Honig E, Mouton J W, van der Meijden W I
Department of Dermatology and Venereology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Infect Dis Obstet Gynecol. 1999;7(4):206-9. doi: 10.1002/(SICI)1098-0997(1999)7:4<206::AID-IDOG9>3.0.CO;2-6.
Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic.
We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment.
We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients.
孕妇宫颈阴道被B族兰斯菲尔德链球菌(GBS)定植是新生儿发病和死亡的重要危险因素。约15%的女性为GBS携带者。通常,她们没有症状。
我们描述了两名有症状性阴道炎但未发现明显病因的患者。两名患者均被GBS大量定植。抗生素治疗后,两人均无症状且培养结果为阴性,但GBS再次定植后,症状复发。这种现象反复出现。在出现抗生素耐药后,局部应用氯己定似乎是唯一有效的治疗方法。
我们推测GBS阴道炎可能是一种疾病实体。虽然目前尚不清楚为何有些患者会出现症状,但我们推测这类患者的免疫反应在某种程度上受到了选择性抑制。