scholarly journals DIAGNOSTIC VALUE OF LABORATORY TESTS OF WOMEN IN THE DYNAMICS OF TREATMENT OF PERIODONTAL DISEASES CONCOMITANT WITH BACTERIAL VAGINOSIS

2019 ◽  
Vol 23 (3-4) ◽  
pp. 17-21
Author(s):  
T.O. Petrushanko ◽  
A.D. Krutikova ◽  
E.I. Krutikova
Keyword(s):  
Oral Cavity ◽  
Bacterial Vaginosis ◽  
Oral Fluid ◽  
Periodontal Diseases ◽  
Diagnostic Value ◽  
Reproductive Age ◽  
Alpha Amylase ◽  
Gardnerella Vaginalis ◽  
Group Iii ◽  
Kinetic Activity

The lack of clear dental screening strategy for women with bacterial vaginosis (BV) leads to inadequate treatment planning, since atypical triggering factors are not considered, despite the given evidence for the presence of chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases in patients with BV. The analysis of the oral fluid, especially its protective properties, is crucial in the noninvasive diagnostics. In this regard, alpha-amylase and secretory IgA (sIgA) are noteworthy. The aim of the research. The paper was aimed at verification of the diagnostic value of the assessment of the outcomes of the recent treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women of reproductive age with bacterial vaginosis by determining the changes in the kinetic activity of alpha- amylase and sIgA concentration. Material and Methods. 50 women of reproductive age have been examined. The subjects were assigned into groups according to their gynecological status: Group I (control) (n=10) included women with the I and II degree of purity of the vagina Group II (n=10) included carriers of Gardnerella vaginalis without diagnosed bacterial vaginosis ; Group ІІІ-A (n=15) included women with verified diagnosis of BV who received conventional treatment; Group IІІ-B (n=15) included women with BV, who received treatment using our patented treatment regimen that takes into account the presence of specific BV-microflora found in the oral cavity in this group of subjects. In the oral cavity the results of the amino-test of the oral fluid were analyzed and kinetic activity of alpha-amylase and sIgA concentration was determined. The presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity was determined by the polymerase chain reaction (PCR) method. Results. The sIgA level of women with BV was by 30-45% lower as compared to the value of patients without BV. Concentration of oral sIgA in both groups of women was restored after treatment, but the results of the III-A and III-B groups after treatment significantly differed (the result of sIgA in subjects of Group III-B was by 1.33 times higher than the value of Group III-A), indicating the higher efficacy of the proposed treatment regimen, which takes into account the presence of etiological agents of BV in the oral cavity. The results of the amino test of oral fluid were positive in patients of Group III-A before treatment in 73.3%, after treatment only in 53.3%, while in the subjects of Group III-B the initial result was 80%; after treatment, a decrease to 20% was registered. Conclusions. The diagnostic value of the applied laboratory methods for examination of local resistance in women is sufficient for mass use as a control of the results in periodontal treatment of patients with inflammatory and inflammatory-dystrophic periodontal diseases concomitant with bacterial vaginosis.

scholarly journals TACTICS OF DENTAL EXAMINATION OF WOMEN WITH PERIODONTAL DISEASE AGAINST THE BACKGROUND OF BACTERIAL VAGINOSIS AND THEIR SEXUAL PARTNERS

2020 ◽  
Vol 20 (2) ◽  
pp. 206-210
Author(s):  
A.D. Krutikova
Keyword(s):  
Oral Cavity ◽  
Bacterial Vaginosis ◽  
Oral Fluid ◽  
Periodontal Diseases ◽  
Sexual Partners ◽  
Gardnerella Vaginalis ◽  
Dental Examination ◽  
Initial Stage ◽  
Periodontal Index ◽  
Atopobium Vaginae

