Studies of Vaginal Flora and Bacterial Vaginosis

阴道菌群和细菌性阴道病的研究

• 批准号: 7334095
• 负责人: JIM ZHANG
• 金额: --
• 依托单位: EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7334095
• 关键词: Studies; Vaginal; Flora; Bacterial; Vaginosis

Bacterial vaginosis is a syndrome in which the normal Lactobacillus-predominant vaginal flora is replaced with mixed anaerobic-predominant organisms. It is present in 10 to 25% of women in the general population, and is the most common vaginal infection. It has been associated with a number of adverse sequelae in reproductive health including acquisition of HIV, pelvic inflammatory disease, cervical dysplasia, and complications of gynecological procedures. During pregnancy it has been associated with an increased risk of preterm birth and postpartum maternal infection. However, the vaginal microbial flora remains poorly understood. Information on variation in microbial flora and its association with BV from a longitudinal study is unavailable. This prospective observational study aims to advance our knowledge of the natural history and abnormal alteration in vaginal microbial flora, and to identify risk factors that are associated with these changes. A total of 3600 healthy, non-pregnant women of reproductive age have been enrolled and were followed in Birmingham, Alabama for one year (baseline visit plus once every three months afterwards, totaling five visits). Detailed information on sociodemographic status, medical history, hygiene practice, sexual behavior and psychosocial stress was collected through in-person interviews. Routine gynecological and dental examinations were carried out during the study visits. Samples of vaginal secretion and blood were collected. Laboratory tests to quantify vaginal microbial flora and to identify infection of bacterial vaginosis as well as common sexually transmitted diseases were conducted. Sub-studies evaluate the day-to-day change in vaginal flora, and the effect of cessation of douching. The final study visits were completed in June 2003, and various analyses are underway. In results poublished during this reporting period, a pilot randomized trial of douching cessation and the incidence and persistence of bacterial vaginosis demonstrated the feasibility of such a large trial. Compliance with assigned treatment was very good, and no adverse effects of douching continuation versus cessation were found. Also, perceived psychological stress was demonstrated to increase a woman's risk of acquiring BV. This study used the novel "case-crossover" design, and is the first paper on this topic to utilize this approach. Abstracts describing the association between BV and periodontal disease, between BV and obesity, and on nutritional risk factors for BV were presented. In addition, the case-crossover design on factors that prompt a change in douching behavior resulted in an abstract at this year's Congress of epidemiology. Ongoing analysis are focusing on the effect of douching cessation and BV incidence. In addition, work continued with the NICHD MFMU Network Bacterial Vaginosis and Trichomonas vaginalis clinical trials, publishing several secondary papers from this effort.

细菌性阴道病是一种综合征，其中正常的乳酸杆菌 - 主导性阴道菌群被混合的厌氧性促销生物代替。它存在于普通人群中10％至25％的女性中，是最常见的阴道感染。它与生殖健康中的许多不良后遗症有关，包括获得HIV，骨盆炎性疾病，宫颈发育不良以及妇科程序并发症。在怀孕期间，这与早产和产后母体感染的风险增加有关。但是，阴道微生物菌群仍然了解不足。关于微生物菌群变异及其与纵向研究的BV相关的信息是不可用的。这项前瞻性观察性研究旨在促进我们对阴道微生物菌群的自然史和异常改变的了解，并确定与这些变化相关的危险因素。总共招募了3600名健康，非怀孕的妇女，并在阿拉巴马州伯明翰进行了一年的访问（基线访问加一次每三个月后一次，总共五次访问）。有关社会人口统计学状况，病史，卫生实践，性行为和社会心理压力的详细信息通过面对面的访谈收集。在研究访问期间进行了常规的妇科和牙科检查。收集阴道分泌和血液样本。实验室测试以量化阴道微生物菌群并确定细菌性阴道病的感染以及常见的性传播疾病。子研究员评估阴道菌群的日常变化以及呕吐的效果。 最终的研究访问于2003年6月完成，正在进行各种分析。在这一报告期间，结果p缩得很厉害，一项针对暂停的试验随机试验以及细菌性阴道病的发生率和持久性证明了这项大型试验的可行性。遵守指定的治疗非常好，并且没有发现灌溉延续与停止的不利影响。同样，证明心理压力会增加女性获得BV的风险。这项研究使用了新颖的“案例交叉”设计，并且是有关此主题的第一篇论文。摘要描述了BV与牙周疾病之间的关联，BV和肥胖之间以及BV的营养风险因素。此外，关于促使拉触摸行为发生变化的因素，案例交叉设计在今年的流行病学大会上引起了摘要。持续的分析集中在施用停止和BV发病率的效果上。 此外，NICHD MFMU网络细菌性阴道病和阴道型trichomonas临床试验的工作继续进行，发表了这项工作的几篇次要论文。