fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2020-5-3-66-76fcmedicine-300Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHМикрофлора половых путей мужчин–партнеров женщин с бактериальным вагинозом и ее роль в развитии рецидивов данного заболеванияGenital microbiota of sexual partners of female patients with bacterial vaginosis is responsible for its recurrenceshttps://orcid.org/0000-0002-0357-7097БариновС. В.BarinovS. V.

Баринов Сергей Владимирович, профессор, доктор медицинских наук, заведующий кафедрой акушерства и гинекологии

644099, г. Омск, ул. Ленина, д. 12

Prof. Sergey V. Barinov, MD, DSc, Professor, Head of the Department of Obstetrics and Gynecology #2

12, Lenina Street, Omsk, 644099

https://orcid.org/0000-0002-3515-6027ОхлопковВ. А.OkhlopkovV. A.

Охлопков Виталий Александрович, профессор, доктор медицинских наук, ректор 

107031, г. Москва, ул. Петровка, д. 25, строение 2

Prof. Vitaliy A. Okhlopkov, MD, DSc, Professor, Rector

25, Petrovka Street, Building 2, 107031, Moscow

https://orcid.org/0000-0001-5365-7119ТирскаяЮ. И.TirskayaYu. I.

Тирская Юлия Игоревна, доктор медицинских наук, доцент кафедры акушерства и гинекологии №2

644099, г. Омск, ул. Ленина, д. 12

Dr. Yuliya I. Tirskaya, MD, Associate Professor, Department of Obstetrics and Gynecology #2

12, Lenina Street, Omsk, 644099

https://orcid.org/0000-0002-9960-6197БабаеваТ. Ш.BabaevaT. S.-K.

Бабаева Туран Шахин кызы, аспирант кафедры акушерства и гинекологии №2; врач акушергинеколог 

644099, г. Омск, ул. Ленина, д. 12

644111, г. Омск, ул. Березовая, д. 3

Dr. Turan S.-K. Babaeva, MD, PhD Student, Department of Obstetrics and Gynecology #2; Obstetrician-Gynecologist

12, Lenina Street, Omsk, 644099

3, Berezovaya Street, Omsk, 644111

babaeva.turan@mail.ruhttps://orcid.org/0000-0002-5959-7636СинельниковаЛ. Б.Sinel'nikovaL. В.

Синельникова Людмила Борисовна, врач-дерматовенеролог

644001, г. Омск, ул. 5-я линия, д. 117а

Dr. Lyudmila B. Sinel'nikova, MD, Dermatologist-Venereologist

117a, 5th Liniya Street, Omsk, 644001

https://orcid.org/0000-0001-5425-0847ТерлецкаяТ. В.TerletskayaT. V.

Терлецкая Татьяна Викторовна, врач-дерматовенеролог

644001, г. Омск, ул. 5-я линия, д. 117а

Dr. Tatiana V. Terletskaya, MD, Dermatologist-Venereologist

117a, 5th Liniya Street, Omsk, 644001

ФГБОУ ВО «Омский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияOmsk State Medical UniversityRussian FederationИнститут высшего и дополнительного профессионального образования Федерального научно-клинического центра реаниматологии и реабилитологии Министерства образования и науки Российской федерацииРоссияInstitute of the Higher and Postgraduate Professional Education, Federal Research and Clinical Center of Resuscitation and RehabilitationRussian FederationФГБОУ ВО «Омский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Перинатальный центр бюджетного учреждения здравоохранения Омской области «Областная клиническая больница»РоссияOmsk State Medical University; Institute of the Higher and Postgraduate Professional Education, Federal Research and Clinical Center of Resuscitation and Rehabilitation; Perinatal Center, Regional Clinical HospitalRussian FederationБУЗ Омской области «Клинический кожно-венерологический диспансер»РоссияClinical Dermatology and Venereology DispensaryRussian Federation202029092020536676Copyright © Баринов С.В., Охлопков В.А., Тирская Ю.И., Бабаева Т.Ш., Синельникова Л.Б., Терлецкая Т.В., 20202020Баринов С.В., Охлопков В.А., Тирская Ю.И., Бабаева Т.Ш., Синельникова Л.Б., Терлецкая Т.В.Barinov S.V., Okhlopkov V.A., Tirskaya Y.I., Babaeva T.S., Sinel'nikova L.В., Terletskaya T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/300

Цель. Оценить микрофлору половых путей мужчин – партнеров женщин с бактериальным вагинозом и ее роль в развитии рецидивов данного заболевания. Материалы и методы. Обследовано 59 пациенток с бактериальным вагинозом. В основной группе А женщины обследовались и лечились совместно с половыми партнерами-мужчинами. Лечение мужчин проводилось клиндамицином местно. В группу сравнения В вошли женщины, лечившиеся без партнера. Все участники исследования подписывали информированное согласие. Все женщины, включенные в исследование, получали одинаковую терапию: на 1 этапе проводилась антибактериальная терапия метронидазолом в таблетках и клиндамицином местно, на втором этапе применялся препарат молочной кислоты местно. Методы обследования мужчин и женщин: микроскопия, ПЦР-тест с детекцией в режиме реального времени и посев отделяемого половых органов. Наблюдение за женщинами с бактериальным вагинозом продолжалось в течение 6 месяцев. Результаты. У мужчин микрофлора наружных половых органов была схожей с их партнершами. С помощью ПЦР-теста чаще всего и у женщин, и у мужчин были обнаружены: Gardnerella vaginalis – у 96% женщин и у 62% мужчин; Prevotella spp. – у 93% женщин и 41% мужчин и Atopobium vaginae – у 79% пациенток и у 48% их половых партнеров. Количество высеваемых бактерий у супружеских пар в основной группе А было аналогично. Чаще всего высевались следующие микроорганизмы: Escherichia сoli, Stahylococcus spp. И Enterococcus faecalis. В основной группе, где лечились оба партнера, у женщин регистрировалась в два раза меньше рецидивов, чем у женщин группы сравнения, лечившихся без партнеров. Заключение. Микрофлора мужских половых органов может быть ответственна за развитие рецидивов бактериального вагиноза у женщин. Лечение мужчин – сексуальных партнеров женщин с бактериальным вагинозом позволяет снизить количество рецидивов данного заболевания и тем самым улучшить результаты лечения.

Aim. To evaluate the genital microbiota of sexual partners of women with bacterial vaginosis and its role in the development of its recurrences. Materials and Methods. We examined 59 consecutive patients with bacterial vaginosis. In the treatment group, sexual partners of the female patients were treated by local delivery of clindamycin; in the comparison group, sexual partners did not receive the drug. All women included in the study received the same therapy: metronidazole per os and local delivery of clindamycin at the stage 1 and local delivery of lactic acid at the stage 2. All patients were examined by microscopy, PCR test, and inoculation of the genital discharge. Monitoring of the female patients with bacterial vaginosis was continued for 6 months. Results. In male patients, genital microbiota was similar to their female partners. Gardnerella vaginalis was detected in 96% of females and 62% of males. Prevotella was identified in 93% of females and 41% of males while Atopobium vaginae was found in 79% of women and 48% of their sexual partners. The amount of bacterial species was similar in males and females of the treatment group. The most frequent microorganisms were Escherichia coli, Staphylococcus spp. and Enterococcus faecalis. Female patients of the treatment group had two-fold lower risk of recurrent bacterial vaginosis than those of the comparison group. Conclusion. Genital microbiota of sexual partners may be responsible for the recurrent bacterial vaginosis in females, and parallel treatment of sexual partners is required to minimize its risk.

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The authors declare that there are no conflicts of interest present.