ORIGINAL RESEARCH

Normal vaginal microbiota: patient’s subjective evaluation, physical examination and laboratory tests

About authors

1 Department of Microbiology, Virology and Immunology, Faculty of Preventive Medicine,
Ural State Medical University, Yekaterinburg, Russia

2 Harmony Medical and Pharmaceutical Center, Yekaterinburg, Russia

3 Department of Obstetrics and Gynecology, Faculty of Medicine and Healthcare,
Ural State Medical University, Yekaterinburg, Russia

Correspondence should be addressed: Еkaterina S. Voroshilina
ul. Furmanova, d. 30, Yekaterinburg, Russia, 620142; moc.liamg@anilihsorov

About paper

Acknowledgements: the authors wish to thank Director of Harmony Medical and Pharmaceutical Center, Yekaterinburg, for the opportunity to conduct the study at the facilities of the Center.

Contribution of the authors to this work: Voroshilina ES and Zornikov DL — analysis of literature, research planning, data collection, analysis, and interpretation, drafting of a manuscript; Plotko EE — data analysis and interpretation, drafting of a manuscript. All authors participated in editing of the manuscript.

Received: 2017-04-11 Accepted: 2017-04-20 Published online: 2017-05-31
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Criteria of normality for the vaginal microbiota of healthy women are still a subject of discussion. A decision to assign a study participant to a group of healthy individuals is quite subjective if based on the absence of complaints and physical examination only, which renders study results ambiguous. Below we compare occurrence of the normal vaginal flora and vaginal dysbiosis in women divided into 3 groups according to the examination type (patient’s subjective evaluation of her condition, physical examination, and laboratory tests). We examined 234 women of reproductive age from Yekaterinburg (mean age was 30.3 ± 6.6 years). Microbiota composition and lactobacillus diversity (L. crispatus, L. iners, L. jensenii, L. gasseri, L. johnsonii, L. vaginalis) were evaluated by real-time polymerase chain reaction using the Femoflor assay and reagent kits by DNA-Technology, Russia. One in 5 women of reproductive age who had no health complaints was found to have dysbiosis. The normal microbiota of those women was dominated mostly by L.iners, while dominant L. crispatus were observed in every third participant. Prevailing L. crispatus were also found in the normal microbiota of 46.2 % of women who were considered healthy based on the doctor’s examination and laboratory tests. Thus, clinical evaluation of the female lower reproductive tract can be compromised by doctor’s subjectivity if not supported by laboratory tests and may overlook vaginal dysbiosis in the patient.

Keywords: vaginal microbiota, vaginal lactobacilli, Lactobacillus iners, Lactobacillus gasseri, Lactobacillus crispatus, normal vaginal flora, dysbiosis

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