BACTERIAL MORPHOTYPES OF BACTERIAL VAGINOSIS
Keywords:bacterial morphotype, bacterial vaginosis, Gardnerella vaginalis
Bacterial vaginosis is a disorder in the composition of the vaginal flora that leads to a decrease in the number of hydrogen peroxide-producing lactobacilli and a predominance of various anaerobic bacteria. A retrospective cohort study, performed on a series of 192 patients aged 20 to 59 years, divided into two groups: examined and control. The study group included 128 sexually active women with a Pap smear that showed the presence of a squamous intraepithelial lesion or squamous invasive cervical cancer. The control group included 64 sexually active women with a normal PAP smear. All women have a Nugent score system. The most common bacterial morphotype of bacterial vaginosis in women in the study group was Gardnerella vaginalis (96.43%; 54/56), followed by descending order: Bacteroides species (69.64%; 39/56), Mobiluncus species (51,78%; 29/56), Prevotella species (50.00; 28/56) and Lactobacillus species (19.64%; 11/56). The most common bacterial morphotype detected in patients with normal cervical cytology was Lactobacillus species (96.87%; 62/64), followed by descending order: Gardnerella vaginalis (28.12%; 18/64), Bacteroides species (23.44%; 15/64) and Mobiluncus species and Prevotella species (with 9.37% each; 6/64). Bacterial vaginosis was detected in 43.75% of patients with squamous cell abnormalities of the cervix and in 12.50% of patients with normal cervical cytology. Data analysis showed: correlation between the presence of bacterial vaginosis and the occurrence of squamous cell abnormalities of the cervix (chi-square test = 4.19, p <0.05); increase in the presence of bacterial vaginosis in parallel with an increase in the cytopathological degree of cervical lesion (chi-square test = 12.19, p˂0.05) and that bacterial vaginosis was most common in patients under 30 years of age (57, 14%; 16/28). Our study showed that Gardnerella vaginalis is the most common bacterial morphotype of bacterial vaginosis
Avery, K.N.L., Bosch, J.L.H.R., Gotoh, M., Naughton, M., Jackson, S., Radley, S.C., et al. (2007). Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol.;177:39–49
Antovska, V., Basheska, N., Grncarova, Z, & Aleksioska N. (2012). Relationship among bacterial vaginosis, local inflammatory response and presence of cervical intraepithelial neoplasia in women with and without human papillomavirus infection. Korean J Obstet Gynecol, 55:468-476.
Antovska, V., Bahar, H., Torun, M. M., Ocer, F. & Kocazejbek, B. (2005). Mobiluncus species in gynaecological and obstetric infections: antimicrobial resistance in a Turkish population, 25(3):268-271.
Behbakht, K., Friedman, J., Heimler, I., Aroutcheva, A. & Simoes, J. (2002). Role of the vaginal microbiological ecosystem and cytokine profile in the promotion of cervical dysplasia: a case-control study. Infect Dis Obstet Gynecol, 10:181-186.
Briselden, A. M., Moncla, B. J., Stevens, C. E, & Hillier S. L. (1992). Sialidases (neuraminidases) in bacterial vaginosis and bacterial vaginosis-associated microflora. J Clin Microbiol, 30:663-6.
Caixeta, R. C., Ribeiro, A. A., Segatti, K. D., Saddi, V. A., Figueiredo Alves, R. R., Dos Santos Carneiro, M. A. & Rabelo-Santos, S. H. (2015). Association between the human papillomavirus, bacterial vaginosis and cervicitis and the detection of abnormalities in cervical smears from teenage girls and young women. Diagn Cytopathol, 43(10):780-5.
Discacciati, M. G., Simoes, J. A., Lopes, E. S., Silva, S. M., Montemor, E. B., Rabelo-Santos, S. H. & Westin, M. C. (2006). Is bacterial vaginosis associated with squamous intraepithelial lesion of the uterine cervix? Diagn Cytopathol, 34(5):323-5.
Djukic, S., Opavski, N., Mijac, V. & Ranin, L. (2011). Current knowledge of bacterial vaginosis. Srp Arh Celok Lek, 139(5-6):402-8.
Djukic, S. (2000). Bakterijska vaginoza u trudnoci. Beograd: Univerzitet u Beogradu.
Eriksson, K. (2011). Bacterial Vaginosis: Diagnosis, Prevalence and Treatment. Linkoping, Sweden: Unitryck.
Forsum, U., Holst, E., Larsson, P. G., Vasques, A., Jakobsson, T. & Mattsby-Baltzer, I. (2005). Bacterial vaginosis-a microbiological and immunological enigma. APMIS, 113:81-90.
Gad, G. F. M., El-Adawy, A. R., Mohammed, M. S., Ahmed, A. F. & Mohammed, H. A. (2014). Evaluation of different diagnostic methods of bacterial vaginosis. IOSP-JDMS, 13:15-23.
