Abstract:
Female genital tract infections (FGTIs) include vaginal infections (e.g., bacterial vaginosis [BV]), endometritis, pelvic inflammatory disease [PID], and chorioamnionitis [amniotic fluid infection]. They commonly occur in women of reproductive age and are strongly associated with multiple adverse health outcomes including increased risk of HIV/sexually transmitted infection acquisition and transmission, infertility, and adverse birth outcomes such as preterm birth. These FGTIs are characterized by a disruption of the cervicovaginal microbiota which largely affects host immunity through the loss of protective, lactic acid-producing Lactobacillus spp. and the overgrowth of facultative and strict anaerobic bacteria. Prevotella species (spp.), anaerobic Gram-negative rods, are implicated in the pathogenesis of multiple bacterial FGTIs. Specifically, P. bivia, P. amnii, and P. timonensis have unique virulence factors in this setting, including resistance to antibiotics commonly used in treatment. Additionally, evidence suggests that the presence of Prevotella spp. in untreated BV cases can lead to infections of the upper female genital tract by ascension into the uterus. This narrative review aims to explore the most common Prevotella spp. in FGTIs, highlight their important role in the pathogenesis of FGTIs, and propose future research in this area.
摘要:
女性生殖道感染(FGTI)包括阴道感染(例如,细菌性阴道病[BV]),子宫内膜炎,盆腔炎[PID],和绒毛膜羊膜炎[羊水感染]。它们通常发生在育龄妇女中,并与多种不良健康结果密切相关,包括增加艾滋病毒/性传播感染的风险,不孕症,以及早产等不良分娩结局。这些FGTI的特征是宫颈阴道微生物群的破坏,通过丧失保护性,产乳酸的乳杆菌属。兼性和严格厌氧细菌的过度生长。Prevotella物种(spp。),厌氧革兰氏阴性棒,与多种细菌FGTI的发病机理有关。具体来说,P.Bivia,P.amnii,在这种情况下,提蒙氏菌具有独特的毒力因子,包括对治疗中常用抗生素的耐药性。此外,证据表明,普雷沃氏菌属的存在。在未经治疗的BV病例中,可通过进入子宫而导致上女性生殖道感染。这篇叙述性综述旨在探讨最常见的普雷沃氏菌属。在FGTI中,突出了它们在FGTI发病机制中的重要作用,并提出了该领域未来的研究方向。