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Chorionic villus sampling (CVS) is a procedure in which biopsies of placental tissue are obtained for prenatal genetic diagnosis. Risk of infection after CVS is low and only sporadic cases of postprocedural sepsis have been reported. Clostridium perfrigens and Escherichia coli are the most commonly described pathogens in cases of sepsis after prenatal invasive diagnostic procedures. However, this report describes a case of sepsis with fetal loss after CVS caused by Atopobium vaginae.

Introduction: The aim of the study was to investigate prevalence of bacteria most frequently associated with bacterial vaginosis using Amsel’s criteria as well as to quantify these bacteria by real-time PCR and to explore the difference in their quantity between healthy and bacterial vaginosis samples. Methodology: For classification of vaginal discharge samples Amsel’s criteria have been used. To detect and quantify Gardnerella vaginalis Atopobium vaginae, Lactobacillus spp. and total vaginal microbiome, real-time PCR has been applied. Results: According to results of our study Amsel’s criteria matched well with real-time PCR diversification of healthy women and women with BV. Nevertheless, real-time PCR has been more sensitive in diagnosis of bacterial vaginosis. DNA quantification of bacteria demonstrated that mutual abundance of G.vaginalis and A. vaginae was good bacterial vaginosis marker . On the contrary, Lactobacillus spp. was present in high amount in both healthy and bacterial vaginosis samples, but ratio of investigated bacteria was different between them. In fact, G. vaginalis and A. vaginae comprised only 0.1% of total microbiome in healthy, whereas Lactobacillus spp. took 99.3% of it. Nonetheless, in bacterial vaginosis, G. vaginalis and A. vaginae made up 34.4% of total microbiome, while Lactobacillus spp. was 21.6%. Conclusions: According to the results of our study real-time PCR analysis was more sensitive in diagnosis of bacterial vaginosis than Amsel’s method, as well as it represented fine tool in making a difference between microbial entities in healthy and bacterial vaginosis samples.

Introduction. Rate of factors affecting preterm birth development has not been fully elucidated. The assessment was carried out by identifying 1-2 causes used to build up prognosis.Aim: to identify most relevant risk factors for preterm birth and assess their impact on pregnancy.Materials and Methods. The prospective comparative study was conducted that included group 1 - 36 women with term pregnancy, group 2 - 35 with preterm labor. Establishment of the menstrual cycle has been studied by assessing reproductive, somatic history, and course of current pregnancy.Results. The postpartum women from group 2 were characterized by older age (30.42 ± 6.19 years; p = 0.038). The groups differed by the age of menarche: in group 2, its onset was recorded earlier (11.31 ± 0.79 years), showing shorter duration of menstruation (4.25 ± 1.26 days) as well as menstrual cycle (27.71 ± 3.46 days). Infections in puberty were substantially more frequent in postpartum women from group 2: group 2 vs. group 1 - in 21 vs. 8 postpartum women (p < 0.001); a history of urinary tract infections was also more common in group 2 (in 17 puerperas; p = 0.003), that is also typical for cases resulting in preterm pregnancy. The causative agent of bacterial vaginosis in group 2 was more often presented by Atopobium vaginae (in 17 puerperas; p = 0.0001), with Gardnerella vaginalis found less frequently (in 13 puerperas; p = 0.024), which is important to know for selecting proper therapy. During full-term pregnancy, the Lactobacillus crispatus strain, that determines vaginal health, was excreted significantly more often (in 29 puerperas; p = 0.009). Anemia affecting the antenatal fetal development and the course of labor was significantly more frequent in group 2 (in 22 puerperas; p < 0.001).Conclusion. While planning pregnancy, it is necessary to take into account the age, menstrual cycle features, history of former infections, vaginal microbiota features, as well as conduct proper therapy and prevention in pregravid period.

