Qualitative and quantitative composition of the urogenital tract microbiota in infected miscarriage

Ruhlyada Nikolaj Nikolaevich, Vinnikova Simona Viktorovna, Tsechoyeva Leyla Shihmurzaeva

An infected miscarriage is an interruption of a developing pregnancy, which is characterized by the presence of fever, chills, malaise, lower abdominal pain, blood, sometimes pus-like discharge from the genital tract. This pathology can lead to a violation or loss of reproductive function. In the North-Western district in 2012-2013, 14.3% died from termination of pregnancy before 22 weeks, 16% died from septic complications, and 3.7 – 5.9% died from miscarriage initiated in an out-of-hospital facility. The aim of this work is to study the qualitative and quantitative composition of the urogenital tract microbiota in infected miscarriage using highly informative molecular genetic methods. The study was conducted on the basis of the SP research Institute. Janelidze in women of reproductive age. The main clinical form of infectious miscarriage is endometritis in 88 (63.8%). The study found that absolute pathogens, namely Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, were detected in 36 (26.1%). When examining the vaginal discharge using the "Femoflor 16" method, Gardnerella vaginalis 38% and Atopobium vaginae 36% were found. The content of one or more facultative (family Enterobacteriacea, Streptococcus spp., Staphylococcus spp.) and/or obligate anaerobes (Gardnerella vaginalis, Atopobium vaginae) in a significant titer (>105 CFU) was detected in 54% and 28%. When comparing the results of the study with data from the last five years, there is a tendency to increase the number of opportunistic flora (Gardnerella vaginalis, atopobium vaginae Streptococcus spp., Staphylococcus spp. and others), an increase in the combination of Mycoplasma hominis and Ureaplasma species (5.8%), while reducing the frequency of detection of STI pathogens (Chlamydia trachomatis) or a combination of infections associated with STIs (Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium). Verification of the microbiota allows applying a differentiated approach to prescribing antibacterial therapy before starting treatment, and if necessary, making an adequate change to antimicrobial therapy if it is ineffective.

Keywords:Infected miscarriage, microbiota, urogenital tract, antimicrobial therapy, "Femoflor 16".