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

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 36 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 Shannons index, p = 0.001; the Simpsons 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.