Chow A W, Percival-Smith R, Bartlett K H, Goldring A M, Morrison B J
Am J Obstet Gynecol. 1986 Jan;154(1):120-6. doi: 10.1016/0002-9378(86)90406-0.
The rate of vaginal colonization with Escherichia coli in 495 healthy women was 12% in a prospective study with use of selective media and semiquantitative culture techniques. Computer-assisted multivariate analysis revealed that vaginal E. coli was significantly associated with the menstrual phase of the cycle, prior use of antibiotics, use of diaphragm or cervical cap for contraception, history of previous urinary tract infection, and coisolation of Staphylococcus aureus that was positive for the toxic shock syndrome toxin-1 (p less than 0.05, multiple stepwise logistic regression analysis). No significant association was observed with tampon use or brand, other contraceptive methods, sexual activity, genital symptoms, recent vaginal infection, or other personal habits. Quantitative cultures obtained sequentially throughout the menstrual cycle in 12 unselected women confirmed higher E. coli counts in menstrual or midcycle samples compared to paired premenstrual specimens (p less than 0.05, Wilcoxon paired rank sign test). These data emphasize the hormonal and other host determinants in vaginal colonization by E. coli and may explain the high rate of vaginal E. coli (64%), in addition to toxicogenic S. aureus, in acute toxic shock syndrome and the higher incidence of urinary tract infection in women with diaphragm or cervical cap for contraception compared to other contraceptive methods.
在一项采用选择性培养基和半定量培养技术的前瞻性研究中，495名健康女性的阴道大肠杆菌定植率为12%。计算机辅助多变量分析显示，阴道大肠杆菌与月经周期的阶段、既往使用抗生素、使用隔膜或宫颈帽避孕、既往尿路感染史以及对中毒性休克综合征毒素-1呈阳性的金黄色葡萄球菌的共同分离显著相关（p<0.05，多步骤逐步逻辑回归分析）。未观察到与使用棉塞或品牌、其他避孕方法、性活动、生殖器症状、近期阴道感染或其他个人习惯有显著关联。在12名未经过挑选的女性中，在整个月经周期中依次进行的定量培养证实，与配对的经前标本相比，月经或月经周期中期样本中的大肠杆菌计数更高（p<0.05，Wilcoxon配对秩和检验）。这些数据强调了激素及其他宿主因素在大肠杆菌阴道定植中的作用，并且可以解释在急性中毒性休克综合征中，除了产毒金黄色葡萄球菌外，阴道大肠杆菌的高发生率（64%），以及与其他避孕方法相比，使用隔膜或宫颈帽避孕的女性尿路感染发生率更高的原因。
