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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">actabiomedica</journal-id><journal-title-group><journal-title xml:lang="ru">Acta Biomedica Scientifica</journal-title><trans-title-group xml:lang="en"><trans-title>Acta Biomedica Scientifica</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2541-9420</issn><issn pub-type="epub">2587-9596</issn><publisher><publisher-name>Scientific Centre for Family Health and Human Reproduction Problems</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.29413/ABS.2021-6.3.2</article-id><article-id custom-type="elpub" pub-id-type="custom">actabiomedica-2842</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АКУШЕРСТВО И ГИНЕКОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OBSTETRICS AND GYNAECOLOGY</subject></subj-group></article-categories><title-group><article-title>Микроорганизмы, ассоциированные с бактериальным вагинозом: разнообразие и клинико-диагностическое значение</article-title><trans-title-group xml:lang="en"><trans-title>Microorganisms associated with bacterial vaginosis: diversity and clinical and diagnostic significance</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7026-2522</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Воропаева</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Voropaeva</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p> младший научный сотрудник лаборатории микробиома и микроэкологии </p><p> 664003, г. Иркутск, ул. Тимирязева, 16, Россия </p></bio><bio xml:lang="en"><p> Junior Research Officer at the Laboratory of microecology and the microbiome </p><p> Timiryazev str. 16, 663004, Irkutsk, Russian Federation </p></bio><email xlink:type="simple">n.m.shabanova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9720-068X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белькова</surname><given-names>Н. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Belkova</surname><given-names>N. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат биологических наук, доцент, ведущий научный сотрудник, заведующий лабораторией микробиома и микроэкологии</p><p> 664003, г. Иркутск, ул. Тимирязева, 16, Россия </p></bio><bio xml:lang="en"><p> Cand.Sc. (Biol), Associate Professor, leading researcher at the Laboratory of microecology and the microbiome </p><p> Timiryazev str. 16, 663004, Irkutsk, Russian Federation </p></bio><email xlink:type="simple">nlbelkova@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7656-342X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Немченко</surname><given-names>У. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Nemchenko</surname><given-names>J. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат биологических наук, научный сотрудник лаборатории микробиома и микроэкологии</p><p> 664003, г. Иркутск, ул. Тимирязева, 16, Россия </p></bio><bio xml:lang="en"><p> Cand.Sc. (Biol), Researcher at the Laboratory for microecology and the microbiome </p><p> Timiryazev str. 16, 663004, Irkutsk, Russian Federation </p></bio><email xlink:type="simple">umnemch@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6588-2591</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Григорова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Grigorova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат биологических наук, научный сотрудник лаборатории микробиома и микроэкологии </p><p> 664003, г. Иркутск, ул. Тимирязева, 16, Россия </p></bio><bio xml:lang="en"><p> Cand. Sc. (Biol), Researcher at the laboratory for microecology and the microbiome  </p><p> Timiryazev str. 16, 663004, Irkutsk, Russian Federation </p></bio><email xlink:type="simple">buxarowa.ekaterina@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8862-5771</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Данусевич</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Danusevich</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p> доктор медицинских наук, старший научный сотрудник лаборатории гинекологической эндокринологии</p><p> тел.: (3952) 20-73-67, факс (3952) 20-76-36</p><p> 664003, г. Иркутск, ул. Тимирязева, 16, Россия </p></bio><bio xml:lang="en"><p> Dr Sc (Med), Senior Research Officer at the Laboratory of Gynecological Endocrinology</p><p>tel.: (3952) 20-73-67, fax: (3952) 20-76-36 </p><p> Timiryazev str. 16, 663004, Irkutsk, Russian Federation </p></bio><email xlink:type="simple">iphr@sbamsr.irk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научный центр проблем здоровья семьи и  репродукции человека»</institution></aff><aff xml:lang="en"><institution>Federal State Public Scientific Institution Scientific Centre for Family Health&#13;
