BACTERIAL VAGINOSIS (literature review)
Relevance. Bacterial vaginosis (BV) is one of the most common vaginal dysbiosis. Many authors offer a variety of ways to treat it, but to date, the issue of BV therapy remains controversial. The main difficulties in the treatment of BV are the frequent occurrence of relapses and the growing antibiotic resistance to drugs used in routine clinical practice. Features of epidemiology, modern aspects of the etiology and pathogenesis of BV. BV most often affects women who are sexually active, between the ages of 20 and 45. Among the factors contributing to the development of BV, there are: genetic predisposition, dietary habits and sexual behavior, race. The presence of BV increases the risk of developing severe sexually transmitted infections, and BV can also be a consequence of another underlying disease or develop in parallel with it. The composition of the vaginal microflora in BV is extremely variable when stained according to Gram, but in 70% of cases, gram - negative flora predominates. The immune response in BV is incompletely consistent with classical concepts of the inflammatory process. Latest known data on BV pathogens and their pathogens. Gardnerella vaginalis, the main causative agent of BV, is highly variable in the composition of genes and virulence factors. This pathogen interacts with other representatives of the vaginal microbiota, such as Mobiluncus spp. and Atopobiumvaginae, which contribute to the multiplication of anaerobic flora and the formation of films. These interactions are discussed in a literature review. Modern concepts of BV diagnostics. The section discusses the methods of laboratory diagnostics used in Russia and abroad. Among all the methods, the test "Florocenosis-Bacterial vaginosis" stands out very favorably, which is easily integrated into the existing and used methods of laboratory diagnostics, has high values of diagnostic sensitivity and diagnostic specificity. Modern tactics of BV treatment. This section examines the effectiveness of treatment methods proposed by both Russian and foreign specialists, compares these methods with standard methods used according to state clinical guidelines. Conclusion. The frequency of vaginal dysbiosis, including the frequency of BV, tends to increase and requires additional attention; in addition, the existing recommendations for the treatment of BV require revision and updating.