Zhang Yingan, Allegre Lucie, Salipante Florian, Morsli Madjid, Thubert Thibault, Lavigne Jean-Philippe, Dunyach-Remy Catherine, de Tayrac Renaud
Department of Obstetrics and Gynecology, University of Montpellier, CHU Carémeau, Nîmes, France.
Department of Biostatistics, Epidemiology, Public Health, and Innovation in Methodology (BESPIM), University of Montpellier, CHU Carémeau, Nîmes, France.
Antimicrob Resist Infect Control. 2025 Aug 26;14(1):102. doi: 10.1186/s13756-025-01622-6.
The study aimed to assess the effects of vaginal disinfection and sterile draping on the composition and dynamics of the vaginal microbiota during vaginal surgery.
A prospective cohort study was conducted involving post-menopausal patients undergoing vaginal urogynecological surgery. The vaginal microbiota was assessed by partial 16 S rRNA gene sequencing at three time points: before disinfection (V1); immediately after disinfection and sterile draping (V2); and one-hour post-disinfection (V3).
In a cohort of 54 postmenopausal women (median age: 69.2 ± 7.6 years), with a mean operative time of 92.89 ± 45.92 min, native tissue prolapse repair was the most common urogynecological vaginal procedure performed (n = 47, 87%). The vaginal microbiota diversity was significantly increased after disinfection associated with reduced abundance of Lactobacillus and Bifidobacterium and increased Pseudomonas (p < 0.0001). Community state type (CST) I prevalence decreased notably from 20% at V1 to 6% at V3, primarily due to the disappearance of CST I-A, while CST IV prevalence rose from 31 to 44%, which was mainly secondary to an increase in CST IV-C (from 20 to 33%).
These findings highlight the impact of povidone-iodine on vaginal microbiota composition during vaginal urogynecological surgery. Disinfection significantly increased vaginal bacterial diversity and reducing Lactobacillus abundance. This observation requires further exploration in the context of development of optimized disinfection protocols aimed at preserving vaginal health during and after surgery.
本研究旨在评估阴道消毒和铺无菌巾对阴道手术期间阴道微生物群的组成和动态变化的影响。
对接受阴道泌尿妇科手术的绝经后患者进行了一项前瞻性队列研究。通过部分16S rRNA基因测序在三个时间点评估阴道微生物群：消毒前（V1）；消毒和铺无菌巾后立即（V2）；消毒后一小时（V3）。
在54名绝经后女性队列中（中位年龄：69.2±7.6岁），平均手术时间为92.89±45.92分钟，原位组织脱垂修复是最常见的泌尿妇科阴道手术（n = 47，87%）。消毒后阴道微生物群多样性显著增加，同时乳酸杆菌和双歧杆菌丰度降低，假单胞菌增加（p < 0.0001）。群落状态类型（CST）I的患病率从V1时的20%显著下降至V3时的6%，主要是由于CST I-A消失，而CST IV的患病率从31%上升至44%，这主要继发于CST IV-C的增加（从20%增至33%）。
这些发现突出了聚维酮碘在阴道泌尿妇科手术期间对阴道微生物群组成的影响。消毒显著增加了阴道细菌多样性并降低了乳酸杆菌丰度。在制定旨在在手术期间和术后保持阴道健康的优化消毒方案的背景下，这一观察结果需要进一步探索。
