Intimate Hygiene Research Articles

On intimate care in men: A review

Even though intimate hygiene plays an essential role in the prevention of various genital diseases, there are currently few studies on this topic. There is a wide range of diseases that affect the male genital organs. There is a wide range of diseases that affect the male genital organs. Inflammation of the glans penis (balanitis) occurs in 3–11% of males during their lifetime; one of its leading causes is poor hygiene. However, many non-venereal dermatoses occur in this anatomical region. Most often, patients complain of itching, as well as pain, burning, and various rashes. The most common reason for seeking medical attention is irritant contact dermatitis. Various allergens cause more acute reactions in the anogenital region due to the structural features of the skin of the genitals. Components of detergents and hygiene products, accessories for sexual practices, medications, and contraceptives can become provoking factors of genital allergic dermatitis. Among the dermatoses affecting the male genitalia, lichen planus should be noted, which occurs in males twice as often as in females, and the oral mucosa is often involved in the inflammatory process. Lichen sclerosus can also occur on the skin of the penis, leading to phimosis, a decrease in quality of sexual life, and often requiring circumcision. Psoriasis also can affect the anogenital area. Rashes may be isolated, but other anatomical areas are also involved in most cases. Psoriatic lesions of the genitals are visually different from typical elements in other areas of the skin. Minimizing discomfort due to these diseases is possible by using specialized care products. The skin of the genitals in men has specific features that are important to consider when developing the composition of the products.

Urogenital health and intimate hygiene practices among Filipino women of all ages: Key issues and insights

Routine intimate hygiene care has a major contribution in maintaining overall urogenital and perineal health in women. However, Filipino women continue to experience a major surge in vulvar and vaginal symptoms across all age groups, in a context of major changes in lifestyles and risk factors impacting their genital health. Personal beliefs, preferences, apprehensions to discuss intimate topics with health-care practitioners (HCPs), availability of cleansing products in the market, and their affordability prevent many women from discussing the role of intimate hygiene care with their HCPs. Communication difficulties and lack of robust evidence, supporting optimal hygiene recommendations are some of the challenges experienced by HCPs. Through this review, the authors discuss the following factors: (i) Differing physiological needs and pathological effects that result from changing dynamics of microflora in the vulvar, perineal, and vaginal region across all age groups of women, (ii) Importance of focusing on perianal and perineal hygiene, and bowel habits, to improve the quality of vulvar hygiene and genital health, (iii) Designing approaches for HCPs to maintain genital health in the light of intimate hygiene, (iv) Recommending improvements in HCP-patient communications to help HCPs dispel the misconceptions pertaining to intimate hygiene practices, and (v) Highlighting the antimicrobial efficacy of feminine hygiene cleansers that preserve the natural microbiome and help maintain the vaginal pH within the normal range. These strategies can fill the knowledge gaps among HCPs, women, and their caregivers’ perspectives and help achieve optimal intimate hygiene.

Cognizance, Formulation and Health Implications of Polyherbal Feminine Intimate Hygiene Wash

Cognizance, Formulation and Health Implications of Polyherbal Feminine Intimate Hygiene Wash

Proses Penanganan Kasus Kekerasan Seksual Pada Anak Berkebutuhan Khusus di Unit Pelaksana Teknis Daerah Perlindungan Perempuan dan Anak (UPTD PPA) Kota Medan

Children with Special Needs are those with limitations in intellectual, mental, physical, social, or emotional functioning. Individuals with disabilities are at a high risk of experiencing sexual violence due to social isolation, limited sexual education, dependence on others for intimate hygiene, reduced physical defenses, and communication barriers hindering the disclosure of abuse. The implementation of child protection is crucial to ensure that all children are nurtured and raised in a supportive environment that meets their basic rights in terms of physical, psychological, and social needs, enabling them to grow and develop optimally while protecting them from various forms violence. UPTD PPA Kota Medan is one of the organizations providing protection for women and children experiencing violence and discrimination, established by the local government. The aim of this research is to understand the process of handling cases of sexual violence against children with special needs at UPTD PPA Kota Medan. This qualitative descriptive study employs data collection techniques such as in-depth interviews, literature review, and documentation with a triangulation approach. The collected data are qualitatively analyzed by the researcher, and the study concludes with findings drawn from the research results. The research reveals that handling of cases involving children with special needs comprises three stages: the initial stage involving case reporting, case outreach, and case identification; the middle stage involving obtaining informed consent, interviews and screening, as well as victim needs assessment; and the final stage involving the provision of necessary services such as legal assistance, healthcare support, and psychological support.

