Intermittent Lactobacilli-containing Vaginal Probiotic or Metronidazole Use to Prevent Bacterial Vaginosis Recurrence: Safety and Preliminary Efficacy by Microscopy and Sequencing
Intermittent Lactobacilli-containing Vaginal Probiotic or Metronidazole Use to Prevent Bacterial Vaginosis Recurrence: Safety and Preliminary Efficacy by Microscopy and Sequencing
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间歇性使用含乳杆菌的阴道益生菌或甲硝唑预防细菌性阴道病复发：通过显微镜检查和测序获得的安全性和初步疗效
DOI：
10.1101/19001156
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Van De Wijgert J
中科院分区：
文献类型：
--
作者：
Van De Wijgert J
细菌性阴道病（BV）与HIV感染和不良妊娠结局有关。甲硝唑治疗后复发率高。hiv阴性、未怀孕的卢旺达BV患者在口服甲硝唑治疗7天后，随机分为4组（n = 17/组）：仅进行行为咨询（对照组），或咨询的同时间歇使用口服甲硝唑、Ecologic Femi+阴道胶囊（含多种乳酸杆菌和一种双歧杆菌）或Gynophilus LP阴道片（L. rhamnosus35），疗程2个月。所有访问的阴道微生物群评估包括革兰氏染色纽金特评分、16S rRNA基因qPCR和HiSeq测序。所有干预措施都是安全的。对照组BV （Nugent 7-10）危险发生率为10.18例/人年，甲硝唑组（1.41例/人年，p = 0.004）、生态美+组（3.58例/人年，p = 0.043）、Gynophilus LP组（5.36例/人年，p = 0.220）风险发生率较低。在调整了激素避孕/怀孕、性冒险和年龄的混合效应模型中，与对照组相比，甲硝唑和Ecologic Femi+使用者的乳酸杆菌估计浓度和/或相对丰度更高，bv -厌氧菌估计浓度和/或相对丰度更低，并且通过测序发现阴道微生物群类型失调的可能性更小。个体间差异很大，干预停止后效果很快消失。基于乳杆菌的阴道益生菌值得进一步评估，因为与抗生素相比，它们不会对肠道微生物群产生负面影响或引起抗菌素耐药性。
Bacterial vaginosis (BV) is associated with HIV acquisition and adverse pregnancy outcomes. Recurrence after metronidazole treatment is high. HIV-negative, non-pregnant Rwandan BV patients were randomized to four groups (n = 17/group) after seven-day oral metronidazole treatment: behavioral counseling only (control), or counseling plus intermittent use of oral metronidazole, Ecologic Femi+ vaginal capsule (containing multipleLactobacillusand oneBifidobacteriumspecies), or Gynophilus LP vaginal tablet (L. rhamnosus35) for two months. Vaginal microbiota assessments at all visits included Gram stain Nugent scoring and 16S rRNA gene qPCR and HiSeq sequencing. All interventions were safe. BV (Nugent 7–10) incidence was 10.18 per person-year at risk in the control group, and lower in the metronidazole (1.41/person-year; p = 0.004), Ecologic Femi+ (3.58/person-year; p = 0.043), and Gynophilus LP groups (5.36/person-year; p = 0.220). In mixed effects models adjusted for hormonal contraception/pregnancy, sexual risk-taking, and age, metronidazole and Ecologic Femi+ users, each compared to controls, had higherLactobacillusand lower BV-anaerobes estimated concentrations and/or relative abundances, and were less likely to have a dysbiotic vaginal microbiota type by sequencing. Inter-individual variability was high and effects disappeared soon after intervention cessation. Lactobacilli-based vaginal probiotics warrant further evaluation because, in contrast to antibiotics, they are not expected to negatively affect gut microbiota or cause antimicrobial resistance.
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影响因子：
4.4
作者：
Fettweis JM;Serrano MG;Sheth NU;Mayer CM;Glascock AL;Brooks JP;Jefferson KK;Vaginal Microbiome Consortium (additional members);Buck GA
通讯作者：
Buck GA
影响因子：
3.7
作者：
Bisanz JE;Seney S;McMillan A;Vongsa R;Koenig D;Wong L;Dvoracek B;Gloor GB;Sumarah M;Ford B;Herman D;Burton JP;Reid G
通讯作者：
Reid G
影响因子：
14.9
作者：
Pruesse E;Quast C;Knittel K;Fuchs BM;Ludwig W;Peplies J;Glöckner FO
通讯作者：
Glöckner FO
DOI：
10.1007/s10096-012-1671-1
发表时间：
2012-11-01
影响因子：
4.5
作者：
Hemalatha, R.;Mastromarino, P.;Sesikeran, B.
通讯作者：
Sesikeran, B.
影响因子：
8
作者：
Borgdorff, H.;Gautam, R.;van de Wijgert, J. H. H. M.
通讯作者：
van de Wijgert, J. H. H. M.