Impact of surgical field disinfection on vaginal microbiome in transvaginal urogynecological surgery: a prospective cohort study.

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Yingan Zhang, Lucie Allegre, Florian Salipante, Madjid Morsli, Thibault Thubert, Jean-Philippe Lavigne, Catherine Dunyach-Remy, Renaud de Tayrac
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Abstract

Background: 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.

Methods: 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).

Findings: 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%).

Conclusions: 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.

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经阴道泌尿妇科手术中手术现场消毒对阴道微生物组的影响:一项前瞻性队列研究
背景:本研究旨在评估阴道消毒和无菌覆盖对阴道手术期间阴道微生物群组成和动态的影响。方法:对绝经后接受阴道泌尿妇科手术的患者进行前瞻性队列研究。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);消毒后立即进行无菌包扎(V2);消毒后1小时(V3)。结果:54名绝经后妇女(中位年龄:69.2±7.6岁),平均手术时间为92.89±45.92分钟,自然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,乳酸菌和双歧杆菌丰度降低,假单胞菌增多(p)。结论:这些发现突出了聚维酮碘对阴道泌尿妇科手术中阴道微生物群组成的影响。消毒显著增加阴道细菌多样性,降低乳酸菌丰度。这一观察结果需要在优化消毒方案的发展背景下进一步探索,目的是在手术期间和术后保持阴道健康。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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