Проблемні питання діагностики та лікування вульвовагінітів змішаної бактеріально-кандидозної етіології

О.V.  Kravchenko

doi:10.18370/2309-4117.2021.57.43-46

Authors

О.V. Kravchenko Higher State Educational Institution of Ukraine “Bukovinian State Medical University”, Ukraine https://orcid.org/0000-0001-8085-8637

DOI:

https://doi.org/10.18370/2309-4117.2021.57.43-46

Keywords:

diagnosis, treatment, bacterial-candidiasis vulvovaginitis

Abstract

The aim of the study is to evaluate the effectiveness of modern antiseptic agent Gynodek in the treatment of mixed bacterial-candidiasis vulvovaginitis.
Materials and methods. There were 67 patients with bacterial-candidiasis vulvovaginitis under observation. The diagnosis of candidiasis infection was verified according to the data of clinical and laboratory research methods. Patients received vaginal gel Gynodek 5 ml once a day for 7 days. The effectiveness of treatment was assessed according to the data of the clinical examination before treatment and
on the 7th day of observation, and according to the laboratory (bacterioscopic, bacteriological) data before and after treatment. Complete clinical and bacterial debridement was criteria of the treatment effectiveness.
Results and discussion. The clinical picture of bacterial-fungal vulvovaginitis was characterized by a decrease in the number and severity of symptoms such as hyperemia and edema of the mucous membrane, discharge from the genital tract was not typical.
There were no complaints in 95.5% of the examined women after end of therapy, there were no objective symptoms in all women on the 7th day of treatment. Bacteriological examination after 2 weeks confirmed the therapy effectiveness in 86.6% of women. Peptostreptococcus spp. after treatment sowed at significant concentrations 106–107 CFU/ml only in 1.5% of patients, Streptococcus spp. in 8.9% of women, Candida albicans in 13.4%. Lactobacilli in the amount of 107 CFU/ml were in 86.6% of patients, which indicates a rapid restoration of normal vaginal microflora.
Conclusions. Bacterial-fungal associations of microorganisms in the vaginal biotope lead to a complex clinical symptoms, which makes it difficult to make a timely diagnosis. Gynodek vaginal gel is highly effective against gram-positive, gram-negative and fungal microflora, which makes it the drug of choice in the treatment of bacterial-candidiasis vulvovaginitis. Gynodek creates a comfortable pH, promotes the rapid restoration of own lactoflora, and increases the functional activity of the vaginal mucosa epithelium, which ensures the prevention of vaginal infection recurrence.

Author Biography

О.V. Kravchenko, Higher State Educational Institution of Ukraine “Bukovinian State Medical University”

