Analysis of changes in the state of vaginal microflora in women of reproductive age under conditions of a three-day "dry" immersion without the use of prophylaxis

Introduction. Currently, the participation of women in space flights is increasing. In this regard, questions about the influence of space factors on the state of the female body arise inevitably. Model experiments, in particular, "dry" immersion, are most convenient for studying the influence of individual factors of space flight on the organism. The aim of this work is a comparative assessment of the state of the vaginal microbiota of 6 female volunteers before and after three-day "dry" immersion.Materials and methods. Microbial samples of all volunteers were stained according to Gram with a sequential culture study in accordance with the medical technology. The species identification of microorganisms was performed by MALDI-TOF-MS analysis using an Autoflex III time-of-flight mass spectrometer with Maldi BioTyper software.To assess changes in the state of the vaginal microflora and microflora of the cervical canal, eubiotic index was used. It reflects the number of positive states of microbiota to the number of negative ones.Results. After 3 days of "dry" immersion volunteers, who had high titer of aerobic microorganisms before isolation, had significant increase of the amount of aerobic microorganisms, while the number of lactobacilli decreased. The other group of volunteers showed activation of colonization resistance of the vaginal microflora. Volunteers, who had a significant contamination with anaerobic opportunistic microflora before isolation, had reduction of the number of all anaerobes, including lactobacilli. The eubiotic index, calculated for the cervical canal, decreased after 3 days of immersion. The data obtained indicate that after 3 days of isolation, the state of the microflora has deteriorated.

Comparison of copper IUDs and hormonal IUDs in prevalence of Candida species in cervicovaginal smears

Candidal vulvovaginitis is one of the most common genital infections that different types of diagnosis are essential for a proper treatment plan. IUD is one of the most influential and long-lasting methods of contraception that can be associated with vaginal candidiasis. This study was performed to investigate the prevalence of Candida species before and three months after IUD placement in patients referred to health centers. Also, a comparison of copper IUDs and hormonal IUDs was evaluated to consider the prevalence of Candida species in cervicovaginal smears. In this regard, cervicovaginal swabs were prepared from 160 women applying for IUDs who did not show signs of vaginal infection during the vaginal examination. These people were divided into two groups of 80 cases. The first group received copper IUDs (NT Cu380, Mona Lisa®, Canada), and the second group received hormonal IUDs (Mirena, USA). They had not used antibiotics or antifungal drugs at least two weeks before and three months after IUD placement. The provided Samples were cultured in a Saburo dextrose agar medium. The milky yeast colony was transferred to chromium agar culture medium, and fungal species were differentiated by dyeing. P <0.05 was considered significant. Three months after IUD insertion, 29.57% of people who received a copper IUD were diagnosed with candidiasis. Also, different species of Candida were observed in 22.95% of people who received hormonal IUD. Because Candida albicans is found in the vaginal microflora of 30 to 80% of asymptomatic women, the decision to treat asymptomatic cases requires further study and testing. The use of Candida chromium agar differential culture medium is easy, reproducible, and cost-effective; however, in cases such as recurrent or complicated vulvovaginal candidiasis where the accurate diagnosis is essential for successful treatment, the use of sensitive and precise molecular methods such as PCR is recommended. Finally, studies with wider dimensions and longer follow-up periods are suggested to confirm and complete the present study.

Vulvovaginal atrophy in postmenopausal women: diagnosis and modern-day treatments

