Risk factors for recurrence of vulvovaginal infections

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Abstract

Relevance. Currently, inflammatory and non-inflammatory infections of the lower urogenital tract are a serious medical problem and are one of the main reasons for seeking medical help from gynecologists. These infections account for a significant share (from 55 to 80 %) of diseases of the reproductive system. The most common symptoms of vulvovaginal infections (VVI) are discomfort in the genitals, discharge, itching, superficial dyspareunia and unpleasant odor. In addition to the main clinical signs of inflammation, there may be the symptoms of vaginal dysbiosis that occurs without obvious signs of inflammation. Thus, VVI is manifested by a wide range of clinical symptoms and is a collective term for several nosological entities. Conclusion. Despite the existence of various methods for diagnosing and treating VVI, the problem of recurrent vulvovaginal infections, which can lead to various pathological conditions both in the reproductive system and in the psychoemotional and sexual sphere of patients, remains extremely relevant and complex. These diseases require timely detection and effective treatment. Therefore, scientific research aimed at identifying the causes (risk factors) of relapse of the disease is becoming especially relevant today. However, even with the exclusion of general risk factors, the exacerbation of vaginal dysbiosis in patients is often impossible to prevent.

About the authors

Ekaterina V. Kolesnikova

Kuban State Medical University

Email: milka82@list.ru
ORCID iD: 0000-0002-6537-2572
SPIN-code: 3707-3561
Krasnodar, Russian Federation

Lyudmila K. Osipova

Kuban State Medical University

Author for correspondence.
Email: milka82@list.ru
ORCID iD: 0009-0003-0257-6732
Krasnodar, Russian Federation

Alexander V. Zharov

Kuban State Medical University; Regional Clinical Hospital No. 2

Email: milka82@list.ru
ORCID iD: 0000-0002-5460-5959
SPIN-code: 5292-3261
Krasnodar, Russian Federation

