Species diversity of the vaginal microbiota and local immune status in patients with recurrent bacterial vaginosis

DOI: https://dx.doi.org/10.18565/pharmateca.2023.13.64-70

B.M. Aisaeva, G.B. Dikke, Z.A. Abusueva, P.Zh. Gitinova

1) Dagestan State Medical University, Makhachkala, Republic of Dagestan, Russia; 2) F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; 3) Makhachkala Maternity Hospital № 2, Makhachkala, Republic of Dagestan, Russia; 4) Serpukhov City Hospital n.a. N.A. Semashko, Women’s Health Clinic № 2, Moscow region, Serpukhov, Russia
Background. Currently, there is a high frequency of relapses of bacterial vaginosis (BV) - more than 50% within 3–6 months and from 69 to 80% of follow-up within 12 months after treatment.
Objective. Evaluation of the features of nonspecific vaginal protection in patients with recurrent BV (RBV) infected with the herpes simplex virus (HSV).
Methods. The study included 100 patients, divided into 2 groups: I (n=80) – with a clinical diagnosis of RBV and HSV, II (n=20) – conditionally healthy. The bacterial composition in vaginal discharge was determined using real-time polymerase chain reaction and the content of interleukin-1β (IL-1β), IL-2, -6, -8, interferon γ, tumor necrosis factor α (TNF-α), IL- 4, -10 in vaginal secretions – by enzyme immunoassay.
Results. Gardnerella vaginalis, Prevotella bivia and Atopobium vaginae were most often isolated (83.8%); Megasphaera spp., Mobiluncus spp. (66.3%) and Staphylococcus spp. (32.5%) were found in most patients, other BV-associated bacteria (Eubacterium spp., Sneathia spp., Leptotrichia spp., Fusobacterium spp., Lachnobacterium spp., Clostridium spp.) were also isolated from more than 50% of patients. The most common HSV in patients with BV was HSV type 2 – 85%; a combination with human papillomavirus (HPV) was detected in 66.3% and a combination of different types of herpes viruses - in 55%. Statistically significant high levels of cytokines were revealed in patients with RBV infected with HSV, compared to women with normal vaginal microbiocenosis: IL-1β – by 1.8 times, IL-6 – 1.7 times, TNF-α – 1.5 times (p<0.001) and IL-8 – by 1.4 times, IL-4 – by1.4 times, IL-10 – by 1.6 times (P<0.01).
Conclusion. In patients with RBV infected with HSV, there is a species diversity of microflora, including Staphylococcus spp. and a combination of herpes viruses and HPV in addition to anaerobic bacteria, increasing the level of cytokines. This justifies the need for complex treatment using not only antimicrobial drugs, but also immunomodulatory agents.

About the Autors

Corresponding author: Bakhu M. Aisaeva, Teaching Assistant at the Department of Medical Simulation and Educational Practice, Dagestan State Medical University, Makhachkala, Russia; aysaevabakhu1995@mail.ru

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