and Human Reproduction Problems</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>11</day><month>08</month><year>2021</year></pub-date><volume>6</volume><issue>3</issue><fpage>17</fpage><lpage>30</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Воропаева Н.М., Белькова Н.Л., Немченко У.М., Григорова Е.В., Данусевич И.Н., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Воропаева Н.М., Белькова Н.Л., Немченко У.М., Григорова Е.В., Данусевич И.Н.</copyright-holder><copyright-holder xml:lang="en">Voropaeva N.M., Belkova N.L., Nemchenko J.M., Grigorova E.V., Danusevich I.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.actabiomedica.ru/jour/article/view/2842">https://www.actabiomedica.ru/jour/article/view/2842</self-uri><abstract><p> Бактериальный вагиноз (БВ) является наиболее распространенным инфекционным невоспалительным  заболеванием женщин репродуктивного возраста.  Ключевая особенность БВ заключается в том, что при  отсутствии специфичного возбудителя заболевание  развивается на фоне дисбиоза влагалищного биотопа. По мнению ряда авторов, изначально, основная роль в патогенезе БВ отводилась виду G. vaginalis. Однако  использование молекулярных методов позволило  существенно расширить спектр микроорганизмов, обнаруживаемых у женщин с БВ, и определить Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Prevotella spp. как первичных возбудителей БВ. Ряд исследований  подтвердили половой путь передачи возбудителей БВ, при этом значимыми факторами риска для эпизодического БВ является новый сексуальный партнер, а для  рецидивирующего – сексуальный контакт с тем же  партнером без использования барьерных методов  контрацепции. При этом БВ-ассоциированные бактерии редко существуют в виде планктонных форм одного вида, чаще – процветают в сложных полимикробных сообществах, окруженных внеклеточным матриксом, так  называемых биопленках. У пациенток с БВ, биопленки выявляются в 90% наблюдений. G. vaginalis и Prevotella bivia  широко распространены у женщин с БВ и являясь  первичными колонизаторами создают бактериальную  биопленку, к которой впоследствии могут присоединяться вторичные колонизаторы, включая A. vaginae, Sneathia spp. и потенциально другие BVAB. Резистентность бактерий в  биопленке к антимикробным препаратам в 1000 раз выше, чем у планктонных форм, что может приводить к хронизации инфекционного процесса и торпидному течению заболевания.Целью данного обзора явился анализ современных  исследований по вопросам распространенности,  характеристикам условно-патогенных микроорганизмов,  ассоциированных с БВ, представить их клинико- диагностическое значение и роль в патогенезе  заболевания.  </p></abstract><trans-abstract xml:lang="en"><p> Bacterial vaginosis (BV) is the most common infectious non-inflammatory disease in women of reproductive age. The key feature of BV is that in the  absence of a specific pathogen, the disease develops against the background of vaginal biotope dysbiosis. According to the opinion of some authors, initially, the main role of BV in the pathogenesis was assigned to the species G. vaginalis. However, using of molecular methods made it possible to significantly expand the range of microorganisms found in women with BV, and to identify Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Prevotella spp. as the primary causative agents of BV. A number of studies have confirmed the sexual transmission of BV pathogens, with a new sexual partner being significant risk factors for episodic BV, and sexual contact with the same partner without using barrier methods of contraception for recurrent BV. At the same time, BV-associated bacterias  rarely exist as planktonic forms of one species, more often, they thrive in complex polymicrobial communities surrounded by an extracellular matrix, the so-called biofilms. In patients with BV, biofilms are detected in 90% of cases. G. vaginalis and Prevotella bivia are widespread in women with BV and, being the primary colonizers, create a bacterial biofilm, to which secondary colonizers can subsequently join, including A. vaginae, Sneathia spp. and potentially other BVABs. The resistance of bacterias in the biofilm to antimicrobial drugs is 1000 times higher than of planktonic forms, which can lead to chronicity of the infectious process and torpid course of the disease.The aim of this review was analyzing of modern studies on the prevalence, characteristics of opportunistic microorganisms associated with BV, to present their clinical and diagnostic significance and role in the pathogenesis of  diseases. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>бактериальный вагиноз</kwd><kwd>полимикробная инфекция</kwd><kwd>Gardnerella vaginalis</kwd><kwd>Atopobium vaginae</kwd><kwd>Mobiluncus spp.</kwd><kwd>Prevotella spp.</kwd><kwd>бактериальные биопленки</kwd></kwd-group><kwd-group xml:lang="en"><kwd>bacterial vaginosis</kwd><kwd>polymicrobial infection</kwd><kwd>Gardnerella vaginalis</kwd><kwd>Atopobium vaginae</kwd><kwd>Mobiluncus spp.</kwd><kwd>Prevotella spp.</kwd><kwd>bacterial biofilms</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин (Издание 2-е, исправленное и дополненное). 2019. 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