Скинеит, цистит, нарушение микробиоты — как интимная гигиена помогает выбраться из замкнутого круга?

Aim. To consider the problem of disruption of the vaginal microbiota and demonstrate a method for complex treatment of inflammatory recurrent disease of the paraurethral glands. Key points. In the treatment of paraurethritis, conservative therapy is mainly used, however, intimate hygiene also plays an important role in the treatment and prevention of vulvovaginitis, as well as postcoital cystitis, being an integral part of the process of restoring health and preventing relapses of the disease. Today, the officially recognized recommendations on intimate hygiene available only in some countries mostly reflect the influence of various factors on intimate hygiene: individual preferences, cultural characteristics, religious rituals, social aspects. Conclusion. Proper care helps maintain the normal state of microflora in the intimate area, preventing inflammatory processes and ensuring optimal health of the female body. Key words: skeneitis, paraurethral cysts, postcoital cystitis, intimate hygiene, clinical case.

The influence of intimate hygiene on vaginal microbiota and health

Abstract There is a direct correlation between the vaginal microbiome and the health of a woman’s reproductive system. The microbiome is mainly composed of lactic acid rods – Lactobacillus, the metabolism of which ensures an acidic pH, playing a protective role for vaginal homeostasis. One of the typical disorders of homeostasis is bacterial vaginosis, defined as predominance of group IV CST system bacteria (comprising different genera characterized by anaerobic metabolism), which is an essential problem of the female population all over the world. The maintenance of this homeostasis can be restored by medicinal preparations. In addition to well-known antibiotics aimed at inhibiting the development of bacterial pathogens, probiotics and products that promote the development of beneficial microbiota are increasingly used. It seems more relevant not to cure, but to prevent imbalance of homeostasis. For this purpose, women use different washing and care techniques of external genitalia. Women’s everyday practices also include the use of washing preparations from the group of cosmetics; however, little is known about their impact on the microbiota. These products potentially constitute an element of early prevention, which is highly beneficial for female health. The main controversial type of ingredients are cleaning surfactants, which can lead to disruption of the epidermal barrier and to breakthrough of pathogens.

Cosmetic product (spray) for intimate hygiene

Cosmetic product (spray) for intimate hygiene

Application to prevent pressure injury in elderly caregivers

Objective To develop and validate the content of a mobile application prototype on Pressure Injury (PI) Prevention for elderly caregivers. Methods Methodological study of prototype-type technological production in mobile application. The application development was guided by the Contextualized Instructional Design (CID) model. The content validation stage was carried out by seven teaching nurses of a technical course for elderly caregivers in a federal educational institution with the application of the Suitability Assessment of Materials (SAM) instrument. Data were analyzed using descriptive statistics. Results The prototype, which was named LPPrev, contains information about the concept, staging, causes of LP, and main affecting sites, in addition to reminders to reposition the elderly in bed; registration of nutritional information, oral hydration, body and intimate hygiene, and guidance on preventive care is also possible. The content evaluation obtained 96.6% of agreement between professors, being considered a material of superior quality. Conclusion LPPrev is an application prototype properly structured according to the categories evaluated by the SAM, with relevant information for caregivers of bedridden and dependent elderly, contributing to theoretical knowledge and fundamental care in the prevention of injury by pressure, being prepared to move on to the other stages of the DIC model.

Vital issue of intimate care for women

The vulva and vagina are a unique anatomical region, which anatomy and physiology changes throughout a woman's life. The most noticeable changes are hormone-mediated and are associated with the onset of puberty, menstrual cycle, pregnancy and menopause. The microbiome changes over time due to various factors, such as hormones, which leads to a change in pH. Various hygiene practices and habits also have a huge impact on the microflora of the vulva and vagina, and therefore on a woman’s health. Today, the market offers a huge number of care and hygiene products designed for the genital area of women. But, unfortunately, information about their correct use and safety of use is limited. For example, various health behaviours, such as vaginal douching and pubic hair removal are still widely used, although there is some evidence of their negative impacts on the health of the vulva and vagina. Despite the abundance of specialized intimate hygiene products, the use of general care products that are not intended for the genital area and therefore can cause irritation, itching and other unpleasant effects is reported. Foreign guidelines for intimate female hygiene practices resolve itself to recommendations of daily vulva cleansing with a gentle hypoallergenic liquid wash. There is a need to increase women's awareness about rational choice of feminine hygiene products and disorders of the vulva and vagina to improve their intimate health.

