The state of vaginal microbiocenosis of adolescent girls with urinary tract and gastrointestinal diseases

Justification. Changes in the microbiocenosis of the vagina of adolescent girls with diseases of the urinary tract and gastrointestinal tract may be a marker of future diseases of the reproductive system. Currently, more than 20 types of vaginal lactobacilli have been identified, the relationship of which among themselves and with other microorganisms can be a predictor of vulvovaginitis. These issues are relevant and poorly understood among adolescent girls.

The aim of this study. To determine the features of vaginal microbiocenosis and to establish factors preventing the vulvovaginitis in adolescent girls of the hospital sample.

Materials and methods. The analysis of the vaginal microbiocenosis of 60 adolescent girls in a hospital sample with urinary tract and gastrointestinal diseases was performed using microscopic, bacteriological, and molecular genetic research methods (species typing of lactobacilli).

Results. In 53.4 % and 46.6 % of cases of urinary tract and gastrointestinal diseases in adolescent girls had vulvovaginitis, regardless of the reason for hospitalization (p = 0.82). Moderate vulvovaginitis (5–6 points on the ISSVD score) is associated with microorganisms such as Escherichia coli (103–106 CFU/ml) and Staphylococcus aureus (103–104 CFU/ml) and the absence of lactobacilli (OR = 10.4 95% CI [0.90; 120.2], p = 0.03; OR = 7.5, 95% CI [0.61; 91.8], p = 0.18). In adolescent girls without vulvovaginitis, vaginal microbiocenosis is characterized by the dominance of lactobacilli (88.3 %); L. crispatus (46.0 %) and L. gasseri (30.7 %). In adolescent girls with urinary tract diseases, the number of lactobacilli greater than 105 CFU/ml reduces the risk of developing vulvovaginitis by 7.7 times, in adolescent girls with gastrointestinal diseases – by 8.3 times (OR = 0.13, 95% CI [0.03; 0.65] and OR = 0.12, 95% CI [0.02; 0.63]).

Conclusion. Vulvovaginitis is often associated with diseases of the urinary tract and gastrointestinal tract in adolescent girls. The number of lactobacilli exceeding 105 CFU/ml and the dominance of L. crispatus are a significant protective factor against the development of vulvovaginitis (p = 0.002).

1. Veselova EN, et al. The problem of comorbidity in diseases of the gastrointestinal tract in women: solutions. The South Russian Journal of Therapeutic Practice. 2023; 1(4): 40–45. (In Russ.). doi: 10.21886/2712-8156-2023-4-1-40-45

2. Akhmetova MYu, Florensov VV, Leshchenko OYa, Baryaeva OE, Kolesnikova LI. Modern ideas about the biocenosis of the vagina of adolescent girls and its changes. Acta Biomedica Scientifica. 2025; 10(1): 12–24. (In Russ.). doi: 10.29413/ABS.2025-10.1.2

3. Meštrović T, Matijašić M, Perić M, Čipčić Paljetak H, Barešić A, Verbanac D. The role of gut, vaginal, and urinary microbiome in urinary tract infections: from bench to bedside. Diagnostics. 2021; 11(1): 7. doi: 10.3390/diagnostics11010007

4. Sanfilippo JS, Lara-Torre E, Gomez-Lobo V. (Eds.). Sanfilippo’s Textbook of Pediatric and Adolescent Gynecology (2nd ed.). CRC Press, 2019: 358. doi: 10.1201/9781315147659

5. Naboka YuL, Kogan MI, Gudima IA, Mitusova EV, Jalagonia KT, Ivanov SN. Is there a relationship between the microbiota of urine, vagina and intestines in upper urinary tract infection? Bulletin of Urology. 2019; 1(7): 38–45. (In Russ.). doi: 10.21886/2308-6424-2019-7-1-38-45

6. Molchanov OL, Kira EF. The microecosystem of the vagina. Features of normal functioning. Obstetrics and gynecology of St. Petersburg. 2018; 1: 65–68. (In Russ.).

