The study of vaginal flora in pregnant women with the assessment antibiotikograms if signs of dysbiosis"

RESUME

The peculiarity of the normal flora of the genital tract in women is the diversity of its species composition represented by lifelong strict and facultative anaerobic microorganisms and significantly less aerobic and microaerophilic. We are studying the microflora of the vagina in order to understand how the bacteria involves the normal microflora of the vagina, and some anaerobes predominate in it, as well as study the factors that affect the composition of the microflora.

Key words: microflora,vagina biocenosis, pathogens.

From the microbiological position remains relatively unexplored question of the extent to which conditionally pathogenic microorganisms can be considered as a component of the normal vaginal flora, and under what conditions, opportunistic microorganisms act now as agents of the inflammatory process.

Microbiocenosis vagina in women of reproductive age normally consists of constantly living microorganisms (an indigenous, autochthonous flora) and transient (allochthonous, random microflora). Indigenous microflora outnumber the population of random, but the number of species of autochthonous flora is not as great as the diversity of species of allochthonous microorganisms. Hormonal changes from the beginning of pregnancy affect the mucous membrane and vaginal microflora, so often the first sign of pregnancy becomes itchy and cheesy discharge - the symptoms of thrush, which meet up to 80% of pregnant women.

Objective: to define the etiological structure of vaginal flora in pregnant women and antibiotikograms isolates from women with different clinical manifestations of the state of the vagina dysbiotic.

Materials and Methods: The study included results of a study microecology vagina in women who have applied to receive a local gynecologist at the antenatal clinic with complaints of abnormal discharge from the genital routes- itching, burning, dysurical disorder.Microbiological studies (microscopic, bacteriological, mycological, serological and molecular genetic methods) underwent vaginal discharge 30 women. Specimen - discharge from the posterior vaginal fornix microscopy , elective plated on nutrient medium and cultured anaerobically and with subsequent identification. Screening for bacterial vaginosis and chlamydia urogenital conducted serological (ELISA) and molecular genetic (PCR) methods.

All samples (except 6.9% gave no growth) of flora were dominant bacteria of the genus Lactobacillus, the share of transient microflora had an average of 22.5% of the total number of colony forming units. The etiological structure of opportunistic pathogens presented: coccal flora Staphylococcus epidermidis, Streptococcus agalactae (17,2%), Corynebacterium spp. (13.8%), fungi of the genus Candida (6,9%), Leptotrichia spp. (3.5%), 10.3% were uncultivated Chlamydia trachomatis, confirmed detection of DNA by polymerase chain reaction. As a result, 17 strains were identified S.aureus (5,9%), whereas in the control - 1 strain (3.3%). When analyzing antibiotic strains experimental group showed 100% of strains sensitive to meropenem, clindamycin, clarithromycin, oxacillin, vancomycin; 35.3% moderately resistant to amoxicillin and ceftriaxone; 47.1% moderately resistant, and 17.6% are resistant to tetracycline; 58.8% moderately resistant and 41.2% resistant to neomycin; 52.9% moderately resistant and 47.1% resistant to ciprofloxacin. Antibiotic sensitivity control strain did not differ from the experimental strains. Thus, antibiotic resistance identified S.aureus tetracycline, neomycin, ciprofloxacin. Resistant strains to oxacillin and vancomycin were found.Analyzing the results we can say, the study of the microflora of the vagina revealed the role of opportunistic microflora in violation of the ratio of vaginal contents, their isolation in moderate or abundant amount of growth that makes it possible to prove their etiological role in the development of state dysbiotic vaginal microflora.

LITERATURE

  1. Шамбилова Н.А., Азизов И.С., Дегтев А.Ю., Мельникова Н.А.Резистентность к противогрибковым препаратам грибов рода Candida Медицина и Экология, 2004, №4. - с.37-40.
  2. Шамбилова Н.А., Азизов И.С., Якубенко А.В., Гладкова В.Г. Антибиотикорезистентность микроорганизмов рода Pseudomonas Медицина и Экология, 2005, №1. - С.33-35.
  3. Шамбилова Н.А., Канатчикова В.А., Бекбосынова С.Ш., Карабаева Б.Ж. Применение антимикробных препаратов молодыми женщинами при острых циститах //Мат. I-й Республ. Конф. «Антибиотикорезистентность, клиническая и экономическая эффективность, безопасность антимикробной терапии», Караганда, 2008. - С.9-11
  4. Копобаева И.Л., Гребенникова Г.А. Исходы беременности и родов при дородовом излитии вод. // Материалы Республиканской конференции «Репродуктология и перинатология: современный взгляд на проблему», Алматы, 2009. - С. 104-107.
Year: 2015
City: Shymkent
Category: Medicine