Features of vaginal microbiocenosis in women of reproductive age with overweight and obesity

Abstract

Overweight and obesity play a negative role in gynecological and obstetric practicE.In women, the frequency of infectious pathology increases against the background of metabolic disorderS.The most common form of infectious vaginitis is bacterial urogenital candidiasis, in the etiological structure of which a significant role belongs to the fungi Candida albicans, as well as Candida non-albicans: C.glabrata, C.tropicalis, C.parapsilosis, C.krusei. Associations of Candida fungi with various representatives of opportunistic microflora, such as gram-positive and gram-negative aerobic, facultative-anaerobic and obligate-anaerobic microorganisms, are often formed. As a result, numerous bacterial pathogens multiply and the number of lactobacilli, which are usually part of the bacterial flora of the vagina, is significantly reduced. In bacterial vaginosis (BV), the concentration of anaerobic pathogens Peptostreptococcus sp, Gardnerella vaginalis, Peptostreptococcus Mobiluncus sp, Mycoplasma hominis can increase 100 timeS.Activation of Atopobium vaginae and Gardnerella vaginalis, which play a “key” role in the pathogenesis of BV, has been proven. The aim of the study was to study changes in the vaginal microbiome in women with candidiasis and bacterial vaginosis in order to improve existing treatment regimenS.We examined 120 women of reproductive age with overweight and obesity. The degree of microbial contamination was determined and the maximum possible spectrum of aerobic and facultative-anaerobic microflora was detected. In women with vulvovaginal candidiasis, overweight and obesity, a high concentration (lg5.8 CFU/ml) of Candida fungi was found, and in 95% of patients two-, three- and four-component associations of Candida fungi with various representatives of conditional pathogenic microflora. Lactobacillus deficiency was found in 58.3% of patients, and their complete absence – in 10.0%. Bacteriological examination of the vaginal contents of women with vaginosis and obesity revealed significant dysbiotic disorders of the vaginal microflora, three-, four- and even five-component associations of anaerobic and facultative anaerobic microflora with a predominance of anaerobeS.A low seeding level of lactobacilli (lg2.2 CFU/ml) was established. Thus, the gram-positive anaerobic and facultative anaerobic microflora of Firmicutes have a significant share in the spectrum of vaginal microflora in overweight and obese patients, in contrast to non-obese women of reproductive agE.In women of reproductive age with vulvovaginal candidiasis and obesity, in contrast to non-obese patients, a higher frequency of fungal-bacterial associations, a higher quantitative level of vaginal contamination by Candida albicans and non-albicans with a lack or general absence of lactoflora.