Comparative assessment of the parietal microflora of the vagina in healthy girls and girls with vulvovaginitis in the neutral period of sexual development

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Abstract

BACKGROUND: Vulvovaginitis is a common gynecological problem in prepubertal girls and is most likely caused by an imbalance in the vaginal microbiota. A number of studies have been carried out to determine the vaginal microflora of healthy prepubertal girls and girls with vulvovaginitis using traditional bacteriological methods. However, until now, a comparative study of the composition of the vaginal microflora in prepubertal girls using molecular methods has not been performed.

AIM: The aim of this study was to conduct a comparative assessment of the composition of the parietal microflora of the vagina in healthy girls and girls with vulvovaginitis in the neutral period of sexual development.

MATERIALS AND METHODS: This study included 168 prepubertal girls aged 3–6 years, of which 70 girls with vulvovaginitis made up the main group and 98 girls without symptoms or signs of vulvovaginitis comprised the comparison group. All girls were assessed for the parietal microflora of the vagina by real-time PCR (Lactobacillus spp, Enterobacteriaceae, Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis / Prevotella bivia / Porphyromonas spp., Eubacterium spp., Sneathia spp. / Leptotrihia spp. / Fusobacterium spp., Megasphaera spp. / Veillonella spp. / Dialister spp., Lachnobacterium spp. / Clostridium spp., Mobiluncus spp. / Corynebacterium spp., Peptostreptococcus spp., Atopobium vaginae, Mycoplasma hominis, Ureaplasma (urealyticum + parvum), Candida spp., and Mycoplasma genitalium) using the Femoflor 16 REAL-TIME PCR Detection Kit (DNA-Technology Research & Production, Moscow, Russia).

RESULTS AND CONCLUSIONS: In healthy prepubertal girls, the vaginal microflora is mainly composed of obligate anaerobes. With vulvovaginitis in the vaginal biotope of girls, the total bacterial mass of microorganisms (p = 0.005) decreased, both the biodiversity (the Shannon’s index, p = 0.001; the Simpson’s index, p = 0.004) and the number of obligate anaerobes (p = 0.006) decreased, while the number of facultative anaerobes increased (p = 0.043). The frequency of obligate anaerobes in vulvovaginitis, despite their prevalence in general, was significantly lesser: Peptostreptococcus spp. (p = 0.002), Mobiluncus spp. + Corynebacterium spp. (p = 0.048), Megasphaera spp. + Veillonella spp. + Dialister spp. (p = 0.004); while the frequency of Atopobium vaginae increased (p = 0.002). The concentrations of Peptostreptococcus spp. (p = 0.002); Megasphaera spp. + Veillonella spp. + Dialister spp. (p = 0.002), Gardnerella vaginalis + Prevotella bivia + Porphyromonas spp. (p = 0.006), and Eubacterium spp. (p =0.006) significantly decreased; while the absolute concentration of Sneathia spp. + Leptotrichia spp. + Fusobacterium spp. (p = 0.042), and Mobiluncus spp. + Corynebacterium spp. (p = 0.012) increased. The frequency of facultative anaerobes remained unchanged (p = 0.067) against an increase in the concentration of the family Enterobacteriaceae (p = 0.026). The concentrations of Streptococcus spp. and Staphylococcus spp. remained unchanged, with Lactobacillus spp. not detected in any girl in both study groups.

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About the authors

Alina A. Bezrukova

Samara State Medical University

Email: bezzrukovaa@yandex.ru
ORCID iD: 0000-0002-3929-4187
SPIN-code: 7105-4287
Scopus Author ID: 57196486185
ResearcherId: AAG-7985-2020
Russian Federation, Samara

Maria I. Yarmolinskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605
Scopus Author ID: 7801562649
ResearcherId: P-2183-2014

MD, Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences

Russian Federation, Saint Petersburg

Olga V. Sazonova

Samara State Medical University

Email: ov_2004@mail.ru
ORCID iD: 0000-0002-4130-492X
SPIN-code: 1789-6104
Scopus Author ID: 26641501400
ResearcherId: A-6126-2019

MD, Dr. Sci. (Med.), Assistant Professor

Russian Federation, Samara

Natalia V. Spiridonova

Samara State Medical University

Author for correspondence.
Email: nvspiridonova@mail.ru
ORCID iD: 0000-0003-3390-8034
SPIN-code: 3079-3658
Scopus Author ID: 56089251400
ResearcherId: S-6918-2016

