Genital Tract Of Women Research Articles

Features of the vaginal microbiota in women with relapsing-remitting multiple sclerosis

Introduction. Multiple sclerosis (MS) is a chronic disease of the central nervous system predominantly affecting women of reproductive age. It is known that there is a high incidence of low urinary tract infections in MS. However, information about microbiology of the genital tract in women with MS is extremely limited.Aim. To study the qualitative and quantitative composition of the vaginal microflora in patients with MS.Materials and methods. 19 patients with relapsing-remitting MS of the main group and 19 healthy women of the control group, the qualitative and quantitative composition of the microflora in the vaginal secretion was determined using the polymerase chain reaction method in real time (a set of reagents was used to study the biocenosis of the urogenital tract in women, Femoflor 16, DNA-Technology, Moscow), a gynecological smear from the vagina was performed. The neurological status was assessed using the EDSS scale and The questionnaire on pelvic organ function. The following statistical indicators were determined: frequency, spread, average and χ² test.Results. A status of normocenosis was observed in the majority of women with MS (14 subjects, 73.7%), Lactobacillus bacteria were found in 16 subjects (84.2%), and an increased number of facultative anaerobes was identified in 7 subjects (37.4%), there were no significant differences with the comparator group. Bacteriological examination findings from vaginal smears did not show any signs of inflammation in either group. A high incidence of vaginal infections in anamnesis was reported in women with neurogenic lower urinary tract dysfunction (16 subjects, 84.2%).Conclusion. Data on the state of the vaginal biocenosis of women with MS has been presented for the first time. It was found the preservation of normocenosis with a tendency to shift the balance towards dysbiotic processes in the vagina.

Possibilities of using lactobacilli metabolites for the treatment and prevention of bacterial vaginosis

Bacterial vaginosis is one of the most common reasons for pathological discharge from the genital tract in women of reproductive age, which, among other things, is characterized by a high recurrence rate after standard antibacterial treatment. To date, issues related to the prevention and treatment of bacterial vaginosis have remained relevant and unresolved. This review article discusses the feasibility of using lactobacilli metabolites in the treatment and prevention of bacterial vaginosis, taking into account the data accumulated. The use of lactic acid as an additional second stage of bacterial vaginosis treatment can be considered as a way to improve the effectiveness of therapy and patient adherence to treatment, as well as to reduce the likelihood of recurrences.

ерсонифицированный подход к диагностике и лечению рецидивирующих форм бактериального вагиноза

According to world statistics, bacterial vaginosis (BV) occupies one of the first places among vaginal diseases. The frequency of its distribution in the population ranges from 12% to 80% and depends on the contingent of women examined. BV develops mainly in women of reproductive age: in 80–87% of women with pathological vaginal discharge and 37–40% of pregnant women. Aim. To evaluate the effectiveness of three-stage therapy for recurrent and combined forms of BV based on the characteristics of the microbiome of the genital tract in women of early reproductive age. Materials and methods. We observed 445 women, who were divided into the following clinical groups. The IP group included 174 (39.10±2.31%) women with a confirmed diagnosis of recurrent BV. The IIP group included 153 (34.38±2.25%) women in whom BV was combined with cervicitis of nonspecific etiology. Group IIIP included 85 (19.10±1.86%) patients with a verified diagnosis of recurrent BV in combination with vulvovaginal candidiasis. The comparison group included 33 (7.42±1.24%) women, whose examination results corresponded to the reference values. Verification of the diagnosis in patients was carried out when contacting the antenatal clinic, based on the anamnesis, the nature of the complaints, and the results of clinical and laboratory examination methods. Laboratory examination included: pH – measurement of vaginal fluid using colpotest; bacterioscopic (urethra, cervical canal, vagina, rectum), bacteriological examination and polymerase chain reaction method in real time characterized the vaginal biotope. Patients with recurrent BV were offered three-stage therapy according to a personalized algorithm we developed, taking into account concomitant vaginal pathology. Results. The data obtained indicated an improvement in the quality of life of patients who underwent a course of three-stage therapy. The clinical effect showed that there were no relapses of the disease in patients of the IIIP group in 83% of cases, in the IIP and IP groups – in 90% and 91% of women, respectively. The highest frequency of relapses after therapy after 6 and 12 months was observed in patients of group IIIP, which amounted to 6% and 8% of Clinical cases (p<0.05). Conclusion. Our data indicate that the use of the proposed diagnostic algorithm and three-stage therapy for recurrent and combined forms of BV made it possible to reduce the frequency of reproductive losses in patients in the prospective study groups: spontaneous miscarriages in early and late gestation – in 6.29, ectopic pregnancies – by 5.54 times, premature births by 3.65 times. The frequency of normal term births in women in the prospective study groups after three-stage therapy increased by 1.4 times.

