HEALTH OF WOMAN. 2020.5-6(151-152): 89-92; doi 10.15574/HW.2020.151-152.89
Kondratiuk V. K.^1,2, Hasparian K. A.², Kondratiuk K. O.³, Dzіs N. P.⁴, Koblosh N. D.^2
1Shupyk National Medical Academy of Postgraduate Education, Kiev
²SI «Institute of pediatrics, obstetrics and ginecology named academic Elena. M. Lukyanova NAMS of Ukraine»
³Bogomolets National Medical University, Kiev
⁴Vinnitsa national medical University

The aim of the study was to evaluate the clinical efficacy of an integrated approach to therapy and prevention of relapse of bacterial vaginosis in women of reproductive age with overweight and obesity. We examined 60 women of reproductive age (19–39 years) with overweight and obesity (BMI+30±4.2) and a verified diagnosis of recurrent bacterial vaginosis (real-time PCR, diagnostic system Femoflor–16).
The effectiveness of treatment of bacterial vaginosis in overweight and obese women was 94.0% due to the rapid elimination of the pathogen by a single dose of 2 g of the drug group 5-nitroimidazoles Secnidox and macrolide 16-membered antibiotic with bactericidal mechanism Doramycin (World Medicine, United Kingdom). Combination prolonged therapy with the multi-strain probiotic Brevelac and the natural drug Reitoil increased the remission period of bacterial vaginosis to 6 months in 91.0% of this group of patients.
Keywords: bacterial vaginosis, overweight, obesity, therapy, remission.

REFERENCES

1. Qin J et al. 2010. A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 464;7285:59-65. https://doi.org/10.1038/nature08821; PMid:20203603 PMCid:PMC3779803

2. Lloyd-Price J, Mahurkar A, Rahnavard G. 2017. Strains, functions and dynamics in the expanded Human Microbiome Project. Nature. 550(7674):61-6. https://doi.org/10.1038/nature23889; PMid:28953883 PMCid:PMC5831082

3. Stoma IO, Yushchuk ND. 2019. Human microbiome at the junction of Infectology and other branches of medicine: the current state of the problem and reassessment of views on the pathogenesis of diseases. Infektsionnye bolezni: novosti, mneniya, obuchenie. Infectious Diseases: News, Opinions, Training 8(3):78-84.

4. Tamburini S, Shen N, Wu HC, Clemente JC. 2016. The microbiome in early life: implications for health outcomes. Nat Med. 22(7):713-22. https://doi.org/10.1038/nm.4142; PMid:27387886

5. Magnúsdóttir S, Thiele I. 2018. Modeling metabolism of the human gut microbiome. Curr. Opin. Biotech. 51:90-6. https://doi.org/10.1016/j.copbio.2017.12.005; PMid:29258014

6. Yankovskiy DS. 2011. Integralnaya rol simbioticheskoy mikrofloryi v fiziologii cheloveka. K, TOV «Chervona Ruta-Turs»:169.

7. Aggarwala V, Liang G, Bushman FD. 2017. Viral communities of the human gut: metagenomic analysis of composition and dynamics. Mobile DNA. 8(October):12. https://doi.org/10.1186/s13100-017-0095-y; PMid:29026445 PMCid:PMC5627405

8. Vieira S, Hiltensperger M, Kumar V. 2018. Translocation of a gut pathobiont drives autoimmunity in mice and humans. Science. 359(6380):1156-61. https://doi.org/10.1126/science.aar7201; PMid:29590047 PMCid:PMC5959731

9. Rita T. BROOKHEART, Warren G. LEWIS, Association between obesity and bacterial vaginosis as assessed by Nugent score Am J Obstet Gynecol. 2020, May 18.

10. Sujatha Srinivasan, Martin T Morgan, Tina L. 2015, Mar-Apr. Metabolic Signatures of Bacterial Vaginosis mBio. 6(2). https://doi.org/10.1128/mBio.00204-15; PMid:25873373 PMCid:PMC4453549

11. Duranti S, Ferrario C, van Sinderen D, Ventura M, Turroni F. 2017. Obesity and microbiota: An example of an intricate relationship. Genes Nutr. 12:18. https://doi.org/10.1186/s12263-017-0566-2; PMid:28638490 PMCid:PMC5473000

12. Bespalova ID, Ryazantseva NV, Kalyuzhin VV i dr. 2013. Sistemnoe vospalenie v patogeneze metabolicheskogo sindroma i assotsiirovannyih s nim zabolevaniy. Sib. med. zhurn. 2:5-9.