Статья посвящена изучению современных методов диагностики и лечения доброкачественных заболеваний вульвы и влагалища у женщин постменопаузального возраста. Проведен анализ этиологии, клинической картины, методов диагностики и лечения вульвовагинальной атрофии как наиболее часто встречающегося доброкачественного заболевания вульвы и влагалища в постменопаузе. Установлено, что основной фактор, приводящий к вульвовагинальной атрофии, — климактерический гормональный дисбаланс с постепенно нарастающим дефицитом эстрогенов. Женщины в постменопаузе отмечают такие признаки вульвовагинальной атрофии, как сухость влагалища, жжение и зуд, диспареуния, повышенная чувствительность к инфекционным болезням органов малого таза, что существенно усугубляет плохое самочувствие и отрицательное влияние на общее и сексуальное качество жизни. Диагностика вульвовагинальной атрофии основывается на данных осмотра, лабораторных и инструментальных исследованиях. Основная терапевтическая цель при лечении вульвовагинальной атрофии – облегчение симптомов и восстановление среды влагалища до здорового пременопаузального состояния. Золотым стандартом лечения вульвовагинальной атрофии является местная и системная терапия эстрогенами. Препараты заместительной гормональной терапии содействуют увеличению пролиферативных процессов, улучшению кровоснабжения, стремительной нормализации микрофлоры влагалища и могут назначаться с лечебной и профилактической целью. Для лечения вульвовагинальной атрофии у женщин, которым противопоказаны препараты эстрогена, используют селективные модуляторы рецепторов эстрогена. Препараты этой группы – оспемифеном и ласофоксифен способствуют облегчению симптомов атрофии влагалища и диспареунии, улучшению вагинального эпителия и pH влагалища. Также при маловыраженных симптомах улучшение состояния наступает при использовании негормональных вагинальных лубрикантов. Кроме того, существуют экспериментальные варианты вульвовагинального омоложения у женщин с симптомами, которым не подходят или которые не переносят местной или системной терапии эстрогенами: инъекции богатой тромбоцитами плазмы, гиалуроновая кислота или жировые имплантаты, фракционный лазер на диоксиде углерода, диодный лазер и монополярные радиочастотные устройства, вагинопластика. The article is devoted to the study of modern methods of diagnosis and treatment of benign diseases of the vulva and vagina in postmenopausal women. The analysis of the etiology, clinical picture, methods of diagnosis and treatment of vulvovaginal atrophy, as the most common benign disease of the vulva and vagina in postmenopausal women, has been carried out. It has been established that the main factor leading to vulvovaginal atrophy in postmenopausal women is climacteric hormonal imbalance with a gradually increasing estrogen deficiency. Postmenopausal women note such signs of vulvovaginal atrophy as vaginal dryness, burning and itching, dyspareunia, hypersensitivity to infectious diseases of the pelvic organs, which significantly aggravates the state of health, a negative effect on the general and sexual quality of life. Diagnosis of vulvovaginal atrophy is based on examination data, laboratory and instrumental studies. The main therapeutic goal in the treatment of vulvovaginal atrophy is to relieve symptoms and restore the vaginal environment to a healthy premenopausal state. The «gold standard» for the treatment of vulvovaginal atrophy is local and systemic estrogen therapy. HRT drugs contribute to an increase in proliferative processes, an improvement in blood supply, a rapid normalization of the vaginal microflora and can be prescribed for therapeutic and prophylactic purposes. For the treatment of vulvovaginal atrophy in women for whom estrogen preparations are contraindicated, selective estrogen receptor modulators are used. The drugs in this group, ospemifen and lasofoxifene, help to alleviate the symptoms of vaginal atrophy and dyspareunia, improve vaginal epithelium and vaginal pH. Also, with mild symptoms, an improvement in the condition occurs with the use of non-hormonal vaginal lubricants. In addition, there are experimental options for vulvovaginal rejuvenation in women with symptoms that do not fit or tolerate local or systemic estrogen therapy: platelet-rich plasma injections, hyaluronic acid or fat implants, fractional carbon dioxide laser, diode laser and monopolar radiofrequency devices, vaginoplasty.

