A Narrative Review Discussing the Obstetric Repercussions Due to Alterations of Personalized Bacterial Sites Developed within the Vagina, Cervix, and Endometrium

Doroftei, Bogdan; Ilie, Ovidiu-Dumitru; Armeanu, Theodora; Stoian, Irina-Liviana; Anton, Nicoleta; Babici, Ramona-Geanina; Ilea, Ciprian

doi:10.3390/jcm12155069

Cited by 4 publications

(1 citation statement)

References 246 publications

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“…приводит к переходу от эубиоза к дисбактериозу (бактериальному вагинозу), а также к нарушению локального метаболического гомеостаза и эндокринных взаимоотношений. Вслед за этим активизируется каскад провоспалительных цитокинов и сигнальных путей из-за активности бактериальных липополисахаридов/эндотоксинов, что связано с высоким риском выкидыша на различных стадиях [32]. Присутствие некоторых патогенных организмов (наиболее часто определяемых при бактериальном вагинозе) может указывать на предрасположенность и к другим акушерским осложнениям [33].…”

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Pregravid preparation for women with bacterial vaginosis and a history of early pregnancy loss

Gerasimova,

Solovyeva,

Chegus

et al. 2024

Medicinskij sovet

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Introduction. Statistics show that about 13 to 15 in 100 pregnancies end in early miscarriage. This represents both a medical and social issue, as such outcome may be associated with maternal depression and anxiety, which inevitably affects women’s activities, performance efficiency and social inclusion. Restoration of normobiocenosis and lactobacilli pool dominance is one of the key challenges for women planning pregnancy.Aim. To evaluate the effectiveness of probiotics at the pregravid preparation stage in women with a history of early pregnancy loss and bacterial vaginosis (BV).Materials and methods. We selected 46 patients of reproductive age (24–39 years) who applied for early pregnancy loss, with complaints of vaginal discharge with an unpleasant odour, pruritus, burning, and dyspareunia, using databases of 5 medical clinics in Moscow, Tyumen and Stavropol. To treat bacterial vaginosis, two-stage therapy aimed at eliminating the increased number of anaerobic microorganisms and restoring the vaginal microbiocenosis was used.Results. The effectiveness of combination therapy was assessed at 1 month. All patients on therapy experienced clinical improvement, normalization of vaginal microbiocenosis parameters based on Femoflor-16 test findings after the end of treatment. Physiological microbiocenosis of Lactobacillus spp. > 107 was detected in 43 (94.5%). In all patients, the average vaginal pH after two-stage therapy was 4.3 ± 0.7. The safety of Acilact Duo therapy was assessed in all study participants. No negative trends were recorded.Conclusion. Superlimflife (Acilact Duo), acidophilus bacteria + vitamin-mineral protein-peptide complex, quickly restores optimal vaginal acidity (pH), stimulates the growth of lactobacilli, and reduces the incidence of BV relapses.

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Pregravid preparation for women with bacterial vaginosis and a history of early pregnancy loss

Gerasimova,

Solovyeva,

Chegus

et al. 2024

Medicinskij sovet

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The prevalence of optrA -carrying Enterococci in the vaginal micro-ecology of pregnant women in late pregnancy