Resolution of the Council of Experts in obstetrics-gynecology, dermatovenerology, gastroenterology and microbiology "Principles of intimate hygiene in healthy women and in vulvar diseases"

Resolution of the Council of Experts in obstetrics-gynecology, dermatovenerology, gastroenterology and microbiology "Principles of intimate hygiene in healthy women and in vulvar diseases"

Current methods of normalization and maintenance of mucous membranes in gynecology: A prospective study

Background. The study of the recovery and restoration of the mucous membranes of the genital tract with vaginal intimate gels is presented.
 Aim. To determine the clinical effectiveness of special cosmetic gels for intimate hygiene, Floragel and Vagizhenal for restoration of the mucous membranes of the vulva and vagina.
 Materials and methods. Two groups of women were formed, Floragel and Vagizhenal, to analyze the clinical efficacy of cosmetic gels for intimate hygiene. Group 1 included 30 women aged 25 to 55 with clinical symptoms of genital tract mucosa atrophic changes and the absence of normal vaginal microflora. For intimate hygiene, this group regularly used the gel for intimate hygiene Floragel for 1 month. Group 2 included 30 women aged 25 to 55 with clinical symptoms of genital tract mucosa atrophic changes of various etiologies. For intimate hygiene, this group regularly used the gel for intimate hygiene Vagizhenal for 1 month. The gels were applied regularly, two times a day in the morning and evening, in a thin layer after hygienic procedures. Evaluation of the clinical effectiveness of special cosmetic gels for intimate hygiene Floragel and Vagizhenal included assessment of clinical efficacy, indicators of gynecological status, findings of microscopic and microbiological examination of vaginal discharge (Femoflor system), determination of the vaginal health index, and measurement of nonspecific immune protection of the vagina levels of interferon , interleukin (IL)-1, IL-6, IL-10 in the vaginal discharge using enzyme-linked immunosorbent assay.
 Results. As shown by the questionnaires and interviews with patients, the use of special cosmetic gels for intimate hygiene, Floragel and Vagizhenal was associated with a significant improvement (p0.05) in clinical symptoms: an improvement of vaginal discharge, the disappearance of unpleasant odor and itching, and an improvement in the state of the vaginal mucous membranes and vulva. A special gynecological examination showed significant changes in the visual morphological and functional state characteristics of the vaginal mucosa and vulva. An improvement was reported in 90% (27) patients (p0.05) who used Floragel and in 80% (24) patients who used Vagizhenal.
 Conclusion. The results demonstrate Floragel and Vagizhenal gels' high efficiency in restoring normal microflora and moisturizing mucous membranes by optimizing microbiological indicators, improving the vaginal health index and local immunity factors, indicating that special gels for intimate hygiene Floragel and Vagizhenal have not only cosmetic but also therapeutic properties.

Factors Associated with Bacterial Vaginosis in Women of Reproductive Age

The BV is the most prevalent alteration of the vaginal microbiota and constitutes an important public health problem, the prevalence varies by age, ethnicity, socioeconomic factors, and geographic region and the risk factors associated with this condition, are included the number of sexual partners, the use of the intrauterine device, use of vaginal douche, hygiene habits and sexual practices/behaviors. To determine the prevalence and factors associated with bacterial vaginosis in women of reproductive age. Cross-sectional study was developed in Botucatu, Brazil, including 315 women. Data were obtained by applying a questionnaire and gynecological examination, with sample collection for analysis of the vaginal microbiota pattern, according to the Nugent scoring system. The association between independent variables and outcome was performed using a regression model. The variables that most influenced the outcome (p<0.20) were taken to the multiple logistic regression model and those independently associated with the outcome (p<0.05) were identified. The prevalence of bacterial vaginosis was 32% (101/315) and the associated variables were: not living with a partner [1.13(1.02-1.25), p=0.021], use of vaginal douche [1.42(1.22-1.64), p=0.000] and genital hair removal [1.19(1.01-1.42), p=0.042]. Results point to the importance of screening for this vaginal dysbiosis in routine gynecological care and suggest the importance of health professionals conducting guidance on proper intimate hygiene practices for women.

