질염 증상을 가진 여성에서 질 내 칸디다와 성병관련 미생물
Vaginal Candida and Microorganisms Related to Sexual Transmitted Diseases in Women with Symptoms of Vaginitis
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배경: 여성의 생식관은 여러 가지 미생물을 포함하는 다양한 이물질과 접촉하게 되며, 감염이 아닌 집락형성과 질염 사이의 균형에서 칸디다-세균의 상호작용을 고려하는 것이 중요하다. 본 연구의 목적은 질염과 미생물 분포 간 연관성을 평가하고 여성 생식관에 존재하는 칸디다와 다른 미생물 간의 상호작용 가능성을 연구하는 것이다. 방법: 2008년 10월부터 2010년 6월까지 외음질염이 의심되는 환자로부터 채취한 총 516건의 질 분비물을 대상으로 하였다. 칸디다 종동정과 배양이 까다로운 6균종의 미생물(Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, 그리고 Ureaplasma urealyticum) 검출은 각각 VITEK 2 system (bioMérieux, Inc., Hazelwood, MO, USA)과 다중 PCR (Seegene, Biotechnology, Inc., Seoul, Korea)을 사용하여 시행하였다. 결과: M. genitalium, U. urealyticum, 그리고 C. trachomatis가 질 칸디다증과 관련하여 더 많이 검출되었고, M. genitalium은 통계적으로 유의하게 많이 검출되었다(P＜0.05). N. gonorrhoeae는 질 칸디다증이 있는 경우에 더 적게 검출되었다. 결론: 본 연구는 질염에서 질 내 칸디다가 일부 균종과 관련될 가능성을 시사한다. 그러므로 향후 칸디다와 미생물 간의 상호작용 확인과 기전을 밝히기 위한 추가적인 다양한 연구가 필요하다고 사료되었다.
Abstract
Background: The female genital tract is equipped to deal with a variety of foreign substances including a wide array of microorganisms. It is important to consider Candida-bacterial interactions in balance between healthy colonization versus vaginitis. The objectives of this study were to evaluate the association between microorganism distribution and vaginitis, and to investigate the possibility of an interaction between vaginal Candida and other microorganisms in female genital tract. Methods: A total of 516 vaginal secretions were collected between October 2008 and June 2010 from patients with suspected vaginitis. Identification of Candida species and detection of 6 fastidious microorganisms (Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum) were performed using a VITEK 2 system (bioMérieux, Inc., Hazelwood, MO, USA) and multiplex PCR (Seegene, Biotechnology, Inc., Seoul, Korea), respectively. Results: M. genitalium, U. urealyticum, and C. trachomatis were more often detected in association with vaginal candidiasis. A statistically significant association between Candida and M. genitalium was observed (P＜0.05). N. gonorrhoeae was detected less often in women with vaginal candidiasis. Conclusion: The results of this study suggest the possibility that vaginal Candida may associate with some microorganisms in patients with vaginitis. Further studies will be required to define the Candida-bacterial interactions and its mechanisms.
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