Currently, the problem of the development of resistance to drugs among microorganisms that colonize the urogenital system is becoming especially relevant due to broadly distributed dysbiotic conditions of the reproductive system of men and women. Therefore, there should be constant monitoring of the qualitative and quantitative composition of microbiota of the urogential tract and determination of the levels of antibiotic-resistance of strains of conditionally pathogenic microorganisms in the reproductive system of various layers of the population. We monitored 774,375 people of various age and sex – patients of the independent diagnostic laboratory INVITRO in the city Dnipro in 2017–2019. Among the examined people, 640,783 of the patients were diagnosed with the development of dysbiotic disorders, accounting for 82.7% of the total amount of the applications for medical help. According to the results of identification of the range of dysbiotic conditions of the urogenital system of patients of different ages and sexes, we determined the dominating role of facultative anaerobes in the development of dysbiotic impairments caused by colonizations by large numbers of conditionally-pathogenic microorganisms: in women, Gardnerella accounted for 86.1%, Staphylococcus – 63.2%, Streptococcus – 54.1%, Candida – 69.3%; in men, Streptococcus were found in 83.0%, Staphylococcus – 79.4%, Corynebacterium – 54.2% and Candida – 37.6% of the cases. Share of obligate anaerobes was also quite large: women were diagnosed with Prevotella in 59.7%, Peptostreptococcus in 53.2%, Fusobacterium in 45.4% of the cases cases; men were observed to have Peptostreptococcus 62.4%, Clostridium in 54.3%, Bacteroides in 32.5% of the cases. We determined high parameters of frequency of diagnosing antibiotic-resistant isolates of conditionally pathogenic microorganisms that circulate in the urogenital tract of patients with dysbiotic impairments, belonging to the following families: Mycoplasmataceae – 78.6%, Enterobacteriaceae – 56.0% and genera – Staphylococcus – 76.1%, Gardnerella – 24.3%, Corynebacterium – 21.2%. The research revealed increase in the frequency of detection of strains of urapathogenic bacteria resistant to the applied antibiotic preparations in 2018–2019 compared with the data of 2017: increases of 10.3% and 6.4% in representatives of family Mycoplasmataceae resistant to ciprofloxacin and ofloxacin respectively, 4.8% and 4.0% in Enterobacteriaceae resistant to chloramphenicol and ampicillin respectively, and 8.9% in the genus Staphylococcus resistant to vancomycin.
The aim of research was to analyze the frequency of detection of dysbiotic states of the reproductive tract of women with different pathologies. It was established the presence of dysbiotic disorders of the II and III degrees according to the manifestation of bacterial vaginosis and urogenital candidiasis in 100% of cases in patients with malignant neoplasms and pregnant women with cervical cancer in situ; the frequency of dysbiosis detection in pregnant women was 31% and in women with miscarriage -58% of cases. The obtained data made Escherichia coli, Candida albicans, Gardnerella vaginalis are the dominant etiopathogenic agents of genital microbiota disorders and the cause of reproductive system imbalance in women of all risk categories.
The spectrum of causative agents of nonspecific infections of the women urogenital tracts is studied. It is established that the typical etiological agents of the vaginosis are yeast-like fungi Candida albicans (35.7 %) and Escherichia coli (30.2 %), and the clinical isolates of E. coli (47.3 %) and Proteus mirabilis (15.8 %) are usual for vulvovaginitis. The frequency of detection of the causative agents of inflammatory genito-urinary diseases in women of different age groups varies: strains of E. coli are often found in patients of 1–12 years (47.3 %) and in women of 43–66 years old (36.0 %), but C. albicans – in patients of 18–42 years (39.0 %). High levels of the resistance to penicilline, tetracycline and fluoroquinolone antibiotics in selected clinical isolates of opportunistic microorganisms are determined.
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