References

  1. Strelec IO, Grechkanev GO. Experience of successful combination therapy of frequently recurrent bacterial vaginosis. Medical almanac. 2021;3(68): 66—69 (In Russ.) [Стрелец И.О., Гречканев Г.О. Опыт успешной комбинированной терапии часто рецидивирующего бактериального вагиноза. Медицинский альманах. 2021;3(68): 66—69.]
  2. Bebneva TN, Dyshkovets AA. Vaginal dysbiosis is an interdisciplinary issue. Perspectives from a gynecologist and immunologist. Methods, options, and prospects for addressing. Russian Journal of Woman and Child Health. 2020;3(3): 157—162 (In Russian) doi: 10.32364/2618-8430-2020-3-3-157-162
  3. Thomas-­White K, Navarro P, Wever F, King L, Dillard LR, Krapf J. Psychosocial impact of recurrent urogenital infections: a review. Womens Health (Lond). 2023;19:17455057231216537. doi: 10.1177/17455057231216537
  4. Osipova LK, Kolesnikova EV, Zharov AV, Penzhoyan МA. Obstetric, somatic and infectious risk factors for vulvar lichen sclerosus. RUDN Journal of Medicine. 2024;28(1):86—103. [Осипова Л.К., Колесникова Е.В., Жаров А.В., Пенжоян М.А. Акушерские, соматические и инфекционные факторы риска склеротического лихена вульвы. Вестник Российского университета дружбы народов. Серия: Медицина. 2024;28(1):86—103.] doi: 10.22363/2313-0245-2024-28-1-86-103
  5. Mulinganya G, De Vulder A, Bisimwa G, Boelens J, Claeys G, De Keyser K, De Vos D, Hendwa E, Kampara F, Kujirakwinja Y, Mongane J, Mubalama I, Vaneechoutte M, Callens S, Cools P. Prevalence, risk factors and adverse pregnancy outcomes of second trimester bacterial vaginosis among pregnant women in Bukavu, Democratic Republic of the Congo. PLoS One. 2021;25;16(10): e0257939. doi: 10.1371/journal.pone.0257939
  6. Abramashvili YuG, Kolesnikova NV, Borisova OYu, Guryanova SV. Low molecular weight bioregulator of bacterial origin in condylomatosis therapy optimization. RUDN Journal of Medicine. 2020;24(2):163—167. doi: 10.22363/2313-0245-2020-24-2-163-167
  7. Kozlova AA, Nikolaeva AV, Priputnevich TV, Baranov II, Meshalkina IV. Vaginal microbiome in women during pregnancy and postpartum period: dynamics, its link with the intestinal microflora and its influence on microbiota formation in newborns. Obstetrics and Gynecology: News, Opinions, Training. 2021;9(4):71—8. (In Russian) doi: https://doi.org/10.33029/2303-9698-2021-9-4-71-78
  8. Kolesnikova EV, Zharov AV, Osipova LK, Dupleev AI. Predicting the development of vulvar lichen sclerosus. RUDN Journal of Medicine. 2024;28(1):76—85. (In Russian). doi: 10.22363/2313-0245-2024-28-1-76-85
  9. Verwijs MC, Agaba SK, Darby AC, van de Wijgert JHHM. Impact of oral metronidazole treatment on the vaginal microbiota and correlates of treatment failure. Am J Obstet Gynecol. 2020;222(2):157.e1—157.e13. doi: 10.1016/j.ajog.2019.08.008
  10. Vodstrcil LA, Muzny CA, Plummer EL, Sobel JD, Bradshaw CS. Bacterial vaginosis: drivers of recurrence and challenges and opportunities in partner treatment. BMC Med. 2021;19(1):194. doi: 10.1186/s12916-021-02077-3
  11. Dikke GB. Bacterial vaginosis: novel aspects of etiology, pathogenesis, and selection of therapeutic strategy. Russian Journal of Woman and Child Health. 2019;2(4):307—313 (In Russian) doi: 10.32364/2618-8430-2019-2-4-307-313
  12. Ma X, Wu M, Wang C, Li H, Fan A, Wang Y, Han C, Xue F. The pathogenesis of prevalent aerobic bacteria in aerobic vaginitis and adverse pregnancy outcomes: a narrative review. Reprod Health. 2022;19(1):21. doi: 10.1186/s12978-021-01292-8
  13. Barrientos-­Durán A, Fuentes-­López A, de Salazar A, Plaza-­Díaz J, García F. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis. Nutrients. 2020;12(2):419. doi: 10.3390/nu12020419
