Tuberculosis of respiratory tract and chemotherapy: the influence on the state of vaginal microbiota

Aim. To assess the state of the vaginal microbiota in patients with tuberculosis (TB) of the respiratory tract during the monitoring of chemotherapy (CTH). Materials and methods. The study “case-control” was conducted in compliance with STROBErecommendations, where the «case» meant the presence of TB of the respiratory tract and CTH; “control” - the absence of TB of the respiratory tract and CTH. 108 women of reproductive age were examined. They were stratified into 2 groups: group 1 - 54 patients with TB of the respiratory tract treated with CTH; group 2 - 54 women without TB of the respiratory tract and CTH. The standard obstetrical-gynecological and phthisiological researches were used; special study of vaginal microbiota was conducted with the use of “Femoflor” test system with a realtime polymerase chain reaction and quantitative characteristics of 28 conditionally pathogenic microorganisms. Statistical data analysis was performed using scripts in the R programming language version 3.5 in the R Studio environment. Results. With prolongation of therapy (for 60 and 150 days after CTH), a statistically significant decrease in Lactobacillus spp. - 6 [5,7; 6,6], 0 [0; 4] и 0 [0; 3] (р40,0001), a gradual increase in the majority of associates of conditionally pathogenic microflora (the most indicative were Gardnerella vaginalis and Candida spp.) were noted in microbiota. The m icroscopic characteristic of the vaginal biotope was the presence of normocenosis prior to CXT in the vast majority in group 1 - 47 (87%). 60 and 150 days after CXT, there was absence of normocenosis - 0 (0%), and statistically significant increase in the incidence of dysbiosis and an inflammatory bowel disease was 29 (54%) (р<0,0001) and 12 (22%) (р=0,02); 25 (46%) (р<0,0001) and 29 (54%). Conclusion. The presence of 2 aggressive factors - TB of the respiratory tract and CXT damage the vaginal biotope resulting in formation of aerobic-anaerobic dysbiosis. No statistically significant relationship was observed between the development of vaginal dysbiosis and the clinical form of TB of the respiratory tract, the severity of the specific process and the selected chemotherapy regimen. Further studies in this direction should be continued.

vaginal mictobiota, tuberculosis of the respiratory tract, dysbiosis