患有阴道感染的女性中产生过氧化氢的乳酸杆菌

Hydrogen peroxide producing lactobacilli in women with vaginal infections.

作者信息

Mijac Vera D, Dukić Slobodanka V, Opavski Natasa Z, Dukić Milan K, Ranin Lazar T

机构信息

Institute for Microbiology and Immunology, Medical School, University of Belgrade, Dr. Subotića 1, Serbia and Montenegro.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2006 Nov;129(1):69-76. doi: 10.1016/j.ejogrb.2005.11.036. Epub 2006 Jul 11.

DOI:10.1016/j.ejogrb.2005.11.036

PMID:16814920

Abstract

OBJECTIVE

Hydrogen peroxide producing lactobacilli are isolated from the vaginas of a majority of healthy reproductive age women. Their toxic and inhibitory effect against the overgrowth of pathogens in the vagina is documented by in vitro studies. Clinical studies concerning the role of hydrogen peroxide producing lactobacilli in vaginal infections are controversial.

STUDY DESIGN

The aim of this study was to isolate lactobacilli from women with major vaginal infections: bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis (TV), and from women with normal flora (NF), to test their ability to produce hydrogen peroxide, to quantitate lactobacilli and to evaluate factors related to the colonization of vagina with hydrogen peroxide producing lactobacilli. The study group comprised 108 women: 27 with VVC, 26 with BV, 20 with TV and 35 with NF. Data was analysed with Fisher exact test, chi2-test, and ANOVA.

RESULTS

Lactobacilli were isolated from 81.5% of women with VVC, 58% of women with BV (p=0019), 55% of women with TV (p=0.015) and from 86% of women with NF. The majority of isolates of lactobacilli from women with VVC, TV and NF produced hydrogen peroxide (77%, 63.5% and 80%, respectively), compared with women with BV where only 26.5% of isolates produced hydrogen peroxide (p=0.01). Quantitative analysis showed that in an overwhelming majority of women colonized with lactobacilli, their count was >10(7) CFU/ml. Upon evaluation of behavioural and demographic characteristics, we found that smokers had a lower incidence of isolation of hydrogen peroxide producing lactobacilli (p=0.018). Our results showed that women with BV lack lactobacilli, especially hydrogen peroxide producing ones. Women with TV had a lower rate of lactobacilli. In women with VVC, there was neither significant difference in the isolation of lactobacilli, nor in their ability to produce hydrogen peroxide, compared to women with NF.

CONCLUSION

Our results point out that hydrogen peroxide producing lactobacilli could protect against the development of BV, but not against VVC and TV.

摘要

目的

大多数健康育龄女性阴道内可分离出产过氧化氢的乳酸杆菌。体外研究证实了它们对阴道内病原体过度生长具有毒性和抑制作用。关于产过氧化氢乳酸杆菌在阴道感染中作用的临床研究存在争议。

研究设计

本研究旨在从患有主要阴道感染的女性中分离乳酸杆菌，这些感染包括细菌性阴道病（BV）、外阴阴道假丝酵母菌病（VVC）和滴虫病（TV），并从具有正常菌群（NF）的女性中分离，以测试它们产生过氧化氢的能力，定量乳酸杆菌，并评估与产过氧化氢乳酸杆菌在阴道定植相关的因素。研究组包括108名女性：27名患有VVC，26名患有BV，20名患有TV，35名具有NF。数据采用Fisher精确检验、卡方检验和方差分析进行分析。

结果

从81.5%的VVC女性、58%的BV女性（p = 0.019）、55%的TV女性（p = 0.015）以及86%的NF女性中分离出了乳酸杆菌。与BV女性相比，VVC、TV和NF女性中分离出的大多数乳酸杆菌菌株产生过氧化氢（分别为77%、63.5%和80%），而BV女性中只有26.5%的分离菌株产生过氧化氢（p = 0.01）。定量分析表明，在绝大多数定植有乳酸杆菌的女性中，其数量>10⁷CFU/ml。在评估行为和人口统计学特征时，我们发现吸烟者中产过氧化氢乳酸杆菌的分离率较低（p = 0.018）。我们的结果表明，BV女性缺乏乳酸杆菌，尤其是产过氧化氢的乳酸杆菌。TV女性的乳酸杆菌率较低。与NF女性相比，VVC女性在乳酸杆菌分离及其产生过氧化氢的能力方面均无显著差异。