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首页> 外文期刊>Gynécologie, obstétrique, fertilité & sénologie. >Pelvic inflammatory diseases: Microbiologic diagnosis - CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines
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Pelvic inflammatory diseases: Microbiologic diagnosis - CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines

机译：盆腔炎性疾病:微生物学的诊断——CNGOF和SPILF盆腔炎症疾病指南

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abstract_textpObjectives. - To determine the microorganisms potentially involved in pelvic inflammatory diseases (PIDs) and the different diagnostic methods of PID./ppMethods. - PubMed and International Guidelines search./ppResults. - 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 (NPI). C. trachomatis is the most commonly described bacterium in PID (NPI), 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). (C) 2019 CNGOF and SPILF. Published by Elsevier Masson Sas. All rights reserved./p/abstract_text
机译：& abstract_text & p目标。确定微生物可能涉及盆腔炎性疾病(pid)和不同的诊断方法PID。;/ p & p方法。国际准则搜索灵活;/ p & p结果。各种微生物的原因。性传播的主要代理商沙眼衣原体感染,淋病奈瑟氏菌和支原体支原体证明(NPI)。最常见的描述细菌在PID (NPI),尤其是在30岁以下的女性。发生在减少的情况宫颈的有效性微生物锁,如细菌性阴道炎,允许兼性阴道细菌如大肠杆菌、链球菌agalactiae和厌氧生物提升子宫腔。参与的不同的细菌阴道微生物群,尤其是厌氧菌字符的幼童腹壁薄弱的pid不同的欣赏。简单的PID,获得微生物诊断、建议子宫抽样在镜下妇科检查(乙级)。第一次擦洗允许一个涂片幻灯片直接检查(克,“万人迷”女友)。第二个拭子,在一个适应传输介质,用于标准文化与n球菌和兼性阴道菌群细菌文化,与抗生素敏感性试验。拭子,在一个适当的传输介质,允许为寻找n球菌,C。trachomatis,如果可能的生殖支原体核酸扩增技术(NAATs),(NP1)。适合(i)的传输媒介的生存细菌和(2)NAATs。积极NAAT PID临床兼容一个或多个三STI-associated细菌在生殖器样本支持PID诊断(NP1)。不允许排除PID的STI代理诊断(NP1)。是不可能的,抽样将阴道吗默认执行。tuboperitoneal样品可以执行放射检查或手术。无菌,细菌会吗认为致病(NP2)。血清学不是有趣的第一行PID诊断和诊断工具用于监控的进化PID (NP1)。(C) 2019 CNGOF和SPILF。马森Sas。保留。;/ p & / abstract_text

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