Research objective:to examine the incidence of asymptomatic and recurrent bacterial vaginosis (BV) in Ukrainian women and to evaluate diagnostic and treatment strategies for the disease control. Materials and methods.This study lasted from January to March 2021 and included 277 doctors of women's clinics, gynecological hospitals and oncology centers from all regions of Ukraine. Information was provided on 12 896 patients between of 18 and 59 ages with BV. Results.Analysis of data from 12 896 questionnaires allowed us to determine that women from 18 to 35 years of age (62.6%) were the most frequently consulted about BV. Only 58.72% patients with BV reported about abnormal vaginal discharge as the reason for visit, while 41.24% of the respondents reported other reasons. Questionnaire analysis of patients with vaginal discharge revealed scant symptoms of the disease: only 62.67% complained about the change of discharge character; 38.49% and 36.35% of examinees pointed to the vaginal itching and unpleasant odor, respectively; 19.89% of patients were troubled by dysuric symptoms and 15.10% of patients mentioned dyspareunia. In the list of submitted questionnaires, 59.92% of patients indicated an additional examination to identify the causes of vaginitis by the PCR method (urogenital scraping). According to its results, Gardnerella vaginalis was detected in diagnostically significant concentrations in 71.49% of patients, Atopobium vaginae was found in 11.32% of cases, Mobiluncus spp. was detected in 19.96% of patients and Trichomonas vaginalis was found in 13.12% of patients. Candida colonization was diagnosed in 62.07%, with Candida albicans in 48,52% cases and non-albicans forms in 13,55% of patients. In the treatment of BV priority was given to the vaginal forms of the most compliant therapy regimens: 2 times a day for 3 days or once a day for 7 days, depending on the clinical situation. Some patients opted for a long course of treatment for recurrent infections, choosing the combination metronidazole 750 mg / miconazole 200 mg 1 suppository once a day for 5 days for 12 months. Conclusion.Diagnosis of BV in Ukraine continues to be based on clinical conditions and requires a unified algorithm that will be based on current clinical guidelines and dictated by national protocols for management. High mycotic colonization (62,07%) in BV makes it expedient to use combined agents (metronidazole 750 mg / miconazole 200 mg tioconazole/tinidazole) both as etiotropic and empirical therapy and especially if there are clinical conditions that may can cause BV (before surgical interventions, after antibiotic therapy, in endocrine pathology, etc.).

Abstract A panel of 10 IgG enzyme-linked immunosorbent assays (ELISAs) were developed for the detection of anti-microbial immune responses in the cerebrospinal fluid (CSF) of patients with demyelinating diseases (DD). The anti-microbial ELISA assays follow on prior human brain tissue RNA sequencing studies that established multiple sclerosis (MS) microbial candidates. Lysates included in the ELISA panel were derived from Akkermansia muciniphila, Atopobium vaginae, Bacteroides fragilis, Lactobacillus paracasei, Odoribacter splanchnicus, Pseudomonas aeruginosa, Cutibacterium (Propionibacterium) acnes, Fusobacterium necrophorum, Porphyromonas gingivalis, and Streptococcus mutans. CSF responses from patients with demyelinating diseases (DD, N = 14) were compared to those with other neurological diseases (OND, N = 8) and controls (N = 13). Commercial positive and negative control CSF specimens were run with each assay. ELISA index values were derived for each specimen against each of the 10 bacterial lysates. CSF reactivity was significantly higher in the DD group compared to the controls against Akkermansia, Atopobium, Bacteroides, Lactobacillus, Odoribacter, and Fusobacterium. Four of the 11 tested DD group subjects had elevated antibody indexes against at least one of the 10 bacterial species, suggesting intrathecal antibody production. This CSF serological study supports the hypothesis that several of the previously identified MS candidate microbes contribute to demyelination in some patients. Key messages A panel of 10 IgG enzyme-linked immunosorbent assays (ELISAs) were developed for the detection of anti-microbial immune responses in the cerebrospinal fluid (CSF) of patients with demyelinating diseases, including multiple sclerosis and acute disseminated encephalomyelitis. CSF reactivity was significantly higher in the demyelination group compared to the controls against the bacteria Akkermansia, Atopobium, Bacteroides, Lactobacillus, Odoribacter, and Fusobacterium. Several of the demyelination subjects had elevated antibody indexes against at least one of the 10 antigens, suggesting at least limited intrathecal production of anti-bacterial antibodies. This CSF serological study supports the hypothesis that several of the previously identified MS candidate microbes contribute to demyelination in some patients.

