Polymicrobial associations in the etiology of inflammatory diseases of the female genital organs

Dikke G.B.

Peoples’ Friendship University of Russia, Moscow 117198, Miklukho-Maklaya str. 8, Russia
Objective. To assess the role of polymicrobial associations in the genesis of inflammatory diseases of the female genital organs and to determine the most rational approaches to diagnosis and treatment.
Material and methods. The materials of the World Health Organization, the Cochrane Society, the guidelines of leading professional societies, and clinical trials published on official websites and in open access were analyzed.
Results. There was information on the frequency of female genital tract inflammatory diseases caused by microbial combinations, as well as the established facts on resistance to antimicrobial agents, recommendations for their diagnosis and treatment, by indicating the strength of the evidence and convincingness of recommendations.
Conclusion. The recent changes in the epidemiology of inflammatory diseases, the prevalence of polymicrobial associations in their etiology, and the increasing microbial resistance require new approaches to the treatment and prevention of sexually transmitted infections and diseases accompanied by abnormal vaginal discharge.

Keywords

vaginitis
cervicitis
pelvic inflammatory diseases
polymicrobial infections
sexually transmitted infections
abnormal vaginal discharge
resistance

Supplementary Materials

  1. Table 1. The need for screening for the presence of infection associated with syndromal and approaches etiological diagnosis of diseases involving abnormal vaginal discharge
  2. Table 2. Comparative efficacy and features of metronidazole and clindamycin [43, 44]
  3. Table 3. Efficacy of combined formulations containing 500 mg metronidazole and miconazole 100 mg compared to a combined preparation containing 200 mg ternidazol [45]
  4. Figure. Dynamics of the sensitivity of various species of Candida: albicans * and non - albicans * * in Russia [6]

References

1. Khryanin A.A. Bacterial vaginosis. New ideas about the microbial biosociety and treatment options. Meditsinskiy sovet. 2014; 17: 128-33. (in Russian)

2. Gerasimova O.P. Clinico-morphological evaluation of the effectiveness of pregravid preparation of women who undergone a non-developing pregnancy: the author’s abstract. Diss. ... cand. med. sciences. Moscow; 2014. 18p. (in Russian)

3. Report on global sexually transmitted infection surveillance 2015. WHO; 2016. 54р.

4. Swidsinski A., Mendling W., Loening-Baucke V. et al. Adherent biofilms in bacterial vaginosis. Obstet. Gynecol. 2005; 106: 1013-23.

5. Creatsas G., Deligeoroglou E. Microbial ecology of the lower genital tract in women with sexually transmitted diseases. J. Med. Microbiol. 2012; 61:1347-51.

6. Rakhmatulina M.R., Tsoi E.G. Modern indicators of resistance of fungi of the genus Candida to antimycotic drugs. Farmateka. 2017; Dermatology. Spec. iss.: 22-5. (in Russian)

7. Tansarli G.S., Kostaras E.K., Athanasiou S., Falagas M.E. Prevalence and treatment of aerobic vaginitis among non-pregnant women: evaluation of the evidence for an underestimated clinical entity. Eur. J. Clin. Microbiol. Infect. Dis. 2013; 32(8): 977-84.

8. Sexually Transmitted Diseases Treatment Guidelines. CDC; 2015. Available at: https://www.cdc.gov

9. Mugo N., Dadabhai S.S., Bunnell R. et al. Prevalence of herpes simplex virus type 2 infection, human immunodeficiency virus/herpes simplex virus type 2 coinfection, and associated risk factors in a national, population-based survey in Kenya. Sex. Transm. Dis. 2011; 38(11): 1059-66.

10. Marrazzo J.M., Wiesenfeld H.C., Murray P.J. et al. Risk factors for cervicitis among women with bacterial vaginosis. J. Infect. Dis. 2006; 193(5): 617-24.

11. Ljubin-Sternak S., Meštrovićc T. Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an impact. Hum. Rep. Health J. Pat. 2014; 183167.

12. Clarke L.M., Duerr A., Yeung K.H. et al. Recovery of cytomegalovirus and herpes simplex virus from upper and lower genital tract specimens obtained from women with pelvic inflammatory disease. J. Infect. Dis. 1997; 176(1): 286-8.

13. Ness R.B., Kip K.E., Hillier S.L. et al. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am. J. Epidemiol. 2005; 162(6): 585-90.

14. Johnson H.L., Ghanem K.G., Zenilman J.M., Erbelding E.J. Sexually transmitted infections and adverse pregnancy outcomes among women attending inner city public sexually transmitted diseases clinics. Sex. Transm. Dis. 2011; 38(3): 167-71.

15. Fan A., Yue Y., Geng N. et al. Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings. Arch. Gynecol. Obstet. 2013; 287(2): 329-35.

16. Poljak M., Seme K., Maver P.J. et al. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Central and Eastern Europe. Vaccine. 2013; 31 (7): 59-70.

17. Walker C.K., Sweet R.L. Gonorrhea infection in women: prevalence, effects, screening, and management. Int. J. Womens Health. 2011; 3: 197-206.

18. Wiesenfeld H.C., Hillier S.L., Krohn M.A. et al. Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection. Clin. Infect. Dis. 2003; 36(5): 663-8.

