Microbial Correlates of Bacterial Vaginosis Treatment Failure and Recurrence in H

细菌性阴道病治疗失败和复发的微生物相关性

• 批准号: 7687874
• 负责人: MICHAEL J FERRIS
• 金额: $ 39.15万
• 依托单位: CHILDREN'S HOSPITAL (NEW ORLEANS)
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-25 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7687874
• 关键词: Address; Amniotic Fluid; Antibiotic Therapy; Antibiotics; Bacterial Vaginosis; Behavior Control; Biological Assay; Communities; Complex; Condition; DNA; Data; Development; Diagnosis; Disease; Ecology; Ecosystem; Endometritis; Environment; Epithelium; Etiology; Evaluation; Failure; Female; Genital system; HIV Infections; Health; Human; Human Characteristics; Infant; Infection; Infection of amniotic sac and membranes; Knowledge; Lead; Methods; Metronidazole; Metronidazole resistance; Minor; Molecular; Molecular Analysis; Nature; Numbers; One-Step dentin bonding system; Oral; Organism; Outcome; Pelvic Inflammatory Disease; Play; Polymerase Chain Reaction; Postpartum Period; Premature Birth; Premature Labor; Premature Rupture Fetal Membranes; Prevention strategy; Pruritus; Rate; Recurrence; Relative (related person); Research; Risk; Role; Sequence Analysis; Sexually Transmitted Diseases; Smell Perception; Standards of Weights and Measures; Syndrome; Time; Tissues; Treatment Failure; Treatment Protocols; Treatment outcome; Vagina; Vaginal Discharge; Visit; Weight; Woman; abortion; abstracting; base; cohort; compliance behavior; follow-up; human disease; insight; irritation; male; member; microbial; pathogen; prevent; rRNA Genes; tool; treatment trial

Abstract The long term objective of this research is to achieve a more rational, realistic paradigm of vaginal bacterial species and their influence on health and disease. Relevance: Bacterial Vaginosis (BV) is the most frequent cause of gynecological visits relating to vaginal irritation. More significantly, this very common ailment is associated with severe sequelae including preterm delivery and increased risk of HIV infection. BV is a microbiologic enigma. It appears to be a change in bacterial species that colonize the vaginal epithelium rather than a true tissue infection by a specific pathogen, however the cause is unknown. Standard treatment with metronidazol often fails, and recurrence rates are high. The fact that currently recommended therapy is relatively ineffective may explain why antibiotic treatment trials directed at preventing the complications of BV have failed. While evidence from studies of virgins suggests BV can arise endogenously, studies of sexually active women strongly suggest it is sexually transmitted. Recurrent infection rates following treatment are high and though partner treatment appears not to reduce these rates, the data strongly suggest that the male plays a role in re introducing BV associated organisms into the vagina. Insight: Recent cultivation-independent PCR analyses of vaginal flora have shown that the vaginal micro environment is much more complex than previously understood. Molecular tools are now available begin to better understand the etiology of BV, how it causes human disease and why current treatment is so inadequate. Hypothesis: BV treatment failures are associated with here-to-fore unstudied, uniquely definable, bacterial species consortia while recurrence is related to sexual contact with male partners who harbor these previously unknown BV-associated species. Specific Aims: (1) A panel of twenty species-specific quantitative real time PCR assays will be used to obtain detailed profiles of bacterial species-composition, and relative abundance, in women with clinically defined BV and in their male partners. (2) A cohort of monogamous women receiving oral metronidazole for treatment of BV, and their untreated male partners, will be followed to determine correlations between microbial species composition, treatment failure and recurrent BV. These analyses will be controlled for behavioral factors that might influence outcomes as well as treatment compliance. Significance: The results should lead to more effective methods of diagnosing and treating BV, and preventing the serious sequelae associated with this common syndrome.

抽象的 这项研究的长期目标是实现阴道细菌的更合理，现实的范式 物种及其对健康和疾病的影响。相关性：细菌性阴道病（BV）是最常见的 与阴道刺激有关的妇科访问的原因。更重要的是，这种非常普遍的疾病是 与严重的后遗症有关，包括早产和增加HIV感染的风险。 BV是一个 微生物谜团。它似乎是细菌物种的变化，使阴道上皮定居 比特定病原体的真实组织感染相比，原因尚不清楚。标准治疗 甲硝唑通常会失败，并且复发率很高。目前推荐治疗的事实是 相对无效可以解释为什么抗生素治疗试验旨在防止BV的并发症 失败了。虽然对处女研究的证据表明BV可以内源性出现，但对性研究 活跃的女性强烈暗示它是性传播的。治疗后的复发感染率很高 尽管合作伙伴的治疗似乎不会降低这些速度，但数据强烈表明男性戏剧 将BV相关生物引入阴道中的作用。洞察力：最近独立培养的PCR 阴道菌群的分析表明，阴道微环境比 以前理解。现在可以使用分子工具，以更好地了解BV的病因 导致人类疾病以及为什么当前治疗如此不足。假设：BV治疗失败是 与此前未经研究，独特的细菌物种群结有关，而复发是 与携带这些以前未知的BV相关物种的男性伴侣的性接触有关。 具体目的：（1）将使用一组二十个物种特异性定量实时PCR分析来获得 临床定义的BV的女性中细菌种类组成和相对丰度的详细特征 以及他们的男性伴侣。 （2）一夫一妻制的妇女接受口服甲硝唑的治疗 BV及其未经处理的男性伴侣将被遵循以确定微生物物种之间的相关性 组成，治疗失败和复发性BV。这些分析将受到行为因素的控制 可能会影响结果和治疗依从性。意义：结果应导致更多 诊断和治疗BV的有效方法，并防止与此相关的严重后遗症 普通综合征。