Multimodality imaging of diseases of the vagina.

Pathologies of the vagina are important causes of symptoms related to the genital tract in women. They can be missed on transabdominal ultrasonography (USG), which is the baseline modality used for evaluation of gynaecological complaints. Transperineal USG and MRI are the imaging modalities of choice for evaluation of the vagina. Diseases of the vagina can be grouped depending upon the age group in which they occur. In children and young adults, congenital anomalies like longitudinal or transverse vaginal septum, imperforate hymen, vaginal aplasia or atresia, and rectovaginal fistula can be seen. Malignant tumours can rarely occur in children, rhabdomyosarcoma being the most common one. Common diseases affecting adults include benign lesions like epidermoid, Gartner duct, and Bartholin cysts, and urogenital fistulas involving the vagina. Endometriosis and other benign tumours of vagina including leiomyoma, fibroepithelial polyp, and angiomyxoma are occasionally seen. Malignant tumours can be primary, the most common one being squamous cell carcinoma, or secondary, due to direct extension from cancers involving the adjacent organs. Characteristic morphological changes occur in the vagina after radiotherapy, which can be identified on imaging. Knowledge about the imaging appearances of these diseases is crucial in guiding appropriate management.

Disorder of the Microbiota and Mucosal Immunity of the Genital Tract in Women of Reproductive Age with Different Clinical Courses of Acute Uncomplicated Pyelonephritis

The research deals with the study of immuno-microbiological parallels of the genital tract in women with acute uncomplicated pyelonephritis with concomitant chronic pelvic inflammatory diseases. In addition to etiotropic antibacterial therapy, correction of the mucosal immunity state of the genital tract is crucial for the treatment of the disease and prevention of its recurrence. The purpose of the work was to investigate the contamination and state of local immunity of the genital tract in women with acute uncomplicated pyelonephritis with different clinical courses. Methods. 246 women of reproductive age suffering from acute uncomplicated pyelonephritis were studied, divided into three variants of the disease clinical course: group 1 - mild (n=105), group 2 - moderate (n=90), and group 3 - severe (n=51) courses. The scrapings of the mucous membrane of the cervical canal and washings from the vagina were obtained before the start of antimicrobial therapy. Quantitative determination of pathogens was carried out by sowing the biological material on solid nutrient environment. Identification of detached bacteria was carried out according to Bergeys. Mollicutes (Ureaplasma spp., Mycoplasma hominis) were determined by the cultural-fermentative method using test systems and the polymerase chain reaction. Vaginal washings of 121 sick women were used for immunological studies. The levels of myeloperoxidase, lysozyme, human β-defensin-2, immunoglobulins M, A, G, secretory IgA, lactoferrin, C3-component of complement, secretory component, and tumor necrosis factor-α were determined. The reference group consisted of 23 clinically healthy women. The Statistica 12.0 program package for Windows was used, and a difference of p<0.05 was considered verifi able. Results. In the majority of patients with acute uncomplicated pyelonephritis (85.6% of cases), concomitant chronic pelvic inflammatory diseases (colpitis, salpingitis, underlying medical condition of cervix) were observed. Classical bacteria were more often detected in vaginal washings of patients of all groups, while mollicutes were detected in scrapings of the mucous membrane of the cervical canal, whereas the frequency of their detection increased with increase in the pyelonephritis severity. The analysis of indicators of local immunity determined disorders of mucosal immunity of the genital tract in the form of increased levels of myeloperoxidase, IgA, and IgG relative to reference values. The highest levels of lysozyme and myeloperoxidase were determined in patients with a severe course of acute uncomplicated pyelonephritis (by 5.3 and 3.6 times more, respectively), and the content of immunoglobulins A, M, and G in patients with a mild course of the disease (by 3.2, 3.1, and 4.0 times more, respectively). An increase in the level of tumor necrosis factor-α was detected in all patients, although no significant differences from controls were found in any group, but the highest median value was recorded in patients with severe pyelonephritis. In the group of patients with a severe clinical course, the lowest median was observed for β-defensin-2, which makes it impossible to inhibit the synthesis of TNF-α and, thus, supports the inflammatory process. Conclusions. It has been proven that in women with acute uncomplicated pyelonephritis, the severity of the course probably correlates with infection of the genital tract by mollicutes, mainly in association with classical bacteria and with level of mucosal immunity disorder. The obtained results of microbiological and immunological studies of biological material collected before the start of antibacterial therapy in patients with acute uncomplicated pyelonephritis proved the need for a mandatory examination by a gynecologist to ascertain concomitant chronic pelvic inflammatory diseases and establish infection with mollicutes to provide relevant etiotropic treatment. The above is the basis for adding the data regarding laboratory examination and treatment to the management protocols of patients with acute uncomplicated pyelonephritis.