19. Cherpes T.L., Meyn L.A., Krohn M.A. et al. Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Clin. Infect. Dis. 2003; 37(3): 319-25.

20. Cu-Uvin S., Hogan J.W., Caliendo A.M. et al. Association between bacterial vaginosis and expression of human immunodeficiency virus type 1 RNA in the female genital tract. Clin. Infect. Dis. 2001; 33(6):894-6.

21. Atashili J., Poole C., Ndumbe P.M. et al. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. 2008; 22(12):1493-501.

22. Bautista C.T., Wurapa E., Sateren W.B. et al. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil. Med .Res. 2016; 3: 4.

23. Mutagoma M., Remera E., Sebuhoro D. et al. The prevalence of syphilis infection and its associated factors in the general population of Rwanda: A National Household-Based Survey. J. Sex. Transm. Dis. 2016; 2016:4980417.

24. Grueva E., Borisov I. The role of chlamydia trachomatis and some other associated microorganisms in endocervicitis. Akush. Ginekol. (Sofiia). 2006; 45(5): 32-5.

25. Guidelines for the treatment of Chlamydia trachomatis. WHO’ 2016. 47р.

26. Federal clinical guidelines for managing patients with Chlamydia infection. 2015. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2016; 4: 57-64. (in Russian)

27. Sorvillo F., Kerndt P. Trichomonas vaginalis and amplification of HIV-1 transmission. Lancet. 1998; 351(9097): 213-4.

28. Guidelines for the treatment of Neisseria gonorrhoeae. WHO; 2016. 55р.

29. Guidelines for the treatment of Genital Herpes Simplex Virus. WHO; 2016. 47р.

30. Guidelines for the treatment of Treponema pallidum. WHO; 2016. 51р.

31. Federal clinical guidelines for management of patients with urogenital diseases caused by Mycoplasma genitalium. 2015. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2016; 4: 64-70. (in Russian)

32. Federal clinical guidelines for management of patients with urogenital trichomoniasis. Moscow; 2013. 14p. (in Russian)

33. Federal clinical guidelines for management of patients with bacterial vaginosis. 2015. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2016; 4: 43-50. (in Russian)

34. Swidsinski A., Verstraelen H., Loening-Baucke V. et al. Presence of a polymicrobial endometrial biofilm in patients with bacterial vaginosis. PLoS One. 2013; 8(1): e53997.

35. Koumans E.H., Markowitz L.E., Hogan V. Indications for therapy and treatment recommendations for bacterial vaginosis in nonpregnant and pregnant women: a synthesis of data. Clin. Infect. Dis. 2002; 35(2): 152-72.

36. Federal clinical guidelines for managing patients with urogenital candidiasis. 2015. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2016; 4: 50-7. (in Russian)

37. Gottschick C., Szafranski S.P., Kunze B. et al. Screening of compounds against Gardnerella vaginalis biofilms. PLoS One. 2016; 11(4): e0154086.

38. McMillan A., Dell M., Zellar M.P., Cribby S., Martz S., Hong E. et al. Disruption of urogenital biofilms by lactobacilli. Colloids Surf. B Biointerfaces. 2011; 86(1): 58-64.

39. Mania-Pramanik J., Kerkar S.C., Salvi V.S. Bacterial vaginosis: a cause of infertility? Int. J. STD AIDS. 2009; 20: 778-781.

40. Sherrard1 J., Donders G., White D., Jensen J.S. European (IUSTI/WHO) guideline on the management of vaginal discharge. 2011. 23р. Available at: http://www.iusti.org/

41. Burton J.P., Devillard E., Cadieux P.A. et al. Detection of Atopobium vaginae in postmenopausal women by cultivationindependent methods warrants further investigation. J. Clin. Microbiol. 2004; 42: 1829-31.

42. Beigi R.H., Austin M.N., Meyn L.A. et al. Antimicrobial resistance associated with the treatment of bacterial vaginosis. Am. J. Obstet. Gynecol. 2004; 191(4): 1124-9.

43. Truter I., Graz M. Bacterial vaginosis: Literature review of treatment options with specific emphasis on non-antibiotic treatment. Review. Afr. J. Pharm. Pharmacol. 2013; 7(48): 3060-7.

44. Geissdorfer W., Bohmer C., Pelz K. et al. Tubo-ovarian abscess caused by Atopobium vaginae following transvaginal oocyte recovery. J. Clin. Microbiol. 2003; 41: 2788-90.

45. Sarvilina I.V., Kuzmina N. New combined topical drug for the treatment of chronic vulvovaginitis. Vrach. 2015; 9: 74-80. (in Russian)

46. Aral S.O. Utility and delivery of behavioural interventions to prevent sexually transmitted infections. Sex. Transm. Infect. 2011;87(2): 31-3.

Received 10.02.2017

Accepted 17.02.2017

About the Authors

Dikke Galina B., Honoured Science and Education, MD, professor of obstetrics, gynecology and reproductive medicine, faculty of continuing medical education,
Peoples' Friendship University of Russia. 117198, Russia, Moscow, Miklukho-Maklaya str. 8. Tel.: +74954345300. E-mail: galadikke@yandex.ru

For citations: Dikke G.B. Polymicrobial associations in the etiology
of inflammatory diseases of the female genital organs.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 151-8. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.151-8

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