Xie,

Xu,

Dong

et al. 2024

Microbiol Spectr

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The colonization of Enterococcus in the female vagina leads to neonatal and pediatric enterococcal septicemia. Linezolid (LZD) is a kind of mainstream drug for treating multidrug-resistant Gram-positive infections. OptrA is the main LZD-resistance gene at Enterococci in human isolates. It is essential to explore the prevalence of optrA -carrying Enterococcus in vaginal secretions of late pregnant women and the drug resistance of optrA . From May to June 2023, this study recruited 340 volunteers in late pregnancy (35–40 weeks of pregnancy) to provide non-repetitive vaginal discharge samples. Luria-Bertani broth and florfenicol (10 µg/mL) were used to enrich bacteria. Enterococci was identified through time-of-flight mass spectrometry. Additionally, antimicrobial susceptibility, polymerase chain reaction, and next-generation sequencing assays were applied to this study. Fifty-four optrA -carrying Enterococcus strains were obtained, the proportion of the whole vagina of late pregnant women was 15.88% (54 out of 340), and Enterococcus faecalis account the highest proportion. All optrA -carrying Enterococcus were resistant to at least three drugs. Tetracycline, chloramphenicol, erythromycin, and LZD have higher bacterial resistance rates. Genetic environment analysis revealed that IS 1216E , fexA , and erm (A) may synergistically exert multidrug resistance with optrA . It is necessary to strengthen the surveillance of optrA -carrying Enterococcus in pregnant women. This study provides scientific support for controlling hospital infections and managing antibiotic-resistant bacteria, and provides a scientific basis for rational clinical medication. IMPORTANCE The disruption of cervicovaginal microbiota homeostasis is considered a key factor in causing imbalance in the microenvironment, leading to inflammation, transmission of infections, and illness. Enterococcus is considered a major cause of healthcare-related infections globally. It has resistance to multiple antimicrobial drugs, which pose significant challenges for clinical treatment. Therefore, it is crucial to assess the prevalence of optrA -carrying Enterococcus in vaginal secretions of late pregnant women and the drug resistance of optrA . This study detected 15.88% of optrA -carried Enterococci in 340 pregnant women. Furthermore, we found that optrA -carrying Enterococcus strains are highly resistant to tetracycline, chloramphenicol, erythromycin, and Linezolid. Additionally, genetic environment analysis revealed that IS1216E , fexA , and erm (A) may synergistically exert multidrug resistance with optrA . This study provides scientific support for controlling hospital infections and managing antibiotic-resistant bacteria and provides a scientific basis for rational clinical medication.

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Microbiota and Recurrent Pregnancy Loss (RPL); More than a Simple Connection

Garmendia,

De Sanctis,

Hajdúch

et al. 2024

Microorganisms

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Recurrent Pregnancy Loss (RPL) affects 1–2% of women, and its triggering factors are unclear. Several studies have shown that the vaginal, endometrial, and gut microbiota may play a role in RPL. A decrease in the quantity of Lactobacillus crispatus in local microbiota has been associated with an increase in local (vaginal and endometrial) inflammatory response and immune cell activation that leads to pregnancy loss. The inflammatory response may be triggered by gram-negative bacteria, lipopolysaccharides (LPS), viral infections, mycosis, or atypia (tumor growth). Bacterial structures and metabolites produced by microbiota could be involved in immune cell modulation and may be responsible for immune cell activation and molecular mimicry. Gut microbiota metabolic products may increase the amount of circulating pro-inflammatory lymphocytes, which, in turn, will migrate into vaginal or endometrial tissues. Local pro-inflammatory Th1 and Th17 subpopulations and a decrease in local Treg and tolerogenic NK cells are accountable for the increase in pregnancy loss. Local microbiota may modulate the local inflammatory response, increasing pregnancy success. Analyzing local and gut microbiota may be necessary to characterize some RPL patients. Although oral supplementation of probiotics has not been shown to modify vaginal or endometrial microbiota, the metabolites produced by it may benefit patients. Lactobacillus crispatus transplantation into the vagina may enhance the required immune tolerogenic response to achieve a normal pregnancy. The effect of hormone stimulation and progesterone to maintain early pregnancy on microbiota has not been adequately studied, and more research is needed in this area. Well-designed clinical trials are required to ascertain the benefit of microbiota modulation in RPL.

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A Narrative Review Discussing the Obstetric Repercussions Due to Alterations of Personalized Bacterial Sites Developed within the Vagina, Cervix, and Endometrium

Cited by 4 publications

References 246 publications

Pregravid preparation for women with bacterial vaginosis and a history of early pregnancy loss

Pregravid preparation for women with bacterial vaginosis and a history of early pregnancy loss

The prevalence of optrA -carrying Enterococci in the vaginal micro-ecology of pregnant women in late pregnancy

Microbiota and Recurrent Pregnancy Loss (RPL); More than a Simple Connection

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