Correlation Analysis of Vaginal Microbiome Changes and Bacterial Vaginosis Plus Vulvovaginal Candidiasis Mixed Vaginitis Prognosis.
Correlation Analysis of Vaginal Microbiome Changes and Bacterial Vaginosis Plus Vulvovaginal Candidiasis Mixed Vaginitis Prognosis.
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DOI：
10.3389/fcimb.2022.860589
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发表时间：
2022
影响因子：
5.7
通讯作者：
Zhang D
中科院分区：
文献类型：
--
作者：
Xiao B;A D;Qin H;Mi L;Zhang D
混合性阴道炎是由至少两种阴道病原体介导的不同致病过程同时存在的结果。在各类混合性阴道炎表现中，细菌性阴道病（BV）合并外阴阴道假丝酵母菌病（VVC）最为常见。混合性阴道炎影响着全球各个年龄段女性的健康。然而，针对混合性阴道炎的临床表现、发病机制、诊断标准或治疗的研究却很少。我们招募了48例临床诊断为VVC合并BV的有症状患者，给予口服甲硝唑联合局部使用克霉唑进行治疗，并随访评估治疗前后的药物疗效以及阴道微生物群的变化。经联合药物治疗后，BV + VVC混合性阴道炎患者的阴道微生物群发生了显著改变，其改变形式独特，并非BV和VVC的简单叠加，关键菌群包括加德纳菌、阿托波菌和乳杆菌。本研究中针对混合性阴道炎的联合药物治疗是有效的，鉴于治疗结果显示BV更难处理，加强对BV的治疗可能更为有利。混合性阴道炎患者体内乳杆菌的丰度会影响阴道微生物群的恢复以及预后，应积极恢复其丰度。这是首项研究BV + VVC混合性阴道炎患者药物治疗前后阴道微生物群的组成、多样性及其他特征的研究，我们的研究结果为提高治愈率和减少复发提供了线索。
Mixed vaginitis is the result of the simultaneous presence of different pathogenic processes mediated by at least two types of vaginal pathogens. Among the various types of mixed vaginitis presentations, bacterial vaginosis (BV) plus vulvovaginal candidiasis (VVC) presents to be the most prevalent form. Mixed vaginitis affects the health of women of all ages worldwide. However, few studies have focused on clinical manifestations, pathogenesis, diagnostic criteria, or therapy of mixed vaginitis. We recruited 48 symptomatic patients with clinical diagnoses of VVC complicated with BV, they were treated with oral metronidazole combined with local clotrimazole and followed to assess the drug efficacy and vaginal microbiome alterations before and after treatment. The vaginal microbiome in BV+VVC mixed vaginitis patients was altered significantly after the combined drug treatment within a unique form different from a simple overlay mode of BV and VVC, the key bacteria including Gardnerella and Atopobium, Lactobacillus. The combined drug therapy for the mixed vaginitis in this study was effective and enhanced treatment for BV may be more favorable because of more difficulty in dealing with BV according to the treatment outcome. The abundance of Lactobacillus in patients with mixed vaginitis affects the recovery of the vaginal microbiome as well as the prognosis, and the abundance should be actively restored. This is the first study to investigate the composition, diversity, and other characteristics of the vaginal microbiome in patients with BV+VVC mixed vaginitis before and after drug treatment, our results provide clues to improving the cure rate and reducing recurrences.