THE CLINICAL AND MICROBIOLOGICAL FEATURES OF BACTERIAL VAGINOSIS

Aim : to determine the clinical and microbiological features of bacterial vaginosis on the basis of the microbiological examination, assessment of the cytokine status in female patients. Material and methods . The article presents the results of the complex clinical and microbiological examination of 86 female patients of the fertile age. 30 (34.88 ± 5.14 %) patients were diagnosed bacterial vaginosis on the basis of revelation and identification of DNA of Gardnerella vaginalis, Atopobium vaginae, Lactobacillus spp. and the total number of bacteria. The control group consisted of 56 (65.12 ± 5.14 %) patients without bacterial vaginosis. The work also presents the results of the microbiological analysis of the material obtained from the cervical canal and endometrium. All the patients underwent blood tests for detection of the inflammatory reaction - interleukins IL-1, IL-2, tumor necrosis factor (TNF-α), interferon (γ-IFN). Results . The prevalence of bacterial vaginosis among the patients of the reproductive age was 34.8 %. The pathology of the reproductive function was found with equal frequency in the patients of both the groups. Disorders of the immune status in favor of pro-inflammatory cytokines were not diagnosed. The clinical and laboratory criteria made it possible to diagnose bacterial vaginosis in 3.49 % of the patients, the use of PCR diagnosis - in 34.88 %. The concentration of lactobacillus spp. is reliably lower in the patients with bacterial vaginosis, than in the control group (p = 0.0085). As for the concentrations of Gardnerella vaginalis and Atopobium vaginae the groups do not significantly differ. Only 4 (13.33 ± 6.21 %) patients (χ = 5.51, p = 0.02) in the main group detected sexually transmitted infections, which should be taken into account while performing the diagnostic activities. Conclusion. The identification of DNA of certain kinds of microorganisms give an opportunity to assess the state of vaginal microcenosis and the degree of its malfunction even in the absence of clinical and other laboratory signs of bacterial vaginosis. The malfunction of the biocenosis of the genital tract is not associated with disorders of the reproductive function and does not lead to a change in the cytokine status. Patients with bacterial vaginosis are in the risk group for development of sexually transmitted infections, which should be taken into account while performing the diagnostic activities.

антенатальная гибель плода, беременность, послед, antenatal fetal death, pregnancy, placenta

1. Захарова, Т. В. Бактериальный вагиноз и бактериальный вагинит: клинико-микробиологические варианты течения / Т. В. Захарова // Вестник новых медицинских технологий. - 2008. - Т. 25, № 2. - С. 192-194.

2. Менухова, Ю. Н. Бактериальный вагиноз: этиопатогенез, клинико-лабораторные особенности / Ю. Н. Менухова // Журнал акушерства и женских болезней. - 2013. - Вып. 4. - С. 79-86.

3. Сгибнев, А. В. Потенцирование активности антибиотиков метаболитами нормальной вагинальной микрофлоры / А. В. Сгибнев, Е. А. Кремлева // Акушерство и гинекология. - 2017. - № 3. - С. 108-112.

4. The role of infection in miscarriage / S. Giakoumelou [et al.] // Human reproduction update. - 2016. - № 1. - Р. 116-133.

5. Witkin, S. S. An altered immunity hypothesis for the development of symptomatic bacterial vaginosis / S. S. Witkin // Clinical Infectious Diseases. -2007. - Vol. 44, № 4. - P. 1112-1119.

6. Подгорная, А. В. Бактериальное и антимикробное звенья неспецифического иммунитета влагалища при рецидивирующем бактериальном вагинозе у беременных женщин / А. В. Подгорная, А. Ш. Шахмутходжаев // Акушерство и гинекология. - 2016. - № 12. - С. 66-68.

7. Микроэкология половых путей у женщин с бесплодием хламидийной этиологии / Т. А. Лисяна [и др.] // Клиническая лабораторная диагностика. - 2016. - № 6(12). - C. 853-857.