P-439 Intimate hygiene practices and the correlation with abnormal vaginal microbiota in in vitro fertilization (IVF) patients – a cohort study in 1421 patients

Abstract Study question What are the intimate hygiene practices of women in IVF treatment and do they correlate with the vaginal microbiota? Summary answer Hygiene practices, in specific douching and use of intimate soap significantly increased the risk of abnormal vaginal microbiota (AVM). What is known already The normal vaginal microbiota acts as a defense system against infection. AVM is a molecularly defined vaginal dysbiosis, resembling bacterial vaginosis (BV) and is dominated by anaerobic bacteria such as Gardnerella vaginalis. Importantly, AVM is associated with an increased risk of genital tract infections, poor IVF outcomes, early miscarriage and preterm labor. The cause of AVM is multifactorial and hygiene practices may interrupt the normal microbiota. Previous small studies suggested vaginal douching to be associated with an increased risk of AVM. Few studies have investigated the possible correlation between intimate hygiene practices, menstrual practices and the vaginal microbiota. Study design, size, duration Observational cohort study, including a total of 1421 IVF patients from four Danish fertility centers. The inclusion period was from 2017 to January 2022. Participants/materials, setting, methods Patients aged 18-42 years and undergoing their first, second or third IVF stimulation cycle were eligible for inclusion. The intimate hygiene practices in terms of type of soap, menstrual protection, douching and probiotics, were reported in a structured questionnaire including a total of 40 questions. Vaginal swabs were obtained prior to ovarian stimulation and subsequently subjected to quantitative PCR testing, targeting DNA of dysbiotic bacteria. Main results and the role of chance AVM was present in a total of 34 % (479/1421) of women, and 20% (272/1384) reported vaginal douching, which significantly correlated with AVM (p < 0.01, OR = 1.62 [1.23-2.12]). Intimate soap was used by 39 % (535/1384) of patients, which also significantly increased the risk of AVM ( P = 0.04, OR = 1.35 [1.08-1.69]). Water only was used by 36% (492/1384), and regular soap was used by 27% (374/1384). No correlation between use of water only and regular soap and AVM was detected. For menstrual protection 40% (433/1078) used pads, followed by tampons alone 25% (265/1078) or a combination 21% (230/1078), and 14 % (148/1078) used a menstrual cup. A trend for an increased risk of AVM when using tampons, OR 1.21 [0.91-1.62] was seen whereas use of a menstrual cup seemed to lower the risk of AVM, OR 0.71 [0.48-1.04] Active smoking, higher BMI, drinking >7 units per week and previous chlamydia infection significantly correlated with AVM (p = 0.01, p = 0.01, p = 0.04 and p = 0.01). Finally, 84% (1190/1421) reported gynecological symptoms such as vaginal discharge, dyspareunia and fungal infection, but only fishy odor significantly correlated with AVM (p < 0.01). Limitations, reasons for caution To the best of our knowledge, this is the largest study investigating the intimate hygiene practice and its correlation with AVM in an IVF population. As these results describe the practices of a Scandinavian IVF population, results may differ from other settings and ethnicities. Wider implications of the findings Exploration of the cause-and-effect relations between intimate hygiene practices and AVM is needed, requiring intervention-based prospective studies. This would lead to evidence-based advice on intimate hygiene practices and AVM prevention, possibly increasing live birth rates. The unexpected high prevalence of douching in a Danish IVF population needs further exploration. Trial registration number NCT03420859

TRASH TALK: WHO USES WHICH REUSABLE PRODUCT? USER INSIGHTS AND DESIGN OPPORTUNITIES FOR SINGLE-USE ALTERNATIVES

AbstractSingle-use products often end up in the environment as waste, threatening ecosystems and human life. This indicates a need to transition towards sustainable reuse routines. In this study, we investigate to what extent reusable products are already established in society and what design properties users require. We compare the results between user clusters and countries. To create a meaningful list of reusable products to investigate, we distinguish four categories based on typical barriers by means of focus groups (n=3) and interviews (n=32). Next, we did a survey (n=3000) in three countries (Belgium, Russia, U.S.) to define user clusters and investigate product usage and design requirements. Most established products are hard-material products such as lunch boxes, while intimate hygiene products, such as menstrual cups, are not established yet. Multifunctionality and compactness are the most indicated product requirements. There are significant differences between countries and clusters for both research questions. We conclude that different types of users have different needs: while a sharing system might work for one group, a customizable option would be more suitable for others.

