Recovery of Vaginal Flora after Douching Cessation

停止冲洗后阴道菌群的恢复

• 批准号: 7024484
• 负责人: Jonathan M Zenilman
• 金额: $ 6.15万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-15 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7024484
• 关键词: behavioral /social science research tag; cervical /vaginal smear; clinical research; disease /disorder proneness /risk; female; health behavior; human subject; interview; patient oriented research; vagina; vaginitis; women' s health

DESCRIPTION (provided by applicant): Vaginal douching is a commonly practiced behavior and previous work in Baltimore found that 70 percent of women in the Baltimore STD clinics report current douching. Douching is associated with a number of adverse outcomes, including bacterial vaginosis (BV), cervical infection, pelvic inflammatory disease (PID), and increased risk for ectopic pregnancy. BV, in particular, is associated with an increased risk of pre-term delivery, low birth weight and HIV. Most studies evaluating the effect of douching on risk for BV have been limited in their evaluation of feminine hygiene behavior and have been largely cross-sectional, limiting direct causal inference. Little data are available on how douching affects the vaginal flora on either a short or long-term basis or why women douche. No studies to date have evaluated vaginal flora after discontinuation of douching. We propose a cross-over intervention trial of vaginal douching to evaluate the change in vaginal flora after cessation of douching. We will recruit 150 women who currently douche from posted flyers, the Bayview Medical Center Gynecology clinic and Baltimore City Health Department STD clinics. We will measure the vaginal flora from self-collected samples (with Nugent's criteria) twice per week during a one month douching period. Subjects will then be asked to stop douching, and we will measure vaginal flora twice weekly for two months. Women who return to their normal douching patterns at the conclusion of the study will also be evaluated for a second cross-over exposure sample. Participants will maintain daily sexual and hygiene diaries throughout the study. Generalized estimating equations will be used to assess the following: 1) the effect of vaginal douching cessation on the risk of BV; 2) the risk for BV among women who abstain from douching but then revert to their previous douching habits. Common vaginal douching practices, motivations and techniques will also be evaluated. Data from this research will begin to describe the natural history of BV and aid in the design of behavioral interventions for vaginal douching.

描述（由申请人提供）：阴道冲洗是一种常见的行为，巴尔的摩先前的研究发现，巴尔的摩性病诊所70%的女性报告有过阴道冲洗。冲洗与许多不良后果相关，包括细菌性阴道病（BV）、宫颈感染、盆腔炎（PID）和宫外孕风险增加。尤其是细菌性阴道炎，与早产、低出生体重和艾滋病毒的风险增加有关。大多数评估冲洗对细菌性阴道炎风险影响的研究都局限于对女性卫生行为的评估，而且大多是横断面的，限制了直接的因果推断。关于冲洗对阴道菌群的短期或长期影响，以及女性为什么要冲洗的数据很少。到目前为止，还没有研究对停止冲洗后阴道菌群进行评估。我们建议进行阴道冲洗的交叉干预试验，以评估停止冲洗后阴道菌群的变化。我们将招募150名目前在海湾医疗中心妇科诊所和巴尔的摩市卫生局性病诊所进行冲洗的女性。我们将在一个月的冲洗期间，每周两次测量自采样本的阴道菌群（用纽金特标准）。然后受试者将被要求停止冲洗，我们将在两个月内每周测量两次阴道菌群。在研究结束时恢复正常灌洗模式的妇女也将被评估为第二次交叉暴露样本。在整个研究过程中，参与者将保持每天的性和卫生日记。将使用广义估计方程来评估以下内容：1)停止阴道灌洗对BV风险的影响；2)停止冲洗后又恢复冲洗习惯的妇女感染细菌性阴道炎的风险。还将评价常见的阴道灌洗做法、动机和技术。这项研究的数据将开始描述细菌性阴道炎的自然历史，并有助于设计阴道灌洗的行为干预措施。

项目成果

Temporal dynamics of the human vaginal microbiota.

• DOI: 10.1126/scitranslmed.3003605
• 发表时间: 2012-05-02
• 期刊: Science translational medicine
• 影响因子: 17.1
• 作者: Gajer P;Brotman RM;Bai G;Sakamoto J;Schütte UM;Zhong X;Koenig SS;Fu L;Ma ZS;Zhou X;Abdo Z;Forney LJ;Ravel J
• 通讯作者: Ravel J

Characterizing the temporal dynamics of human papillomavirus DNA detectability using short-interval sampling.

• DOI: 10.1158/1055-9965.epi-13-0666
• 发表时间: 2014-01
• 期刊: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
• 作者: Liu SH;Cummings DA;Zenilman JM;Gravitt PE;Brotman RM
• 通讯作者: Brotman RM