加德纳菌生物膜在复发性细菌性阴道病中的作用研究

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1、加德纳菌生物膜在复发性细菌性阴道病中的作用研究隋龙余竑敏苏婷婷【摘要】目的通过对阴道加德纳菌的生物膜形成能力和不同的pH环境下的生长情况进行评估，研究其生物膜形成的致病机制及诱发耐药与导致BV复发的关系。方法从58例BV患者阴道分泌物标本中分离培养出阴道加德纳菌株，检测其在不同的pH环境下的生长情况，通过K-B法和肉汤稀释法检测其耐药情况，使用微量板半定量法检测其生物膜形成能力。结果加德纳菌在阴道酸性环境下生长受到抑制，而在碱性环境下能够正常生长。临床加德纳菌对克林霉素、红霉素、头孢曲松、青霉素和万古霉素等敏感率较高，而对左氧氟沙星和甲硝唑的耐药率分别为67.2%和63.8%。

2、加德纳菌生物膜形成阳性率为48.3%。结论BV患者的阴道pH值升高，易于阴道加德纳菌的繁殖。加德纳菌的生物膜形成能力较强，可能与细菌性阴道病治疗后易复发有关。【关键词】致病菌细菌性阴道病微生态失衡加德纳菌生物膜耐药ResearchoftheroleofGardnerellaVaginalisinrecurrentbacterialvaginosisYUHong-min，SUTing-ting，SUILongDepartmentofGynecology，KeyLaboratoryofFemaleReproductiveEndocrineRelatedDiseasesofShang

3、hai，ObstetricsandGynecologyHospital，FudanUniversity，Shanghai200011，ChinaCorrespondingauthor:SUILong,Email:suilong@sh163.net1Abstract:OBJECTIVEToevaluatetheassociationofGardnerellavaginaliswithbacterialvaginosisonitspathogenesisandtherapeuticefficacy.Italsoassessestheantimicrobialresistanceof

4、clinicalisolatesofGardnerellavaginalistowardsthecurrentcommonly-usedantimicrobialdrugs,metronidazoleandclindamycin.Undervariousmodificationsofin-vitroenvironmentalfactors,thegrowthandcolonizationofGardnerellavaginaliscanbeappraised.METHODSVaginalswabswerecollectedfromwomenattendingthegynaeco

5、logyoutpatientdepartmentandclinicallydiagnosedasbacterialvaginosis(BV)overaperiodofsevenmonthsfromSeptember2012toFebruary2013.Atotalof58GardnerellavaginalisisolateswereidentifiedandevaluateditsgrowthalterationundervariouspHfluctuations.Antibioticresistanceassayofclinicalisolateswasdetermined

6、utilisingthediskdiffusionandbrothmicrodilutionmethods,andemploymentofsemi-quantificationmicrotiterplatetoassessbiofilm-formingcapacity.RESULESGrowthofGardnerellavaginaliswasrestrictedinacidicvaginalenvironmentwhereasalkalineconditionwasfoundbemoreconduciveforitsgrowth.Highantimicrobialsuscep

7、tibilitytestingofclinicalisolatestoclindamycin,erythromycin,ceftriaxone,penicillinandvancomycinwasobserved,whereasresultofantibioticresistancetolevoflovaxinandmetronidazoleindicated67.2%and63.8%,respectively.48.3%ofthestrainsexhibitedstrongbiofilm-