Indicators microecology genital tract in patients with HPV infections

Анотація

Introduction. In recent years proved the involvement of papillomaviruses in the development of a wide range of diseases, which are based neoplastic processes of precancerous and tumor genesis. Human papilloma virus (HPV) are highly contagious, progressive increase in the incidence of genital tract lesions and high oncogenicity. Proven link between the risk of precancerous disease in patients with HPV and chlamydia infection, viruses (HSV, CMV) and pathogens "new generation". The purpose of this study was to evaluate the state of microbiota and analysis of associative forms of genital tract infection in women with HPV depending on the degree of cervical pathology. Materials and methods. In order to assess the state microecology cervical cancer in women with HPV infection examined 90 patients.Analysis of the results of bacteriological studies conducted taking into account the nature of pathological changes in the lining of the cervix. In particular, examined 23 women (group I) type of inflammatory disorders of the mucosa, 45 patients (group II) with mild cervical dysplasia (CIN I) and 22 - (third group) with cervical dysplasia moderate severity (CIN II). As a control, examined 25 healthy women. Conducting microbiological analysis and calculation of results was performed according to the order number 535 Ministry of Health from 1985 years and the order number 234 Ministry of Health of Ukraine of 10.05.2007 years. Crops performed by sectoral dense planting on differential - diagnostic culture media, to determine the degree of microbial contamination and to identify the best possible range of aerobic and facultative anaerobic microorganisms. Taxonomic position microorganisms was determined according to the directory Bergey. Diagnosis of herpes, cytomegalovirus, chlamydia, mycoplasmosis, ureaplasmosis and fluorescent performed by using a set of "Herpes-Scan" , "CMV-Scan "," Сhlamy-Scan "," Urea-Scan "and" Miko-Scan "(Moscow). HPV infection detected by PCR. Gardnerellesis diagnosed by microscopy by staining smears on Romanovsky with subsequent calculation of "core" of cells, setting amine test, determination of pH. The results of bacteriological studies were subject to statistical analysis by Student's method. Results. The obtained data indicate that patients of the first group identified changes microecology which was to raise the frequency of registration of mixed infection of the cervix opportunistic gram-positive cocci in combination with viruses, as well as the tendency to reduce the protective microflora. The frequency of associative forms of cervical infection was significant and was 72,7%, (n = 16). Women with HPV group II and CIN I and indicators microbiota slightly different from the data obtained in women with inflammatory type of stroke. In the second group of patients with HPV and mild cervical dysplasia tended to increase the level of seeding microorganisms pathogenic properties and increased frequency of diagnosis of infections such as chlamydia, mycoplasmosis, ureaplasmosis and gardnerella. The majority (66,6%, (n = 30)) of the second group of patients with HPV and CIN I bacterial flora was located in association with viruses and infectious agents "new generation". For comparison purposes, we examined three groups of women HPV who had cervical dysplasia moderate severity (CIN II). In this group of patients revealed increasing contamination cervical gram-positive coccus, not only, but also enterobacteria. The essential deficit lactobacillus. Compared with the data observed in women with HPV and CIN I, in patients with cervical dysplasia moderate severity (CIN II) revealed increased frequency of diagnosis of HSV, gardnerellez, chlamydia and ureaplasmosis. State microecology cervix in patients with HPV and CIN II is characterized by increased levels of viral infection, increasing the proportion of the total spectrum of microorganisms isolated anaerobic bacteria, Enterobacteriaceae and a significant decrease in contamination of the cervix protective microflora. Found increased frequency of registration associative forms of infection (86,3%, (n = 19)). Indicators expression of viral and bacterial associations in the third group of women with exaggerated HPV data obtained in patients with HPV and mild cervical dysplasia. Conclusions 1. Dependence indicators microecology cervical cytologic changes in the type mucosa. In the group of women with inflammatory type of stroke and mild dysplasia as part of the biological community dominated pathogens herpes or cytomegalovirus infection on the background of increases in expression of gram-positive coccal flora and lack of protective microflora. In the group of women with cervical dysplasia moderate severity recorded a significant increase in the frequency of diagnosis of HPV infection, chlamydia, increasing the share spectrum allocated flora anaerobic bacteria (Gardnerella, mobilyunkus) and a significant decrease in lactobacilli. 2. The differences between the frequency and composition of associations of infectious agents from the state epithelium of the mucous membrane of the cervix. The greatest rate of associative forms of contamination of the cervix (86,3%, (n = 19)) was found in women with human papillomavirus infection and cervical dysplasia Stepun medium severity. 3. The data obtained indicate the need for control parameters microecology cervix in women for the purpose of early diagnosis of HPV infection, assess the extent of violations of microbiota and the risk of complications.