MD, Dr. Sci. (Med.), Professor

Russian Federation, Samara

References

  1. Beyitler İ, Kavukcu S. Clinical presentation, diagnosis and treatment of vulvovaginitis in girls: a current approach and review of the literature. World J Pediatr. 2017;13(2):101–105. doi: 10.1007/s12519-016-0078-y
  2. Ranđelović G, Mladenović V, Ristić L, et al. Microbiological aspects of vulvovaginitis in prepubertal girls. Eur J Pediatr. 2012;171(8):1203–1208. doi: 10.1007/s00431-012-1705-9
  3. Dei M, Di Maggio F, Di Paolo G, et al. Vulvovaginitis in childhood. Best Pract Res Clin Obstet Gynaecol. 2010;24(2):129–137. doi: 10.1016/j.bpobgyn.2009.09.010
  4. Sharma B, Preston J, Greenwood P. Management of vulvovaginitis and vaginal discharge in prepubertal girls. Rev Gynaecol Pract. 2004;4(2):111. doi: 10.1016/j.rigp.2003.12.005
  5. Kazakova AV, Spiridonova NV. Knowledge and skills of intimate hygiene according to the questionnaire surveyin young age group of girls. Reproduktivnoe zdorov’e detej i podrostkov. 2017. № 4–5. С. 82–98. (In Russ.)
  6. Joishy M, Ashtekar CS, Jain A, et al. Do we need to treat vulvovaginitis in prepubertal girls? BMJ. 2005;330(7484):186–188. doi: 10.1136/bmj.330.7484.186
  7. Emans SJ. Vulvovaginal problems in the prepubertal child. In: Pediatric and adolescent gynecology. Ed. by S.J. Emans, M.R. Laufer. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2012:42–59.
  8. Sadolina IV. Kliniko-immunologicheskie kriterii otsenki polovogo i fizicheskogo razvitiya devochek. [dissertation abstract] Moscow; 2000. (In Russ.)
  9. Goje O, Munoz JL. Vulvovaginitis: Find the cause to treat it. Cleve Clin J Med. 2017;84(3):215–224. doi: 10.3949/ccjm.84a.15163
  10. Loveless M, Myint O. Vulvovaginitis- presentation of more common problems in pediatric and adolescent gynecology. Best Pract Res Clin Obstet Gynaecol. 2018;48:14–27. doi: 10.1016/j.bpobgyn.2017.08.014
  11. Hammerschlag MR, Alpert S, Rosner I, et al. Microbiology of the vagina in children: normal and potentially pathogenic organisms. Pediatrics. 1978;62(1):57–62.
  12. Gerstner GJ, Grünberger W, Boschitsch E, et al. Vaginal organisms in prepubertal children with and without vulvovaginitis. A vaginoscopic study. Arch Gynecol. 1982;231(3):247–252. doi: 10.1007/BF02110125
  13. Jaquiery A, Stylianopoulos A, Hogg G, et al. Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract. Arch Dis Child. 1999;81(1):64–67. doi: 10.1136/adc.81.1.64
  14. Kim H, Chai SM, Ahn EH, et al. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009-2014: a single center experience. Obstet Gynecol Sci. 2016;59(2):130–136. doi: 10.5468/ogs.2016.59.2.130
  15. Cemek F, Odabaş D, Şenel Ü, et al. Personal hygiene and vulvovaginitis in prepubertal Children. J Pediatr Adolesc Gynecol. 2016;29(3):223–227. doi: 10.1016/j.jpag.2015.07.002
  16. Zuckerman A, Romano M. Clinical recommendation: Vulvovaginitis. J Pediatr Adolesc Gynecol. 2016;29(6):673–679. doi: 10.1016/j.jpag.2016.08.002
  17. Garden AS. Vulvovaginitis and other common childhood gynaecological conditions. Arch Dis Child Educ Pract Ed. 2011;96(2):73–78. doi: 10.1136/adc.2009.181883
  18. Xiaoming W, Jing L, Yuchen P, et al. Characteristics of the vaginal microbiomes in prepubertal girls with and without vulvovaginitis. Eur J Clin Microbiol Infect Dis. 2021;40(6):1253–1261. doi: 10.1007/s10096-021-04152-2
  19. Sikanić-Dugić N, Pustisek N, Hirsl-Hećej V, et al. Microbiological findings in prepubertal girls with vulvovaginitis. Acta Dermatovenerol Croat. 2009;17(4):267–272.
  20. Yilmaz AE, Celik N, Soylu G, et al. Comparison of clinical and microbiological features of vulvovaginitis in prepubertal and pubertal girls. J Formos Med Assoc. 2012;111(7):392–396. doi: 10.1016/j.jfma.2011.05.013
  21. Jarienė K, Drejerienė E, Jaras A, et al. Clinical and microbiological findings of vulvovaginitis in prepubertal girls. J Pediatr Adolesc Gynecol. 2019;32(6):574–578. doi: 10.1016/j.jpag.2019.08.009
  22. Bumbulienė Ž, Venclavičiūtė K, Ramašauskaite D, et al. Microbiological findings of vulvovaginitis in prepubertal girls. Postgrad Med J. 2014;90(1059):8–12. doi: 10.1136/postgradmedj-2013-131959
  23. Tartaglia E, Giugliano B, Ucciferri C, et al. Vulvo-vaginitis in prepubertal girls: new ways of administering old drugs. J Pediatr Adolesc Gynecol. 2013;26(5):277–280. doi: 10.1016/j.jpag.2013.05.003
  24. Stricker T, Navratil F, Sennhauser FH. Vulvovaginitis in prepubertal girls. Arch Dis Child. 2003;88(4):324–326. doi: 10.1136/adc.88.4.324
  25. Hansen MT, Sanchez VT, Eyster K, et al. Streptococcus pyogenes pharyngeal colonization resulting in recurrent, prepubertal vulvovaginitis. J Pediatr Adolesc Gynecol. 2007;20(5):315–317. doi: 10.1016/j.jpag.2006.12.001
  26. Usonis V. Vaccines and Vaccination. Vilnius: Homo Liber; 2010. P. 328.
  27. McGreal S, Wood P. Recurrent vaginal discharge in children. J Pediatr Adolesc Gynecol. 2013;26(4):205–208. doi: 10.1016/j.jpag.2011.12.065

Supplementary files

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2. Fig. 1. Total bacterial mass of microorganisms (TBM) in the composition of the parietal vaginal microflora of healthy girls and girls with vulvovaginitis

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3. Fig. 2. Indices of the diversity of microorganisms: a — Shannon index; b — Simpson index

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4. Fig. 3. Frequency of detection (%) and concentration (lg) of obligate and facultative anaerobes in healthy and vulvovaginitis groups

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5.  Fig. 4. The incidence (%) and concentration (lg) of obligate anaerobes in healthy and vulvovaginitis groups

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6. Fig. 5. The incidence (%) and concentration (lg) of facultative anaerobes in healthy and vulvovaginitis groups

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7. Fig. 6. The percentage of certain types of bacteria in the total pool of vaginal microbiota in the studied groups

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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