ОСОБЕННОСТИ МИКРОБИОЦЕНОЗА УРОГЕНИТАЛЬНОГО ТРАКТА ЖЕНЩИН С ВПЧ-АССОЦИИРОВАННЫМИ ПЛОСКОКЛЕТОЧНЫМИ ИНТРАЭПИТЕЛИАЛЬНЫМИ ПОРАЖЕНИЯМИ ШЕЙКИ МАТКИ

Abstract

Objective: To reveal the features of the microbiocenosis of the cervical canal with the species identification of lactobacilli in women with HPV-associated squamous intraepithelial lesions of the cervix. Materials and methods: A survey of 80 patients of reproductive age with HPV-associated squamous intraepithelial lesions of the cervix (SIL), who had not received local and systemic antibacterial drugs at the time of the examination, was carried out. According to the results of morphohistological examination of cervical biopsies, this cohort of patients was divided into two groups. Group 1 included 40 patients with CIN II and CIN III, which corresponds to Нigh-grade squamous intraepithelial lesions (HSIL), group 2 — 40 patients with CIN I, which corresponds to Low-grade squamous intraepithelial lesions (LSIL). The comparison group (3rd) consisted of 30 clinically healthy women. All patients underwent a cytological study by the «liquid method» BD SurePath technology, genotyping of the human papillomavirus by the polymerase chain reaction method (6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), cultural studies of the microbiocenosis of the cervical canal (by the MALDI method — TOF mass spectrometry, in the VITEKMS analyzer), extended colposcopy. Conclusion. It was found that in all women with HPV-associated squamous intraepithelial lesions of the cervix, the microflora of the cervical canal is characterized by the presence of Gardnerella vaginalis, as well as a decrease in the detection rate and number of lactobacilli, with the presence of the facultative anaerobe Lactobacillus iners. In the structure of opportunistic microflora, the predominance of Enterococcus faecalis and Escherichia coli was demonstrated in HSIL, while for LSIL, representatives of the enterococcus group.