Jespers Vicky, Crucitti Tania, van de Wijgert Janneke, Vaneechoutte Mario, Delany-Moretlwe Sinead, Mwaura Mary, Agabe Stephen, Menten Joris
HIV and Sexual Health Unit, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, Belgium.
HIV/STI Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, Belgium.
Res Microbiol. 2016 Feb-Mar;167(2):133-41. doi: 10.1016/j.resmic.2015.10.006. Epub 2015 Nov 11.
A next-generation diagnostic tool for bacterial vaginosis, consisting of quantitative and/or qualitative molecular criteria, has not yet been identified. The optimal diagnostic tool should not only diagnose bacterial vaginosis in diverse populations, but should also detect early signs of transition to dysbiosis. We evaluated a tool based on log10-transformed qPCR data for Lactobacillus crispatus, Lactobacillus iners, Lactobacillus jensenii, Lactobacillus gasseri, Lactobacillus vaginalis, Lactobacillus genus, Atopobium vaginae and Gardnerella vaginalis in vaginal specimens of 426 African women to detect dysbiosis and predict transition to dysbiosis. G. vaginalis (p = 0.204) and A. vaginae (p = 0.001) were more commonly present in women who evolved to an intermediate (Nugent 4-6) or bacterial vaginosis score (Nugent 7-10) compared to women who continued to have a normal Nugent score. The combination of G. vaginalis, A. vaginae and Lactobacillus genus counts performed best for diagnostic accuracy for bacterial vaginosis--sensitivity 93.4% and specificity 83.6%; and for predictive accuracy for bacterial vaginosis--sensitivity 79% and specificity 52%. L. crispatus combinations did not perform well. We conclude that a triple-G. vaginalis-A. vaginae-Lactobacillus genus-qPCR tool holds promise for research in sub-Saharan Africa or when developed as a next-generation clinical diagnostic modality for bacterial vaginosis, ideally engineered as a rapid assay.
一种用于细菌性阴道病的下一代诊断工具，由定量和/或定性分子标准组成，目前尚未确定。最佳诊断工具不仅应能在不同人群中诊断细菌性阴道病，还应能检测到向生态失调转变的早期迹象。我们评估了一种基于对数10转换的qPCR数据的工具，该数据用于检测426名非洲女性阴道标本中的卷曲乳杆菌、惰性乳杆菌、詹氏乳杆菌、加氏乳杆菌、阴道乳杆菌、乳杆菌属、阴道阿托波菌和阴道加德纳菌，以检测生态失调并预测向生态失调的转变。与 Nugent 评分正常的女性相比，阴道加德纳菌（p = 0.204）和阴道阿托波菌（p = 0.001）在演变为中间（Nugent 4-6）或细菌性阴道病评分（Nugent 7-10）的女性中更常见。阴道加德纳菌、阴道阿托波菌和乳杆菌属计数的组合对细菌性阴道病的诊断准确性最佳——敏感性为93.4%，特异性为83.6%；对细菌性阴道病的预测准确性——敏感性为79%，特异性为52%。卷曲乳杆菌组合表现不佳。我们得出结论，阴道加德纳菌-阴道阿托波菌-乳杆菌属-qPCR三联工具在撒哈拉以南非洲的研究中或作为细菌性阴道病的下一代临床诊断方法（理想情况下设计为快速检测方法）具有应用前景。
