Bassis Christine M, Allsworth Jenifer E, Wahl Heather N, Sack Daniel E, Young Vincent B, Bell Jason D
Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109.
Department of Biomedical & Health, University of Missouri - Kansas City School of Medicine, Kansas City, MO 64108; Department of Obstetrics & Gynecology, University of Missouri - Kansas City School of Medicine, Kansas City, MO 64108.
Contraception. 2017 Sep;96(3):189-195. doi: 10.1016/j.contraception.2017.05.017. Epub 2017 Jun 15.
There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota.
DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months. A third swab from approximately 12 months following insertion was available for 69 (Cu-IUD, n=33; LNG-IUS, n=36) of these women. The V4 region of the bacterial 16S rRNA-encoding gene was amplified from the vaginal swab DNA and sequenced. The 16S rRNA gene sequences were processed and analyzed using the software package mothur to compare the structure and dynamics of the vaginal bacterial communities.
The vaginal microbiota from individuals in this study clustered into 3 major vaginal bacterial community types: one dominated by Lactobacillus iners, one dominated by Lactobacillus crispatus and one community type that was not dominated by a single Lactobacillus species. Changes in the vaginal bacterial community composition were not associated with the use of Cu-IUD or LNG-IUS. Additionally, we did not observe a clear difference in vaginal microbiota stability with Cu-IUD versus LNG-IUS use.
Although the vaginal microbiota can be highly dynamic, alterations in the community associated with the use of intrauterine contraception (Cu-IUD or LNG-IUS) were not detected over 12 months.
We found no evidence that intrauterine contraception (Cu-IUD or LNG-IUS) altered the vaginal microbiota composition. Therefore, the use of intrauterine contraception is unlikely to shift the composition of the vaginal microbiota such that infection susceptibility is altered.
关于避孕措施使用与阴道微生物群改变及感染易感性之间的关系，已有相互矛盾的报道。本研究的目的是确定宫内避孕是否会改变阴道微生物群，并比较铜宫内节育器（Cu-IUD）和左炔诺孕酮宫内节育系统（LNG-IUS）对阴道微生物群的影响。
从76名使用Cu-IUD（n = 36）或LNG-IUS（n = 40）的女性的阴道拭子样本中分离DNA，这些样本在宫内避孕器插入前（基线）和6个月时采集。在插入后约12个月时，其中69名女性（Cu-IUD组n = 33；LNG-IUS组n = 36）可获得第三次拭子样本。从阴道拭子DNA中扩增细菌16S rRNA编码基因的V4区域并进行测序。使用软件包mothur对16S rRNA基因序列进行处理和分析，以比较阴道细菌群落的结构和动态变化。
本研究中个体的阴道微生物群聚为3种主要的阴道细菌群落类型：一种以惰性乳杆菌为主导，一种以卷曲乳杆菌为主导，还有一种群落类型不以单一乳杆菌种类为主导。阴道细菌群落组成的变化与Cu-IUD或LNG-IUS的使用无关。此外，我们未观察到使用Cu-IUD与LNG-IUS在阴道微生物群稳定性方面存在明显差异。
尽管阴道微生物群可能具有高度动态性，但在12个月内未检测到与使用宫内避孕措施（Cu-IUD或LNG-IUS）相关的群落改变。
我们没有发现证据表明宫内避孕措施（Cu-IUD或LNG-IUS）会改变阴道微生物群的组成。因此，使用宫内避孕措施不太可能改变阴道微生物群的组成，从而改变感染易感性。
