Francis Suzanna Carter, Crucitti Tania, Smekens Tom, Hansen Christian Holm, Andreasen Aura, Jespers Vicky, Hardy Liselotte, Irani Julia, Changalucha John, Baisley Kathy, Hayes Richard, Watson-Jones Deborah, Buvé Anne
MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Front Cell Infect Microbiol. 2020 Jun 25;10:305. doi: 10.3389/fcimb.2020.00305. eCollection 2020.
The aetiology of bacterial vaginosis (BV) is not well-understood, and prevalence appears to be higher among women living in sub-Saharan Africa. A recent conceptual model implicates three main bacteria ( and ), sexual activity, sialidase activity, and biofilm formation in the pathogenesis of BV. We describe the vaginal microbiota, presence of the putative sialidase A gene of , and biofilm among 386 adolescent girls aged 17 and 18 years in a cross-sectional study in Mwanza, Tanzania around the time of expected sexual debut. Vaginal swabs were collected and tested by quantitative polymerase chain reaction (qPCR) for five species, , the sialidase A gene of , and by fluorescence hybridisation (FISH) for evidence of and biofilm. We conducted a risk factor analysis of and , and explored the associations between biofilm, the presence of the sialidase A gene, and non-optimal vaginal microbiota (Nugent 4-7) and were detected in 69 and 82% of girls, respectively. The prevalence of was higher than previously reported in earlier studies among East and Southern African women. were independently associated with reported penile-vaginal sex. Samples with all three BV-associated bacteria made up the highest proportion of samples with Nugent-BV compared to samples with each bacterium alone or together in pairs. Of the 238 girls with , 63% had the sialidase A gene detected, though there was no difference by reported sexual activity ( = 0.197). Of the 191 girls with results for sialidase A gene and FISH, there was strong evidence for an increased presence of sialidase A gene among those with evidence of a biofilm ( < 0.001). There was a strong association between biofilm and non-optimal microbiota (aOR67.00; 95% CI 26.72-190.53). These results support several of the steps outlined in the conceptual model, although the role of sexual activity is less clear. We recommend longitudinal studies to better understand changes in vaginal microbiota and biofilm formation around the time of sexual debut.
细菌性阴道病（BV）的病因尚未完全明确，撒哈拉以南非洲地区女性的患病率似乎更高。最近的一个概念模型表明，三种主要细菌（和）、性活动、唾液酸酶活性以及生物膜形成与BV的发病机制有关。在坦桑尼亚姆万扎进行的一项横断面研究中，我们描述了386名17至18岁青春期女孩在预期首次性行为前后的阴道微生物群、假定的唾液酸酶A基因的存在情况以及生物膜情况。采集阴道拭子，通过定量聚合酶链反应（qPCR）检测五种细菌、唾液酸酶A基因，并通过荧光原位杂交（FISH）检测和生物膜的证据。我们对和进行了危险因素分析，并探讨了生物膜、唾液酸酶A基因的存在与非最佳阴道微生物群（ Nugent 4 - 7）之间的关联，分别在69%和82%的女孩中检测到和。的患病率高于此前在东非和南部非洲女性早期研究中的报道。与报告的阴茎 - 阴道性行为独立相关。与单独含有每种细菌或成对含有细菌的样本相比，含有所有三种与BV相关细菌的样本在Nugent - BV样本中所占比例最高。在238名有的女孩中，63%检测到唾液酸酶A基因，不过按报告的性活动情况无差异（= 0.197）。在191名有唾液酸酶A基因和FISH检测结果的女孩中，有强有力的证据表明，在有生物膜证据的女孩中唾液酸酶A基因的存在增加（< 0.001）。生物膜与非最佳微生物群之间存在很强的关联（调整后比值比67.00；95%可信区间26.72 - 190.53）。这些结果支持了概念模型中概述的几个步骤，尽管性活动的作用尚不太明确。我们建议进行纵向研究，以更好地了解首次性行为前后阴道微生物群和生物膜形成的变化。
