Bansal Shikha, Bhargava Aradhana, Verma Prashant, Khunger Niti, Panchal Paveen, Joshi Naveen
Department of Dermatology and STD, Apex Regional STD Centre, VMMC and Safdarjung Hospital, New Delhi, India.
Indian J Sex Transm Dis AIDS. 2022 Jul-Dec;43(2):174-178. doi: 10.4103/ijstd.ijstd_75_21. Epub 2022 Nov 17.
Considering the changing causative and resistance pattern of agents implicated in sexually transmitted infections (STIs), etiological diagnosis is imperative, especially in countries practicing syndromic management. This study was designed to identify etiological agents associated with cervicitis and to analyze their association with clinical and behavioral profile.
Female STI clinic attendees presenting with cervico-vaginal discharge were examined for the presence of cervicitis. Endocervical swabs were collected for gram staining and real-time polymerase chain reaction was performed for various bacterial and viral STI agents in patients presenting with cervical discharge. A vaginal swab was also evaluated for bacterial vaginosis by Nugent's criteria.
Of 64 patients with vaginal discharge, 26.6% and 12.5% patients complained of genital itching and lower abdominal pain, respectively. Mean of 36.6 pus cells/hpf were observed, appreciably greater number in patients with and infections ( 0.0063 and 0.0032, respectively). Pus cells were high (mean 68 pus cells/hpf) in patients with , though this may be attributed to coexisting . Agents isolated from endocervix were 17 (26.6%), 4 (6.3%), HSV1 and 1 each (1.6%), HSV2, 9 (14.1%), 5 (7.8%), 26 (40.6%), (0%), and 11 (17.2%). Bacterial vaginosis was diagnosed in 14 (21.9%) patients. Multiple agents were isolated in 10 (two), 6 (three), 6 (four), and 1 (five) patients. Isolation of and was significantly associated with bacterial vaginosis ( 0.04 and 0.003, respectively). Nonusage of condoms and mental stress predisposed to cervicitis.
We concluded that there are changing etiological patterns of cervicitis. There is need to use tests that detect wider array of organisms, and can replace standard culture methods with molecular assays, to increase the ability to diagnose more number of organisms implicated in cervicitis.
考虑到性传播感染（STIs）病原体及其耐药模式的变化，病因诊断至关重要，尤其是在实施综合征管理的国家。本研究旨在确定与宫颈炎相关的病原体，并分析它们与临床和行为特征的关联。
对出现宫颈阴道分泌物的女性性传播感染门诊患者进行宫颈炎检查。采集宫颈拭子进行革兰氏染色，并对出现宫颈分泌物的患者进行各种细菌性和病毒性性传播感染病原体的实时聚合酶链反应检测。还根据 Nugent 标准对阴道拭子进行细菌性阴道病评估。
在 64 例有阴道分泌物的患者中，分别有 26.6%和 12.5%的患者主诉有生殖器瘙痒和下腹部疼痛。观察到平均每高倍视野有 36.6 个脓细胞，在沙眼衣原体和淋病奈瑟菌感染患者中数量明显更多（分别为 0.0063 和 0.0032）。在解脲脲原体感染患者中脓细胞数量较高（平均每高倍视野 68 个脓细胞），不过这可能归因于同时存在其他感染。从宫颈内分离出的病原体有沙眼衣原体 17 例（26.6%）、淋病奈瑟菌 4 例（6.3%）、单纯疱疹病毒 1 型和生殖支原体各 1 例（1.6%）、单纯疱疹病毒 2 型 9 例（14.1%）、解脲脲原体 5 例（7.8%）、人乳头瘤病毒 26 例（40.6%）、杜克雷嗜血杆菌（0%）和阴道毛滴虫 11 例（17.2%）。14 例（21.9%）患者被诊断为细菌性阴道病。在 10 例（两种病原体）、6 例（三种病原体）、6 例（四种病原体）和 1 例（五种病原体）患者中分离出多种病原体。沙眼衣原体和解脲脲原体的分离与细菌性阴道病显著相关（分别为 P = 0.04 和 P = 0.003）。不使用避孕套和精神压力易引发宫颈炎。
我们得出结论，宫颈炎的病因模式在不断变化。需要使用能检测更多种类病原体的检测方法，并用分子检测方法取代标准培养方法，以提高诊断更多与宫颈炎相关病原体的能力。