The Vaginal Microbiome in Health and Disease—What Role Do Common Intimate Hygiene Practices Play?

The vaginal microbiome is a dynamic, sensitive microenvironment. The hallmark of a 'healthy' vaginal microbiome is currently believed to be one dominated by Lactobacillus spp., which acidifies the vaginal environment and help to protect against invading pathogens. However, a 'normal' microbiome is often difficult, if not impossible, to characterise given that it varies in response to numerous variables, including pregnancy, the menstrual cycle, contraceptive use, diet, ethnicity, and stress. A Lactobacillus-depleted microbiome has been linked to a variety of adverse vaginal health outcomes, including preterm birth (PTB), bacterial vaginosis (BV), and increased risk of sexually transmitted infections. The latter two of these have also been associated with feminine intimate hygiene practices, many of which are practised without any evidence of health benefits. The most extensively studied practice is vaginal douching, which is known to cause vaginal dysbiosis, predisposing women to BV, pelvic inflammatory disease, and PTB. However, little is known of the impact that intimate hygiene practices and associated products have on the vaginal microbiome. This review aims to outline the major factors influencing the vaginal microbiome and common vaginal infections, as well as to summarise current research surrounding the impact of hygiene products and practices on the vaginal microbiome.

Бытовые и гигиенические факторы риска и их влияние на развитие и течение склеротического лихена вульвы

Objective: To identify statistically significant household and hygienic factors that influence the risk of developing lichen sclerosus of the vulva. Design: Cross-sectional cohort comparative case-control study. Materials and methods. The study involved 344 patients with sclerotic lichen of the vulva aged 20 to 70 years and 60 women of the control group of the same age. Based on the survey of women of the main and control groups, a comparative analysis of intimate and household anamnestic factors of the development of sclerotic lichen of the vulva was carried out according to several categorical indicators characterizing the features of sexual life, intimate hygiene, underwear of the patient, etc. Statistical correlation analysis of the obtained anamnestic data of the subjects was performed using the Spearman correlation coefficient (correlations were considered statistically significant at R > 0.15), the Mann -Whitney U—test and the Student t-test (differences were considered statistically significant at p < 0.05). Results. The study established statistically significant household and hygienic risk factors for the development of sclerotic lichen of the vulva: regular shaving and other types of depilation of hair in the vulva (R = –0.38); wearing underwear mainly with a narrow gusset (R = –0.32); intimate hygiene only with water (R = –0.27); wearing underwear mainly with rough seams, lace (R = –0.17); intimate hygiene with perfumes (R = –0.17), p < 0.05. Statistically significant household and hygienic factors that reduce the risk of developing and progressing sclerotic lichen of the vulva have been identified: the use of pharmaceutical products for intimate hygiene containing lactic acid (R = 0.73); wearing underwear made of natural fabrics (R = 0.42), absence or rare shaving /depilation of the vulva (R = 0.21); regular sexual life (R = 0.18), p < 0.05. Conclusion. The data obtained on the influence of household and hygienic factors on the risk of development and the nature of the course of sclerotic lichen of the vulva not only confirm, but also significantly expand and refine the results of foreign studies. Elimination of negative triggers and compliance with favorable household and hygienic conditions can become the basis for the prevention of the occurrence of sclerotic lichen of the vulva and the development of complications of this disease. Keywords: sclerotic lichen, vulva lichen, risk factors, intimate hygiene, vulva, prevention, emollients.

Conhecimento de puérperas sobre a higiene corporal do recém-nascido

Abstract Objectives: to identify puerperal women’s knowledge attending the housing unit at a teaching hospital about newborn body hygiene after receiving routine guidance from the nursing team. Methods: cross-sectional study, carried out with 207 puerperal women from a teaching hospital in the Minas Gerais State between December 2018 and May 2019. For data collection, an instrument was built and validated following three phases and descriptive statistics and linear correlation were used of Spearman’s, with a confidence level of 95% for knowledge analysis. Results: 207 puerperal women participated in the study, with a mean age of 27 ± 6.3 years. Inadequate knowledge was observed, mainly regarding the sequence of cleaning the face and scalp, adequate products and hygiene of the nose, ear and mouth. The domain “before the bath” presented the highest average percentage of correct questions (94.0%±10.1), including care with the environment, temperature and intimate hygiene. Conclusion: the identification of inadequate knowledge about the newborn’s body hygiene raises the need for constant and more effective guidelines, with the use of active methodologies starting in prenatal care.