Вплив вітаміну D на мікробіоценоз статевих шляхів у жінок із багатоплідною вагітністю

Insufficiency of vitamin D during pregnancy was and remains one of the urgent problems of modern obstetric practice, which focuses on itself the attention of researchers from different countries. The importance of the issue of multiple pregnancy (МР) is determined by the significant number of complications that may arise during pregnancy, childbirth and the postpartum period. Possessing an immunomodulatory and anti-inflammatory effect, vitamin D ensures not only implantation, placentation, but also the course of the entire multiple pregnancy. Microbiocenosis of the female genital tract is a marker of the overall health of the female body, the issue of its disruption under the influence of vitamin D deficiency is of particular scientific interest. Purpose - to study the peculiarities of the genital tract microbiocenosis in women with multiple pregnancies and vitamin D deficiency. Materials and methods. Were examined 120 pregnant women, 90 of whom had multiple pregnancies and vitamin D deficiency, and were divided into two groups depending on the onset of pregnancy: the Group I consisted of 48 women with multiple births as a result of assisted reproductive technologies, and the Group II consisted of 42 pregnant women with spontaneous multiple births. The control group consisted of 30 healthy women with a singleton pregnancy and a normal level of 25(OH)D. The content of vitamin D in blood serum was studied by the immunoenzymatic method in the first and second trimesters of pregnancy. Microbiocenosis of the vagina of examined pregnant women was studied on the basis of bacterioscopic and bacteriological research. Results. A deviation in the ratio between cocci and bacilli flora was found in the I and II trimesters of pregnancy. The predominance of cocci flora was observed in women with multifertility due to the use of assisted reproductive technologies (55.9%), compared to women of the Group II (22.6%) and the control group (18.4%), which indicates the presence of inflammatory processes caused by vitamin D deficiency in this contingent of pregnant women, both in the first and second trimesters of pregnancy. The high activity of pro-inflammatory cytokines, which activate proteolytic enzymes in the vagina of pregnant women under the influence of vitamin D deficiency, causes the inflammatory process, thereby disrupting the vaginal microbiocenosis of pregnant women with MP. Conclusions. Violations of the microbiocenosis of the genital tract in women with MP in the early stages of pregnancy indicate that vitamin D deficiency plays a leading role in the genesis of inflammatory changes in the vaginal ecosystem. Early detection and timely treatment of vitamin D deficiency will contribute to reducing the number of violations of vaginal microbiocenosis and, as a result, prolongation of multiple pregnancies due to the use of assisted reproductive technologies. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

The state of the microbiota of the genital tract in women who smoke

The state of the microbiota of the genital tract in women who smoke

Study on the Correlation between Genital Tract Microenvironment and GBS Carrier Rate of Late-Stage Pregnant Women in Dongguan.