  14. Cooke G, Watson C, Deckx L, Pirotta M, Smith J, van Driel ML. Treatment for recurrent vulvovaginal candidiasis (thrush). Cochrane Database Syst Rev. 2022;1(1): CD009151. doi: 10.1002/14651858.CD009151.pub2
  15. Ivanova EA, Radzinsky VE, Makarov AV. Recurrent bacterial vaginosis: etiology, pathogenesis, diagnosis, treatment. M.: “GEOTAR-Media”, 2018. 256 p. (In Russian).
  16. Lokken EM, Balkus JE, Kiarie J, Hughes JP, Jaoko W, Totten PA, McClelland RS, Manhart LE. Association of Recent Bacterial Vaginosis With Acquisition of Mycoplasma genitalium. Am J Epidemiol. 2017;186(2):194—201.
  17. Tamarelle J, Thiébaut ACM, de Barbeyrac B, Bébéar C, Ravel J, Delarocque-­Astagneau E. The vaginal microbiota and its association with human papillomavirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections: a systematic review and meta-analysis. Clin Microbiol Infect. 2019;25(1):35—47. doi: 10.1016/j.cmi.2018.04.019
  18. Norenhag J, Du J, Olovsson M, Verstraelen H, Engstrand L, Brusselaers N. The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta-analysis. BJOG. 2020;127(2):171—180. doi: 10.1111/1471-0528.15854
  19. Kira EF, Yatsyshina SA, Dyakonov SA. Microbial secrets. Status Praesens. Gynecology, obstetrics, infertile marriage. 2020;4(69):70—75. (In Russian).
  20. Vodstrcil LA, Muzny CA, Plummer EL, Sobel JD, Bradshaw CS. Bacterial vaginosis: drivers of recurrence and challenges and opportunities in partner treatment. BMC Med. 2021;19(1):194. doi: 10.1186/s12916-021-02077-3
  21. Guryanova SV. Immunomodulation, Bioavailability and Safety of Bacteriocins. Life. 2023;13:1521. doi: https://doi.org/10.3390/life13071521
  22. Guryanova SV. Regulation of Immune Homeostasis via Muramyl Peptides-­Low Molecular Weight Bioregulators of Bacterial Origin. Microorganisms. 2022;10(8):1526. doi: https://doi.org/10.3390/microorganisms10081526
  23. Guryanova SV, Gigani OB, Gudima GO, Kataeva AM, Kolesnikova NV. Dual Effect of Low Molecular Weight Bioregulators of Bacterial Origin in Experimental Model of Asthma. Life. 2022;12:192. doi: https://doi.org/10.3390/life12020192
  24. Nikolaeva AV, Kozlova AA, Baranov II, Priputnevich TV. Current understanding of the relationship between gut and vaginal microbiotas. Obstetrics and Gynecology. 2021;9:5—11. (In Russian). doi: 10.18565/aig.2021.9.5‑ll
  25. Bezmenko AA, Sadovaya ND. Vaginal and intestinal microbiocenosis composition in pregnant women. Journal of obstetrics and women’s diseases. 2019; 68(6): 29—36. (In Russian). doi: 10.17816/JOWD68629-36
  26. Salazar AS, Nogueira NF, Rodriguez VJ, Mantero A, Cherenack EM, Raccamarich P, Maddalon M, Brophy T, Montgomerie E, Klatt NR, Jones DL, Alcaide ML. A Syndemic Approach to Explore Factors Associated with Bacterial Vaginosis. AIDS Behav. 2022;26(9):3110—3118. doi: 10.1007/s10461-022-03634-4
  27. Nakama C, Thompson B, Szybala C, McBeth A, Dobner P, Zwickey H. The Continuum of Microbial Ecosystems along the Female Reproductive Tract: Implications for Health and Fertility. Pathogens. 2022;11(11):1244. doi: 10.3390/pathogens11111244
  28. Kolde R, Franzosa EA, Rahnavard G, Hall AB, Vlamakis H, Stevens C, Daly MJ, Xavier RJ, Huttenhower C. Host genetic variation and its microbiome interactions within the Human Microbiome Project. Genome Med. 2018;10(1):6. doi: 10.1186/s13073-018-0515-8
  29. Beamer MA, Austin MN, Avolia HA, Meyn LA, Bunge KE, Hillier SL. Bacterial species colonizing the vagina of healthy women are not associated with race. Anaerobe. 2017;45:40—43. doi: 10.1016/j.anaerobe.2017.02.020
  30. Mutli E, Mändar R, Koort K, Salumets A, Team EBR, Laisk T. Genome-wide association study in Estonia reveals importance of vaginal epithelium associated genes in case of recurrent vaginitis. J Reprod Immunol. 2024;162:104216. doi: 10.1016/j.jri.2024.104216