Background. Biological pathomorphosis of the leading pathogens of the vaginal microecological system with the occurrence of vulvovaginitis in human papillomavirus (HPV)-associated cervical intraepithelial neoplasia (CIN) is a fundamental prerequisite for optimizing the complex treatment of this disease. Aim. Optimization of treatment of vulvovaginitis based on the study of the pathomorphism of their pathogens in patients with HPV-associated CIN. Materials and methods. A two-stage examination of 211 patients with HPV-associated CIN I was carried out from 2013 to 2020. To study the pathomorphosis of the disease, the patients were divided into 2 groups, the 1st group was examined in 2013–2016, the 2nd – in 2017–2020. The study of microbiocenosis was carried out by RT-PCR using Femoflor-16 reagents. At the second stage, a study of the clinical efficacy of treatment of vulvovaginitis with the complex drug nifuratel 500 mg + nystatin 200 thousand IU (Macmiror Complex) in comparison with metronidazole 500 mg. Results and discussion. It was revealed that patients with HPV-associated CIN I over the last 8 years have a pathomorphosis of pathogens. In particular, the change in the dominance of anaerobic dysbiosis with the highest bacterial replication of Gardnerella vaginalis in association with Clostridium, Megasphaera spp. and Fusobacterium on the mixed nature of microflora, manifested in the form of vulvaginitis with the dominance of Atopobium vaginae in association with G. vaginalis, Ureaplasma ( urealyticum + parvum ) and the addition of the intestinal group Enterobacteriaceae spp. and Escherichia coli . The use of the complex drug nifuratel 500 mg + nystatin 200 thousand IU (Macmiror Complex) demonstrated a higher (4 times) clinical efficacy, a 12-fold decrease in the recurrence of the inflammatory process compared with metronidazole in the treatment of vulvovaginitis in patients with CIN I. Conclusions. 1. The structure of the cervico-vaginal microbiota in HPV-associated CIN I degree is characterized by dysbiotic disorders in 68.3% of cases. During the last 8 years, there was a pathomorphosis of the microecological status from the dominant anaerobic (in 74.2% of cases, χ²=9.39 at p =0.001) to the dominant mixed (in 60.8% of cases, χ²=8.54 at p =0.001 ) with the addition of the intestinal group Enterobacteriaceae spp. and E. coli in 60.8% of patients (χ²=9.59 at p =0.001), which indicated a change in the dominant causative agents of vulvovaginitis in CIN I. 2. Comparative analysis of the clinical efficacy of complex drugs has demonstrated an increase in clinical efficacy when using the drug nifuratel 500 mg + nystatin 200 thousand IU by 4 times, a decrease in the recurrence of the inflammatory process by 12 times, compared with standard therapy with metronidazole, which allows us to recommend inclusion of the drug nifuratel 500 mg + nystatin 200 thousand IU in the therapy of vulvovaginitis in patients with CIN I.

Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including infertility. Bacterial vaginosis is characterized by a lower prevalence of lactobacilli and a higher prevalence of anaerobic bacteria, including Gardnerella vaginalis, Megasphaera spp., and Atopobium vaginae. Endometritis and pelvic inflammatory disease are caused by the ascension of pathogenic bacteria to the uterus, although the mechanisms by which they do so are unclear. Bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease have been linked to infertility in retrospective and prospective trials. Similarly, the causes of bacterial vaginosis and endometritis-related infertility are likely multifactorial and stem from inflammation, immune targeting of sperm antigens, the presence of bacterial toxins, and increased risk of sexually transmitted infections. Diagnosis and treatment of bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease before attempting conception may be important components of preconceptional care for symptomatic women to improve outcomes of natural and assisted reproduction.

To investigate associations between bacterial species in the vagina in mid-trimester pregnant women from Brazil. The vaginal microbiome in 613 subjects was identified by analysis of the V1–V3 region of bacterial 16S ribosomal RNA and the relative prevalence of individual bacteria were determined. The bacterial species present in the greatest number of women were Lactobacillus crispatus (306 women), L. iners (298 women) and Gardnerella vaginalis (179 women). When present in the vagina, L. crispatus was the most abundant bacterium more than 85% of the time. In contrast, L. iners and G. vaginalis were most abundant in 63% and 41% of women who were positive for these microorganisms, respectively (p