The carrier rate of group B Streptococcus (GBS) in the genital tract of women in the late stage of pregnancy and its correlation with the genital tract microenvironment were investigated in a group of pregnant women in Dongguan, China, to provide a basis for the clinical prevention and treatment of GBS. A retrospective analysis was done of the results of routine testing for GBS, leucorrhea and bacterial vaginosis (BV) in 6,166 women in the late stage of pregnancy (35 - 37 weeks of gestation) who underwent a prenatal examination at Dongguan Southeast Central Hospital from January 2018 to December 2020. GBS positivity was detected by RT-PCR. Normal saline floating microscopy was used to detect routine indicators of leucorrhea, including white blood cells (WBCs), Lactobacillus (Lab), vulvovaginal Candida (VVC), and trichomoniasis (TV). BV was detected based on an enzymatic reaction. The correlation between GBS infection and age and the vaginal microenvironment was determined statistically. The rate of GBS positivity was 10.53% (649/6,166) and was statistically significant for women 20 years of age (p < 0.05). Logistic regression showed that abnormal VVC, TV, BV, WBCs, and Lactobacillus were associated with GBS infection. The results of a rank sum test of the WBC group showed that the infection risk in groups with < 15 WBCs/hpf increased as the WBC count increased, but there was no statistical difference between groups with > 15 WBCs/hpf. The rank sum test results for Lactobacillus showed a significant difference between the abnormal and normal and other groups, but no significant difference between the other groups. The overall carrier rate of GBS in the genital tract of late-stage pregnant women in Dongguan was 10.53%. GBS infection is related to the genital tract microenvironment. Our results provide a basis for the prevention and treatment of clinically confirmed GBS.

СОВРЕМЕННЫЕ ИЗМЕНЕНИЯ МИКРОБИОЦЕНОЗА ВЛАГАЛИЩА НА ПРИМЕРЕ ЖЕНЩИН РЕПРОДУКТИВНОГО ПЕРИОДА Г. НОВОСИБИРСКА

Introduction. Bacterial vaginosis is associated with a large number of pregnancy complications as well as pelvic inflammatory diseases. However, it is necessary to take into account the species composition of pathogens before starting empirical therapy. Aim of the research. Study of the species composition of vaginal discharge in women of reproductive age in the city of Novosibirsk. Materials and methods. To assess the species composition of the vaginal microflora in women with complaints of pathological discharge from the genital tract, 485 women of the reproductive period of the Central District of Novosibirsk were selected who applied to the antenatal clinic and were diagnosed with bacterial vaginosis. All women underwent a bacteriological examination of the discharge from the genital tract, and 240 women with complaints of pathological discharge from the genital tract were assessed for microbiocenosis using the real-time PCR method. Results. According to the bacteriological examination, the majority of patients did not reveal opportunistic pathogens (75.05%). Representatives of the genus Candida sp. predominated among the identified microorganisms (11.55%), Enterococcus sp. – 9.07%. Representatives of the genus Proteus were detected least often during bacteriological examination – 0.21%. According to the RT-PCR study, representatives of Gardnerella vaginalis + Prevotella bivia + Porphyromonas (89.17%), Eubacterium spp. (68.33%), Megasphaera spp. + Veillonella spp. + Dialister spp. (37.5%) and Atopobium vaginae (30.83%) predominated. Staphylococcus spp., Mycoplasma ho-minis – 2.83% and Enterobacterium spp. were detected less frequently – 4.17%. Conclusion. Since in more than 50% of cases it is not possible to isolate an infectious agent in the presence of pathological discharge from the genital tract of women by the bacteriological method of research, while the real-time PCR method is not always available, an understanding of the microbial landscape of the vagina in women with pathological discharge from the genital tract will allow to prescribe an effective empiric therapy.

Genital Microbiota and Outcome of Assisted Reproductive Treatment-A Systematic Review.

The balance between different bacterial species is essential for optimal vaginal health. Microbiome includes the host genome along with microorganism genomes and incorporates the biotic and abiotic factors, reflecting the habitat as a whole. A significant difference exists in the composition and number of the human microbiota in healthy individuals. About one-tenth of the total body microbiota exists in the urogenital tract and these can be identified by microscopy and culture-based methods, quantitative PCR, next generation and whole genome sequencing. The trend of delaying the planning of pregnancy to a later age nowadays has resulted in magnifying the use of assisted reproductive treatment (ART). Hence, genital microbiota and its impact on fertility has generated immense interest in recent years. In this systematic review, we searched the available evidence on the microbiota of the genital tract in women undergoing ART and studied the outcomes of IVF in different microbial compositions. Despite the inconsistency of the studies, it is evident that vaginal, cervical and endometrial microbiota might play a role in predicting ART outcomes. However, there is no clear evidence yet on whether the diversity, richness, quantity, or composition of species in the maternal genital tract significantly affects the outcomes in ARTs.