Recurrent bacterial vaginosis: possible ways of correction

Research objective: to increase the effectiveness of bacterial vaginosis (BV) treatment in women of reproductive age.Materials and methods. The study involved 64 women of reproductive age with BV. After a course of local antibiotic therapy participants were divided into 2 groups: patients of group I were not prescribed local remedies to restore the vaginal microflora, patients of group II were prescribed vaginal prebiotic suppositories Folial № 10. No additional drugs were used in subgroups IA and IIA, while oral probiotic Maxibalance was prescribed in subgroups IB and IIB. The effectiveness of BV treatment was evaluated at the first, third and sixth months of the observation period according to the results of clinical examination and vaginal pH evaluation by litmus strips.Results. The course of BV in subgroup IA was characterized by prevailing number of relapses and their early appearance. 1 case of BV recurrence was found among patients of subgroup IA at the 1st month of follow-up, 6 and 8 BV episodes were found at 3 and 6 months of follow-up respectively. Sequential treatment with antibiotics and oral probiotics (subgroup IIB) was associated with the onset of 3 BV relapses on 4–5 months from baseline. Local prebiotic (subgroup IIA) after the vaginal sanation was associated with BV reoccurrence in only one patient at the end of the study. No relapses of BV were detected in subgroup IIB during the study.Conclusions. Permanent imbalance of vaginal normocenosis creates optimal conditions for chronic and recurrent diseases of dysbiosis nature, especially BV. Despite the sensitivity of the anaerobic flora to the recommended antibacterial medications, their use as monotherapy in BV treatment is often insufficient. The results of the study demonstrate a significant anti-relapse efficiency of consecutive treatment by antibacterial drugs and a complex of probiotic + prebiotic. This effect is probably based on the restoration of vaginal immunity and metabolism by stable colonization of the vaginal mucosa with live lactobacilli of eubiotic origin.

The value of vaginal lactobacilli in the restoration of vaginal microbiocenosis in women in the early postpartum period, depending on the method of delivery

BACKGROUND: Despite numerous studies of the vaginal microbiota, there is still a lack of knowledge regarding its restoring dynamics in the early postpartum period. The condition of the vaginal microflora during pregnancy plays a key role in maintaining the physiological microbiocenosis of the birth canal and creating conditions for the normal course of pregnancy, the establishment of an infants intestinal microbiota, and the further development of the child. AIM: The aim of this study was to estimate the role of certain types of lactobacilli in restoring the vaginal microbiota in women in the early postpartum period, depending on the method of delivery. MATERIALS AND METHODS: We examined 150 women at 38-41 weeks of gestation. The clinical material for the study was vaginal discharge before and after delivery. To determine the species of lactobacilli and other microorganisms in the clinical material, we used quantitative real-time PCR. RESULTS: Before delivery, lactobacilli were found in vaginal discharge in 144 out of 150 women (96.0%), their number in the majority being more than 106 GE. In the postpartum period, lactobacilli were found in 66/128 (51.5%) cases, while prevailing in women after vaginal delivery in 50/65 (76.9%) cases (4.61.6, p = 0.000000). Among the dominant species of lactobacilli was L. crispatus, found in vaginal discharge before delivery, which most often affects the recovery of the vaginal microbiota in the postpartum period (29 out of 61 women, 47.5%). L. iners detected in the lochia predisposes to the violation of uterine involution in the early postpartum period (p = 0.03). CONCLUSIONS: Normal vaginal microbiota in the postpartum period is restored more quickly in women after vaginal delivery. Our study confirms that L. crispatus and L. iners play a major role in restoring the vaginal microbiota in the postpartum period.

