Correction of vaginal microbiota in comorbidity
Objective. To show the acceptability of using ammonium glycyrrhizinate spray in patients with clinical manifestations of papillomavirus infection (PVI) in the presence of bacterial vaginosis (BV) as a therapy aimed at preventing recurrences.Karakhalis L.Yu., Ponomareva Yu.S., Petrenko V.S., Petrenko S.I., Bagdasaryan L.Yu.
Materials and methods. Examinations were made in 78 reproductive-aged patients with BV and PVI, who complained of itching and burning in the genital area, vaginal discharge, dyspareunia, and dysuria. Data were collected from the medical records of all the patients; their somatic and gynecological diseases were taken into account; their clinical symptoms were evaluated; weight and height were determined; and the body mass index was calculated. The Colpo-pH test and extended colposcopy were carried out. Human papillomavirus was detected with PCR; bacterial mass and its components were determined by Femoflor-16 real-time PCR. During therapy with ammonium glycyrrhizinate, PCR and mass spectrometry were used to investigate changes in the vaginal microbiota.
Results. 94.9% of the patients had severe/moderate mixed dysbiosis after standard treatment with inosine pranobex for BV and PVI, as indicated in the available recommendations. Complains of itching and burning in the genital area and genital discharge remained in 73.1 and 88.5%, respectively. After the first cycle of therapy with the drug, Panavir intim Normaflore was chosen to correct vaginal dysbiosis and PVI; mass spectrometry showed lactobacilli (Lactobacillus rhamnosus) in moderate amounts, clinical manifestations, such as itching and burning, ceased, the discharge practically disappeared, the clinical picture corresponded to moderate dysbiosis; after the second cycle of therapy, a month later, lactobacilli (Lactobacillus crispatus) were abundantly isolated, which corresponded to the microflora of healthy women and after two cycles, there was microbiota normalization and clinical recovery.
Conclusion. Two consecutive cycles of therapy with Panavir intim Normaflore in the concentration equal to 3 doses 5 times daily for 15 days contributes to the normalization of the clinical picture, the leveling of the existing complaints, and the normalization of the flora due to the growth of lactobacilli.
Keywords
bacterial vaginosis
papillomavirus infection
restoration of the vaginal microbiota
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Received 08.12.2020
Accepted 12.12.2020
About the Authors
Lyudmila Yu. Karakhalis, Dr. of Sci.(Med.), Professor, Professor of Chair for Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia. E-mail: lomela@mail.ru. ORCID: 0000-0003- 1040-6736.4, Mitrofana Sedina str., Krasnodar, 350063, Russia.
Yuliya S. Ponomareva, a postgraduate student of Chair for Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia. E-mail: oleg25101979@yandex.ru. ORCID: 0000-0002-7183-3531.
4, Mitrofana Sedina str., Krasnodar, 350063, Russia.
Valentina S. Petrenko, resident of Chair of Obstetrics, Gynecology and Perinatology Faculty of Continuing Education and Professional Retraining of Specialists,
Kuban State Medical University, Ministry of Health of Russia. E-mail: valentinapetrenko25@gmail.com; sipetr@mail.ru. ORCID: 0000-0002-1428-3190.
4, Mitrofana Sedina str., Krasnodar, 350063, Russia.
Sergei I. Petrenko, obstetrician-gynecologist, director of the clinic «Centre for Colposcopy and Cervical Pathology», Krasnodar.
E-mail: sipetr@mail.ru. ORCID: https://orcid.org/0000-0002-2346-34848. 42, Chekistov Ave., Krasnodar, Russia.
Liana Yu. Bagdasaryan, a postgraduate student of Chair for Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia; gynecologist of the Gynecological Department, Territorial Clinical Hospital No 2.
E-mail: lianochka88@mail.ru. ORCID: 0000-0001-7379-9122. 4, Mitrofana Sedina str., Krasnodar, 350063, Russia.
For citation: Karakhalis L.Yu., Ponomareva Yu.S., Petrenko V.S., Petrenko S.I., Bagdasaryan L.Yu. Correction of vaginal microbiota in comorbidity.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 12: 177-184 (in Russian)
https://dx.doi.org/10.18565/aig.2020.12.177-184
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