Haggerty C L, Totten P A, Ferris M, Martin D H, Hoferka S, Astete S G, Ondondo R, Norori J, Ness R B
University of Pittsburgh, Department of Epidemiology, Pittsburgh, Philadelphia 15261, USA.
Sex Transm Infect. 2009 Aug;85(4):242-8. doi: 10.1136/sti.2008.032821. Epub 2008 Nov 12.
As the aetiology of bacterial vaginosis (BV) is not well understood, this study sought to determine the relationships between several fastidious microbes, BV and selected clinical characteristics of BV.
Endometrial and cervical specimens from 50 women with non-gonococcal, non-chlamydial endometritis were tested for Leptotrichia sanguinegens/amnionii, Atopobium vaginae, bacterial vaginosis-associated bacteria 1 (BVAB1), Ureaplasma urealyticum biovar 2 (UU-2) and Ureaplasma parvum using PCR. BV was categorised using Nugent's and Amsel's criteria. Odds ratios (OR) adjusted for age and race were estimated using multivariable logistic regression.
Although elevated pH was a universal feature, other BV characteristics differed by pathogen, suggesting variable clinical presentation. Only UU-2 was strongly associated with vaginal discharge, but a positive whiff test and a 20% or greater classification of epithelial cells as clue cells were more common among women with L sanguinegens/amnionii, A vaginae and BVAB1. For each of these bacteria, there were trends towards associations with BV defined by Amsel's criteria (L sanguinegens/amnionii OR 2.9, 95% CI 0.5 to 15.7; A vaginae OR 2.6, 95% CI 0.6 to 11.4; BVAB1 OR 5.7, 95% CI 1.0 to 31.1) and significant associations with BV defined by Gram stain (L sanguinegens/amnionii OR 17.7, 95% CI 2.8 to 113.0; A vaginae OR 19.2, 95% CI 3.7 to 98.7; BVAB1 OR 21.1, 95% CI 2.2 to 198.5).
L sanguinegens/amnionii, A vaginae and BVAB1 are associated with clinical characteristics consistent with BV and BV defined by Nugent's and Amsel's criteria. These fastidious bacteria may cause unrecognised infection, as none was associated with abnormal vaginal discharge.
由于细菌性阴道病（BV）的病因尚未完全明确，本研究旨在确定几种苛求菌、BV与BV的某些临床特征之间的关系。
对50例非淋菌性、非衣原体性子宫内膜炎患者的子宫内膜和宫颈标本进行检测，采用聚合酶链反应（PCR）检测血/羊膜纤细杆菌、阴道阿托波菌、细菌性阴道病相关细菌1（BVAB1）、解脲脲原体生物变种2（UU-2）和微小脲原体。使用 Nugent 标准和 Amsel 标准对BV进行分类。采用多变量逻辑回归估计经年龄和种族调整的比值比（OR）。
虽然pH升高是一个普遍特征，但其他BV特征因病原体而异，提示临床表现存在差异。只有UU-2与阴道分泌物密切相关，但在血/羊膜纤细杆菌、阴道阿托波菌和BVAB1感染的女性中，阳性嗅味试验以及上皮细胞分类为线索细胞的比例达到20%或更高更为常见。对于这些细菌中的每一种，与根据Amsel标准定义的BV存在关联趋势（血/羊膜纤细杆菌OR 2.9，95%CI 0.5至15.7；阴道阿托波菌OR 2.6，95%CI 0.6至11.4；BVAB1 OR 5.7，95%CI 1.0至31.1），并且与革兰氏染色定义的BV存在显著关联（血/羊膜纤细杆菌OR 17.7，95%CI 2.8至113.0；阴道阿托波菌OR 19.2，95%CI 3.7至98.7；BVAB1 OR 21.1，95%CI 2.2至198.5）。
血/羊膜纤细杆菌、阴道阿托波菌和BVAB1与符合BV以及根据Nugent标准和Amsel标准定义的BV的临床特征相关。这些苛求菌可能导致未被识别的感染，因为没有一种与异常阴道分泌物相关。