Miscarriage is one of the fundamental complications occurring in pregnant women. Many fastidious and uncultivated bacterial species are related to miscarriage and have a significant role in the infection. The association between inverse pregnancy outcomes and infections of abnormal bacteria has been rarely investigated. Therefore, this study aimed to determine Leptotrichia amnionii and Atopobium vaginae as a risk factor for miscarriage states. A total of 80 cervical swabs and blood samples were obtained from females (34 non-pregnant with recurrent spontaneous miscarriage, 11 pregnant who had previous miscarriage, and 35 without miscarriage as control) who were referred to a hospital in Baghdad city. The relationship between demographic characteristics and miscarriage groups indicates a positive association between the age of 30 years and >45 years and miscarriage states, while no significant association (p>0.05) was found for the other parameters compared with the control. Also, no association was observed between the levels of TORCH IgM , antiphospholipid (APL) IgM, and anticardiolipidin (ACL) IgM antibodies and spontaneous miscarriage. The findings of RT-PCR detection revealed that, out of 45 samples of recurrent spontaneous miscarriage, 17 were detected with high-risk of L. aminonia compared with two samples from the control group. Also, 7 samples of recurrent spontaneous miscarriage were shown to be infected with A. vaginae compared with five samples from the control group. The adjusted odd ratios (ORs) of L. anmionii for spontaneous miscarriage and pregnancy states were 7.89 (CI 95%, 1.60 - 39.00) and 9.43 (CI 95%, 1.43 - 61.9), respectively, with highly significant difference between the study groups compared with the control. While no significant result was recorded between the adjusted ORs of A. vaginae for spontaneous miscarriage and pregnancy states, which were 1.23 (CI 95%, 0.416 - 3.67) and 0.636 (CI 95%, 0.083 - 4.88), respectively, compared with the control.

Objective. To study the microbial landscape of amniotic fluid in physiological process of full-term pregnancy. Recently, after publication of a number of studies regarding human microbiota (The Human Microbiome Project – HMP), there occurred a change in paradigm on absolute sterility of fetal membranes and amniotic fluid in physiologically developing pregnancy. Materials and methods. At the City Clinical Hospital № 1 named after N.I. Pirogov, during elective cesarean section of 19 pregnant women (at the terms of 37–41 weeks) with intact fetal membranes, an amniotic fluid of the following microorganisms was taken by means of PCR-PB: Lactobacillus spp. , Enterobacteriaceae , Streptococcus spp. , Staphylococcus spp. , Gardnerella vaginalis / Prevotella bivia / Porphyromonas spp. , Eubacterium spp. , Sneathia spp. / Leptotrihia spp. / Fusobacterium spp. , Megasphaera spp. / Veillonella spp. / Dialister spp. , Lachnobacterium spp. / Clostridium spp. , Mobiluncus spp. / Corynebacterium spp. , Peptostreptococcus spp. , Atopobium vaginae , Mycoplasma hominis , Ureaplasma (urealyticum + parvum) , Candida spp. , Mycoplasma henitalium . Results. The general bacterial mass (GBM) of amniotic fluid in intact fetal membranes is 10 3,02 Ge/copies, in 47.4 % of cases the amniotic fluid is sterile. Microbiota is most often presented by Enterobacteriaceae spp. – 37 %, the share of the rest, identified bacteria is 28 %, the share of “unknown” is 35 %. Conclusions. In case of physiologically developing pregnancy and intact fetal membranes, the general bacterial mass is low (GBM = 10 3,02 ± 345 Ge/ml). In the intact amniotic sac the most typical microorganisms living in amniotic fluid are Enterobacteriaceae spp. (37 %), the rest are presented in single instances. The presence of the representatives of anaerobic vaginal dysbiosis as well as lactobacilli is not typical for the intact fetal membranes.

