以新西伯利亚育龄妇女为例,介绍阴道微生物病的现代变化

U. Piletskaya, K. Makarov, T. M. Sokolova
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摘要

介绍。细菌性阴道病与大量妊娠并发症以及盆腔炎有关。然而,在开始经验性治疗之前,有必要考虑到病原体的种类组成。研究的目的。新西伯利亚市育龄妇女阴道分泌物种类组成的研究。材料和方法。为了解病理性阴道分泌物患者阴道菌群的种类组成,选取了新西伯利亚中央区产前门诊确诊为细菌性阴道病的育龄妇女485例。所有妇女都对生殖道分泌物进行细菌学检查,并使用实时PCR方法对240名有生殖道病理性分泌物的妇女进行微生物病评估。结果。细菌学检查未检出条件致病菌的占多数(75.05%)。检出的微生物以念珠菌属(11.55%)和肠球菌(9.07%)为主。在细菌学检查中,Proteus属的代表菌检出率最低,为0.21%。RT-PCR结果显示,以阴道加德纳菌+毕氏普氏菌+卟啉单胞菌(89.17%)、真杆菌(68.33%)、巨孢子菌+细孔菌+ Dialister菌(37.5%)和阴道托必菌(30.83%)为代表。葡萄球菌、小支原体和肠杆菌检出率较低,分别为2.83%和4.17%。结论。由于在超过50%的病例中,不可能通过细菌学研究方法在女性生殖道病理性分泌物中分离出感染因子,而实时PCR方法并不总是可用,因此了解生殖道病理性分泌物女性阴道的微生物情况将允许开出有效的经验性治疗处方。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MODERN CHANGES IN THE VAGINAL MICROBIOCENOSIS THROUGH THE EXAMPLE OF WOMEN OF THE REPRODUCTIVE AGE IN NOVOSIBIRSK
Introduction. Bacterial vaginosis is associated with a large number of pregnancy complications as well as pelvic inflammatory diseases. However, it is necessary to take into account the species composition of pathogens before starting empirical therapy. Aim of the research. Study of the species composition of vaginal discharge in women of reproductive age in the city of Novosibirsk. Materials and methods. To assess the species composition of the vaginal microflora in women with complaints of pathological discharge from the genital tract, 485 women of the reproductive period of the Central District of Novosibirsk were selected who applied to the antenatal clinic and were diagnosed with bacterial vaginosis. All women underwent a bacteriological examination of the discharge from the genital tract, and 240 women with complaints of pathological discharge from the genital tract were assessed for microbiocenosis using the real-time PCR method. Results. According to the bacteriological examination, the majority of patients did not reveal opportunistic pathogens (75.05%). Representatives of the genus Candida sp. predominated among the identified microorganisms (11.55%), Enterococcus sp. – 9.07%. Representatives of the genus Proteus were detected least often during bacteriological examination – 0.21%. According to the RT-PCR study, representatives of Gardnerella vaginalis + Prevotella bivia + Porphyromonas (89.17%), Eubacterium spp. (68.33%), Megasphaera spp. + Veillonella spp. + Dialister spp. (37.5%) and Atopobium vaginae (30.83%) predominated. Staphylococcus spp., Mycoplasma ho-minis – 2.83% and Enterobacterium spp. were detected less frequently – 4.17%. Conclusion. Since in more than 50% of cases it is not possible to isolate an infectious agent in the presence of pathological discharge from the genital tract of women by the bacteriological method of research, while the real-time PCR method is not always available, an understanding of the microbial landscape of the vagina in women with pathological discharge from the genital tract will allow to prescribe an effective empiric therapy.
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