DOI: https://doi.org/10.22263/2312-4156.2022.5.69
Yu.I. Shchitenko, N.P. Zhukova
Features of vaginal microbiocenosis in prepubertal girls with chronic recurrent vulvovaginitis against the background of concomitant somatic pathology
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2022;21(5):69-80.
Abstract.
Objectives. To find out the special features of vaginal microbiocenosis in prepubertal girls with chronic recurrent vulvovaginitis against the background of concomitant somatic pathology.
Material and methods. The state of microbiocenosis of the vagina was studied in 110 girls with somatic pathology aged 3-6 years with clinical manifestations of exacerbation of chronic vulvovaginitis (main group), divided into three subgroups (I – 38 girls with diseases of the urinary system organs, II – 36 girls with allergic diseases, III – 36 girls with diseases of the gastrointestinal tract and enterobiasis), and in 25 practically healthy girls of the same age without vulvovaginitis (control group).
Results. It has been found that the inflammatory type of vaginal microbiocenosis prevailed in girls of subgroups I and II in case of exacerbation of chronic vulvovaginitis according to the microscopy results of vaginal smears. As for girls of subgroup III the inflammatory type of vaginal microbiocenosis and the transitional type occurred with the same frequency. The causative agents of chronic recurrent vulvovaginitis in girls of subgroups I and III are predominantly gram-negative bacteria of the Entobacteriaceae family and Enterococcus spp., at the same time, microbiological disorders are detected simultaneously in two biotopes (urinary tract-vagina; intestine-vagina, respectively) and are characterized by almost the same spectrum of opportunistic microorganisms, but with different frequency of their occurrence. In girls of subgroup II the main pathogen was Staphylococcus aureus. In all examined female patients regardless of somatic pathology there is an associative growth of various opportunistic microorganisms. This fact confirms the polyetiology of the inflammatory process.
Conclusions. Further in-depth study of the characteristic properties of vaginal microbiocenosis in prepubertal girls with vulvovaginitis against the background of concomitant somatic pathology is necessary to implement adequate and justified preventive and therapeutic measures.
Keywords: chronic vulvovaginitis, prepubertal period, somatic pathology, vaginal microbiocenosis.
References
1. Kazakova AV, Uvarova EV, Limareva LV. Inflammatory diseases of the vulva and vagina in girls: prognosis and prevention: monografiya. Cheboksary, RF: ID Sreda; 2020. 184 р. doi: http://dx.doi.org/10.31483/a-117. (In Russ.)
2. Kirillova EN, Pavlyukova SA, Akulich NS. Vulvovaginitis in children. Med Zhurn. 2017;(2):151-3. (In Russ.)
3. Batyrova ZK, Uvarova EV, Kumykova ZKh, Khashchenko EP, Latypova NKh. Modern approach in the treatment of acute bacterial vulvovaginitis in baby girls. Reproduktiv Zdorov'e Detei Podrostkov. 2017;(6):40-4. (In Russ.)
4. Kokhreidze NA, Gurkin YuA, Kutusheva GF, Mironova AV. Current Approaches to Diagnosis, Treatment and Prevention of Vulvovaginitis in Girls in Early Childhood: ucheb-metod posobie. St Petersburg, RF: SPbGPMU; 2018. 24 р. (In Russ.)
5. Khuraseva AB. Optimization of Treatment and Prevention Approaches in Girls with Recurrent Vulvovaginitis. Reproduktiv Zdorov'e Detei Podrostkov. 2019;15(1):35-40. (In Russ.)
6. Beyitler İ, Kavukcu S. Clinical presentation, diagnosis and treatment of vulvovaginitis in girls: a current approach and review of the literature. World J Pediatr. 2017 Apr;13(2):101-105. doi: http://dx.doi.org/10.1007/s12519-016-0078-y
7. Kim H, Chai SM, Ahn EH, Lee M-H. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009–2014: a single center experience. Obstet Gynecol Sci. 2016 Mar;59(2):130-6. doi: http://dx.doi.org/10.5468/ogs.2016.59.2.130
8. Gurkin YuA, Rukhlyada NN. Gynecology of childhood and adolescence: ruk dlya vrachei. Moscow, RF: MIA; 2019. 392 р. (In Russ.)
9. Cemek F, Odabaş D, Şenel Ü, Kocaman AT. Personal hygiene and vulvovaginitis in prepubertal children. J Pediatr Adolesc Gynecol. 2016 Jun;29(3):223-7. doi: http://dx.doi.org/10.1016/j.jpag.2015.07.002
10. Zuckerman A, Romano M. Clinical Recommendation: Vulvovaginitis. J Pediatr Adolesc Gynecol. 2016 Dec;29(6):673-679. doi: http://dx.doi.org/10.1016/j.jpag.2016.08.002
11. Jarienė K, Drejerienė E, Jaras A, Kabašinskienė A, Čelkienė I, Urbonavičienė N. Clinical and Microbiological Findings of Vulvovaginitis in Prepubertal Girls. J Pediatr Adolesc Gynecol. 2019 Dec;32(6):574-578. doi: http://dx.doi.org/10.1016/j.jpag.2019.08.009
12. Garden AS. Vulvovaginitis and other common childhood gynecological conditions. Arch Dis Child Educ Pract Ed. 2011 Apr;96(2):73-8. doi: http://dx.doi.org/10.1136/adc.2009.181883
13. Dei M, Di Maggio F, Di Paolo G, Bruni V. Vulvovaginitis in childhood. Best Pract Res Clin Obstet Gynaecol. 2010 Apr;24(2):129-37. doi: http://dx.doi.org/10.1016/j.bpobgyn.2009.09.010
14. Loveless M, Myint O. Vulvovaginitis- presentation of more common problems in pediatric and adolescent gynecology. Best Pract Res Clin Obstet Gynaecol. 2018 Apr;48:14-27. doi: http://dx.doi.org/10.1016/j.bpobgyn.2017.08.014
15. Kazakova AV, Uvarova EV, Spiridonova NV, Ovchinnikova AO. The role of hygiene skills in the formation of vaginal microbiocenosis in girls, taking into account the stage of sexual development. Reproduktiv Zdorov'e Detei Podrostkov. 2017;(1):79-85. (In Russ.)
16. Beyitler I, Kavukcu S. Clinical presentation, diagnosis and treatment of vulvovaginitis in girls: a current approach and review of the literature. World J Pediatr. 2017 Apr;13(2):101-105. doi: http://dx.doi.org/10.1007/s12519-016-0078-y
17. Xiaoming W, Jing L, Yuchen P, Huili L, Miao Z, Jing S. Characteristics of the vaginal microbiomes in prepubertal girls with and without vulvovaginitis. Eur J Clin Microbiol Infect Dis. 2021 Jun;40(6):1253-1261. doi: http://dx.doi.org/10.1007/s10096-021-04152-2
Information about authors:
Yu.I. Shchitenko – lecturer of the Chair of Obstetrics & Gynecology, Vitebsk State Order of Peoples’ Friendship Medical University,
E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yuliya I. Shchitenko;
N.P. Zhukova – Doctor of Medical Sciences, professor of the Chair of Obstetrics & Gynecology, Vitebsk State Order of Peoples’ Friendship Medical University.