Numerous studies have proved that periodontal pathology is an issue that requires a comprehensive and multidisciplinary approach in diagnosis, treatment and prevention, as most periodontal diseases are syndromic manifestations of somatic and psycho-somatic diseases, but there are little data on the periodontal status in patients with disturbance of the genital microflora. The aim of the study was to provide the grounds for the tactics of dental examination of child-bearing women with bacterial vaginosis and their sexual partners and to compare the results of different sex groups. Materials and methods. 28 heterosexual couples aged 18-45 years were examined. Objective periodontal examination included the calculation of Green-Vermilion oral hygiene index, papillary-marginal-alveolar index, complex periodontal index by P.A. Leus, Svrakov's iodine number. Amino test of oral fluid, assessment of oral fluid pH, identification of bacterial vaginosis pathogens, and in particular, Gardnerella vaginalis and Atopobium vaginae, in the oral cavity of the patients by polymerase chain reaction-diagnostics and bacterioscopically. Results. Chronic generalized catarrhal gingivitis was detected in 10.71% of the women, chronic generalized periodontitis in the initial stage was found out in 64.29% of the women, and chronic generalized periodontitis of the first degree in 25% of the female patients. Men, who were carriers of bacterial vaginosis, chronic generalized catarrhal gingivitis, made up 7.14%; chronic generalized periodontitis in the initial stage was found in 60.71% of the men and chronic generalized periodontitis was found in 32.14%. The values ​​of periodontal indices did not really differ between the indicators of different sex groups. Amino tests of the oral fluid in the women and men showed a positive result those points out the presence of volatile amines. The oral fluid pH is reduced in patients of both groups that indicate an inflammatory process in the oral cavity. All the patients have "key cells", which are exfoliated epitheliocytes with Atopobium vaginae and Gardnerella vaginalis adhered to them. This is one of the main markers of bacterial vaginosis. Conclusions. Summing up the results of the performed clinical and laboratory observations, it should be noted that when collecting the history of bearing aged women, the dentist should pay attention to the presence of diseases of the genital tract, and in particular, bacterial vaginosis. To detect inflammatory and inflammatory-dystrophic periodontal diseases in women of childbearing age, amino tests of oral fluid not only in women but also in their sexual partners for rapid diagnosis of pathogens such as bacterial vaginosis and vaginal vaginal vagina can be very informative.

scholarly journals CHARACTERISTICS OF THE AMINO TEST AS AN EXPRESS METHOD FOR DETECTING CAUSATIVE AGENTS OF BACTERIAL VAGINOSIS IN ORAL CAVITY

2019 ◽  
Vol 19 (2) ◽  
pp. 164-169
Author(s):  
A.D. Krutikova
Keyword(s):  
Oral Cavity ◽  
Bacterial Vaginosis ◽  
Oral Fluid ◽  
Cross Infection ◽  
Gardnerella Vaginalis ◽  
Express Method ◽  
Group Iii ◽  
Periodontal Tissues ◽  
Pcr Diagnosis ◽  
Atopobium Vaginae