Initiating Intramuscular Depot Medroxyprogesterone Acetate Increases Frequencies of Th17-like Human Immunodeficiency Virus Target Cells in the Genital Tract of Women in South Africa: A Randomized Trial.

Cervicovaginal CD4+ T cells are preferential targets for human immunodeficiency virus (HIV) infection and have consequently been used as a proxy measure for HIV susceptibility. The ECHO randomized trial offered a unique opportunity to consider the association between contraceptives and Th17-like cells within a trial designed to evaluate HIV risk. In a mucosal substudy of the ECHO trial, we compared the impact of initiating intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper-IUD, and the levonorgestrel (LNG) implant on cervical T cells. Cervical cytobrushes from 58 women enrolled in the ECHO trial were collected at baseline and 1 month after contraceptive initiation. We phenotyped cervical T cells using multiparameter flow cytometry, characterized the vaginal microbiome using 16s sequencing, and determined proteomic signatures associated with Th17-like cells using mass spectrometry. Unlike the LNG implant or copper-IUD, DMPA-IM was associated with higher frequencies of cervical Th17-like cells within 1 month of initiation (P = .012), including a highly susceptible, activated population co-expressing CD38, CCR5, and α4β7 (P = .003). After 1 month, women using DMPA-IM also had more Th17-like cells than women using the Cu-IUD (P = .0002) or LNG implant (P = .04). Importantly, in women using DMPA-IM, proteomic signatures signifying enhanced mucosal barrier function were associated with the increased abundance of Th17-like cells. We also found that a non-Lactobacillus-dominant microbiome at baseline was associated with more Th17-like cells post-DMPA-IM (P = .03), although this did not influence barrier function. Our data suggest that DMPA-IM-driven accumulation of HIV-susceptible Th17-like cells might be counteracted by their role in maintaining mucosal barrier integrity. NCT02550067.

ACTINOMYCOSIS OF THE SPINE AND ABDOMINOPELVIAN: CASE REPORT

Actinomycosis is a very rare disease caused by Actinomyces israelii, a saprophytic bacterium of the oropharynx and genital tract of women. Its diagnosis is made difficult by the lack of clinical and radiological specificity. We report three cases of patients with actinomycosis of various locations, but with similar management. These cases recall the radio-clinical and therapeutic aspects of this rare infection. They underline the necessity of a microbiological diagnosis for any surgical specimen and the major importance of the histological study in the diagnosis of this condition.

Chlamydia trachomatis and Neisseria gonorrhoeae PCR detection in women treated for ectopic pregnancy

The aim of this study was to determine the presence of Chlamydia trachomatis (ChT) and Neisseria gonorrhoae (NG) in the genital tract of women with ectopic pregnancy and to compare the positive results with patients’ self-reported history of PID. Overall 40 women were eligible for the study. The samples for the ChT and NG Polymerase Chain-reaction (PCR) detection were obtained from the cervix, endometrium and fallopian tube. The results of testing for NG at all sites were negative as were the results from cervical testing for ChT. The prevalence of ChT in the upper genital tract was 12.5%. No statistically significant correlation was found between the positive cases and the previous signs of PID and laparoscopic findings. We found statistically significant relationship between signs of pelvic inflammation in a pacients’ history and histopathological findings of tubal inflammation. 12.5% prevalence of ChT confirms the ascending genital infection. There was no association between the positive PCR result and clinical history of pelvic inflammation. IMPACT STATEMENT What is already known on this subject? Pelvic inflammatory disease, Chlamydia trachomatis and Neisseria gonorrhoae infections are the main risks for ectopic pregnancy. Clinical history of PID and perioperative adhesions may suggest prior upper genital infection. What do the results of this study add? Chlamydia trachomatis positive PCR result can be found in the upper genital tract without the positivity of cervical smear in women with ectopic pregnancy. Our study is unique in assessing the endometrial biopsy for the presence of Chlamydia trachomatis and Neisseria gonorrhoae. What are the implications of these findings for future clinical practice and/or future clinical research? There is no statistically significant association between positive PCR result and clinical history of PID or pelvic adhesions found during laparoscopy for tubal pregnancy. Therefore there is no need for the preventive antibiotic treatment in patients with these findings.

