Occhipinti Sara, Incognito Giosuè Giordano, Palumbo Marco
Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
Arch Gynecol Obstet. 2025 Feb;311(2):347-353. doi: 10.1007/s00404-024-07626-8. Epub 2024 Jul 11.
This study aimed to demonstrate the correlation between altered balance of the vaginal ecosystem and increased risk of vaginitis, bacterial vaginosis, and sexually transmitted diseases and the association between specific alterations found in fresh bacterioscopic examinations (FBE) and the risk of certain infections.
A retrospective, monocentric study was conducted from January 2013 to December 2023. Patients who underwent FBE and vaginal swabs following reported symptoms or suspected syndromic pictures of vulvovaginal infections were included.
Two thousand one hundred ten patients were included and divided into a control group (n = 811, 38.4%) and a pathological group (n = 1299 patients, 61.6%), based on the presence of alterations at the FBE. In the pathological group, 1185 women (91% of positive FBE) had vaginal infections detected through vaginal swabs. The presence of lactobacilli and typical inflammatory cells was detected in 111 (8%) women with pathological FBE and correlated with higher rates of positive swabs for common germs (n = 104, 94%), often leading to co-infections (n = 30, 29%). Conversely, Döderlein's cytolysis (n = 56, 4.3% of positive FBE) indicated a predominance of positive human papillomavirus (HPV) swabs (n = 33, 59%). The presence of fungal elements (n = 208, 16% of positive FBE) suggested a higher prevalence of co-infections (n = 62, 30%). Similarly, mixed bacterial flora (n = 470, 36% of positive FBE) and Trichomonas vaginalis (n = 11, 0.8% of positive FBE) correlated with positive swabs for other pathogens, except for Mycoplasma (n = 0). Bacterial vaginosis (n = 443, 34% of positive FBE) was linked to co-infections (n = 142, 32%) and HPV (n = 123, 28%).
The importance of conducting FBE in patients with vulvovaginal symptoms is emphasized. This approach aids in determining the need for further diagnostic tests like vaginal swabs, guided by microscopic findings. A strong correlation emerges between the presence of specific alterations in the FBE and an increased prevalence of certain infections.
本研究旨在证明阴道生态系统平衡改变与阴道炎、细菌性阴道病和性传播疾病风险增加之间的相关性，以及新鲜细菌学检查（FBE）中发现的特定改变与某些感染风险之间的关联。
2013年1月至2023年12月进行了一项回顾性单中心研究。纳入了因报告有症状或疑似外阴阴道感染综合征而接受FBE和阴道拭子检查的患者。
共纳入2110例患者，根据FBE检查结果分为对照组（n = 811，38.4%）和病理组（n = 1299例患者，61.6%）。在病理组中，1185名女性（FBE阳性者的91%）通过阴道拭子检测出阴道感染。在111名（8%）FBE病理结果异常的女性中检测到乳酸杆菌和典型炎症细胞，这与常见病菌拭子阳性率较高（n = 104，94%）相关，常导致合并感染（n = 30，29%）。相反，杜德林细胞溶解（n = 56，FBE阳性者的4.3%）表明人乳头瘤病毒（HPV）拭子阳性占优势（n = 33，59%）。真菌成分的存在（n = 208，FBE阳性者的16%）提示合并感染的患病率较高（n = 62，30%）。同样，混合细菌菌群（n = 470，FBE阳性者的36%）和阴道毛滴虫（n = 11，FBE阳性者的0.8%）与其他病原体的拭子阳性相关，但支原体除外（n = 0）。细菌性阴道病（n = 443，FBE阳性者的34%）与合并感染（n = 142，32%）和HPV（n = 123，28%）有关。
强调了对外阴阴道症状患者进行FBE检查的重要性。这种方法有助于根据显微镜检查结果确定是否需要进一步进行如阴道拭子等诊断测试。FBE中特定改变的存在与某些感染患病率增加之间存在密切相关性。
