目的:探讨妊娠期外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)患者烯醇化酶(enolase,Eno)含量、阴道微生态与妊娠结局的相关性。方法:选取2021年4月—2022年4月在中国人民解放军联勤保障部队第九八〇医院产科住院并分娩的77例...目的:探讨妊娠期外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)患者烯醇化酶(enolase,Eno)含量、阴道微生态与妊娠结局的相关性。方法:选取2021年4月—2022年4月在中国人民解放军联勤保障部队第九八〇医院产科住院并分娩的77例妊娠期VVC患者为研究对象,根据妊娠结局分为不良妊娠结局组49例、正常妊娠结局组28例。比较2组患者一般资料、阴道微生态指标、(1,3)-β-D-葡聚糖和Eno水平。Logistic回归分析妊娠期VVC患者发生不良妊娠结局的影响因素。受试者工作特征(receiver operator characteristic,ROC)曲线分析(1,3)-β-D-葡聚糖、Eno对妊娠期VVC患者不良妊娠结局的诊断价值。结果:不良妊娠结局组抗感染治疗患者比例低于正常妊娠结局组(χ^(2)=4.270,P=0.039)。不良妊娠结局组阴道菌群密集度Ⅱ~Ⅲ级、菌群多样性Ⅱ~Ⅲ级、清洁度Ⅰ~Ⅱ度、pH值3.8~4.5、过氧化氢阳性和白细胞酯酶阴性患者的比例均低于正常妊娠结局组(均P<0.05)。不良妊娠结局组(1,3)-β-D-葡聚糖和Eno水平均高于正常妊娠结局组,差异有统计学意义(均P<0.001)。(1,3)-β-D-葡聚糖和Eno升高均是妊娠期VVC患者发生不良妊娠结局的危险因素(P<0.05),阴道菌群密集度为Ⅱ~Ⅲ级是保护因素(P<0.05)。(1,3)-β-D-葡聚糖、Eno两者联合诊断妊娠期VVC患者不良妊娠结局的曲线下面积(area under the curve,AUC)高于单一指标,联合诊断的敏感度为95.92%,特异度为82.14%,二者联合优于(1,3)-β-D-葡聚糖(Z=2.092,P=0.036)、Eno(Z=2.703,P=0.007)各自单独诊断。结论:(1,3)-β-D-葡聚糖和Eno水平升高、阴道微生态发生异常均可增加妊娠期VVC患者发生不良妊娠结局的风险,可利用(1,3)-β-D-葡聚糖和Eno联合对妊娠期VVC患者进行不良妊娠结局的风险筛查。展开更多
目的本研究运用Illumina高通量测序技术对健康孕妇与妊娠合并外阴阴道假丝酵母菌病(Vulvovaginal candidiasis,VVC)患者的阴道分泌物进行检测,以阐述不同孕期VVC患者的阴道菌群组成。方法选取在濮阳市妇幼保健院产科门诊诊断为妊娠合并...目的本研究运用Illumina高通量测序技术对健康孕妇与妊娠合并外阴阴道假丝酵母菌病(Vulvovaginal candidiasis,VVC)患者的阴道分泌物进行检测,以阐述不同孕期VVC患者的阴道菌群组成。方法选取在濮阳市妇幼保健院产科门诊诊断为妊娠合并VVC的孕早期患者20例、孕中期患者9例、孕晚期患者23例,健康孕妇孕早期30例、孕中期9例、孕晚期30例。选择16S r DNA测序方法对所有样本的V3V4可变区进行分析,比较各组之间阴道菌群构成的差异。结果孕早期健康孕妇组与孕早期VVC组、孕晚期健康孕妇组与孕晚期VVC组之间的Alpha多样性比较,差异有统计学意义(P<0.05),孕中期健康孕妇组与孕中期VVC组之间的Alpha多样性比较,无显著统计学差异。共发现25个门,各组均以厚壁菌门、放线菌门占主要比例。在属水平上,共发现51个属,孕早、中、晚期健康孕妇组相对丰度最高的是乳杆菌属(约占87%、74%、97%)。VVC患者乳杆菌属明显减少,加德纳菌属、阿托波菌属,普氏菌属,气球菌属明显增多。结论健康孕妇阴道菌群多以乳杆菌属主导,还存在加德纳菌属、普氏菌属,双歧杆菌属等差异菌属;大部分VVC患者阴道菌群表现为乳杆菌属显著减少甚至缺失。展开更多
Both diabetes and fungal infections contribute significantly to the global disease burden,with increasing trends seen in most developed and developing countries during recent decades.This is reflected in urogenital in...Both diabetes and fungal infections contribute significantly to the global disease burden,with increasing trends seen in most developed and developing countries during recent decades.This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients,particularly those that present with unsatisfactory glycemic control.In addition,a relatively new group of anti-hyperglycemic drugs,known as sodium glucose cotransporter 2 inhibitors,has been linked with an increased risk for colonization of the urogenital region with Candida spp.,which can subsequently lead to an infectious process.In this review paper,we have highlighted notable virulence factors of Candida species(with an emphasis on Candida albicans)and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis,potentially complicated with recurrences and dire pregnancy outcomes.We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes,further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in(primarily uncircumcised)males.With a steadily increasing global burden of diabetes,urogenital mycotic infections will undoubtedly become more prevalent in the future;hence,there is a need for an evidence-based approach from both clinical and public health perspectives.展开更多