Group B Streptococcus vaginal colonization in pregnant women living with HIV infection: prevalence and antibiotic susceptibility at HIV referral centers in Lagos, Nigeria

Objectives Group B Streptococcus (GBS) colonization of the genital tract is often asymptomatic yet associated with increased risks of maternal and neonatal morbidity especially amongst women living with HIV infection. The objectives of this study were to determine the prevalence of GBS colonization of the genital tract in women living with HIV infection and antibiotic susceptibility of GBS in the genital tract. Method This cross-sectional study recruited 244 pregnant women (122 women living with HIV infection and 122 HIV-uninfected women) between 35 and 37 weeks of gestation. GBS colonization was determined by collecting lower vaginal and anal swabs at recruitment. Swabs were cultured in Todd Hewitt’s broth and confirmed by Christie, Atkins, and Munch-Peterson (CAMP) test. Most recent CD4 count and viral load estimates were retrieved from the women’s records. Maternal and neonatal outcomes and antibiotic susceptibility were assessed. Statistical analysis was performed at 95% confidence interval at a statistical significance of p < .005 Results The prevalence of GBS colonization of the genital tract in all participants was 3.3%; GBS was isolated in 4 (3.3%) of 122 pregnant women living with HIV. No woman with a GBS-colonized genital tract developed puerperal sepsis and no neonatal infection occurred in neonates born to GBS-positive women, irrespective of HIV infection status. In women living with HIV, GBS isolate was resistant to Ampicillin (100%), Ceftriaxone (100%), Vancomycin (100%), yet partially sensitive to Ciprofloxacin (50%). Conclusion Pregnant women living with HIV do not have an increased risk of genital GBS colonization. Vaginal GBS colonization was not associated with an adverse perinatal outcome. Antibiotic use for GBS colonization should be based on sensitivity pattern and not empiric.

The Potential Relationship Between Different Human Female Reproductive Disorders and Sperm Quality in Female Genital Tract.

Spermatozoa should travel throughout the female reproductive tract to reach its ultimate goal, fertilization of the oocyte. At the ejaculation moment, millions of sperm within a few milliliters of the ejaculate are deposited at the cranial segment of vagina and make their journey to the fertilization site. This is done by means of various factors, such as sperm motility, the uterine and fallopian tubes contractility, and the ciliary movement of the lining cells. During this migration, spermatozoa interact with the female microenvironment both physically and molecularly. In this regard, the quality of the environmental conditions may affect this interaction. Therefore, some alterations in women's genital tract microenvironment, such as conditions that occur in female reproductive disorders, may have detrimental effects on sperm reproductive function. In this review, human sperm migration through the female tract is described, and the potential effects of different reproductive disorders at reproductive organs, such as vagina, uterine cervix, uterus, fallopian tubes, and ovary on sperm survival and quality, are also argued. The understanding of those conditions that may impair sperm fertility in the female genital tract can provide a more accurate diagnosis of the causes of infertility in couples. This can ultimately lead to the discovery of effective treatment approaches.

Potential Association between Vaginal Microbiota and Cervical Carcinogenesis in Korean Women: A Cohort Study.

Convincing studies demonstrated that vaginal flora is one of the most impactful key components for the well-being of the genital tract in women. Nevertheless, the potential capability of vaginal-derived bacterial communities as biomarkers to monitor cervical carcinogenesis (CC) has yet to be studied actively compared to those of bacterial vaginosis (BV). We hypothesized that vaginal microbiota might be associated with the progression of CC. In this study, we enrolled 23 participants, including healthy controls (HC group; n = 7), patients with cervical intraepithelial neoplasia (CIN) 2 and 3 (CIN group, n = 8), and patients with invasive cervical cancer (CAN group; n = 8). Amplicon sequencing was performed using the Ion Torrent PGM to characterize the vaginal microbiota. Patients with CIN and CAN presented vaginal microbiota dysbiosis compared with HC. The alpha diversity analysis revealed that CC has a trend to be increased in terms of diversity indexes. Moreover, CC was associated with the abundance of specific microbes, of which Lactobacillus and Gardnerella were the most significantly different between HC and CIN, whereas Streptococcus was differentially abundant in CAN compared with CIN. We then evaluated their diagnostic abilities. Testing in terms of diagnostic ability using the three genera revealed considerably high performance with an area under the receiver-operating characteristic curve of 0.982, 0.953, and 0.922. The current study suggests that the presence of Gardnerella and Streptococcus may be involved in the advancment of CC.

