PDF(Sci-hub)
Abstract：
To determine the microorganisms potentially involved in pelvic inflammatory diseases (PIDs) and the different diagnostic methods of PID.
PubMed and International Guidelines search.
PIDs have various microbial causes. The pathogenic role of the main agents of sexually transmitted infections (STIs), Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium is well demonstrated (NP1). C. trachomatis is the most commonly described bacterium in PID (NP1), especially in women under 30 years old. PIDs also occur in situations that decrease the effectiveness of the cervix microbiological lock, such as bacterial vaginosis, allowing facultative vaginal bacteria such as Escherichia coli, Streptococcus agalactiae and anaerobes to ascend to the uterine cavity. Nevertheless, participation of the diverse bacteria of the vaginal microbiota, in particular anaerobes, and the polymicrobial character of PIDs are still differently appreciated. In the case of uncomplicated PID, to obtain a microbiological diagnosis, endocervical sampling is recommended during gynecological examination under speculum (grade B). A first swab allows for a smear on a slide for direct examination (Gram, MGG). A second swab, in an adapted transport medium, is useful for standard culture with N. gonorrhoeae and facultative vaginal flora bacteria cultures, with antibiotic susceptibility testing. A third swab, in an appropriate transport medium, allows for the search for N. gonorrhoeae, C. trachomatis, and if possible M. genitalium by nucleic acid amplification techniques (NAATs), (NP1). It is possible to only use one swab in a transport medium suitable for (i) survival of bacteria and (ii) NAATs. When the diagnosis of PID is clinically compatible, a positive NAAT for one or more of the three STI-associated bacteria on a genital sample supports the PID diagnosis (NP1). On the other hand, a negative NAAT does not allow the exclusion of an STI agent for PID diagnosis (NP1). In situations where speculum use is not possible, vaginal sampling will be performed by default. In case of complicated IGH, tuboperitoneal samples can be performed either radiologically or surgically. Since these sites are sterile, any bacteria present will be considered pathogenic (NP2). C. trachomatis serology is not interesting as a first line diagnostic tool for PID diagnosis and is not useful for monitoring the evolution of PID (NP1).
PubMed and International Guidelines search.
PIDs have various microbial causes. The pathogenic role of the main agents of sexually transmitted infections (STIs), Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium is well demonstrated (NP1). C. trachomatis is the most commonly described bacterium in PID (NP1), especially in women under 30 years old. PIDs also occur in situations that decrease the effectiveness of the cervix microbiological lock, such as bacterial vaginosis, allowing facultative vaginal bacteria such as Escherichia coli, Streptococcus agalactiae and anaerobes to ascend to the uterine cavity. Nevertheless, participation of the diverse bacteria of the vaginal microbiota, in particular anaerobes, and the polymicrobial character of PIDs are still differently appreciated. In the case of uncomplicated PID, to obtain a microbiological diagnosis, endocervical sampling is recommended during gynecological examination under speculum (grade B). A first swab allows for a smear on a slide for direct examination (Gram, MGG). A second swab, in an adapted transport medium, is useful for standard culture with N. gonorrhoeae and facultative vaginal flora bacteria cultures, with antibiotic susceptibility testing. A third swab, in an appropriate transport medium, allows for the search for N. gonorrhoeae, C. trachomatis, and if possible M. genitalium by nucleic acid amplification techniques (NAATs), (NP1). It is possible to only use one swab in a transport medium suitable for (i) survival of bacteria and (ii) NAATs. When the diagnosis of PID is clinically compatible, a positive NAAT for one or more of the three STI-associated bacteria on a genital sample supports the PID diagnosis (NP1). On the other hand, a negative NAAT does not allow the exclusion of an STI agent for PID diagnosis (NP1). In situations where speculum use is not possible, vaginal sampling will be performed by default. In case of complicated IGH, tuboperitoneal samples can be performed either radiologically or surgically. Since these sites are sterile, any bacteria present will be considered pathogenic (NP2). C. trachomatis serology is not interesting as a first line diagnostic tool for PID diagnosis and is not useful for monitoring the evolution of PID (NP1).