At present, the issue of cross-contamination and cross-infection between the oral cavity and other body sites has not sufficiently studied yet and requires the elaboration of clinical protocols for diagnosis infectious diseases, which the dentists can rely on in their practice. We consider it necessary to highlight the issue of cross-infection between the oral cavity and vagina in women with bacterial vaginosis. This gynaecologic diagnosis draws much attention of healthcare professionals due to its prevalence, the frequency of relapses and the specificity of the microflora causing pathology. The purpose of the work was to characterize the diagnostic value of the amino test of oral fluid as an express method for detecting bacterial vaginosis in the oral cavity. Materials and methods. 106 women of child-bearing age without marked somatic and orthodontic pathologies were examined. Patients were divided into 3 groups depending on their gynaecological status. I group included 25 women with the 1st and 2nd degree of vaginal purity; II group involved 27 individuals – carriers of Gardnerella vaginalis; the third group included 54 women with a confirmed diagnosis of bacterial vaginosis, who were divided into 2 subgroups depending on the prescribed treatment. 26 women who received standard treatment and supportive therapy made up III-A subgroup; 28 patients who received the treatment and preventive therapy aimed at eliminating atypical microflora in the oral cavity and preventing relapse, constituted III-B subgroup. The examination was carried out before starting therapy and in 6 and 12 months following the therapy. The amino-test of oral fluid that we patented is designed for express diagnosis of mixed saliva for the presence of volatile amine of isonitrile produced by bacteria Gardnerella vaginalis and Atopobium vaginae associated with bacterial vaginosis. To confirm the results of the amino test of the oral fluid, a PCR-diagnosis for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity was performed. Results. In women with bacterial vaginosis (group III), chronic catarrhal gingivitis was diagnosed in 12.96%, chronic generalized periodontitis of initial severity was found in 25.93% of the patients studied, chronic generalized periodontitis I severity degree was diagnosed in 61.11% of the patients; clinically intact periodontitis was not registered. Comparing the results of the amino test of oral fluid at all stages of the observation with the results of PCR-diagnosis of Gardnerella vaginalis and Atopobium vaginae, we have found out that the patients of groups I demonstrated complete conformity to the results obtained in the group II: the absence of these microorganisms in the oral cavity was confirmed by negative results of amino test. In the group III-A examined, the percentage of the positive amine test was directly proportional to the changes in the detection of Atopobium vaginae in the oral cavity: before the treatment, this microorganism was detected in 84.6% of the amino test, at the beginning of the survey it was 76.9%; in 6 months following the therapy, the PCR decreased by 26.9%, while the result of the amino test dropped by 34.6%; in a year the detection of Atopobium vaginae increased by 42.3% and the percentage of positive test increased by 34.6%. In groups III-B, direct correlation of the changes in the results of the Gardnerella vaginalis PCR and the amino-test of oral fluid were noted. The primary findings of Gardnerella vaginalis and the positive amine test of women in this group made up 67.9% and 75% respectively. In 6 months, the percentage of Gardnerella vaginalis detection was reduced by 39.3% and by 53.6%, the positive oral test in the oral cavity decreased; in one year, Gardnerella vaginalis was found to be 14.3% less frequent in the patients of group III-B, and the registration of the positive amino test decreased by 7.1%. The obtained data make it possible to suggest the informativeness of the amino test of oral fluid as an express method for detecting bacterial vaginosis agents in the oral cavity, such as Gardnerella vaginalis and Atopobium vaginae, to use this method in the diagnosis of concomitant diseases of periodontal tissues and to prescribe treatment, taking into account the presence of oral microbes from atypical representatives who are resistant to traditional treatment regimens.

scholarly journals PECULIARITIES OF DENTAL TREATMENT OF PATIENTS WITH BACTERIAL VAGINOSIS AND THEIR SEX PARTNERS

2020 ◽  
pp. 21-24
Author(s):  
A.D. Krutikova
Keyword(s):  
Oral Cavity ◽  
Bacterial Vaginosis ◽  
Oral Hygiene ◽  
Dental Treatment ◽  
Periodontal Diseases ◽  
Sexual Partners ◽  
Gardnerella Vaginalis ◽  
Initial Degree ◽  
Significant Difference ◽  
Atopobium Vaginae

