Department of Laboratory Medicine, University of California San Francisco CA.
Sex Transm Dis. 2019 Feb;46(2):86-90. doi: 10.1097/OLQ.0000000000000926.
An understanding of the biological reasons why 25% to 35% of women resist infection during vaginal intercourse with a man infected with Neisseria gonorrhoeae could lead to novel control measures. We sought modifiable biological bases for infection resistance by comparing women in the same core-mixing group who did or did not become infected after sexual exposure.
We enrolled 61 female contacts of index men with gonorrhea seen at Baltimore City Health Department clinics from January 2008 through May 2012. Exposure and sexual practices and histories, co-infections, physical signs on exam, patient symptom report, and menstrual history were collected.
Thirty-eight (62.3%) of the exposed women developed cervical infections. Multiple logistic regression found that a vaginal pH of 4.5 or higher at presentation to clinic was significantly associated with gonococcal infection (adjusted odds ratio, 5.5; P = 0.037) in women who presented within one menstrual cycle, 35 days. In this group of women, there was a significant association between acquiring an N. gonorrhoeae cervical infection and sexual exposure during menstruation (adjusted odds ratio 12.5; P = 0.05).
Modification of vaginal pH could be explored as novel strategy for reducing the risk of N. gonorrhoeae infections in women.
了解为什么 25%至 35%的女性在与感染淋病奈瑟菌的男性进行阴道性交时能够抵抗感染的生物学原因，可能会导致新的控制措施。我们通过比较在性接触后感染或未感染的同一核心混合组中的女性，寻找感染抵抗的可改变的生物学基础。
我们招募了 61 名 2008 年 1 月至 2012 年 5 月在巴尔的摩市卫生局诊所就诊的患有淋病的男性的女性接触者。收集了暴露和性行为史、合并感染、检查时的身体体征、患者症状报告和月经史。
38 名（62.3%）暴露女性发生了宫颈感染。多变量逻辑回归发现，在月经周期内就诊的女性中，阴道 pH 值为 4.5 或更高与淋病奈瑟菌感染显著相关（调整后的优势比，5.5；P = 0.037），在这些女性中，经期发生性行为与获得淋病奈瑟菌宫颈感染之间存在显著关联（调整后的优势比，12.5；P = 0.05）。
阴道 pH 值的改变可能作为降低女性淋病奈瑟菌感染风险的新策略进行探索。