Gillet, E., Meys, J. F. A., Verstraelen, H., Verhelst, R., De Sutter, P., Temmerman, M. & Broeck, D. V. (2012). Association between Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Systematic Review and Meta-Analysis. PLoS ONE, 7(1):45201.
Kero, K., Rautava, J., Syrjanen, K., Grenman, S. & Syrjanen S. (2017). Association of asymptomatic bacterial vaginosis with persistence of female genital human papillomavirus infection. Eur J Clin Microbiol Infect Dis, 36(11):2215-2219.
Klomp, J. M., Boon, M. E., Van Haaften, M. & Heintz, P.M. (2008). Cytologically diagnosed Gardnerella Vaginalis infection and cervical (pre)neoplasia as established in population-based cervical screening. Am J Obstet Gynecol, 199:480.
Kurman, R. J., Carcangin, M. L., Herrington, C. S., & Young, R. H. (2014). World Health Organization Classification of Tumors of Female Reproductive Organs. 4th ed. Lyon, France: IARC Press.
Livengood, C.H. (2009). Bacterial vaginosis: an overview for 2009. Rev Obstet Gynecol, 2:28-37.
Mongelos, P., Mendoza, L.P., Rodrguez-Riveros, I., Castro, A., Gimenez, G., Araujo, P., Paez, M., Castro, W. & Basilleti J. (2015). Distribution of human papillomavirus (HPV) genotypes and bacterial vaginosis presence in cervical samples from Paraguayan indigenous. Int J InfecDis, 39:44-9.
Machado, A., Jefferson, K.K. & Cerca, N. (2013). Interactions between Lactobacillus crispatus and bacterial vaginosis (BV)-associated bacterial species in initial attachment and biofilm formation. Int J Mol Sci, 14:12004-12.
Morris, M., Nicoll, A. & Simms, I. (2001). Bacterial vaginosis: a public health review. Br J Obstet Gynaecol, 108:439-50.
Murta, E. F., Souza, M. A., Argujo Junior, E. & Adad, S. J. (2000). Incidence of gardnerella vaginalis, candida and human papillomavirus in cytological smears. Sao Paulo Med J, 118:105-8.
Nam, K. H. (2009). Association between bacterial vaginosis and cervical intraepithelial neoplasia. J Gynecol Oncol, 1:39-43.
Nugent, R. P., Krohn, M. J. & Hillier, S. L. (1991). Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J Clin Microbiol, 29:297-301.
Numanovic, F., Hukic, M., Gegic, M., Nukic, M., Delibegovic, Z., Pasic, S & Cicko E. (2008). Bacterial vaginosis presence in sexually active women in Tuzla Canton area. Bosn J Basic Med Sci, 8(4):322-30.
Nzomo, J., Waiyaki, P. & Waihenya, R. (2013). Bacterial vaginosis and correlates in women of reproductive age in thika, Kenya. Advances in Microbiology, 3:249-254.
Oh, H. Y., Kim, B. S., Seo, S. S., Kong, J. S., Lee, J. K., Park, S. Y., Hong, K. M., Kim, H. M. & Kim, M. K. (2015). The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia. Clin Microbiol Infect, 21(7):674.
Patterson, J. L., Stull-Lane, A., Girerd, P. H. & Jefferson, K. K. (2010). Analysis of adherence, biofilm formation and cytotoxicity suggests a greater virulence potential of Gardnerella vaginalis relative to other bacterial vaginosis-associated anaerobes. Microbiology, 156:392-9.
Roeters, A. M., Boon, M. E., Van Haaften, M., Vernooij, F. & Bontekoe, T. R. (2009). Inflammatory events as detected in cervical smears and squamous intraepithelial lesions. Diagn Cytopathol, 38:85-93.
Solomon, D., Davey, D., & Kurman, R. (2002). The 2001 Bethesda System. Terminology for reporting results of cervical cytology. JAMA; 287:2114-19.
Srinivasan, S., Hoffman, N. G. & Morgan M. T. (2012). Bacterial communities in women with bacterial vaginosis: high resolution phylogenetic analysis reveal relationships of microbiota to clinical criteria. PloS One, 7:37818.
Verbruggen, B. S., Boon, M. E. & Boon, L. M. (2006). Dysbacteriosis and squamous (pre)neoplasia of immigrants and Durch women as established in population-based cervical screening. Diagn Cytopathol, 34:377-381.
Vetrano, G., Pacchiarott,i A., Lombardi, G., Cimellaro, V. & Verrico, M. (2007). Correlation between squmous intraepithelial lesions and bacterial vaginosis. Eur J Gynaecol Oncol, 28:310-312.
Yan, D. H., Lu, Z. & Su, R. J. (2009). Comparison of main Lactobacillus species between women and women with bacterial vaginosis. Chin Med J, 122:2748-51.
Zerat, L. (2002). La nouvelle terminologie de Bethesda: quellschangements? Rev Prat Gynecol Obstet. Numero Special, 3-10.