Patients with bacterial vaginosis are diagnosed with chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases, such as chronic catarrhal gingivitis, periodontitis of initial and first severity. The aim of the study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. Materials and methods. 28 heterosexual couples aged 18-45 years took part in the survey. Clinical dental examination was performed at the time of treatment and 3 months after completion of treatment. Green-Vermilion indices, RMA (in Parma modification), complex periodontal index according to Leus (KPI), Svrakov's number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included: "Fluconazole" 50 mg 1 time per day (7 days), "Clindamycin" 150 mg every 6 hours (5 days), starting from the 3rd day of antibiotics - probiotic "Symbiter acidophilus concentrated "(21 days), Calcium-D3-Nycomed 1 tab. during dinner 30 days. Local treatment included: oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures (7 days), application of "Metrogil-dent" on the gums (7 days), the drug "Lizak" 1 tab. keep in the mouth until complete dissolution every 6 hours (5 days), after the use of "Stomatophyte" and "Metrogil - dent" - application of "Symbiter omega" on the gums in silicone caps at night (21 days). Results. In women, chronic generalized catarrhal gingivitis was detected in 10.71%, chronic generalized periodontitis of the initial degree in 64.29% and chronic generalized periodontitis of the I degree in 25%. In men who are carriers of pathogens of BV, chronic generalized catarrhal gingivitis was found in 7.14%, chronic generalized periodontitis of the initial degree in 60.71% and chronic generalized periodontitis in grade 32.1. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive objective dynamics of dental status. Thus, after 3 months of clinical and laboratory observations, there were no complaints, the state of oral hygiene improved significantly. If before the treatment the Green-Vermilion index in general in women with BV was 1.323 ± 0.035 points, then after 3 months it was equal to 1.032 ± 0.021. A similar dynamics was determined in men: from the starting index of 1.336 ± 0.041, the Green-Vermilion index decreased to 1.048 ± 0.036. 3 months after treatment, the PMA of patients decreased by 49.03%, in men - by 51.95%, no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant . According to the KPI index, women had a significant difference between baseline and post-treatment outcomes of 1.98 points, while men had a score of 2.01 points. No significant difference was found between the results of groups I and II both before and after treatment. A similar positive dynamics characterizes the indicator - Srakov's number, according to this indicator before treatment and after differences between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. Before treatment and after the detection rate in the oral cavity, Gardnerella vaginalis and Atopobium vaginae did not have a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after treatment in the middle and second groups. Thus, Gardnerella vaginalis was detected less by 67.87% and 61.59%, Atopobium vaginae - by 65.79% and 58.65% in women and men, respectively. Conclusions. The developed and patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory phenomena, improves oral hygiene, and is suitable for the treatment of women with this comorbidity and for the treatment of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens corresponded to the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who were their sexual partners, which once again confirms the equal effectiveness of treatment for both gender groups.

scholarly journals CLINICAL AND LABORATORY EFFICIENCY OF TREATMENT OF WOMEN WITH PERIODONTAL DISEASES ON THE BACKGROUND OF BACTERIAL VAGINOSIS

2018 ◽  
pp. 35-39
Author(s):  
A.D. Shulzhenko ◽  
T.O. Petrushanko ◽  
M.V. Mykytiuk
Keyword(s):  
Periodontal Disease ◽  
Bacterial Vaginosis ◽  
Periodontal Diseases ◽  
Local Treatment ◽  
Integrated Treatment ◽  
Alpha Amylase ◽  
Gardnerella Vaginalis ◽  
Periodontal Tissues ◽  
Significant Difference ◽  
Atopobium Vaginae

