B族链球菌直肠定植作为阴道定植的预测指标
Rectal colonization by group B Streptococcus as a predictor of vaginal colonization.
作者信息
Meyn Leslie A, Krohn Marijane A, Hillier Sharon L
机构信息
Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA.
出版信息
Am J Obstet Gynecol. 2009 Jul;201(1):76.e1-7. doi: 10.1016/j.ajog.2009.02.011. Epub 2009 Apr 15.
OBJECTIVE
The purpose of this article was to describe rectal colonization by group B Streptococcus (GBS) and its role in the prediction of vaginal colonization.
STUDY DESIGN
In this prospective cohort of 1248 nonpregnant women, vaginal and rectal swabs for GBS culture were obtained at enrollment and at three 4-month intervals. Generalized estimating equations were used to identify factors that are associated with colonization.
RESULTS
Eight hundred fourteen (65%) women had GBS colonization sometime during the observation period. Rectal GBS colonization was the strongest predictor of vaginal colonization (adjusted odds ratio, 14.3; 95% CI, 11.9-17.1). Recent sexual intercourse, vaginal colonization with yeast, and a vaginal Nugent score >/= 4 were also independent determinants of vaginal GBS colonization. Antimicrobial use decreased vaginal GBS colonization only among women who had no rectal colonization.
CONCLUSION
GBS in the gastrointestinal tract is a risk factor for vaginal GBS. Sexual activity and abnormal vaginal microflora are independent determinants of vaginal GBS colonization.
目的
本文旨在描述B族链球菌（GBS）在直肠的定植情况及其在预测阴道定植中的作用。
研究设计
在这项针对1248名非孕妇的前瞻性队列研究中，在入组时以及每隔4个月采集阴道和直肠拭子进行GBS培养。采用广义估计方程来确定与定植相关的因素。
结果
在观察期内，有814名（65%）女性出现GBS定植。直肠GBS定植是阴道定植的最强预测因素（校正比值比为14.3；95%可信区间为11.9 - 17.1）。近期性交、阴道酵母菌定植以及阴道 Nugent评分≥4也是阴道GBS定植的独立决定因素。抗菌药物的使用仅在无直肠定植的女性中降低了阴道GBS定植。
结论
胃肠道中的GBS是阴道GBS的一个危险因素。性活动和异常阴道微生物群是阴道GBS定植的独立决定因素。
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