INTESTINAL MICROFLORA ON THE BACKGROUND OF BACTERIAL VAGINOSIS ON VULVOVAGINAL CANDIDIASIS IN OVERWEIGHT AND OBESE WOMEN.

OBJECTIVE: The aim of our work was to study the intestinal microbiome in obese women and further develop differentiated patterns of exposure to the intestinal microbiota to improve metabolism and reduce excess weight. PATIENTS AND METHODS: Materials and methods: Surveyed 120 overweight and obese women. For comparison, 60 women without overweight and obesity were examined. Group I - women with vulvovaginal candidiasis and overweight and obesity (60 women); group II - women with vulvovaginal candidiasis without overweight and obesity (30 women); group III - women with bacterial vaginosis and overweight and obesity (60 women); ІV - women with bacterial vaginosis without overweight and obesity (30 women). The study of the intestinal microbiocenosis included the determination of the species and quantitative composition of the microflora. Quantitative indicators of intestinal microflora were studied by seeding 1 ml from each dilution on differential diagnostic media: Endo, Ploskireva, ICA (bismuth - agar sulfide) to detect pathogenic enterobacteria; ZhSA (yellow - salt agar) for determination of staphylococci. To study the hemolytic activity of bacteria was used agar with 5% erythrocyte content of sheep. The presence of bifidobacteria in the test material was studied on Blaurok medium, and lactobacilli - on MRS medium. Statistical analysis of the obtained research results was performed using standard computer packages "Data Analysis" Microsoft Excel for Windows 2002. RESULTS: Results: Based on the results of studies, we can summarize the nature of changes in the intestinal microbiome on the background of vulvovaginal candidiasis and bacterial vaginosis in women with overweight and obesity. In all women with excess body weight and obesity, intestinal microflora disorders have been registered, which are characterized by the replacing the lactobacilli and bifidum bacteria to opportunistic pathogens. A significant increase in Firmicutes phylum microorganisms and a significant decrease in Bacteroidetes phylum were found. The obtained data prove that changes in the species composition of the intestinal microbiota play an important role in the pathogenesis of obesity. CONCLUSION: Conclusions: The results indicate the feasibility of monitoring the intestinal microbiota in women with vulvovaginal candidiasis and bacterial vaginosis, especially in the presence of excess body weight and obesity to determine the degree of violations of its components, and timely correction of the detected changes.

Prevalence of postpartum endometritis and antimicrobial resistance of responsible pathogens in ukraine: results a multicenter study (2015-2017).

OBJECTIVE: The aim: To obtain the prevalence of postpartum endometritis women and antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: We performed a retrospective multicenter cohort study. The study population consisted of all women who had a vaginal delivery or cesarean section in 14 Regional Women's Hospitals of Ukraine. RESULTS: Results: Total 2460 of 25,344 patients were found to have postpartum endometritis, for an overall infection rate of 9.7%. The postpartum endometritis rates were 7.6% after vaginal delivery and 16.4% after cesarean section. Incidence of postpartum endometritis after cesarean section is affected mainly by the mode of delivery (scheduled caesarean deliveries (done before labor starts) - 13.8% and unscheduled caesarean deliveries (done after labor starts) - 22.5%. The predominant pathogens were: Escherichia coli (32.7%), Enterococcus faecalis (13.0%), Streptococcus spp. (12.1%), Klebsiella spp. (10.4%) and Enterobacter spp. (10%). Among the antimicrobial agents tested, the ertapenem, piperacillin/tazobactam, and cefotaxim were the most consistently active in vitro against Enterobacteriaceae in both vaginal deliveries and after cesarean section infections. The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 22.8% and of methicillin-resistance in Staphylococcus aureus (MRSA) 15.4%. CONCLUSION: Conclusions: Postpartum endometritis and antimicrobial resistance of responsible pathogens presents a significant burden to the hospital system. Postpartum infections surveillance is required in all women's hospitals. This knowledge is essential to develop targeted strategies to reduce the incidence of postpartum infections.