7. Kazakova AV, Uvarova EV, Limareva LV. Inflammatory diseases of the vulva and vagina in girls: prognosis and prevention: monograph. Cheboksary: Sreda, 2020: 184. (In Russ.). doi: 10.31483/a-117

8. Fujimura KE, Sitarik AR, Havstad S, Lin DL, Levan S, Fadrosh D, et al. Neonatal gut microbiota associates with childhood multisensitized atopy and T cell differentiation. Nat Med. 2016; 22: 1187–1191. doi: 10.1038/nm.4176

9. Demkin VV. Species diversity of lactobacilli in the vaginal microbiome: whatever you look at. Molecular genetics, microbiology and virology. 2018; 36(3): 3–12. (In Russ.). doi: 10.17116/molgen2018360313

10. Budilovskaya OV, Shipitsyna EV, Gerasimova EN, et al. Species diversity of vaginal lactobacilli in norm and in dysbiotic states. Journal of Obstetrics and Women’s Diseases. 2017; 66(2): 24–32. (In Russ.). doi: 10.17816/JOWD66224-32

11. Voroshilina ES, Zornikov DL, Boronina LG. Results of determining the species composition of vaginal lactobacilli using real-time PCR testing and bacteriological method. Journal of Microbiology, Epidemiology and Immunobiology. 2018; (4): 17‒21. (In Russ.). doi: 10.36233/0372-9311-2018-4-17-21

12. Fedorova KS, Abramovskikh KA, Savochkina AYu, Minasova AA, Zotova MA, Samatova AI, et al. The state of the vaginal biocenosis depending on the species diversity of lactobacilli. Infection and immunity. 2024; 3(14): 544–550. (In Russ.). doi: 10.15789/2220-7619-TSO-16754

13. Zaitsev AV, et al. The role of violation of the vaginal microbiota in the pathogenesis of recurrent lower urinary tract infection: a modern view of the problem. Obstetrics and gynecology. 2021; 5: 40–46. (In Russ.). doi: 10.18565/aig.2021.5.40-46

14. Malaeva EG. Urinary tract infections and microbiota. Health and environmental issues. 2021; 18(3): 5–14. (In Russ.). doi: 10.51523/2708-6011.2021-18-3-1

15. Clinical guidelines – Urinary tract infection in children – 2024-2025-2026 – Approved by the Ministry of Health of the Russian Federation (In Russ.).

16. Kosova IV, Barseghyan VA, Sinyakova LA, Lukyanov IV, Kolbasov DN. Vaginal dysbiosis as a risk factor for the development of recurrent lower urinary tract infections. Bulletin of Urology. 2023; 1: 34–41. (In Russ.). doi: 10.21886/2308-6424-2023-11-1-34-41

17. Romanitsa AI, Nemchenko UM, Pogodina AV, Grigorova EV, Belkova NL, Voropaeva NM, et al. Associations of clinical manifestations of functional intestinal disorders with characteristics of the microbiota of the colon in adolescents: a pilot study. Acta Biomedica Scientifica. 2021; 2(6): 73–81. (In Russ.). doi: 10.29413/ABS.2021-6.6-2.8

18. Melkozerova OA, Braslavskaya EP, Mikhelson AA, Okulova EO, Avseenko MA. The role of the intestinal and reproductive tract microbiota in the progression and recurrence of genital endometriosis. Russian Journal of Human Reproduction. 2023; 29(4): 6874. (In Russ.). doi: 10.17116/repro20232904168

19. Belmer SV, Razumovsky AYu, Khavkin AI, et al. Diseases of the stomach and duodenum in children. M: Medpraktika, 2017: 536. (In Russ.).

20. Savicheva AM, Moskvicheva VS, Martynova MA; ed. Radzinsky VE. A global view of the microcosm. ISSVD recommendations on vulvovaginitis (2023): Newsletter. Moscow: Editorial Office of the journal StatusPraesens. 2024: 20. (In Russ.).