Hillier S L, Krohn M A, Rabe L K, Klebanoff S J, Eschenbach D A
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.
Clin Infect Dis. 1993 Jun;16 Suppl 4:S273-81. doi: 10.1093/clinids/16.supplement_4.s273.
In this study of the vaginal flora of 171 pregnant women in labor at term, the flora was categorized as normal (Lactobacillus predominant), intermediate, or representative of bacterial vaginosis (BV) on the basis of a vaginal smear. BV was diagnosed in 39 women (23%); the vaginal flora was classified as normal in 50% of cases and as intermediate in 27%. H2O2-producing lactobacilli were recovered from 5% of women with BV, 37% of those with an intermediate flora, and 61% of those with a normal flora. H2O2-negative lactobacilli were equally frequent (57%-65%) in all three groups. The microorganisms most frequently recovered from women with BV included Gardnerella vaginalis, Prevotella bivia/disiens, Bacteroides ureolyticus, Prevotella corporis/Bacteroides levii, Fusobacterium nucleatum, Mobiluncus species, Peptostreptococcus prevotii, Peptostreptococcus tetradius, Peptostreptococcus anaerobius, viridans streptococci, Ureaplasma urealyticum, and Mycoplasma hominis (P < .05 for each). The presence of all but three of these organisms was inversely related to vaginal colonization by H2O2-producing lactobacilli; the exceptions were B. ureolyticus, F. nucleatum, and P. prevotii. Other microorganisms were equally frequent among women with and without BV. We conclude that specific groups of anaerobes are associated with BV in this population and that a strong association exists between species associated with BV and those inhibited by H2O2-producing lactobacilli.
在这项针对171名足月待产孕妇阴道菌群的研究中，根据阴道涂片将菌群分类为正常（以乳酸杆菌为主）、中间型或细菌性阴道病（BV）代表型。39名女性（23%）被诊断为BV；50%的病例阴道菌群被分类为正常，27%为中间型。在患有BV的女性中，5%分离出产生H2O2的乳酸杆菌，中间型菌群女性中这一比例为37%，正常菌群女性中为61%。在所有三组中，H2O2阴性乳酸杆菌的出现频率相同（57%-65%）。从患有BV的女性中最常分离出的微生物包括阴道加德纳菌、二路/双路普雷沃菌、解脲拟杆菌、人体普雷沃菌/轻拟杆菌、具核梭杆菌、动弯杆菌属、普氏消化链球菌、四联消化链球菌、厌氧消化链球菌、草绿色链球菌、解脲脲原体和人型支原体（每种微生物P < 0.05）。除三种微生物外，所有这些微生物的存在与产生H2O2的乳酸杆菌在阴道的定植呈负相关；例外的是解脲拟杆菌、具核梭杆菌和普氏消化链球菌。有无BV的女性中其他微生物出现频率相同。我们得出结论，在这一人群中特定的厌氧菌组与BV相关，且与BV相关的菌种和被产生H2O2的乳酸杆菌抑制的菌种之间存在强烈关联。
