SOME ASPECTS OF VULVOVAGINITIS CHRONIZATION IN GIRLS WITH URINARY TRACT INFECTIONS
https://doi.org/10.24884/1561-6274-2018-22-5-71-76
Abstract
THE AIM: to evaluate the effectiveness of complex immunomodulatory therapy of vulvovaginitis in preschool children with urinary tract infection (UTI) by studying the features of vaginal microbiocenosis and immune status.
PATIENTS AND METHODS. Prospective controlled randomized study was conducted in 94 girls aged 3-6 years with vulvovaginitis, of which 1 group (n=52) – vulvovaginitis with urinary tract infections; 2 group (n=42) – girls with isolated vulvovaginitis. 2 types of treatment were used: standard treatment and treatment with immunomodulatory drug comprising a recombinant interferon alpha-2b and high-level antioxidants – ascorbic acid and alpha- tocopherol acetate.
RESULTS. Microscopic examination revealed type III vaginal smear in all patients. In 1-st group frequency of Gardnerella vaginalis, Esherichia coli, Сandida albicans isolation increased, in 2-nd group – Staphylococcus epidermidis, Enterococcus faecalis (microbial content more than 105 cfu/ml). In reviewing basic immunogram in girls og 1-st group revealed decrease of total content of CD3+CD8+- lymphocytes (0,82 [0,79;0,99]×109/l vs 1,27 [1,01;1,44]×109/l, p<0,05), CD3-CD16+CD56+-lymphocytes (0,29 [0,26; 0,32] × 109/l vs 0,48 [0,41; 0,5] × 109/l, p<0,05), CD3-CD19+-lymphocytes (0,54 [0,5;0,61] × 109/l vs 0,98 [0,91;1,14] × 109/l in control, p<0,05). After complex treatment in 1-st group decreased microbial colonizations of E.coli from 6,8±0,05×106 to 1,7±0,03×102 cfu/ml, р<0,05; in2-nd group – Staphylococcus epidermidis from 3,6±0,02×106 to 1,5±0,2×102 cfu/ml, р<0,05, and in vaginal smear noted normocenosis.
CONCLUSION. Anti-inflammatory therapy of vulvovaginitis in girls with urinary tract infections, including the use of a complex antiviral immunomodulatory drug containing recombinant interferon α2b and highly active antioxidants – ascorbic acid and alpha tocopherol acetate improves the condition of the vaginal biotope, immune status, reduces the rates of microbial colonization, number of vulvovaginitis relapses.
About the Authors
Yu. Y. Chebotareva
Rostov state medical University
Russian Federation
Russian Federation
Department of obstetrics and gynecology №2
344022, Russia, Rostov-on-don, the lane Nakhichevan, 29
Associate professor Julia Ju. Chebotareva, PhD, DMedSci
Phone: 8-928-100-60-55
H. M. Letifov
Rostov state medical University
Russian Federation
Russian Federation
Department of Pediatrics
344022, Russia, Rostov-on-don, the lane Nakhichevan, 29
Prof. Gadgy Letifov, MD, PhD, DMedSci
Phone: 8-909-438-11-13
Z. A. Kostoeva
GBU “Center of protection of motherhood and childhood”
Rostov state medical University
Russian Federation
Russian Federation
366130. Nazran, Ingushetia
Department of obstetrics and gynecology №2
344022, Russia, Rostov-ondon, the lane Nakhichevan, 29
MD, PhD
Phone: 8-928-096-56-06
References
1. Коколина ВФ. Урогенитальные инфекции детей и подростков. Диагностика и лечение: пособие для врачей. ИД «Медпрактика-М», М., 2014: 92 [Kokolina, V. F. Urogenital infections of children and adolescents. Diagnosis and treatment: manual for doctors /V. F. Kokolina. publishing house «Medpraktika-M», Moscow, 2014: 92]
2. Кохреидзе НА, Кутушева ГФ. Проблемные аспекты диагностики и терепии вульвовагинита у девочек. Репродуктивное здоровье детей и подростков 2013; 2 (49): 30-36 [Kukhreidze NA, Kutusheva GF. Problematic aspects of diagnosis and therapy of vulvovaginitis. Reproductive health of children and adolescents. 2013; 2(49): 30-36]
3. Кохреидзе НА, Кутушева ГФ. Ятрогенные причины затяжного течения вульвовагинита у детей. Репродуктивное здоровье детей и подростков 2015;5 (64): 26- 45 [Kоkhreidze NA, Kutusheva GF. Iatrogenic causes prolonged course of vulvovaginitis in children. Reproductive health of children and adolescents 2015; 5 (64): 26-45]
4. Летифов ГМ, Чеботарева ЮЮ, Костоева ЗА. Особенности комплексного лечения вульвовагинита у девочек-дошкольниц с различными формами пиелонефрита. Нефрология 2017; 21(5): 59-64 [Letifov GM, Chebotarev YY, Kostoyev ZA. Features of complex treatment of candidiasis in girls doshkolnitsa with various forms of pyelonephritis. Nephrology 2017; 21(5): 59-64]
5. Уварова ЕВ, Батырова ЗК, Кумыкова ЗХ и др. Микробиоценоз и локальный иммунитет слизистой оболочки влагалища у девочек в раннем детстве: норма и патология. Доктор Ру 2017;3(132): 59-65. [Uvarova EV, Batyrova ZK, Kumykov ZH etc. the Microbiocenosis and local immunity of the mucous membrane of the vagina in girls in early childhood: norm and pathology. Doctor Ru 2017; 3 (132): 59-65]
6. Паршина ОВ, Мазанкова ЛН, Малиновская ВВ и др. Особенности иммунитета часто болеющих детей: иммунодефицит или транзиторные нарушения? Российский вестник перинатологии и педиатрии 2010; 4: 70-74. [Parshina OV, Mazankova LN, Malinovskaya VV еt al. features of immunity of often ill children: immunodeficiency or transient disorders? Russian journal of Perinatology and Pediatrics 2010; 4: 70-74]
7. Нестерова ИВ. Интерфероны в практике клинициста: лучшие друзья или опасные враги? Аллергология и иммунология 2016; 17 (3): 189-191. [Nesterova IV. Interferons in clinical practice: best friends or dangerous enemies? Allergology and immunology 2016; 17 (3): 189-191]
8. Нестерова ИВ, Ковалева СВ, Чудилова ГА и др. Оптимизация тактики интерфероно- и иммунотерапии в реабилитации иммунокомпрометированных детей с повторными респираторными и герпетическими вирусными инфекциями. Педиатрия 2014; 93(3): 66-72. [Nesterova IV, Kovaleva SV, Chudilova GA and others. Optimization of interferon and immunotherapy tactics in rehabilitation of immunocompromised children with repeated respiratory and herpes viral infections. Pediatrics 2014; 93 (3): 66-72.]
Review
For citations:
Chebotareva Yu.Y., Letifov H.M., Kostoeva Z.A. SOME ASPECTS OF VULVOVAGINITIS CHRONIZATION IN GIRLS WITH URINARY TRACT INFECTIONS. Nephrology (Saint-Petersburg). 2018;22(5):71-76. (In Russ.) https://doi.org/10.24884/1561-6274-2018-22-5-71-76
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