Introduction. There is currently no tactic for dental examination and treatment of women suffering from bacterial vaginosis (BV), although chronic catarrhal gingivitis, periodontitis of initial and first degree of severity in patients with this pathology has been proven. The frequency of detection of BV in modern women aged 18-45 is 67-89%. The main pathogens of BV are Gardnerella vaginalis and Atopobium vaginae. Aim. To determine clinical and laboratory effectiveness of the treatment scheme for women with periodontal diseases on the background of bacterial vaginosis. Materials and methods. Diagnosis of BV was established by an obstetrician-gynaecologist based on the Amsel criteria. 54 women aged 18-45 were examined. The examined women were divided into two groups, depending on the intended scheme of integrated treatment. Determination of the degree of inflammation of the periodontal period was carried out according to the PMA indices (modified by S. Parma), KPI by Leus. The quality control of the treatment was performed by PCR method, the presence of Gardnerella vaginalis and Atopobium vagina, the amino test of oral liquid, the quantitative activity of alpha amylase and the concentration of sIgA in saliva. Representatives of the first control group (26 women) were prescribed the common course of treatment, namely: local treatment therapy (oral baths of the solution of the medicine “Stomatophyte” after morning and evening hygiene procedures, application of “Mergagil-denta” (7 days); general therapy (metronidazole 250 mg every 8 hours for every 7 days, probiotic “Symbiter acidophilic concentrate” for 21 days). Women of the second experimental group (28 patients) were treated according to the scheme we patented. Their local treatment included: oral baths with the medicine “Stomatophyte” after morning and evening hygiene procedures (7 days), tablets for resuscitation “Lizak” for 1 tab. every 6 hours (5 days), application of “Metrogil-denta” for 20 minutes twice a day. After using “Stomatophyte” (10 days), use “Symbiter omega” for 21 days in silicone caps for the night after the completion of the use of “Metrogil-Denta”. General medicines for patients in the 2nd group: clindamycin 150 mg every 6 hours (7 days), probiotic “Symbiter acidophilic concentrate” per unit (21 days). Evaluation of the treatment results was carried out 14 days, 3, 6 and 12 months after the end of the course treatment. Results. In the examined two groups, there was a disorder in the condition of periodontal tissues. In women of the first group chronic catarrhal gingivitis was registered in 11.5%, chronic generalized periodontitis of initial degree - in 57.69%, chronic generalized periodontitis - in 30.77%; in patients of the 2nd group – in 10.71%, 64.29% and 25% respectively. None of the 54 patients had clinically intact periodontal disease. The PMA and Leish KPI indices in women of the 1st group after the treatment did not have a significant difference with the initial results, while the rates of patients in the second group decreased significantly, indicating a decrease in inflammation in the periodontal tissues. The concentration of sIgA after the end of the treatment course was higher in women of the 2nd group, which suggests a higher efficacy of the proposed method of treatment. Conclusions. Comparing the conventional and patented treatment regimen, it has been determined that traditional treatment is significantly less effective. Clinical methods of examination are insufficient to control the quality of treatment of women with BV and manifestations of periodontal disease, since a specific microflora appears in the oral cavity of this contingent of patients. In order to objectify clinical results, it is advisable to use a study of local immunity factors, such as saliva alpha-amylase and sIgA. To control the presence of IB pathogens as an express method, an amino test should be used, and in the case of its positive result, PCR should be used to detect Gardnerella vaginalis and Atopobium vaginae.

scholarly journals LONG-TERM OUTCOMES OF DENTAL TREATMENT OF PATIENTS WITH BACTERIAL VAGINOSIS AND THEIR SEXUAL PARTNERS

2021 ◽  
Vol 21 (2) ◽  
pp. 112-116
Author(s):  
A. D. Krutikova
Keyword(s):  
Oral Cavity ◽  
Bacterial Vaginosis ◽  
Oral Hygiene ◽  
Dental Treatment ◽  
Periodontal Diseases ◽  
Sexual Partners ◽  
Gardnerella Vaginalis ◽  
Significant Difference ◽  
Before And After ◽  
Atopobium Vaginae