  31. Murphy K, Keller M, Anastos K. Impact of reproductive aging on the vaginal microbiome and soluble immune mediators in women living with and at-risk for HIV infection. PLoS ONE. 2019;14: e0216049. doi: https://doi.org/10.1371/journal.pone.0216049
  32. Bastianelli C, Farris M, Bianchi P. The effect of different contraceptive methods on the vaginal microbiome. Expert Review of Clinical Pharmacology. 2021;14(7):1—16. doi: https://doi.org/10.1080/17512433.2021.1917373
  33. Sobel JD, Kaur N, Woznicki NA, Boikov D, Aguin T, Gill G, Akins RA. Conventional oral and secondary high dose vaginal metronidazole therapy for recurrent bacterial vaginosis: clinical outcomes, impacts of sex and menses. Infect Drug Resist. 2019;12:2297—2307. doi: 10.2147/IDR.S213853
  34. Song SD, Acharya KD, Zhu JE, Deveney CM, Walther-­Antonio MRS, Tetel MJ, Chia N. Daily Vaginal Microbiota Fluctuations Associated with Natural Hormonal Cycle, Contraceptives, Diet, and Exercise. mSphere. 2020;5(4): e00593—20. doi: 10.1128/mSphere.00593-20
  35. Chen Y, Hong Z, Wang W, Gu L, Gao H, Qiu L, Di W. Association between the vaginal microbiome and high-risk human papillomavirus infection in pregnant Chinese women. BMC Infect Dis. 2019;19(1):677. doi: 10.1186/s12879-019-4279-6
  36. Donders G, Bellen G, Janssens D, Van Bulck B. Hinoul P, Verguts J. Influence of contraceptive choice on vaginal bacterial and fungal microflora. Eur J Clin Microbiol Infect Dis. 2017;36(1):43—48. doi: 10.1007/s10096-016-2768-8
  37. Balle C, Konstantinus IN, Jaumdally SZ, Havyarimana E, Lennard K, Esra R, Barnabas SL, Happel AU, Moodie Z, Gill K, Pidwell T, Karaoz U, Brodie E, Maseko V, Gamieldien H, Bosinger SE, Myer L, Bekker LG, Passmore JS, Jaspan HB. Hormonal contraception alters vaginal microbiota and cytokines in South African adolescents in a randomized trial. Nat Commun. 2020;11(1):5578. doi: 10.1038/s41467-020-19382-9
  38. Jin C, Qin L, Liu Z, Li X, Gao X, Cao Y, Zhao S, Wang J, Han T, Yan L, Song J, Zhang F, Liu F, Zhang Y, Huang Y, Song Y, Liu Y, Yao Z, Chen H, Zhang Z, Zhao S, Feng Y, Zhang YN, Qian Y, Sun T, Feng Q, Zhao H. Comparative analysis of the vaginal microbiome of healthy and polycystic ovary syndrome women: a large cross-­sectional study. Reprod Biomed Online. 2023;46(6):1005—1016. doi: 10.1016/j.rbmo.2023.02.002
  39. Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of Bacterial Vaginosis and Associated Risk Factors among Women Complaining of Genital Tract Infection. Int J Microbiol. 2017;2017:4919404. doi: 10.1155/2017/4919404
  40. Misselwitz B, Butter M. Verbeke K, Fox MR. Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management. Gut. 2019;68:2080—2091. doi: 10.1136/gutjnl‑2019-318404
  41. Olson KM, Boohaker LJ, Schwebke JR, Aslibekyan S, Muzny CA. Comparisons of vaginal flora patterns among sexual behaviour groups of women: implications for the pathogenesis of bacterial vaginosis. Sex Health. 2018;15(1):61—67. doi: 10.1071/SH17087
  42. Nelson TM, Borgogna JC., Michalek RD., Roberts DW, Rath JM, Glover ED, Ravel J, Shardell MD, Yeoman CJ, Brotman RM. Cigarette smoking is associated with an altered vaginal tract metabolomic profile. Sci. Rep. 2018;8:852. doi: 0.1038/s41598-017-14943-3
  43. Amabebe E, Anumba DOC. Psychosocial stress, cortisol levels, and maintenance of vaginal health. Front. Endocrinol. 2018;9:568. doi: 10.3389/fendo.2018.00568
  44. Nansel TR, Riggs MA., Yu KF, Andrews WW, Schwebke JR, Klebanoff MA. The association of psychosocial stress and bacterial vaginosis in a longitudinal cohort. Am J Obstet Gynecol. 2006;194(2):381—6. doi: 10.1016/j.ajog.2005.07.047
