School of Clinical Medicine, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
UP-Ampath Translational Genomics Initiative, Department of Biochemistry, Genetics and Microbiology, Faculty of Health Sciences and Faculty of Natural and Agricultural Sciences, Division of Genetics, University of Pretoria, Pretoria, South Africa.
Front Cell Infect Microbiol. 2020 Aug 11;10:354. doi: 10.3389/fcimb.2020.00354. eCollection 2020.
A healthy female genital tract harbors a microbiome dominated by lactic acid and hydrogen peroxide producing bacteria, which provide protection against infections by maintaining a low pH. Changes in the bacterial compositions of the vaginal microbiome can lead to bacterial vaginosis (BV), which is often associated with vaginal inflammation. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STIs) like human immunodeficiency virus (HIV) and affects women's reproductive health negatively. In pregnant women, BV can lead to chorioamnionitis and adverse pregnancy outcomes, including preterm premature rupture of the membranes and preterm birth. In order to manage BV effectively, good diagnostic procedures are required. Traditionally clinical and microscopic methods have been used to diagnose BV; however, these methods require skilled staff and time and suffer from reduced sensitivity and specificity. New diagnostics, including highly sensitive and specific point-of-care (POC) tests, treatment modalities and vaccines can be developed based on the identification of biomarkers from the growing pool of vaginal microbiome and vaginal metabolome data. In this review the current and future diagnostic avenues will be discussed.
健康女性生殖道内寄居着以产生乳酸和过氧化氢的细菌为主的微生物群，这些细菌通过维持较低的 pH 值来提供抗感染保护。阴道微生物群的细菌组成发生变化可导致细菌性阴道病（BV），BV 常伴有阴道炎症。细菌性阴道病会增加感染性传播感染（STI）的风险，如人类免疫缺陷病毒（HIV），并对女性生殖健康产生负面影响。在孕妇中，BV 可导致绒毛膜羊膜炎和不良妊娠结局，包括胎膜早破和早产。为了有效地管理 BV，需要良好的诊断程序。传统上，临床和显微镜方法已用于诊断 BV；然而，这些方法需要熟练的人员和时间，并且存在敏感性和特异性降低的问题。新的诊断方法，包括高度敏感和特异性的即时检测（POC）测试、治疗方式和疫苗，可以基于从不断增长的阴道微生物群和阴道代谢组学数据中识别生物标志物来开发。在这篇综述中，将讨论当前和未来的诊断途径。
