阴道加德纳菌对细菌性阴道病的病原学诊断评价  

Gardnerella vaginalis in Bacterial Vaginosis: Etiologic Diagnosis and Evaluation

作　　者：李连青[1] 朱庆义[2] 刘俊芬[1] 李兆艾[1] 武素梅[1] 

机构地区：[1]山西省儿童医院山西省妇婴保健院,山西太原030013 [2]广州医学院金域医学检验中心,广东广州510182

出　　处：《中华医院感染学杂志》2005年第2期226-230,共5页Chinese Journal of Nosocomiology

基　　金：山西省科学技术厅科技攻关项目(编号:991068)

摘　　要：目的　探讨阴道加德纳菌对细菌性阴道病(BV)的病原学诊断价值。方法　对237例妇科门诊生殖道感染患者,采集阴道分泌物标本,用直接涂片染色、细菌分离培养、PCR和 BV试验等 4 种方法,检测阴道加德纳菌和细菌性阴道病;BV诊断按照 Amsel金标准分组:BV组 174 例,非 BV组 63 例;另设对照组 40 例为健康体检妇女。结果　BV组174例直接涂片(线索细胞)、细菌培养、PCR和BV试验等4种方法阳性检出率分别为30.5%、51.1%、78.2%和89.7%;63例非BV组,阳性检出率分别为 6.3%、9.5%、11.1%和 28.6%,2 组比较经统计学分析,P值均<0.05,差异有显著性;40例健康对照组,只有PCR阳性检出率为12.5%,余均为阴性;23株 GV药敏试验结果甲硝唑敏感2株,替硝唑敏感3株,罗红霉素敏感3株,阿奇霉素敏感4株,克林霉素敏感 1 株。结论阴道加德纳菌在细菌性阴道病中占有主导作用,是细菌性阴道病的重要致病菌之一;BV诊断试验快速、敏感,适用于BV筛查;涂片染色检测线索细胞简单、易行,且可同时进行真菌、淋菌等检测;细菌分离培养是阴道加德纳菌鉴定的金标准。OBJECTIVE To evaluate the etiologic diagnosis of Gardnerella vaginalis(GV) in the bacterial vaginosis(BV). METHODS A total of 237 samples of vaginal secretion were collected from lower genital tract infection women outpatients of Shanxi Maternal and Children Hospital. According to the gold standard (Amsel standard) for bacterial vaginosis, there were 174 cases in BV group, 63 cases in nonbacterial vaginosis(NBV) group and 40 women in healthy control group. Detection of G.vaginalis specific gene fragment was used by polymerase chain reaction. Gram staining and bacterial culture were used to detect GV. A rapid diagnosis test of BV was used to detect the product of BV. RESULTS The positive rate of detection of clue cells, bacterial culture, PCR and rapid diagnosis test of BV in 174 cases in BV group was 30.5%,51.1%, 78.2% and 89.7%, respectively, while that in non BV group were 6.3%, 9.5%, 11.1% and 28.6%, respectively. The former was significantly higher than that in NBV group (P<0.05). In the healthy control group was only PCR positive 12.5%, all of their 3 tests were negative. Twenty three strains of GV were examined for sensitivities to metronidazole, tinidazole, clindamycin, azithromycin, and roxithromycin. There were 2 strains of GV to be sensitive for metronidazole, 3 strains of GV to be sensitive for tinidazole and roxithromycin, 4 strains of GV to be sensitive for azithromycin and 1 strain of GV to be sensitive for clindamycin. Except for those isolates of GV above, they were all resistant to the traditional drugs. CONCLUSIONS G. vaginalis plays an important role in microbiota of BV because it consists of 1/3 1/2 microbiota of BV. The rapid diagnosis test of BV is a quick and sensitive method for the screening BV. Bacterial culture is a gold standard of bacterial identification, but its positive rate is lower and the test can be interfered by many factors such as drugs. There are important value in bacterial culture with the treatments ofrecurrent and lasting BV. The PCR method is a sensitive and spec

关 键 词：细菌性阴道病(BV) 阴道加德纳菌(GV) 聚合酶链反应(PCR) 

分 类 号：R378[医药卫生—病原生物学]