Patients with bacterial vaginosis are often diagnosed as having chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases including chronic catarrhal gingivitis, mild and moderate periodontitis. The aim of this study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. The study included 28 heterosexual couples aged 18-45. Clinical dental check-up was performed during the treatment and in 3 months after the treatment completion. Green-Vermilion indices, РMA (in Parma modification), complex periodontal index (CPI) according to Leus, Svrakov's iodine number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included "Fluconazole" in a dose of 50 mg once a day for 7 days, "Clindamycin" in a dose of 150 mg every 6 hours for 5 days, probiotic "Symbiter acidophilus concentrated" was prescribed to be taken starting from the 3rd day of antibiotic therapy for 21 days, and Calcium-D3-Nycomed (1 tab. during dinner for 30 days). Local treatment included oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures for 7 days, "Metrogil-dent" ointment for gum application for 7 days, the chewing drug "Lizak" (1 tab. every 6 hours for 5 days), "Symbiter omega" in silicone caps for gum application overnight following the for 21 days. Chronic generalized catarrhal gingivitis was detected in 10.71% of women, mild chronic generalized periodontitis – in 64.29% and moderate chronic generalized periodontitis – in 25% of the women. In men who were carriers of pathogens of bacterial vaginosis, chronic generalized catarrhal gingivitis was found in 7.14% of individuals, mild chronic generalized periodontitis – in 60.71% and moderate chronic generalized periodontitis – in 32 male subjects. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive evidence-based dynamics of dental status. 3 months after clinical and laboratory observations, no complaints were presented and the oral hygiene status improved significantly. Before the treatment, the Green-Vermilion index mean values in women with bacterial vaginosis were 1.323 ± 0.035; by the end of 3 month therapy they equalled to 1.032 ± 0.021. A similar dynamics was seen in the men: from the initial index values of 1.336 ± 0.041, the Green-Vermilion index lowered to 1.048 ± 0.036. By the end of 3 month therapy, the PMA decreased by 49.03% in women and by 51.95% in men; no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant. The analysis of the СPI index values demonstrated the women had a significant difference between baseline and post-treatment outcomes of 1.98 scores, while the men had 2.01 scores. No significant difference was found between the findings of groups I and II both before and after the therapy. A similar positive dynamics was confirmed by the Svrakov's iodine number indicator and according to this indicator obtained before and after the therapy, difference between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. The detection Gardnerella vaginalis and Atopobium vaginae in the oral cavity before and after the therapy did not demonstrate a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after the therapy. Gardnerella vaginalis was detected by 67.87% and 61.59% less, Atopobium vaginae – by 65.79% and 58.65% less in the women and men, respectively. This patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory manifestations, improves oral hygiene, and is effective for the treatment of women with this comorbidity and for the therapy of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens reflects the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who are their sexual partners that confirms the effectiveness of the therapy for both gender groups.

scholarly journals Features of vaginal microbiocenosis in women of reproductive age with overweight and obesity

2021 ◽  
Vol 27 (1) ◽  
pp. 50-57
Author(s):  
K.A. Gasparyan ◽  
V.K. Kondratyuk ◽  
I.G. Ponomareva ◽  
K.O. Kondratyuk ◽  
N.P. Dzis ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Bacterial Vaginosis ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Obese Patients ◽  
Women Of Reproductive Age ◽  
Vaginal Microflora ◽  
Facultative Anaerobic ◽  
Anaerobic Microflora

Overweight and obesity play a negative role in gynecological and obstetric practicE.In women, the frequency of infectious pathology increases against the background of metabolic disorderS.The most common form of infectious vaginitis is bacterial urogenital candidiasis, in the etiological structure of which a significant role belongs to the fungi Candida albicans, as well as Candida non-albicans: C.glabrata, C.tropicalis, C.parapsilosis, C.krusei. Associations of Candida fungi with various representatives of opportunistic microflora, such as gram-positive and gram-negative aerobic, facultative-anaerobic and obligate-anaerobic microorganisms, are often formed. As a result, numerous bacterial pathogens multiply and the number of lactobacilli, which are usually part of the bacterial flora of the vagina, is significantly reduced. In bacterial vaginosis (BV), the concentration of anaerobic pathogens Peptostreptococcus sp, Gardnerella vaginalis, Peptostreptococcus Mobiluncus sp, Mycoplasma hominis can increase 100 timeS.Activation of Atopobium vaginae and Gardnerella vaginalis, which play a “key” role in the pathogenesis of BV, has been proven. The aim of the study was to study changes in the vaginal microbiome in women with candidiasis and bacterial vaginosis in order to improve existing treatment regimenS.We examined 120 women of reproductive age with overweight and obesity. The degree of microbial contamination was determined and the maximum possible spectrum of aerobic and facultative-anaerobic microflora was detected. In women with vulvovaginal candidiasis, overweight and obesity, a high concentration (lg5.8 CFU/ml) of Candida fungi was found, and in 95% of patients two-, three- and four-component associations of Candida fungi with various representatives of conditional pathogenic microflora. Lactobacillus deficiency was found in 58.3% of patients, and their complete absence – in 10.0%. Bacteriological examination of the vaginal contents of women with vaginosis and obesity revealed significant dysbiotic disorders of the vaginal microflora, three-, four- and even five-component associations of anaerobic and facultative anaerobic microflora with a predominance of anaerobeS.A low seeding level of lactobacilli (lg2.2 CFU/ml) was established. Thus, the gram-positive anaerobic and facultative anaerobic microflora of Firmicutes have a significant share in the spectrum of vaginal microflora in overweight and obese patients, in contrast to non-obese women of reproductive agE.In women of reproductive age with vulvovaginal candidiasis and obesity, in contrast to non-obese patients, a higher frequency of fungal-bacterial associations, a higher quantitative level of vaginal contamination by Candida albicans and non-albicans with a lack or general absence of lactoflora.