Coercion, Violation of Privacy and Everyday Difficulties as the Cause of Patient Refusal Treatment in Psychiatric Hospitals in Russia

Treatment in a psychiatric hospital is accompanied by a restriction of independence, violation of privacy, coercion, which causes displeasure of patients. The aim of the study was to verify the scale of everyday problems, violations of privacy and coercion in a psychiatric hospital to develop recommendations for the organization of a therapeutic environment. The study included 191 patients in a psychiatric hospital. Anonymous questionnaire was used. Statistical processing of the database was carried out by nonparametric methods. The majority of patients (67%) estimated the conditions of stay in a psychiatric hospital at 7-10 points (10-point scale), but half of them complained about the need for self-purchase of drugs. A full night's sleep was disturbed by the snoring of others (56.5%), an uncomfortable bed (36.6%), bright light (26.2%). The poor diet was indicated by 45.5% of patients. Patients indicated coercion by medical staff: retention (11.5%), forced administration of drugs (12%), coercion to consent to treatment (22%), refusal to discharge from hospital (35.1%). It was reported that there was a violation of privacy in the toilet (36.6%), difficulties to observe the intimate hygiene (16.8%). These problems caused patients to refuse inpatient treatment if there was the possibility of outpatient treatment (65.2% of men and 52.6% of women). Despite the low level of claims of patients to living conditions, it is important to respect their rights in psychiatric hospitals to privacy, creating a comfortable living space, the organization of differentiated methods of observation by medical staff.

The role of female intimate hygiene practices in the management of vulvovaginal candidiasis: A randomized, controlled open-label trial

In this multicenter, observational, controlled open-label trial, researchers randomized 200 women with vulvovaginal candidiasis (VVC) to: Group 1, 6-days clotrimazole 2% vaginal cream once-daily plus 15-days concomitant acid pH thymol and zinc-containing cleansing wash (SaugellaActi3) twice-daily; Group 2, 6-days clotrimazole treatment alone. In both groups, pruritus and burning VAS scores improved from baseline at Days 6, 10 and 15. On Day 10 and Day 15, the pruritus score was significantly lower in Group 1 versus Group 2 (P <0.005 at both timepoints), suggesting acid pH thymol and zinc-containing cleansing wash ameliorates VVC-associated pruritus as part of a female hygiene regimen.

Effect of intimate hygiene fluids on the number of Listeria monocytogenes isolated from women

Introduction. Listeria monocytogenes is an etiological factor of listeriosis, widespread in the environment. The consequence of fetal infection in the second trimester of pregnancy in most cases is the death of the fetus or stillbirth. Material and methods. In this study, 7 strains of L. monocytogenes isolated from the vagina of women and the reference strain L. monocytogenes ATCC 19111 were used. The examined strains were treated with five commercially available intimate hygiene washes. The efficacy of the wash fluids used was based on the induced decrease in the number of bacteria expressed as a logarithmic colony-forming unit (CFU) × ml-1. Results. The study showed that probiotic fluid (pH = 3.5) decreased the number of bacteria by an average of 4.56 log CFU × ml-1, while wash fluid intended for pregnant and puerperal women (pH = 4.0) reduced the number of L. monocytogenes by an average of 1.55 log CFU × ml-1. Lower bactericidal efficacy was observed in the case of wash fluids intended for everyday use. The fluid containing marigold extract and the liquid with the addition of rice proteins and arnica extract decreased the number of L. monocytogenes by an average of 1.11 log CFU × ml-1, and the fluid with silver and copper nanoparticles by 1.14 log CFU × ml-1. Conclusions. Everyday use of intimate hygiene washes reduces the risk of urogenital infections in women and supports their treatment. Prevention with the use of probiotic wash solutions may reduce the number of vaginal infections caused by L. monocytogenes, which is especially important in the case of pregnant women because the number of patients diagnosed with listeriosis has increased.