Studies of Vaginal Flora and Bacterial Vaginosis

阴道菌群和细菌性阴道病的研究

• 批准号: 7208940
• 负责人: JIM ZHANG
• 金额: --
• 依托单位: EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7208940
• 关键词: anaerobic bacteria; blood chemistry; disease /disorder etiology; disease /disorder proneness /risk; female reproductive system disorder; genital secretion; human subject; infection; interview; longitudinal human study; pathologic process; questionnaires; sex behavior; sexually transmitted diseases; vaginitis; women' s health

Bacterial vaginosis is a syndrome in which the normal Lactobacillus-predominant vaginal flora is replaced with mixed anaerobic-predominant organisms. It is present in 10 to 25% of women in the general population, and is the most common vaginal infection. It has been associated with a number of adverse sequelae in reproductive health including acquisition of HIV, pelvic inflammatory disease, cervical dysplasia, and complications of gynecological procedures. During pregnancy it has been associated with an increased risk of preterm birth and postpartum maternal infection. However, the vaginal microbial flora remains poorly understood. Information on variation in microbial flora and its association with BV from a longitudinal study is unavailable. This prospective observational study aims to advance our knowledge of the natural history and abnormal alteration in vaginal microbial flora, and to identify risk factors that are associated with these changes. A total of 3600 healthy, non-pregnant women of reproductive age have been enrolled and are being followed in Birmingham, Alabama for one year (baseline visit plus once every three months afterwards, totaling five visits). Detailed information on sociodemographic status, medical history, hygiene practice, sexual behavior and psychosocial stress were collected through in-person interviews. Routine gynecological and dental examinations were carried out during the study visits. Samples of vaginal secretion and blood were collected. Laboratory tests to quantify vaginal microbial flora and to identify infection of bacterial vaginosis as well as common sexually transmitted diseases were conducted. Sub-studies evaluate the day-to-day change in vaginal flora, and the effect of cessation of douching. The final study visits were completed in June 2003, and various analyses are underway. An abstract on the a pilot randomized trial of douching cessation and the incidence and persistence of bacterial vaginosis was presented at the Society for Gynecologic Investigation in 2004. Manuscripts describing the degree to which women with BV are asymptomatic, and the association between psychosicial stress and BV incidence were published in FY05, and a paper on contraceptive use and BV is under review. Abstracts describing the association between BV and periodontal disease was presented. Ongoing analysis are focusing on the effect of douching cessation and BV incidence, and dietary risk factors for BV.

细菌性阴道病是一种综合征，其中正常的乳酸杆菌为主的阴道植物群被混合的厌氧菌为主的微生物所取代。它存在于一般人群中10%至25%的女性中，是最常见的阴道感染。它与生殖健康方面的一些不良后遗症有关，包括艾滋病毒感染、盆腔炎、宫颈发育不良和妇科手术并发症。在怀孕期间，它与早产和产后母体感染的风险增加有关。然而，阴道微生物植物群仍然知之甚少。关于微生物植物群变化及其与BV相关性的纵向研究信息不可用。这项前瞻性观察性研究旨在提高我们对阴道微生物植物群的自然史和异常改变的认识，并确定与这些变化相关的风险因素。总共有3600名健康、非妊娠的育龄妇女被纳入研究，并在亚拉巴马的伯明翰接受为期一年的随访（基线访视加上之后每三个月一次，共五次访视）。通过面对面访谈收集了有关社会人口学状况、病史、卫生习惯、性行为和心理社会压力的详细信息。在研究访视期间进行常规妇科和牙科检查。采集阴道分泌物和血液样本。进行了实验室检测，以量化阴道微生物植物群，并确定细菌性阴道病以及常见性传播疾病的感染。子研究评估了阴道植物群的日常变化以及停止灌洗的影响。 最后一次研究访问于2003年6月完成，目前正在进行各种分析。2004年在妇科调查学会上发表了一项关于停止冲洗与细菌性阴道病的发病率和持续性的初步随机试验的摘要。2005财政年度发表了描述BV妇女无症状程度以及精神压力与BV发病率之间关系的文章，一篇关于避孕药具使用与BV的论文正在审查中。摘要描述BV和牙周病之间的关联。正在进行的分析集中在冲洗停止和BV发病率的影响，以及BV的饮食危险因素。