Specifications of Microfloria in Dysbacteriosis of the Urogenital Tract in Women

The microbiocenosis of the vagina is a set of microorganisms that inhabit this habitat, normally represented mainly by lactobacilli. The condition of the microbiocenosis of the vagina is of great importance for reproductive health. Bacterial vaginosis and aerobic vaginitis are infectious diseases of the vagina caused by imbalances between physiological and opportunistic microflora, which are normally found in small quantities. The purpose of the study. The work is devoted to the study and analysis of the microflora of the urogenital tract of women in different periods of life with dysbiotic disorders. Materials and methods. A study of the vaginal microflora of 50 women of different ages who complained to a gynecologist was carried out. Microscopic examination of biological material from the vagina using Pappenheim staining showed complete or partial absence of lactobacilli in the samples and their replacement by other bacteria. Smear microscopy showed an increased content of epithelial cells, leukocytes and "key cells" - Gardnerella vaginalis in 25% of women of the 2nd age category (25-35 years old). In women of the 1st and 3rd age categories (15-25 and 45-65 years old, respectively), the content of epithelial cells and leukocytes was normal or slightly higher than normal. Results and discussion. In no case were gonococci and Trichomonas detected in the examined smears. Lactobacilli (bacillus flora) were most often registered in the 1st age category - almost 80%, against 12% in the second and 13% in the third. In 68% of women of the 2nd age category the mixed coco-stick flora prevailed; in the 3rd age group mixed microflora was found in 36% of people; in the first – was absent. Poor microflora was most often found in group 3 of women – 66%, against 20% in group 2, and was not observed in women of group 1. Real-time polymerase chain reaction was used to identify microorganisms in the studied samples. Conclusion. As a result of the survey of women of all ages, 155 strains of pathogenic microorganisms were isolated. The largest number of samples contained Candida spp. (18.7%), Staphylococcus spp. (10.3%), Gardnerella vaginalis (9.7%), Streptococcus spp. (7.1%), Mobiluncus spp., Atopobium vaginae, Leptotrichia spp., Eubacterium spp. were detected in a small number of samples, Ureaplasma urealytic and Mycoplasma hominis were not detected

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

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.

Vaginal microbiome and serum metabolite differences in late gestation commercial sows at risk for pelvic organ prolapse

Sow mortality attributable to pelvic organ prolapse (POP) has increased in the U.S. swine industry and continues to worsen. Two main objectives of this study were, (1) to develop a perineal scoring system that can be correlated with POP risk, and (2) identify POP risk-associated biological factors. To assess POP risk during late gestation, sows (n = 213) were scored using a newly developed perineal scoring (PS) system. Sows scored as PS1 (low), PS2 (moderate), or PS3 (high) based on POP risk. Subsequently, 1.5, 0.8, and 23.1% of sows scored PS1, PS2, or PS3, respectively, experienced POP. To identify biomarkers, serum and vaginal swabs were collected from late gestation sows differing in PS. Using GC–MS, 82 serum metabolite differences between PS1 and PS3 animals (P < 0.05) were identified. Vaginal swabs were utilized for 16S rRNA gene sequencing and differences in vaginal microbiomes between PS1 and PS3 animals were detected on a community level (P < 0.01) along with differences in abundances of 89 operational taxonomic units (P < 0.05). Collectively, these data demonstrate that sows with greater POP risk have differential serum metabolites and vaginal microflora. Additionally, an initial and novel characterization of the sow vaginal microbiome was determined.

Improvement of Bacterial Vaginosis by Oral Lactobacillus Supplement: A Randomized, Double-Blinded Trial

Bacterial vaginosis (BV) is the most common vaginal infection globally, with a high recurrent rate after antibiotic treatment. Probiotics consumption is known to improve BV with different efficacy among species or strains. After in vitro selection of Lactobacillus strains with growth inhibition and preventing adhesion to HeLa cervical epithelial cells, a randomized and double-blinded trial of two Lactobacillus formula, namely, VGA-1 and VGA-2, in BV patients with Nugent scores of 4–10 was conducted. Among 37 subjects who completed the trial, we observed significantly decreased Nugent scores in both VGA-1 (n = 18) and VGA-2 (n = 19) consumption groups. VGA-1 consumption significantly improved vaginal discharge odor/color and itching at both 2-week and 4-week-consumption, but those only observed after a 4-week-consumption in the VGA-2 group. We also observed a tendency to reduce recurrent rates among enrolled participants after VGA-1 or VGA-2 consumption. The improvement effect of VGA-1/VGA-2 was associated with the significant reduction of interleukin-6 expression after 4-week-consumption and the restoration of normal vaginal microflora by quantitative polymerase chain reaction analysis. In conclusion, VGA-1 or VGA-2 displayed beneficial effects in BV patients, but the VGA-1 formula showed a better efficacy, potentially used for BV intervention.