摘要：
确定可能参与盆腔炎（PID）的微生物以及PID的不同诊断方法。
PubMed和国际指南搜索。
PID具有各种微生物原因。性传播感染（STIs）的主要病原体的致病作用，沙眼衣原体,淋病奈瑟氏球菌和生殖支原体得到充分证实(NP1)。沙眼衣原体是PID（NP1）中最常见的细菌，尤其是30岁以下的女性。PID也发生在降低子宫颈微生物锁的有效性的情况下，比如细菌性阴道病，允许兼性阴道细菌，如大肠杆菌，无乳链球菌和厌氧菌上升到子宫腔。然而，阴道微生物群的多种细菌的参与，特别是厌氧菌，和PID的多微生物特性仍然有不同的认识。在不复杂的PID的情况下，为了获得微生物学诊断，在妇科检查期间，建议在窥器下进行宫颈采样（B级）。第一个拭子允许在载玻片上涂片以进行直接检查（克，MGG）。第二个拭子，在适应的运输介质中，可用于淋病奈瑟菌的标准培养和兼性阴道菌群细菌培养，抗生素药敏试验.第三个拭子，在适当的运输介质中，可以搜索淋病奈瑟菌，C.沙眼，如果可能的话，通过核酸扩增技术（NAAT），（NP1）。可以在适合于(i)细菌存活和(ii)NAAT的运输培养基中仅使用一个拭子。当PID的诊断在临床上是一致的，生殖器样本中3种STI相关细菌中一种或多种的NAAT阳性支持PID诊断(NP1).另一方面,NAAT阴性不允许排除用于PID诊断的STI药物(NP1).在无法使用窥器的情况下，默认情况下将进行阴道采样。如果是复杂的IGH,肾小管腹膜样本可以通过放射学或外科手术进行。因为这些部位是无菌的,任何存在的细菌都将被认为是致病性的（NP2）。沙眼衣原体血清学作为PID诊断的一线诊断工具并不有趣，并且对于监测PID（NP1）的演变也没有用。
PubMed和国际指南搜索。
PID具有各种微生物原因。性传播感染（STIs）的主要病原体的致病作用，沙眼衣原体,淋病奈瑟氏球菌和生殖支原体得到充分证实(NP1)。沙眼衣原体是PID（NP1）中最常见的细菌，尤其是30岁以下的女性。PID也发生在降低子宫颈微生物锁的有效性的情况下，比如细菌性阴道病，允许兼性阴道细菌，如大肠杆菌，无乳链球菌和厌氧菌上升到子宫腔。然而，阴道微生物群的多种细菌的参与，特别是厌氧菌，和PID的多微生物特性仍然有不同的认识。在不复杂的PID的情况下，为了获得微生物学诊断，在妇科检查期间，建议在窥器下进行宫颈采样（B级）。第一个拭子允许在载玻片上涂片以进行直接检查（克，MGG）。第二个拭子，在适应的运输介质中，可用于淋病奈瑟菌的标准培养和兼性阴道菌群细菌培养，抗生素药敏试验.第三个拭子，在适当的运输介质中，可以搜索淋病奈瑟菌，C.沙眼，如果可能的话，通过核酸扩增技术（NAAT），（NP1）。可以在适合于(i)细菌存活和(ii)NAAT的运输培养基中仅使用一个拭子。当PID的诊断在临床上是一致的，生殖器样本中3种STI相关细菌中一种或多种的NAAT阳性支持PID诊断(NP1).另一方面,NAAT阴性不允许排除用于PID诊断的STI药物(NP1).在无法使用窥器的情况下，默认情况下将进行阴道采样。如果是复杂的IGH,肾小管腹膜样本可以通过放射学或外科手术进行。因为这些部位是无菌的,任何存在的细菌都将被认为是致病性的（NP2）。沙眼衣原体血清学作为PID诊断的一线诊断工具并不有趣，并且对于监测PID（NP1）的演变也没有用。
