Hypothesis/aims of study. A lack of timely diagnosis and treatment of inflammatory diseases of the lower genital tract in a woman can lead to serious reproductive disorders. The detection of inflammation is an important component of the diagnosis of these diseases. This study was undertaken to compare methods for detection of local inflammation in women with complaints of vaginal discharge. Study design, materials, and methods. A total of 87 women having vaginal discharge were enrolled in the study. For the detection of inflammation, vaginal discharge was examined using microscopy and reverse transcriptase polymerase chain reaction (the ImmunoQuantex® test, DNA-Technology Ltd., Moscow, Russia). Results. Vaginal infections caused by opportunistic microorganisms were detected in 27 women (31%), as follows: candidal vulvovaginitis (CVV) in 10 patients (11.5%), aerobic vaginitis (AV) in 14 patients (16.1%), and bacterial vaginosis (BV) in 14 patients (16.1%), with 8 (9.2%) of them having BV combined with CVV, AV or both infections. The results of the two methods fully agreed in the analysis of samples from women with CVV and AV as vaginal infections characterized by local inflammation. Testing samples from women with BV, which is a non-inflammatory syndrome, as well as women without vaginal infections resulted in significant discrepancies between the two methods. The sensitivity and specificity of the ImmunoQuantex® test compared to the microscopic method were 85.7% and 48.9%, respectively. Conclusion. The new reverse transcriptase polymerase chain reaction based test for the evaluation of expression profiles of selected genes of immune response enables to assess the local immune status in the vagina. Determination of the presence or absence of inflammatory reaction in the vagina can be used as a diagnostic criterion for resolving discrepancies between laboratory data and clinical manifestations, as well as for choosing effective therapy.
Introduction. The study is in vitro experiment, aimed to determine antibiotic susceptibility of microorganisms isolated from the urogenital tract of women to the combination of substances included in the preparation Terzhinan. Methods. In total, 516 microorganism strains isolated from the vagina of reproductive age women have been tested: Candida spp. (n = 83), bacteria of the family Enterobacteriaceae (n = 138), Streptococcus agalactiae (n = 72), Enterococcus spp. (n = 147), Staphylococcus spp. (n = 37), Actinomyces urogenitalis (n = 7), Gardnerella vaginalis (n = 27), Atopobium vaginae (n = 5). Suspensions of each strain in a volume of 0.5 ml (0.5 according to McFarland) were applied onto culture medium (Muller-Hinton Agar or 5% Blood Muller-Hinton Agar). Furthermore, serial dilutions of Terzhinan were applied with a calibrated loop onto three sectors. Petri dishes were then incubated at 37 °С for 24 h. The results were evaluated visually, by measuring growth inhibition zones. Results. The majority of Candida albicans isolates were susceptible (S) to the preparation, using both undiluted and diluted (10 and 100 times) preparation. Terzhinan without dilution and in the dilution 1:10 was 100% effective against all tested bacteria of the family Enterobacteriaceae. Susceptibility of gram positive bacteria to the antibiotics included in Terzhinan, was 74.1%. All isolates of staphylococci, including Staphylococcus aureus, were susceptible. The frequency of susceptible strains of Streptococcus agalactiae and Enterococcus spp. was 70%. All clinical isolates of Gardnerella vaginalis and Atopobium vaginae were susceptible to the combinations of antibiotics included in the preparation Terzhinan, which is in agreement with data on its high efficiency in the treatment of bacterial vaginosis. Conclusions. In in vitro experiment, the combined preparation Terzhinan showed high activity against major groups of microorganisms isolated from the vagina including pathological conditions, such as bacterial vaginosis and vulvovaginitis of different etiology.
Hypothesis/aims of study. Vulvovaginal candidiasis (VVC) is one of the most common inflammatory diseases of the vagina. Herewith, a synergistic effect of lactobacilli and antifungal drugs in VVC treatment is suggested. In this regard, it seems relevant to study the effect of antimycotics used to treat VVC on the enhanced L. casei rhamnosus 35 (LCR35) probiotic strain. This study was aimed to determine the sensitivity to antimycotic drugs of the probiotic LCR35 strain included in the Lactoginal vaginal capsules, as well as the sensibility of the genus Candida yeast under separate and joint cultivation with lactobacilli. Study design, materials and methods. LCR35 was cultured on a MRS agar. Identification of bacteria grown on the medium, as well as clinical isolates of C. albicans and C. parapsilosis, isolated from the vagina, was performed by MALDI-TOF mass spectrometry. The sensitivity of yeast was determined on a modified Mller-Hinton agar with 40% glucose and methylene blue. Discs with fluconazole, voriconazole, itraconazole, ketoconazole, clotrimazole, and nystatin were used. Interpretation of growth inhibition zones was carried out according to EUCAST-2018 or according to the recommendations of the disc manufacturer. Results. The probiotic LCR35 strain is resistant to antimycotics that are effective against C. albicans and C. parapsilosis. When determining the sensibility of C. albicans and C. parapsilosis to antimycotics in separate and joint cultivation with LCR35, no differences were found in the degree of yeast-like fungi growth suppression. Conclusion. The probiotic LCR35 strain, which is part of the Lactoginal vaginal capsules, is resistant to antimycotic drugs and does not affect the sensitivity of the tested yeast-like fungi to antimycotics.
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