Особливості змін вагінальної мікробіоти у жінок фертильного віку як можливий механізм виникнення хронічних запальних захворювань статевих органів та сучасні можливості корекції

Abstract

The article presents the data of the review of literature sources, concerning the peculiarities of microbiota functioning of organs of reproductive system of women of fertile age, in the aspect of formation and functioning of biological films by pathogenic and conditionally pathogenic microflora. The role of infectious, more often microbial factor in the genesis of inflammatory diseases of the pelvic organs in women can not always be represented only in the form of simple causal structural and functional relationships against the background of post-aggressive metabolic response. Its importance may change even as complications develop. Microbial colonization of the genitals against the background of impaired vaginal microbiocenosis can be an early stage of the infectious process and have a detrimental effect on reproductive health. In healthy women of fertile age, the content of vaginal mucus has an acid reaction (pH=4.0–4.7) due to the high concentration of lactic acid (2.0–3.0%), which is formed during the metabolism of lactobacilli and the presence of hydrogen peroxide. In diseases there is a disturbance of equilibrium in this system. The shift of pH towards the alkaline reaction causes the growth of conditionally pathogenic flora, especially anaerobes. The decrease in the number of lactic acid bacteria enables the growth of titers of opportunistic microflora. Upon reaching the pathogenic microflora of critical titers, it becomes pathogenic and attacks the cells of the host organism. It is also important to note that antagonism between lactic acid bacteria and conditionally pathogenic microflora does not occur, or does not occur frequently, without a dramatic change in homeostasis. Administration of local probiotics in combination with lactic acid after the repair of the vagina significantly reduces the risk of recurrent inflammatory process caused by resident conditionally pathogenic microflora, maintaining the required pH level, and the use of lactic acid bacteria, which have sufficient opportunities for adhesion to cell surfaces and biological pathological conditions of microorganisms. Key words: microbiocenosis, chronic inflammatory diseases of the genital organs, pelvic inflammatory diseases, women of fertile age, opportunistic flora, lactic acid, lactic acid bacteria.