Verteramo Rosita, Pierangeli Alessandra, Mancini Emanuela, Calzolari Ettore, Bucci Mauro, Osborn John, Nicosia Rosa, Chiarini Fernanda, Antonelli Guido, Degener Anna Marta
Department of Gynaecology, Perinatology and Child Health, Sapienza University of Rome, Italy.
BMC Infect Dis. 2009 Feb 12;9:16. doi: 10.1186/1471-2334-9-16.
High grade HPV infections and persistence are the strongest risk factors for cervical cancer. Nevertheless other genital microorganisms may be involved in the progression of HPV associated lesions.
Cervical samples were collected to search for human Papillomavirus (HPV), bacteria and yeast infections in gynaecologic outpatients. HPV typing was carried out by PCR and sequencing on cervical brush specimens. Chlamydia trachomatis was identified by strand displacement amplification (SDA) and the other microorganisms were detected by conventional methods.
In this cross-sectional study on 857 enrolled outpatients, statistical analyses revealed a significant association of HPV with C. trachomatis and Ureaplasma urealyticum (at high density) detection, whereas no correlation was found between HPV infection and bacterial vaginosis, Streptococcus agalactiae, yeasts, Trichomonas vaginalis and U. urealyticum. Mycoplasma hominis was isolated only in a few cases both in HPV positive and negative women and no patient was infected with Neisseria gonorrhoeae.
Although bacterial vaginosis was not significantly associated with HPV, it was more common among the HPV positive women. A significant association between HPV and C. trachomatis was found and interestingly also with U. urealyticum but only at a high colonization rate. These data suggest that it may be important to screen for the simultaneous presence of different microorganisms which may have synergistic pathological effects.
高危型人乳头瘤病毒（HPV）感染及持续感染是宫颈癌最强的危险因素。然而，其他生殖系统微生物可能也参与了HPV相关病变的进展过程。
收集妇科门诊患者的宫颈样本，以检测人乳头瘤病毒（HPV）、细菌及酵母菌感染情况。采用聚合酶链反应（PCR）及测序技术对宫颈刷检样本进行HPV分型。采用链置换扩增法（SDA）检测沙眼衣原体，其他微生物则通过传统方法进行检测。
在这项针对857名登记门诊患者的横断面研究中，统计分析显示HPV与沙眼衣原体及解脲脲原体（高密度）检测存在显著相关性，而HPV感染与细菌性阴道病、无乳链球菌、酵母菌、阴道毛滴虫及解脲脲原体之间未发现相关性。人型支原体仅在少数HPV阳性及阴性女性中分离出，且无患者感染淋病奈瑟菌。
虽然细菌性阴道病与HPV无显著相关性，但在HPV阳性女性中更为常见。发现HPV与沙眼衣原体之间存在显著相关性，有趣的是，与解脲脲原体也存在显著相关性，但仅在高定植率时。这些数据表明，筛查可能具有协同病理效应的不同微生物的同时存在可能很重要。
