Central Clinical School, Monash University, Melbourne, Vic., Australia.
Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia.
BJOG. 2021 Mar;128(4):756-767. doi: 10.1111/1471-0528.16430. Epub 2020 Aug 16.
Determine the associations between factors and sexual practices and the composition of the vaginal microbiome (VM) of women treated for bacterial vaginosis (BV).
Prospective cohort study.
The Melbourne Sexual Health Centre, Melbourne, Australia.
Seventy-five reproductive-age women diagnosed with clinical BV, treated with first-line antibiotics and followed for up to 6 months.
Women self-collected vaginal swabs and completed questionnaires at enrolment, the day following antibiotics and monthly for up to 6months until BV recurrence or no BV recurrence (n = 430 specimens). Bacterial composition was determined using 16S rRNA gene amplicon sequencing. The effects of ongoing factors on VM composition (utilising 291 monthly specimens) were assessed using generalised estimating equations population-averaged models, which accounted for repeated measures within individuals.
The relative abundance of vaginal bacterial taxa.
Women who reported ongoing sex with a regular sexual partner (RSP) had a VM comprised of increased relative abundance of non-optimal BV-associated bacteria (Adjusted co-efficient [Adjusted co-eff] = 11.91, 95% CI 3.39to20.43, P = 0.006) and a decreased relative abundance of optimal, Lactobacillus species (Adjusted co-eff = -12.76, 95% CI -23.03 to -2.49, P = 0.015). A history of BV was also associated with a decreased relative abundance of Lactobacillus spp. (Adjusted co-eff = -12.35, 95% CI -22.68, P = 0.019). The relative abundance of Gardnerella, Atopobium and Sneathia spp. increased following sex with an RSP.
Sex with an untreated RSP after BV treatment was associated with a VM comprised of non-optimal BV-associated bacteria. BV treatment approaches may need to include partner treatment if they are to achieve a sustained optimal VM associated with improved health outcomes.
Sex drives a return to a 'non-optimal' vaginal microbiota after antibiotics for bacterial vaginosis.
确定因素与性行为以及细菌性阴道病（BV）治疗女性阴道微生物组（VM）组成之间的关联。
前瞻性队列研究。
澳大利亚墨尔本性健康中心。
75 名诊断为临床 BV 的育龄妇女，接受一线抗生素治疗，并在长达 6 个月的时间内进行随访。
女性在入组时、使用抗生素后的第二天以及在长达 6 个月的时间内每月自行采集阴道拭子并完成问卷，直至 BV 复发或无 BV 复发（n=430 份标本）。使用 16S rRNA 基因扩增子测序确定细菌组成。使用广义估计方程群体平均模型评估持续因素对 VM 组成的影响（利用 291 份每月标本），该模型考虑了个体内的重复测量。
阴道细菌分类群的相对丰度。
报告与固定性伴侣（RSP）持续发生性行为的女性 VM 中，与非理想 BV 相关的细菌相对丰度增加（调整后的系数[调整后系数]=11.91，95%CI 3.39 至 20.43，P=0.006），而理想的乳酸菌属相对丰度降低（调整后系数=-12.76，95%CI -23.03 至 -2.49，P=0.015）。BV 病史也与乳酸菌属相对丰度降低有关（调整后系数=-12.35，95%CI -22.68，P=0.019）。与 RSP 发生性行为后，加德纳菌属、阿托波氏菌属和希氏菌属的相对丰度增加。
BV 治疗后与未经治疗的 RSP 发生性行为与非理想的 BV 相关细菌组成的 VM 相关。如果要实现与改善健康结果相关的持续理想 VM，BV 治疗方法可能需要包括伴侣治疗。
性行为导致细菌性阴道病抗生素治疗后恢复到“非理想”阴道微生物群。
