Cox C, Watt A P, McKenna J P, Coyle P V
Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK.
Centre for Infection and Immunity, Queen's University Belfast, Belfast, Northern Ireland, UK.
Eur J Clin Microbiol Infect Dis. 2016 Mar;35(3):481-7. doi: 10.1007/s10096-015-2564-x. Epub 2016 Jan 21.
Gardnerella vaginalis plays an important role in bacterial vaginosis (BV,) while the role of genital Mollicutes is less obvious. The diagnosis of BV by use of the current Gram stain Nugent score is also suboptimal for defining the role of Mollicutes that lack a cell wall. Since bacterial load and diversity is an important prerequisite for BV, real-time quantitative polymerase chain reaction (qPCR) assays enable these to be assessed. The purpose of this study was to define the role of genital Mollicutes and potential patterns of synergy with G. vaginalis in women with BV. Vaginal swabs from 130 women categorised by Nugent score as BV (n = 28), intermediate (n = 22) and non-BV (n = 80) were tested against four qPCR TaqMan assays targeting G. vaginalis, Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum and U. parvum. Statistical analyses were used to compare bacterial prevalence and load between the three groups of women. Mycoplasma hominis and G. vaginalis co-infection was significantly more common in BV (60.7 %) compared to intermediate (36.4 %) and non-BV (8.8 %) Nugent scores (p < 0.001). Significantly higher loads of M. hominis (p = 0.001) and G. vaginalis (p < 0.001) were detected in women with BV and the respective loads in M. hominis and G. vaginalis co-infections displayed a significant positive correlation (p < 0.001; r = 0.60). No significant associations were seen with the other Mollicutes. The findings strengthen the evidence of a role for M. hominis in BV and a potential synergy with G. vaginalis. This synergy could be an important trigger of the condition and sexual contact the conduit for the transmission of an otherwise commensal bacterium that could initiate it.
阴道加德纳菌在细菌性阴道病(BV)中起重要作用,而生殖道柔膜菌的作用则不太明显。使用当前的革兰氏染色 Nugent 评分诊断 BV,对于定义缺乏细胞壁的柔膜菌的作用也并不理想。由于细菌载量和多样性是 BV 的重要前提条件,实时定量聚合酶链反应(qPCR)检测能够对这些进行评估。本研究的目的是确定生殖道柔膜菌在 BV 女性中的作用以及与阴道加德纳菌潜在的协同模式。对 130 名根据 Nugent 评分分为 BV(n = 28)、中间型(n = 22)和非 BV(n = 80)的女性的阴道拭子,针对四种靶向阴道加德纳菌、人型支原体、生殖支原体、解脲脲原体和微小脲原体的 qPCR TaqMan 检测进行了测试。采用统计分析比较三组女性之间的细菌患病率和载量。与 Nugent 评分中间型(36.4%)和非 BV(8.8%)相比,人型支原体和阴道加德纳菌共感染在 BV(60.7%)中显著更常见(p < 0.001)。在 BV 女性中检测到显著更高的人型支原体载量(p = 0.001)和阴道加德纳菌载量(p < 0.001),并且人型支原体和阴道加德纳菌共感染中的各自载量呈现显著正相关(p < 0.001;r = 0.60)。未发现与其他柔膜菌有显著关联。这些发现强化了人型支原体在 BV 中起作用以及与阴道加德纳菌存在潜在协同作用的证据。这种协同作用可能是该病症的一个重要触发因素,而性接触则是原本共生的细菌得以传播并引发该病的途径。