  45. Tamarelle J, Creze M M, Savathdy V, Phonekeo S, Wallenborn J, Siengsounthone L, Fink G, Odermatt P, Kounnavong S, Sayasone S, Vonaesch P. Dynamics and consequences of nutrition-­related microbial dysbiosis in early life: study protocol of the VITERBI GUT project. Front Nutr. 2023;10:1111478. doi: 10.3389/fnut.2023.1111478
  46. Rosen EM, Martin CL, Siega-­Riz AM, Dole N, Basta PV, Serrano M, Fettweis J, Wu M, Sun S, Thorp JM, Jr, Buck G, Fodor AA., Engel SM. Is prenatal diet associated with the composition of the vaginal microbiome? Paediatr Perinat Epidemiol. 2022;36(2):243—253. doi: 10.1111/ppe.12830
  47. Dunlop AL, Jordan SL, Ferranti EP, Hill CC, Patel S, Hao L, Corwin EJ, Tangpricha V. Total and Free 25-Hydroxy-­Vitamin D and Bacterial Vaginosis in Pregnant African American Women. Infect Dis Obstet Gynecol. 2019;2019:9426795. doi: 10.1155/2019/9426795
  48. Mojtahedi SF, Mohammadzadeh A, Mohammadzadeh F, Jalili Shahri J, Bahri N. Association between bacterial vaginosis and 25-Hydroxy vitamin D: a case-control study. BMC Infect Dis. 2023;23(1):208. doi: 10.1186/s12879-023-08120-3
  49. Thoma ME, Klebanoff MA, Rovner AJ, Nansel TR, Neggers Y, Andrews WW, Schwebke JR. Bacterial vaginosis is associated with variation in dietary indices. J. Nutr. 2011;141:1698—1704. doi: 10.3945/jn.111.140541
  50. Kurowska K, Kobylińska M, Antosik K. Folic acid — importance for human health and its role in COVID‑19 therapy. Rocz Panstw Zakl Hig. 2023;74(2):131—141. doi: 10.32394/rpzh.2023.0252
  51. Uribe-­Diaz S, Nazeer N, Jaime J, Vargas-­Bermúdez DS. Yitbarek A, Ahmed M, Rodríguez-­Lecompte JC. Folic acid enhances proinflammatory and antiviral molecular pathways in chicken B-lymphocytes infected with a mild infectious bursal disease virus. Br Poult Sci. 2022;63(1):1—13. doi: 10.1080/00071668.2021.1958298
  52. Neggers YH, Nansel TR, Andrews WW, Schwebke JR, Yu KF, Goldenberg RL, Klebanoff MA. Dietary intake of selected nutrients affects bacterial vaginosis in women. J Nutr. 2007;137(9):2128—2133. doi: 10.1093/jn/137.9.2128
  53. Cui TT, Luo J, Deng RL, Yang YT, Yin YW, Chen XF, Chen HK, Liao WZ, Huang ZM, Deng XY, Guo XG. Negative associations between folate and bacterial vaginosis in the NHANES 2001 to 2004. BMC Infect Dis. 2023;23(1):483. doi: 10.1186/s12879-023-08318-5
  54. Golonka R, Yeoh BS, Vijay-­Kumar M. The Iron Tug-of-­War between Bacterial Siderophores and Innate Immunity. J Innate Immun. 2019;11(3):249—262. doi: 10.1159/000494627
  55. Yadav R, Noinaj N, Ostan N, Moraes T, Stoudenmire J, Maurakis S, Cornelissen C.N. Structural Basis for Evasion of Nutritional Immunity by the Pathogenic Neisseriae. Front Microbiol. 2020;10:2981. doi: 10.3389/fmicb.2019.02981
  56. Akinbosede D, Chizea R, Hare SA. Pirates of the haemoglobin. Microb Cell. 2022;9(4):84—102. doi: 10.15698/mic2022.04.775
  57. Zhang Y, Sen S, Giedroc DP. Iron Acquisition by Bacterial Pathogens: Beyond Tris-­Catecholate Complexes. Chembiochem. 2020;21(14):1955—1967. doi: 10.1002/cbic.201900778
  58. Perálvarez-­Marín A, Baranowski E, Bierge P, Pich OQ, Lebrette H. Metal utilization in genome-­reduced bacteria: Do human mycoplasmas rely on iron? Comput Struct Biotechnol J. 2021;19:5752—5761. doi: 10.1016/j.csbj.2021.10.022
  59. Soriano-­Lerma A, García-­Burgos M, Alférez MJM, Pérez-­Carrasco V, Sanchez-­Martin V, Linde-­Rodríguez Á, Ortiz-­González M, Soriano M, García-­Salcedo JA, López-­Aliaga I. Gut microbiome-­short-chain fatty acids interplay in the context of iron deficiency anaemia. Eur J Nutr. 2022;61(1):399—412. doi: 10.1007/s00394-021-02645-6
  60. Verstraelen H, Delanghe J, Roelens K, Blot S, Claeys G, Temmerman M. Subclinical iron deficiency is a strong predictor of bacterial vaginosis in early pregnancy. BMC Infect Dis. 2005;5:55. doi: 10.1186/1471-2334-5-55

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