文摘目的:探讨妊娠期外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)患者烯醇化酶(enolase,Eno)含量、阴道微生态与妊娠结局的相关性。方法:选取2021年4月—2022年4月在中国人民解放军联勤保障部队第九八〇医院产科住院并分娩的77例妊娠期VVC患者为研究对象,根据妊娠结局分为不良妊娠结局组49例、正常妊娠结局组28例。比较2组患者一般资料、阴道微生态指标、(1,3)-β-D-葡聚糖和Eno水平。Logistic回归分析妊娠期VVC患者发生不良妊娠结局的影响因素。受试者工作特征(receiver operator characteristic,ROC)曲线分析(1,3)-β-D-葡聚糖、Eno对妊娠期VVC患者不良妊娠结局的诊断价值。结果:不良妊娠结局组抗感染治疗患者比例低于正常妊娠结局组(χ^(2)=4.270,P=0.039)。不良妊娠结局组阴道菌群密集度Ⅱ~Ⅲ级、菌群多样性Ⅱ~Ⅲ级、清洁度Ⅰ~Ⅱ度、pH值3.8~4.5、过氧化氢阳性和白细胞酯酶阴性患者的比例均低于正常妊娠结局组(均P<0.05)。不良妊娠结局组(1,3)-β-D-葡聚糖和Eno水平均高于正常妊娠结局组,差异有统计学意义(均P<0.001)。(1,3)-β-D-葡聚糖和Eno升高均是妊娠期VVC患者发生不良妊娠结局的危险因素(P<0.05),阴道菌群密集度为Ⅱ~Ⅲ级是保护因素(P<0.05)。(1,3)-β-D-葡聚糖、Eno两者联合诊断妊娠期VVC患者不良妊娠结局的曲线下面积(area under the curve,AUC)高于单一指标,联合诊断的敏感度为95.92%,特异度为82.14%,二者联合优于(1,3)-β-D-葡聚糖(Z=2.092,P=0.036)、Eno(Z=2.703,P=0.007)各自单独诊断。结论:(1,3)-β-D-葡聚糖和Eno水平升高、阴道微生态发生异常均可增加妊娠期VVC患者发生不良妊娠结局的风险,可利用(1,3)-β-D-葡聚糖和Eno联合对妊娠期VVC患者进行不良妊娠结局的风险筛查。
文摘目的本研究运用Illumina高通量测序技术对健康孕妇与妊娠合并外阴阴道假丝酵母菌病(Vulvovaginal candidiasis,VVC)患者的阴道分泌物进行检测,以阐述不同孕期VVC患者的阴道菌群组成。方法选取在濮阳市妇幼保健院产科门诊诊断为妊娠合并VVC的孕早期患者20例、孕中期患者9例、孕晚期患者23例,健康孕妇孕早期30例、孕中期9例、孕晚期30例。选择16S r DNA测序方法对所有样本的V3V4可变区进行分析,比较各组之间阴道菌群构成的差异。结果孕早期健康孕妇组与孕早期VVC组、孕晚期健康孕妇组与孕晚期VVC组之间的Alpha多样性比较,差异有统计学意义(P<0.05),孕中期健康孕妇组与孕中期VVC组之间的Alpha多样性比较,无显著统计学差异。共发现25个门,各组均以厚壁菌门、放线菌门占主要比例。在属水平上,共发现51个属,孕早、中、晚期健康孕妇组相对丰度最高的是乳杆菌属(约占87%、74%、97%)。VVC患者乳杆菌属明显减少,加德纳菌属、阿托波菌属,普氏菌属,气球菌属明显增多。结论健康孕妇阴道菌群多以乳杆菌属主导,还存在加德纳菌属、普氏菌属,双歧杆菌属等差异菌属;大部分VVC患者阴道菌群表现为乳杆菌属显著减少甚至缺失。
文摘Both diabetes and fungal infections contribute significantly to the global disease burden,with increasing trends seen in most developed and developing countries during recent decades.This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients,particularly those that present with unsatisfactory glycemic control.In addition,a relatively new group of anti-hyperglycemic drugs,known as sodium glucose cotransporter 2 inhibitors,has been linked with an increased risk for colonization of the urogenital region with Candida spp.,which can subsequently lead to an infectious process.In this review paper,we have highlighted notable virulence factors of Candida species(with an emphasis on Candida albicans)and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis,potentially complicated with recurrences and dire pregnancy outcomes.We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes,further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in(primarily uncircumcised)males.With a steadily increasing global burden of diabetes,urogenital mycotic infections will undoubtedly become more prevalent in the future;hence,there is a need for an evidence-based approach from both clinical and public health perspectives.