scholarly journals Criteria for diagnosis of bacterial vaginosis using the test Femoflor-16

2017 ◽  
Vol 66 (4) ◽  
pp. 57-67 ◽  
Author(s):  
Veronika V. Nazarova ◽  
Elena V. Shipitsyna ◽  
Ekaterina N. Gerasimova ◽  
Alevtina M. Savicheva
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Bacterial Load ◽  
Anaerobic Bacteria ◽  
Microscopic Investigation ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Nugent Score ◽  
Adverse Pregnancy ◽  
Amsel Criteria

Background. Bacterial vaginosis is disturbance of the balance of the vaginal microflora, associated with a number of infectious diseases of the urogenital tract and adverse pregnancy outcomes. In this country, for the detection of vaginal dysbiotic conditions, the test Femoflor-16 (DNA-Technology, Moscow) is widely used, however interpretation algorithms of this test do not include the category of BV. Aim. The study aimed to elaborate diagnostic criteria for the detection of BV using Femoflor-16 test. Materials and methods. Women of reproductive age addressing a gynecologist with vaginal discharge were enrolled in the study. For clinical diagnosis of BV, the Amsel criteria were used, laboratory analysis for BV was performed via microscopic investigation of vaginal discharge using the Nugent score. Samples of vaginal discharge from all women were analyzed with the test Femoflor-16, intended for characterizing vaginal microbiocenosis using multiplex quantitative real-time PCR. Results. A total of 280 women were included in the study. BV was diagnosed in 86 women (31%) using the Amsel criteria, and in 81 women (29%) using the Nugent score. All groups of anaerobic bacteria included in Femoflor-16 test were shown to be associated with BV, with the exception of bacteria of the genus Mobiluncus, which are detected together with phylogenetically related but not BV-associated bacteria of the genus Corynebacterium. A low amount of lactobacilli (< 10% of total bacterial load) coupled with an elevated amount of Gardnerella vaginalis/Prevotella bivia/Porphyromonas (> 1%) and/or Eubacterium (> 2%) and/or Sneathia/Leptotrichia/Fusobacterium (> 0.1%) and/or Megasphaera/Veillonella/Dialister (> 0.1%) and/or Lachnobacterium/Clostridium (> 0.1%) and/or Peptostreptococcus (> 0.1%) and/or Atopobium vaginae (> 0.2%) detected BV with a sensitivity of 99% and specificity of 93%. Conclusions. Criteria for BV diagnosis using the test Femoflor-16 have been elaborated, which enable to detect BV or exclude it with a sensitivity of 99% and specificity of 93%. These criteria for BV and criteria of the test manufacturers for severe anaerobic dysbiosis determine to a large extent the same category of the vaginal microbiocenosis.

scholarly journals Bacterial communities forming the vaginal micro-ecosystem in norm and in bacterial vaginosis

2017 ◽  
Vol 66 (6) ◽  
pp. 30-43
Author(s):  
Veronika V. Nazarova ◽  
Elena V. Shipitsyna ◽  
Kira V. Shalepo ◽  
Alevtina M. Savicheva
Keyword(s):  
Cluster Analysis ◽  
Bacterial Vaginosis ◽  
Bacterial Communities ◽  
Wide Spectrum ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Nugent Score ◽  
Facultative Anaerobes ◽  
Normal Microflora ◽  
Cluster 2

