫病的18-45岁HIV阴性非妊娠女性（N=68）进行了访谈和采样。他们还接受了其他泌尿生殖系统感染的筛查和治疗（如适用）。通过革兰氏染色Nugent评分、Illumina 16 S rRNA HiSeq测序（相对丰度）和BactQuant 16 S基因定量聚合酶链反应（估计浓度）评估阴道微生物群。只有治疗前Nugent评分7-10分和治疗后Nugent评分有效的妇女（N=55）被纳入甲硝唑治疗失败分析，治疗失败定义为治疗后Nugent评分4- 10分。阴道细菌总数平均值从6.59下降到5.85 log（10）/μ L（P
BACKGROUND: Metronidazole is the first-line treatment for bacterial vaginosis, but cure rates are suboptimal and recurrence rates high.OBJECTIVES: To evaluate the impact of a standard course of oral metronidazole treatment (500 mg twice per day for 7 days) on the vaginal microbiota of Rwandan bacterial vaginosis patients using microscopy and 16S rRNA gene sequencing, and to evaluate correlates of treatment failure.STUDY DESIGN: HIV-negative, nonpregnant women aged 18-45 years with bacterial vaginosis and/or Trichomonas vaginalis (N=68) were interviewed and sampled before and after metronidazole treatment. They were also screened, and treated if applicable, for other urogenital infections. The vaginal microbiota was assessed by Gram stain Nugent scoring, Illumina 16S rRNA HiSeq sequencing (relative abundances), and BactQuant 16S gene quantitative polymerase chain reaction (estimated concentrations). Only women with a pretreatment Nugent score of 7-10 and a valid posttreatment Nugent score (N=55) were included in metronidazole treatment failure analyses, with treatment failure defined as a posttreatment Nugent score of 4-10.RESULTS: The bacterial vaginosis cure rate by Nugent scoring was 54.5%. The mean total vaginal bacterial concentration declined from 6.59 to 5.85 log(10)/mu L (P