Abstract:
Significant increases in rates of sexually transmitted infections (STIs) caused by Trichomonas vaginalis (TV), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) are occurring in the United States. We present results of a U.S. study examining the intersection of STIs and vaginitis. Among 1,051 women with diagnoses for the presence or absence of bacterial vaginosis (BV) and/or symptomatic vulvovaginal candidiasis (VVC), 195 (18.5%) had one or more STIs, including 101 (9.6%) with TV, 24 (2.3%) with CT, 9 (0.8%) with NG, and 93 (8.8%) with MG. STI prevalence in BV-positive women was 26.3% (136/518), significantly higher than STI prevalence of 12.5% (59/474) in BV-negative women (P < 0.0002). Unlike infections with CT or NG, solo infections of MG or TV were each significantly associated with a diagnosis of BV-positive/VVC-negative (OR 3.0751; 95% CI 1.5797-5.9858, P = 0.0113, and OR 2.873; 95% CI 1.5687-5.2619, P = 0.0017, respectively) and with mixed infections containing MG and TV (OR 3.4886; 95% CI 1.8901-6.439, P = 0.0042, and OR 3.1858; 95% CI 1.809-5.6103, P = 0.0014, respectively). TV and MG infection rates were higher in all Nugent score (NS) categories than CT and NG infection rates; however, both STIs had similar comparative prevalence ratios to CT in NS 6-10 vs NS 0-5 (CT: 3.06% vs 1.4%, 2.2-fold; MG: 10.7% vs 6.1%, 1.8-fold; TV: 14.5% vs 7.0%, 2.1-fold). NG prevalence was relatively invariant by the NS category. These results highlight the complexity of associations of STIs with two major causes of vaginitis and underscore the importance of STI testing in women seeking care for abnormal vaginal discharge and inflammation.
OBJECTIVE: This study reports high rates for sexually transmitted infections (STIs) in women seeking care for symptoms of vaginitis and bacterial vaginosis, revealing highly complex associations of STIs with two of the major causes of vaginal dysbiosis. These results underscore the importance of STI testing in women seeking care for abnormal vaginal discharge and inflammation.
摘要:
由阴道毛滴虫(TV)引起的性传播感染(STIs)的比率显着增加,沙眼衣原体(CT),淋病奈瑟菌(NG),和支原体生殖器(MG)在美国发生。我们介绍了一项美国研究的结果,该研究检查了性传播感染和阴道炎的交集。在1,051名诊断为是否存在细菌性阴道病(BV)和/或有症状的外阴阴道念珠菌病(VVC)的妇女中,195(18.5%)有一个或多个性传播感染,包括101(9.6%)与电视,24(2.3%)与CT,9(0.8%)与NG,和93(8.8%)与MG。BV阳性妇女的性传播感染患病率为26.3%(136/518),BV阴性女性的STI患病率为12.5%(59/474)(P<0.0002)。与CT或NG感染不同,MG或TV的单独感染均与BV阳性/VVC阴性的诊断显着相关(OR3.0751;95%CI1.5797-5.9858,P=0.0113和OR2.873;95%CI1.5687-5.2619,P=0.0017),并且与包含MG和TV的混合感染(OR3.4886;95%1.8901-6.439,P=0.0058%和1.695=0.在所有Nugent评分(NS)类别中,TV和MG感染率均高于CT和NG感染率;然而,在NS6-10和NS0-5中,两种性传播感染与CT的比较患病率相似(CT:3.06%和1.4%,2.2倍;MG:10.7%对6.1%,1.8倍;电视:14.5%对7.0%,2.1倍)。NS类别的NG患病率相对不变。这些结果突出了性传播感染与阴道炎的两个主要原因的关联的复杂性,并强调了STI测试在寻求异常阴道分泌物和炎症护理的女性中的重要性。
目的:本研究报告,因阴道炎和细菌性阴道炎症状而寻求治疗的女性性传播感染(STIs)的发生率很高,揭示了性传播感染与阴道菌群失调的两个主要原因的高度复杂关联。这些结果强调了STI测试在寻求异常阴道分泌物和炎症护理的女性中的重要性。