MD, professor, head of Obstetrics, Gynecology and Perinatology Department

References

Budilovskaya, O.V. “Modern ideas about lactobacilli of the vagina of women of reproductive age.” Journal of Obstetrics and Women's Diseases LXV.4 (2016): 34–43. DOI: 10.17816/JOWD65434-43
Voroshilina, E.S., Plotko, E.E., Zornikov, D.L. “The normal state of the vaginal microbiocenosis: an assessment from the subjective, expert and laboratory points of view.” Bulletin of the Russian State Medical University. Scientific medical journal RNSMU named after N.I. Pirogov 2 (2017): 42–6.
Gichka, N.M., Shcherba, O.A., Lastovetska, L.D. “Firing up the pelvic organs: recent findings about etiology, the principle of diagnostics and treatment.” Woman’s Health 2.148 (2020): 7–14. DOI: 10.15574/HW.2020.148.7
Kira, E.F., Savicheva, A.M. “Review of international and Russian scientific data on the use of Polygynax for the treatment and prevention of nonspecific (aerobic), candidal and mixed vaginitis.” Woman's health 3.129 (2018): 58–69.
Klimnyuk, S.I., Mikhailishin, G.I., Malanchuk, L.M. “Microbiological peculiarities of bacterial vaginosis in women of different categories and paths of its microbiological corrections.” Achievements of clinical and experimental medicine 3 (2019): 21–31.
Kuznetsova, I.V., Shikh, E.V. “Aerobic vaginitis: terminological news and the choice of empirical therapy.” Woman’s Health 5.131 (2018): 23–5.
Lisovskaya, S.A., Khaldeeva, E.V., Glushko, N.I. “The role of bacterial-fungal associations in the development of infections associated with the provision of medical care.” Practical Medicine. Surgery, Epidemiology and Microbiology 5.16 (2016).
Medvedev, M.V. “Modern management of candidal vulvovaginitis (conference review).” Medical aspects of women's health 4–5.125–126 (2019): 36–7.
Namazova-Baranova, L.S., Baranov, A.A. “Antibiotic resistance in the modern world.” Pediatric Pharmacology 14.5 (2017): 341–54. DOI: 10.15690/pf.v14i5.1782
Ozolinya, L.A., Lapina, I.A., Bondarenko, K.R. “Prevention of infectious complications of minor gynecological operations.” Questions of gynecology, obstetrics and perinatology 15.1 (2016): 16–20.
Pirogova, V.І. “New approaches to the prevention of infectious and inflammatory complications in obstetric and gynecological practice (conference review).” Medical aspects of women's health 4.101 (2016): 54–61.
Pirogova VІ, Malachinska MY, Shurpyak SO, Shchuruk NV. “Microecology of the vagina – what obstetrician-gynecologist must to know (clinical lecture).” Woman’s health 7.103 (2015): 8–13.
Podolskyi, Vl.V., Podolskyi, V.V. “Peculiarities of changes in the vaginal microbiota in women of childbearing age as a possible mechanism of chronic inflammatory diseases of the genital organs and modern possibilities of correction.” Woman’s health 2.148 (2020): 60–4. DOI: 10.15574/HW.2020.148.60
Pustotina, O.A., Ostromenskiy, V.V. “Review of modern recommendations for the management of women with discharge from the genital tract.” Obstetrics and gynecology 5 (2019): 180–4. DOI: 10.18565/aig.2019.5.180-184
Radzinskyi, V.E., Ordiyants, I.M., Pobedinskaya, O.S., Zykov, E.V. “Experience of using the drug Polygynax in the treatment of vulvovaginitis caused by aerobic and mixed microflora.” Russian Bulletin of Obstetrician-Gynecologist 1 (2016): 45–8.
Rishchuk, S.V. “Infectious and inflammatory diseases of female genital organs: etiology, fundamental approaches to diagnosis and treatment.” Protection of motherhood and childhood 1.27 (2016): 69–79.
Taran, O.А., Bulavenko, O.V., Konkov, D.G., Lobastova, T.V. “Clinical advice in the optimization of the reparative processes of the uterine cervix due to destructive surgical involvement.” Woman’s health 3.139 (2019): 38–42. DOI: 10.15574/HW.2019.139.38
Yankovskyi, D.S., Shirobokov, V.P., Antypkin, Y.G., et al. “Microbiome and women's health (literature review).” Reproductive endocrinology 4.24 (2015): 13–28.
Blanquart, F., Lehtinen, S., Fraser, C. “An evolutionary model to predict the frequency of antibiotic resistance under seasonal antibiotic use, and an application to Streptococcus pneumoniae.” Proc Biol Sci 284.1855 (2017). DOI: 10.1098/rspb.2017.0679
Donders, G.G., Bellen, G., Grinceviciene, S., et al. “Aerobic vaginitis: no longer a stranger.” Res Microbiol 168.9–10 (2017): 845–58. DOI: 10.1016/j.resmic.2017.04.004
Donders, G.G., Ruban, K., Bellen, G. “Selecting anti-microbial treatment of aerobic vaginitis.” Curr Infect Dis Rep 17.5 (2015): 47.
Hay, P., Donders, G., Giraldo, P., Lepargneur, J.P. “Key Opinions in Medicine. New Perspectives in the Diagnosis and Treatment of Vaginal Infections.” Obstet Gynaecol 2.1 (2017).
Jasarevic, E., Howerton, C.L., Howard, C.D., Bale, T.L. “Alterations in the vaginal microbiome by maternal stress are associated with metabolic reprogramming of the offspring gut and brain.” Endocrinology 156 (2015): 3265–76. DOI: 10.1210/en.2015-1177
Liang, Q., Li, N., Song, S., et al. “High-dose nifuratel for simple and mixed aerobic vaginitis: A singlecenter prospective open-label cohort study.” J Obstet Gynaecol Res 42.10 (2016): 1354–60. DOI: 10.1111/jog.13052
Oh, H.Y., Seo, S.S., Kong, J.S., et al. “Association between obesity and cervical microflora dominated by Lactobacillus iners in Korean women.” J Clin Microbiol 53 (2015): 3304–9. DOI: 10.1128/JCM.01387-15