Recent advances in cultivation-independent molecular-based techniques for the characterization of vaginal eubiosis and dysbiosis.

“The bacterial vaginosis syndrome” has significant adverse effects for women and babies, including preterm birth and increased risk of acquisition of sexually transmitted infections and HIV. Currently, the gold standard for diagnosis is Gram stain microscopy of vaginal secretions, which is not readily available, is somewhat subjective, and does not differentiate between the likely different subtypes of vaginal dysbioses that may have different etiologies, microbiology, responses to antibiotics, and phenotypic outcomes. With new information from molecular-based, cultivation-independent studies, there is increasing interest in the use of molecular techniques for the diagnosis of bacterial vaginosis. We reviewed the current evidence on and the rationale behind the use of molecular techniques for the diagnosis of bacterial vaginosis. We found a number of commercially available molecular diagnostic tests, a few of which have US Food and Drug Administration (FDA) and/or Conformité Européenne in vitro diagnostic (CE-IVD) approval, and we have compared their performance with respect to sensitivities and specificities. Molecular-based tests have the advantage of objectivity, quantification, detection of fastidious organisms, and validity for self-obtained vaginal swabs. The performance of the molecular tests against standard microscopy is impressive, but further education of users on interpretation is needed. Bacterial vaginosis is the major cause of vaginal dysbiosis and should be recognized for the threat it is to women’s genital tract health. Quantitative assessment of microbial abundance, the diversity of other organisms present, specific primers for gene sequence regions, and clades and biovars of target microbes should be recognized and incorporated into future molecular diagnostic tests to better differentiate between vaginal eubiosis and dysbiosis.

CHARACTERISTIC OF MICROBIOCENOSIS OF THE GENITAL TRACT IN WOMEN OF FERTILIZED AGE OF THE REPUBLIC OF UZBEKISTAN

The article provides relevant data on the features of the microbiocenosis of the genital tract of women of fertile (childbearing) age. It is known that the microbiocenosis of the reproductive tract begins to form in a newborn girl 3-4 hours after birth, and throughout the neonatal period it is similar to the microbiocenosis of a woman of reproductive age. The key role in maintaining the health and normal functioning of the microbiocenosis of the female reproductive sphere belongs to lactobacilli, as the main component of the vaginal microflora. Microbiological disorders in this biotope usually lead to the development of chronic diseases of the pelvic organs. Based on recent studies on the relationship between the disturbance of the vaginal microflora with intestinal dysbiosis and chronic diseases of the nasopharyngeal biotope, it is relevant to study the quantitative and qualitative composition of the microflora of the reproductive tract, especially in pregnant women and after abortion (artificial termination of pregnancy) of women of fertile age in Uzbekistan.

RESULTS OF STUDIES OF THE EFFECT OF CONTRACEPTION MEANS ON THE VAGINAL MICRO BIOCINOSIS OF HEALTHY WOMEN

This article is devoted to studying the effect of various contraceptives on the vaginal microbiocenosis in healthy women of fertile age in the dynamics of their use. It was found that in healthy women, relative and conditional normocenosis is mainly revealed, the percentage of detection of vaginal dysbiosis is relatively less. The use of contraception for 12 months leads to an increase in the percentage of detection of dysbiosis in the genital tract, due to a decrease in the percentage of detection of normocenosis. It is recommended to conduct microbiological monitoring of the genital tract of women using contraception every 12 months using the test “Femoflor-16”

RESULTS OF STUDIESOF THE EFFECT OF CONTRACEPTION MEANS ON THE VAGINAL MICROBIOCINOSIS OF HEALTHY WOMEN

The study aimed to study the effect of various contraceptives on the vaginal microbiocenosis in healthy women of fertile age in the dynamics of their use. It was found that in healthy women, relative and conditional normocenosis is mainly revealed, the percentage of detection of vaginal dysbiosis is relatively less. The contraception use for 12 months leads to a percentage increase of dysbiosis detection in the genital tract, due to a decrease in the percentage of normocenosis detection. It is recommended to conduct microbiological monitoring of the genital tract of women using contraception every 12 months using the test “Femoflor-16.”