Patients with bacterial vaginosis are diagnosed with chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases, such as chronic catarrhal gingivitis, periodontitis of initial and first severity. The aim of the study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. Materials and methods. 28 heterosexual couples aged 18-45 years took part in the survey. Clinical dental examination was performed at the time of treatment and 3 months after completion of treatment. Green-Vermilion indices, RMA (in Parma modification), complex periodontal index according to Leus (KPI), Svrakov's number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included: "Fluconazole" 50 mg 1 time per day (7 days), "Clindamycin" 150 mg every 6 hours (5 days), starting from the 3rd day of antibiotics - probiotic "Symbiter acidophilus concentrated "(21 days), Calcium-D3-Nycomed 1 tab. during dinner 30 days. Local treatment included: oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures (7 days), application of "Metrogil-dent" on the gums (7 days), the drug "Lizak" 1 tab. keep in the mouth until complete dissolution every 6 hours (5 days), after the use of "Stomatophyte" and "Metrogil - dent" - application of "Symbiter omega" on the gums in silicone caps at night (21 days). Results. In women, chronic generalized catarrhal gingivitis was detected in 10.71%, chronic generalized periodontitis of the initial degree in 64.29% and chronic generalized periodontitis of the I degree in 25%. In men who are carriers of pathogens of BV, chronic generalized catarrhal gingivitis was found in 7.14%, chronic generalized periodontitis of the initial degree in 60.71% and chronic generalized periodontitis in grade 32.1. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive objective dynamics of dental status. Thus, after 3 months of clinical and laboratory observations, there were no complaints, the state of oral hygiene improved significantly. If before the treatment the Green-Vermilion index in general in women with BV was 1.323 ± 0.035 points, then after 3 months it was equal to 1.032 ± 0.021. A similar dynamics was determined in men: from the starting index of 1.336 ± 0.041, the Green-Vermilion index decreased to 1.048 ± 0.036. 3 months after treatment, the PMA of patients decreased by 49.03%, in men - by 51.95%, no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant . According to the KPI index, women had a significant difference between baseline and post-treatment outcomes of 1.98 points, while men had a score of 2.01 points. No significant difference was found between the results of groups I and II both before and after treatment. A similar positive dynamics characterizes the indicator - Srakov's number, according to this indicator before treatment and after differences between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. Before treatment and after the detection rate in the oral cavity, Gardnerella vaginalis and Atopobium vaginae did not have a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after treatment in the middle and second groups. Thus, Gardnerella vaginalis was detected less by 67.87% and 61.59%, Atopobium vaginae - by 65.79% and 58.65% in women and men, respectively. Conclusions. The developed and patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory phenomena, improves oral hygiene, and is suitable for the treatment of women with this comorbidity and for the treatment of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens corresponded to the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who were their sexual partners, which once again confirms the equal effectiveness of treatment for both gender groups.

BACKGROUND: Bacterial vaginosis (BV) is one of the most common diseases affecting women of reproductive age. The main problem of BV is the low efficiency of traditional methods of treatment with a frequent recurrence of up to 50%. MATERIALS AND METHODS: A total of 59 patients were examined and treated with the diagnosis of BV, which was confirmed in accordance with the Amsel criteria. The main group included women with BV and their male partners, whereas the compared group included only women with BV. All women were treated with systemic metronidazole and topical clindamycin, and suppositories with lactic acid were prescribed at the second stage. The men partners were treated systemically with metronidazole and topically with clindamycin. RESULTS: Gardnerella vaginalis, Atopobium vaginae, and Prevotella were the most commonly identified bacteria in the vaginal discharge. In men, BV-associated bacteria were found in the foreskin of the glans penis and distal urethra. The similarity of the microflora of the genital organs of women and their male partners was determined. In women with sexual partners who were treated 6 months after the therapy, the number of BV-associated bacteria was detected two or more times less frequently than in patients in the comparison group. For the men, the number of complaints and clinical symptoms significantly decreased after the treatment. Significant decreases in Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., Leptotrichia amnionii, and Mobiluncus were achieved in the foreskin and Gardnerella in the urethra. In the main group of women, the frequency of BV recurrences recorded was 2.3 times less than that in the comparison group. CONCLUSION: The treatment of partners of women with BV effectively reduces the growth of BV-associated bacteria and significantly decreases the frequency of recurrences.

Objective of the study: to study the clinical and laboratory efficacy of the Femivag® (contains Lactobacillus gasseri, Lactobacillus rhamnosus) drug in the complex treatment of bacterial vaginosis (BV) in pregnant women with high risk of preterm birth.Materials and methods. 42 pregnant women at the 16–18 weeks of gestation with cervical dysfunction and BV diagnosed before cervical pessary installation were examined and treated. All patients were assessed the dynamics of symptoms severity, performed PCR testі with a quantitative count of opportunistic pathogens and Lactobacillus spp. Perinatal and neonatal outcomes were also assessed. Femivag® vaginal capsules were prescribed to 24 women (main group) to restore the vaginal microbiota after BV treatment. 18 pregnant women used dietary supplements containing pro- and prebiotics (comparison group). The examination was performed before treatment, 4 and 15–16 days from the therapy start, 4 and 8 weeks after treatment.Results. Vaginal probiotic Femivag® as a component of complex therapy of BV before the installation of cerclage pessary was more effective than the oral food supplements with pro- and prebiotics in terms of reducing in vaginal discharge and vaginal discomfort, the disappearance of vaginal itching and burning sensation for 4 days of therapy. Gardnerella vaginalis / Prevotella bivia / Porphyromonas spp., Mobiluncus spp. / Corynebacterium spp. and Atopobium vaginae disappeared and vaginal normobiota significant recovered in the second trimester in women with cervical dysfunction at 4 and 8 weeks from the start of BV treatment with Femivag®. Frequency of premature rupture of membranes and chorioamnionitis significantly decreased in the main group. Femivag® was well tolerated and had no side effects.Conclusions. Femivag® vaginal capsules had a pronounced clinical and laboratory effect in the complex treatment of BV in pregnant women with incompetent cervix