Background. Bacterial vaginosis (BV) is disturbance of the vaginal microbiota, characterized by displacement of lactobacilli with anaerobic bacteria and capable of adversely affecting women’s reproductive health. In the development of BV, a wide spectrum of bacteria substantially differing in their properties is involved. Grouping vaginal bacterial communities into clusters, or types of microbiocenosis, might contribute to understanding of pathogenic mechanisms and elaboration of effective tools for diagnostics and therapy of the disease. Aim. Determination and comparative analysis of clusters of vaginal bacterial communities in norm and in BV. Materials and methods. Women of reproductive age were enrolled in the study. For the diagnosis of BV, the Nugent score was used. Vaginal swab samples from all women were analyzed with the test Femoflor-16, intended for evaluation of the vaginal microbiocenosis using multiplex quantitative real-time PCR. Two-step cluster analysis was applied for grouping bacterial communities. Differences between the clusters were evaluated using pairwise comparisons. Results. Of 280 women enrolled in the study, 172 had normal microflora, 27 – intermediate microflora, 81 – BV. In cluster analysis, 270 samples valid in PCR testing were included. All the vaginal bacterial communities were grouped into 4 clusters. Cluster 1 (n = 171) included cases when the vaginal microflora consisted mostly of lactobacilli. Cluster 2 (n = 11) encompassed cases of domination of aerobic microflora: Enterobacteriaceae, Streptococcus and Staphylococcus. Clusters 3 (n = 57) and 4 (n = 31) were connected with BV and included cases of prevailing of facultative anaerobes (Gardnerella vaginalis, Atopobium vaginae) and obligate anaerobes (Sneathia/Leptotrichia/Fusobacterium, Megasphaera/Veillonella/Dialister, Lachnobacterium/Clostridium), respectively. Nearly all cases of cluster 1 belonged to the category of normal microflora of the Nugent score. The majority of bacterial communities of cluster 2 matched intermediate microflora, cluster 3 – BV category with a score of 7 or 8, cluster 4 – BV category with a score of 9 or 10. The clusters differed significantly in vaginal рН, with the highest values observed for cluster 4. Conclusions. Vaginal bacterial communities are grouped into 4 main clusters, characterized by domination of lactobacilli, aerobes, facultative anaerobes or obligate anaerobes. The clusters belong to different categories of the Nugent score and differ significantly in vaginal pH.

Isolation, identification and susceptibility pattern of Gardnerella vaginalis in bacterial vaginosis

2013 ◽  
Vol 5 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Shameem Akhter ◽  
Humayun Sattar ◽  
Ruhul Amin Miah ◽  
Ahmed Abu Saleh ◽  
Sharmeen Ahmed ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Vaginal Swab ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Gram Stain ◽  
Healthy Control ◽  
History Of ◽  
Abnormal Vaginal Discharge ◽  
And Control

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age. A total 200 women aged 15- 45 years with history of abnormal vaginal discharge were included as study population. Fifty women without such history of discharge were taken as healthy control. Two vaginal swab samples were taken from each case and control. These swab samples were subjected to test by Gram stain (Nugent method) and culture. 21.5 % of the cases were diagnosed as bacterial vaginosis by Gram stain (Nugent method) and 21 % by culture. Clindamycin was susceptible to G. vaginalis in (90.5%) followed by metronidazol (76.1 %), chloramphenicol (71.4 %) and erythromycin (66.7 %). Out of 50 cases of recurrent bacterial vaginosis, G. vaginalis was isolated from 15 (30 %) cases, of which 5 (33.3 %) were sensitive and 10 (66.7 %) were resistant to metronidazol, while all 15 cases were sensitive to clindamycin.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15814 Bangladesh J Med Microbiol 2011; 05 (01): 8-11

scholarly journals Comparative study of pap smear and microbiological pattern in bacterial vaginosis

2018 ◽  
Vol 7 (3) ◽  
pp. 1039
Author(s):  
Girishma J. ◽  
Rupakala B. M. ◽  
Sunil Chavan
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Pap Smear ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Gram Stain ◽  
Medical College ◽  
Gram Staining ◽  
Gynecology And Obstetrics

Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.

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