Impaired vaginal biocenosis in reproductive-aged women

Objective. To determine the frequency of aerobic vaginitis and the etiological pattern of vaginal biotope impairments in reproductive-aged women. Subjects and methods. A retrospective study included an analysis of medical records in 122 outpatients aged 18-48 years, who had sought medical advice for lower genital tract biocenosis at the Medical Center, Peoples’ Friendship University of Russia, in 2011 to 2016. After sexually transmitted infections and acute viral infections were ruled out in the women, a comprehensive microbiological study of vaginal discharge encompassing microscopy of its Gram-stained smears, parallel inoculation onto culture media, such as blood agar, Endo agar, Saburo agar, etc. (University Medical Center Laboratory), and a PCR assay (Independent Laboratory, Moscow) was conducted to characterize the vaginal microbiota. Results. Aerobic vaginitis as a nosological entity with signs of a vaginal inflammatory process and a high bacterial pathogen titer was identified in 63 (51.9%) women of reproductive age. Normal biocenosis was found in 17 (13.9%) women; bacterial vaginosis in 34 (27.9%). Fungi of the genus Candida were described in 36 (29.5%) smears of all the specimens and in more than one third (n = 24 (38.1%)) of the vaginal smears with aerobic vaginitis; isolated vulvovaginal candidiasis was seen in 8 (6.6%) women. There was aerobic vaginitis only in 19 (15.6%) women or that concurrent with bacterial vaginosis in 20 (16.4%) or with vulvovaginal candidiasis in 19 (15.6%). Conclusion. This investigation made it possible to concretize the etiological pattern of impaired vaginal biocenosis in reproductive-aged women, to clarify the role of aerobic and facultative anaerobic bacteria, and to determine the frequency of mixed infections. By taking into account the data available in the literature on complex, not fully understood mechanisms for a relationship between causative agents, which are frequently underestimated and lead to a recurrent course, it is appropriate to perform etiotropic therapy of both anaerobes and aerobes, their combination (Clindamycin) and other mixed infections: aerobes/anaerobes and fungi of the genus Candida (Clindamycin + Butoconazole). © 2017, Bionika Media Ltd. All rights reserved