细菌性阴道病:我们目前了解多少?
Bacterial Vaginosis: What Do We Currently Know?
机构信息
Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.
IHU-Méditerranée Infection, Marseille, France.
出版信息
Front Cell Infect Microbiol. 2022 Jan 18;11:672429. doi: 10.3389/fcimb.2021.672429. eCollection 2021.
The vaginal microbiome is a well-defined compartment of the human microbiome. It has unique conditions, characterized by the dominance of one bacterial species, the This microbiota manifests itself by a low degree of diversity and by a strong dynamic of change in its composition under the influence of various exogenous and endogenous factors. The increase in diversity may paradoxically be associated with dysbiosis, such as bacterial vaginosis (BV). BV is the result of a disturbance in the vaginal ecosystem; i.e., a sudden replacement of by anaerobic bacteria such as , and others. It is the most common cause of vaginal discharge in women of childbearing age, approximately 30% of all causes. The etiology of this dysbiosis remains unknown, but its health consequences are significant, including obstetrical complications, increased risk of sexually transmitted infections and urogenital infections. Its diagnosis is based on Amsel's clinical criteria and/or a gram stain based on the Nugent score. While both of these methods have been widely applied worldwide for approximately three decades, Nugent score are still considered the "gold standard" of BV diagnostic tools. Given the limitations of these tools, methods based on molecular biology have been developed as alternative rational strategies for the diagnosis of BV. The treatment of BV aims at restoring the balance of the vaginal flora to stop the proliferation of harmful microorganisms. Prescription of antibiotics such as metronidazole, clindamycin, etc. is recommended. Faced with the considerable uncertainty about the cause of BV, the high rate of recurrence, the unacceptable treatment options, and clinical management which is often insensitive and inconsistent, research on this topic is intensifying. Knowledge of its composition and its associated variations represents the key element in improving the therapeutic management of patients with the most suitable treatments possible.
阴道微生物群是人类微生物群中一个明确界定的部分。它具有独特的条件,其特征是一种细菌物种的主导地位,即 。这种微生物群表现出低度的多样性,并在各种外源和内源因素的影响下,其组成具有强烈的变化动态。多样性的增加可能与菌群失调有关,例如细菌性阴道病(BV)。BV 是阴道生态系统紊乱的结果;即 被厌氧菌如 等突然取代。它是育龄妇女阴道分泌物最常见的原因,约占所有原因的 30%。这种菌群失调的病因尚不清楚,但它对健康的影响是重大的,包括产科并发症、性传播感染和泌尿生殖系统感染的风险增加。其诊断基于 Amsel 的临床标准和/或基于 Nugent 评分的革兰氏染色。虽然这两种方法在全球范围内已经应用了大约三十年,但 Nugent 评分仍然被认为是 BV 诊断工具的“金标准”。鉴于这些工具的局限性,已经开发了基于分子生物学的方法作为替代的合理策略来诊断 BV。BV 的治疗旨在恢复阴道菌群的平衡,阻止有害微生物的增殖。建议使用甲硝唑、克林霉素等抗生素进行处方治疗。鉴于 BV 的病因存在相当大的不确定性、高复发率、不可接受的治疗选择以及临床管理通常不敏感和不一致,因此针对该主题的研究正在加强。对其组成及其相关变化的了解是改善患者治疗管理的关键要素,以便为患者提供最合适的治疗方法。