Aerobic Vaginitis: is Enterococcus faecalis Another Risk Factor in the Progression of Cervical Intraepithelial Neoplasia to Cervical Cancer—Literature Review

Abstract

Objective: The aim of our review article is to show Enterococcus faecalis (E. faecalis) as a risk factor of cervical cancer. Mechanism: Aerobic vaginitis (AV) is the absence of a balance of vaginal flora containing aerobic and intestinal pathogens, varying degrees of vaginal inflammation and immature epithelial cells. The causes of AV responsible for inflammatory changes are: E. faecalis, Esherichia coli, group B streptococcus and Staphylococcus aureus. The pathogenic effect of aerobic microorganisms such as E. faecalis shows that it causes spontaneous abortion, premature birth, puerperal sepsis, abscesses, and urinary tract infections. Findings in Brief: AV caused by E. faecalis is more common in low-grade and high-grade cervical intraepithelial neoplasia (CIN) than in women with a normal Pap test and is thought to contribute to the progression of cervical cancer. E. faecalis produces hydrogen superoxide which causes chromosomal instability in intestinal epithelial cell infection, which is considered a key factor in the carcinogenic process. The presence of the Human papilloma virus (HPV) 16 gene and genome in E. faecalis in cervical cancer biopsy material leads to a specific link that may be a risk factor in the progression of CIN toward cancer. The presence of HPV in this bacteria can lead to persistent HPV infection, CIN development and progression to cervical cancer. Conclusions: Increased vaginal pH, lactobacilli deficiency, and the ability of E. faecalis to contain HPV-16 in episomal form in E. faecalis-induced AV could be key promoters of persistence and proliferation of cervical HPV as a risk factor in development of CIN and cervical cancer.

Aerobic vaginitis in women seen at the laboratory of the university hospital of Befelatanana, Antananarivo, Madagascar

“…New reports indicate the presence of HPV 16 gene and genome in E. faecalis in biopsied materials from cervical cancer, as well as the ability that HPV 16 genes can be translated and transcribed in these bacteria. The fact that HPV gene can form viral particles in these bacteria leads to certain connection that can be a risk factor in the progression of cervical lesions to cancer (12). Enterococcus faecalis as a cause of AV is very often unrecognized or ignored and may be the reason for neglected diagnosis.…”

“…If this AV is not diagnosed or neglected in HPV-positive women, there is a justified possibility of long-term infection due to the presence of HPV in E. faecalis. The presence of HPV in this bacterium can lead to persistent HPV infection and the occurrence of high-grade cervical intraepithelial neoplasia (CIN) as well as progression to cervical cancer (12,13). Thus, in the event of genitourinary disorders, cytobacteriological examination of the cervicovaginal smear is required in order to quickly diagnose possible vaginitis and treat the patient in time to avoid complications.…”

CO2 Cryotherapy Combined with Kushen Gel for the Treatment of Chronic Cervicitis: A Real-World Study

“…The postoperative use of Kushen gel makes up for the vulnerability of wound infection after simple CO 2 cryotherapy. Mahira's study [21] shows that wound infection caused by Enterococcus fecal may become a risk factor for cervical intraepithelial neoplasia. The active ingredients in Kushen gel can quickly enter damaged tissues and increase blood circulation [22].…”

Encapsulation in Oxygen-Loaded Nanobubbles Enhances the Antimicrobial Effectiveness of Photoactivated Curcumin

“…A similar approach could potentially be used for many human bacterial diseases that occur on accessible mucosal surfaces, such as the skin, where staphylococci cause atopic dermatitis, if it were proven to be entirely biocompatible [12]. Other possible applications for which photoactivated curcumin could be used include oral mucosae, which can cause dentinal tubules diseases [13], vaginal mucosae, which can be a source for bacterial migration to the urinary tracts [14,15], and, possibly, endophthalmitis [16].…”