13. Ma B, Forney LJ, Ravel J. 2012. The vaginal microbiome: rethinking health and diseases. Ann Rev Microbiol. 66:371-389. https://doi.org/10.1146/annurev-micro-092611-150157; PMid:22746335 PMCid:PMC3780402

14. Andrew B Onderdonk, Mary L Delaney, Raina N Fichorova. 2016, Apr. The Human Microbiome during Bacterial Vaginosis Clin Microbiol Rev. 29(2):223-238. https://doi.org/10.1128/CMR.00075-15; PMid:26864580 PMCid:PMC4786887

15. Donders GG, Bosmans E, Dekeersmaecker A. 2000. Pathogenesis of abnormal vaginal bacterial flora. Am. J. Obstet. Gynecol. 182:872-878. https://doi.org/10.1016/S0002-9378(00)70338-3

16. Greenblum S, Turnbaugh PJ, Borenstein E. 2012. Metagenomic systems biology of the human gut microbiome reveals topological shifts associated with obesity and inflammatory bowel disease. Proc. Natl. Acad. Sci. USA. 109:594-599. https://doi.org/10.1073/pnas.1116053109; PMid:22184244 PMCid:PMC3258644

17. Bartelt A, Heeren J. 2014. Adipose tissue browning and metabolic health. Nat Rev Endocrinol 10:24-36. https://doi.org/10.1038/nrendo.2013.204; PMid:24146030

18. Kusminski CM, Bickel PE, Scherer PE. 2016. Targeting adipose tissue in the treatment of obesity-associated diabetes. Nat. Rev. Drug Discov. 15:639-660. https://doi.org/10.1038/nrd.2016.75; PMid:27256476

19. Scherer PE. 2006. Adipose tissue: From lipid storage compartment to endocrine organ. Diabetes. 55:1537-1545. https://doi.org/10.2337/db06-0263; PMid:16731815

20.Sabrina Duranti, Chiara Ferrario, Douwe van Sinderen. 2017. Obesity and microbiota: an example of an intricate relationship Genes Nutr. 12. https://doi.org/10.1186/s12263-017-0566-2; PMid:28638490 PMCid:PMC5473000

21. Mitchell C, Marrazzo J. 2014. Bacterial vaginosis and the cervicovaginal immune response. Am J Reprod Immunol. 71(6):555-563. https://doi.org/10.1111/aji.12264; PMid:24832618 PMCid:PMC4128638

22. Mitchell C, Marrazzo J. 2014. Bacterial vaginosis and the cervicovaginal immune response. Am J Reprod Immunol. 71(6):555-563. https://doi.org/10.1111/aji.12264; PMid:24832618 PMCid:PMC4128638

23. Fredricks DN, Fiedler TL, Marrazzo JM. 2005. Molecular identification of bacteria associated with bacterial vaginosis. N. Engl. J. Med. 353:1899-1911. https://doi.org/10.1056/NEJMoa043802; PMid:16267321

24. Beigi RH, Wiesenfeld HC, Hillier SL, Straw T, Krohn MA. 2005. Factors associated with absence of H2O2-producing Lactobacillus among women with bacterial vaginosis. J. Infect. Dis. 191:924-929. https://doi.org/10.1086/428288; PMid:15717268

25. Genc MR, Vardhana S, Delaney ML, Witkin SS, Onderdonk AB. 2007. TNFA-308G>A polymorphism influences the TNF-alpha response to altered vaginal flora. Eur J Obstet Gynecol Reprod Biol. 134(2):188-191. https://doi.org/10.1016/j.ejogrb.2006.10.018; PMid:17123692

26. Gianluca Quaranta, Maurizio Sanguinetti, Luca Masucci. 2019. Fecal Microbiota Transplantation: A Potential Tool for Treatment of Human Female Reproductive Tract Diseases Front Immunol. 10: 2653. https://doi.org/10.3389/fimmu.2019.02653; PMid:31827467 PMCid:PMC6890827

27. Burton JP, Cadieux PA, Reid G. 2003. Improved understanding of the bacterial vaginal microbiota of women before and after probiotic instillation. Appl. Environ. Microbiol. 69:97-101. https://doi.org/10.1128/AEM.69.1.97-101.2003; PMid:12513982 PMCid:PMC152440

28. Kondratiuk KO, Bodnar PM, Yankovskyi DS. 2015. Likuvannia porushen mikroekolohii kyshechnyka u khvorykh tsukrovym diabetom 2 typu ta nealkoholnoiu zhyrovoiu khvoroboiu pechinky. Gepatologiia 1:42-51.