Aim. To evaluate the genital microbiota of sexual partners of women with bacterial vaginosis and its role in the development of its recurrences. Materials and Methods. We examined 59 consecutive patients with bacterial vaginosis. In the treatment group, sexual partners of the female patients were treated by local delivery of clindamycin; in the comparison group, sexual partners did not receive the drug. All women included in the study received the same therapy: metronidazole per os and local delivery of clindamycin at the stage 1 and local delivery of lactic acid at the stage 2. All patients were examined by microscopy, PCR test, and inoculation of the genital discharge. Monitoring of the female patients with bacterial vaginosis was continued for 6 months. Results. In male patients, genital microbiota was similar to their female partners. Gardnerella vaginalis was detected in 96% of females and 62% of males. Prevotella was identified in 93% of females and 41% of males while Atopobium vaginae was found in 79% of women and 48% of their sexual partners. The amount of bacterial species was similar in males and females of the treatment group. The most frequent microorganisms were Escherichia coli, Staphylococcus spp. and Enterococcus faecalis. Female patients of the treatment group had two-fold lower risk of recurrent bacterial vaginosis than those of the comparison group. Conclusion. Genital microbiota of sexual partners may be responsible for the recurrent bacterial vaginosis in females, and parallel treatment of sexual partners is required to minimize its risk.

Numerous studies have proved that periodontal pathology is an issue that requires a comprehensive and multidisciplinary approach in diagnosis, treatment and prevention, as most periodontal diseases are syndromic manifestations of somatic and psycho-somatic diseases, but there are little data on the periodontal status in patients with disturbance of the genital microflora. The aim of the study was to provide the grounds for the tactics of dental examination of child-bearing women with bacterial vaginosis and their sexual partners and to compare the results of different sex groups. Materials and methods. 28 heterosexual couples aged 18-45 years were examined. Objective periodontal examination included the calculation of Green-Vermilion oral hygiene index, papillary-marginal-alveolar index, complex periodontal index by P.A. Leus, Svrakov's iodine number. Amino test of oral fluid, assessment of oral fluid pH, identification of bacterial vaginosis pathogens, and in particular, Gardnerella vaginalis and Atopobium vaginae, in the oral cavity of the patients by polymerase chain reaction-diagnostics and bacterioscopically. Results. Chronic generalized catarrhal gingivitis was detected in 10.71% of the women, chronic generalized periodontitis in the initial stage was found out in 64.29% of the women, and chronic generalized periodontitis of the first degree in 25% of the female patients. Men, who were carriers of bacterial vaginosis, chronic generalized catarrhal gingivitis, made up 7.14%; chronic generalized periodontitis in the initial stage was found in 60.71% of the men and chronic generalized periodontitis was found in 32.14%. The values ​​of periodontal indices did not really differ between the indicators of different sex groups. Amino tests of the oral fluid in the women and men showed a positive result those points out the presence of volatile amines. The oral fluid pH is reduced in patients of both groups that indicate an inflammatory process in the oral cavity. All the patients have "key cells", which are exfoliated epitheliocytes with Atopobium vaginae and Gardnerella vaginalis adhered to them. This is one of the main markers of bacterial vaginosis. Conclusions. Summing up the results of the performed clinical and laboratory observations, it should be noted that when collecting the history of bearing aged women, the dentist should pay attention to the presence of diseases of the genital tract, and in particular, bacterial vaginosis. To detect inflammatory and inflammatory-dystrophic periodontal diseases in women of childbearing age, amino tests of oral fluid not only in women but also in their sexual partners for rapid diagnosis of pathogens such as bacterial vaginosis and vaginal vaginal vagina can be very informative.