29. Russo R, Edu A, De Seta F. 2018. Study on the effects of an oral lactobacilli and lactoferrin complex in women with intermediate vaginal microbiota. Arch Gynecol Obstet. 298(1):139-145. https://doi.org/10.1007/s00404-018-4771-z; PMid:29637269

30. Ziyue Wang, Yining He, Yingjie Zheng. 2019, Oct. Probiotics for the Treatment of Bacterial Vaginosis: A Meta-Analysis Int J Environ Res Public Health 16(20). https://doi.org/10.3390/ijerph16203859; PMid:31614736 PMCid:PMC6848925

31. Muzny CA, Schwebke JR. 2016. Pathogenesis of bacterial vaginosis: discussion of current hypotheses. J Infect Dis. 214 (Suppl 1): S1-S5. https://doi.org/10.1093/infdis/jiw121; PMid:27449868 PMCid:PMC4957507

32. Catriona S Bradshaw, Jack D Sobel. 2016, Aug 15. Current Treatment of Bacterial Vaginosis-Limitations and Need for Innovation J Infect Dis. 214(1):S14-S20. https://doi.org/10.1093/infdis/jiw159; PMid:27449869 PMCid:PMC4957510

33. Joana Castro, Daniela Machado, Nuno Cerca. 2019, May. Unveiling the role of Gardnerella vaginalis in polymicrobial Bacterial Vaginosis biofilms: the impact of other vaginal pathogens living as neighbors ISME J. 13(5):1306-1317. https://doi.org/10.1038/s41396-018-0337-0; PMid:30670827 PMCid:PMC6474217

34. Katherine Fethers, Jimmy Twin, Christopher K. 2012. Bacterial Vaginosis (BV) Candidate Bacteria: Associations with BV and Behavioural Practices in Sexually-Experienced and Inexperienced Women PLoS One. 7(2). https://doi.org/10.1371/journal.pone.0030633; PMid:22363457 PMCid:PMC3281856

35. Nagaraja P. 2008. Antibiotic resistance of Gardnerella vaginalis in recurrent bacterial vaginosis. Indian J Med Microbiol. 26(2):155-157. https://doi.org/10.4103/0255-0857.40531; PMid:18445953

36. De Backer E, Verhelst R, Verstraelen H et al. 2006. Antibiotic susceptibility of Atopobium vaginae. BMC Infect Dis. 6:51. https://doi.org/10.1186/1471-2334-6-51; PMid:16542416 PMCid:PMC1468414

37. Bradshaw CS, Morton AN, Hocking J, Garland SM, Morris MB et al. 2006. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J. Infect. Dis. 193:1478-1486. https://doi.org/10.1086/503780; PMid:16652274

38. Austin MN, Meyn LA, Hillier SL. 2006. Susceptibility of vaginal bacteria to metronidazole and tinidazole. Anaerobe. 12(5-6):227-230. https://doi.org/10.1016/j.anaerobe.2006.06.002; PMid:16893662

39. Nyirjesy Paul, Schwebke Jane R. 2018. Secnidazole: next-generation antimicrobial agent for bacterial vaginosis treatment. Future Microbiology. 13(5):507-524. https://doi.org/10.2217/fmb-2017-0270; PMid:29327947

40. Schwebke JR, Morgan FG Jr, Koltun W, Nyirjesy P. 2017, Dec. A phase-3, double-blind, placebo-controlled study of the effectiveness and safety of single oral doses of secnidazole 2 g for the treatment of women with bacterial vaginosis. Am J Obstet Gynecol. 217(6). https://doi.org/10.1016/j.ajog.2017.08.017; PMid:28867602

41. Faught BM, Reyes SJ. 2019, Sep. Characterization and Treatment of Recurrent Bacterial Vaginosis. Womens Health (Larchmt). 28(9):1218-1226. https://doi.org/10.1089/jwh.2018.7383; PMid:31403349

42. Gillis JC, Wiseman LR. 1996, Apr. Secnidazole. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic use in the management of protozoal infections and bacterial vaginosis. Drugs. 51(4):621-38. https://doi.org/10.2165/00003495-199651040-00007; PMid:8706597

43. Kriuchko TO, Poda OA, Nesina IM. 2019. Pidkhid do profilaktyky y likuvannia nealkoholnoi zhyrovoi khvoroby pechinky v ditei z ozhyrinniam iz pozytsii suchasnykh mizhnarodnykh rekomendatsii. Zdorove rebenka 14;2.

44. Silina NK, Koval HM, Silina TM, Berezhnoi VV. 2017. Mikrobiolohichni aspekty dysbiozu pry bezplidnosti i nevynoshuvanni vagitnosti ta ihnia korektsiia. Zdorove zhenshchynы 10(126):50-52. https://doi.org/10.15574/HW.2017.126.50

45. Gopchuk OM. 2016. Zastosuvannia polinenasychenyh zhyrnyh kyslot omeha-3 u kompleksnii terapii giperandrogennykh staniv. Medychni aspekty zdorovia zhinky 1.