Aim. To confirm that dysbiosis of the urinary tract or gut may be associated with endometriosis course. Materials and methods. We analyzed the samples of vaginal, cervical and intestinal epithelial cell scrapes in 32 patients with a confirmed intraoperative diagnosis of stage III and IV endometriosis and 25 healthy patients as a control group. A wide range of pathogenic and opportunistic microorganisms was evaluated using polymerase-chain reaction (PCR) method to determine real-time results. We found fundamental differences between the samples of microflora in the investigated group and the control group. The lack of opportunistic gram-positive Atopobium vaginae in the vaginal and cervical secretions of women with stage IIIIV endometriosis was statistically significant (p 0.05). In the samples of cervical canal of epithelial scrapes of patients with stage IIIIV endometriosis, there were detected clinically significant amounts (more than 104 million copies of DNA/ml) of opportunistic and pathogenic microorganisms Gardnerella vaginalis, Porphimonas spp. Opportunistic strains Gardnerella vaginalis, Prevotella bivia, Escherichia colli, Streptococcus spp. dominated in the rectal scrapes of the patients of the investigated group. On the basis of the obtained data of microbiota studying, individual correction of the detected dysbiosis was carried out. Results. The obtained data demonstrated an altered microflora of the urogenital tract and gut in patients with stage III and IV endometriosis. After therapy, the groups ceased to differ in the frequency of detection of normocenosis, moderate dysbiosis and severe dysbiosis that testifies to the normalization of urogenital tract and intestinal microflora in patients with moderate and severe courses of ovarian endometriosis. Further research is needed to examine whether dysbiosis is a consequence of the development of moderate and severe endometriosis or dysbiosis is a concomitant background pathology that contributes to the formation of endometriosis of this degree of severity.

Diagnosis of bacterial vaginosis (BV) in resource-poor settings relies on semiquantitative microscopy algorithm such as the Nugent score (NS). We evaluated a quantitative real-time PCR (qPCR) assay to detect and quantify individual BV-associated bacterial communities. Vaginal swabs from 247 South African women attending an STI clinic were evaluated for BV using NS. We used qPCR to analyze DNA from vaginal swabs for eight BV-associated bacteria, Gardnerella vaginalis (GV), Prevotella bivia (PB), BV-associated bacteria 2 (BVAB2), Megasphaera-1 (M-1), Atopobium vaginae (AV), Lactobacillus crispatus (LC), Lactobacillus jensenii (LJ), and Lactobacillus iners (LI). Sensitivities and specificities were generated for each qPCR assay. Using a ROC analysis, cutoffs were calculated for each bacterial species. A logistic regression model was used to determine the strongest predictors of BV status. Nugent scores indicated 35.6% of patients harbor BV-associated flora (NS 7-10). AV, GV, GAMB (GV + AV + M-1 + BVAB2), and LC + LJ showed the highest AUC, sensitivities, and specificities (listed respectively): AV (0.96; 96%; 93%), GV (0.88; 78%; 79%), GAMB (0.9; 87%; 82%), and LC + LJ (0.84; 82%; 72%) (all p

Every year 15 million babies are born prematurely worldwide and a million of these infants die. We know that bacterial infections are associated with and are the primary cause of preterm labor. Unfortunately, current antibiotic-based therapies are either unsafe or are becoming less effective due to the development of bacterial resistance to these therapies. Some of the key microbes associated with preterm labor include Gardnerella vaginalis, Lactobacillus spp., Atopobium vaginae, Mycoplasma hominis, Ureaplasma urealyticum and Escherichia coli (E. coli). Here, we investigated the effectiveness of different whole leaf Moringa oleifera (M. oleifera) extracts and subsequently the sub-fractions of ethanolic whole leaf extract to inhibit growth of and/or lysis E. coli, and compared the most potent leaf extract to common antibiotics. We also sought to determine the proteome-wide expression patterns of the bacterium when incubated with whole leaf M. oleifera extract using quantitative proteomics. From these studies, we demonstrate that: (1) ethanolic whole leaf M. oleifera extract causes the greatest inhibition of E. coli and is comparable to inhibition observed by common antibiotics, (2) the 8 different phases of bacterial growth are prolonged or inhibited by extract treatment, (3) sub-fraction 5 exhibited the most potent inhibitory activities, followed by 8, and (4) proteomics analysis revealed that MO lyses E. coli by altering expression of multiple proteins involved in several biological processes of the bacteria, notably stress response, metabolism and energy maintenance.

Purpose of review The cause of bacterial vaginosis, the most common cause of vaginal discharge in women, remains controversial. We recently published an updated conceptual model on bacterial vaginosis pathogenesis, focusing on the roles of Gardnerella vaginalis and Prevotella bivia as early colonizers and Atopobium vaginae and other bacterial vaginosis-associated bacteria (BVAB) as secondary colonizers in this infection. In this article, we extend the description of our model to include a discussion on the role of host-vaginal microbiota interactions in bacterial vaginosis pathogenesis. Recent findings Although G. vaginalis and P. bivia are highly abundant in women with bacterial vaginosis, neither induce a robust inflammatory response from vaginal epithelial cells. These early colonizers may be evading the immune system while establishing the bacterial vaginosis biofilm. Secondary colonizers, including A. vaginae, Sneathia spp., and potentially other BVAB are more potent stimulators of the host-immune response to bacterial vaginosis and likely contribute to its signs and symptoms as well as its adverse outcomes. Summary Elucidating the cause of bacterial vaginosis has important implications for diagnosis and treatment. Our current bacterial vaginosis pathogenesis model provides a framework for key elements that should be considered when designing and testing novel bacterial vaginosis diagnostics and therapeutics.

Introduction. Bacterial vaginosis (BV) is the most common vaginal disorder in reproductive-age women. The condition is characterised by the replacement of a healthy, lactobacilli-dominated vaginal microbiota by anaerobic and facultative anaerobic bacteria. BV increases the risk of acquisition of STIs and is associated with pregnancy complications. Although the composition of the bacteria in BV varies between individuals, there are some species such as Gardnerella, Atopobium, Mycoplasma, Snethia, Megasphera, Dialister, etc., that are found most frequently. Material and methods. Literature research to the importance of Atopobium vaginae in BV and treatment options. Results. Atopobium (A.) vaginae is an important component of the complex abnormal vaginal flora in BV; even though A. vaginae, like Gardnerella vaginalis, has also been detected in the normal flora, it is much more common in BV patients. A. vaginae has been shown to play an important role in the pathophysiology of BV and is thought to be at least a partial cause of the known negative sequelae. The presence of A. vaginae in the BV-associated biofilms and its resistance to some antimicrobial substances has been described – this seems to have a major impact on treatment outcome. Conclusion. Current scientific data demonstrate that dequalinium chloride (Fluomycin®) is one of the valid therapeutic options for BV treatment, since it displays a broad antimicrobial spectrum against relevant vaginal pathogens, especially against G. vaginalis and A. vaginae, without having safety concerns. Key words: Bacterial vaginosis, Bacterial biofilm, Atopobium vaginae, Metronidazole, Clindamycin, Dequalinium chloride, Microbial resistance

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fcimb.2021.779376/full#supplementary-material, Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age and has been associated with serious health complications, mainly in pregnant women. It is characterized by a decrease in the number of Lactobacillus species in the healthy vaginal microbiota and an overgrowth of strict and facultative anaerobic bacteria that develop a polymicrobial biofilm. Despite over 60 years of research investigating BV, its etiology is not fully understood. Gardnerella spp. is a crucial microorganism that contributes to the formation of the biofilm and the development of BV, but the role of other BV-associated bacteria is not clear. Nevertheless, Fannyhessea vaginae (previously known as Atopobium vaginae) is a highly specific species for BV, and co-colonization with Gardnerella is thought to be a very specific diagnostic marker. The diagnosis of BV still presents some limitations, since currently used methods often fail to accurately detect BV. This work aims to develop a novel peptide nucleic acid (PNA) probe targeting F. vaginae. This probe was further validated in a multiplex assay, which included a Gardnerella-specific PNA probe, as a possible method for diagnosis of BV, and was compared with quantification by qPCR. The new PNA probe showed excellent sensitivity and specificity and could discriminate F. vaginae-Gardnerella biofilms, confirming the potential to be used for the detection of BV-associated pathogens., This work was funded by the National Institute of Allergy and Infectious Diseases (R01AI146065-01A1). It was also partially funded by the Portuguese Foundation for Science and Technology (FCT), under the scope of the strategic funding of unit (UIDB/04469/2020)., info:eu-repo/semantics/publishedVersion

Pelvic inflammatory disease (PID) is a clinical syndrome that has been associated with a wide range of potential causal pathogens. Three broad groups of organisms have been isolated from the genital tract of people with PID: sexually transmitted organisms such as Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis; bacterial vaginosis (BV)-associated species and genera such as Atopobium vaginae, Sneathia, and Megasphaera; and genera and species usually associated with the gastrointestinal or respiratory tracts such as Bacteroides, Escherichia coli, Streptococcus, or Haemophilus influenza. Although PID is often considered to be synonymous with gonorrhea or chlamydia, these pathogens are found in only one quarter to one third of people with PID, suggesting that broader screening and diagnostic and treatment strategies need to be considered to reduce the burden of PID and its associated sequelae.