LAUSR

Dysbacteriosis is characterized by a shift in the microbiota, with a decrease in the amount of lactobacilli accompanied by an increase of anaerobic and/or aerobic bacteria. The infections of the genital tract by aerobic bacteria are associated with aerobic vaginitis (AV), pelvic inflammatory disease, infertility and pregnancy complications, such as chorioamnionitis, premature rupture of membranes and preterm delivery. Universal screening for group B streptococcus (GBS) at 35 to 37 weeks’ gestation is recommended in all pregnant women. Besides this, cervical colonization by aerobic bacteria is an independent and significant factor in the determination of success in assisted reproduction treatments. Dysbacteriosis may also serve to identify groups of patients with an increased risk for a smear with squamous abnormalities. Because of the poor recognition of AV, this condition is often misdiagnosed as bacterial vaginosis (BV). AV and BV may have similar symptoms, such as increased vaginal discharge, a deficiency in lactobacilli and an elevated pH. However, the abnormal microbiota in BV is anaerobic (Gardnerella vaginalis, Mobiluncus sp., Bacteroides sp., Prevotella sp., Peptostreptococcus sp., etc.), while in AV only aerobic enteric bacteria, such as Escherichia coli, Staphylococcus aureus, GBS and enterococci, are recovered. Samples for both conventional cervical cytology and culture of aerobic bacteria were collected from women who underwent annual routine screening. The bacterial microbiota on cervical cytology samples was analyzed in 47 samples with positive culture. For culture, an endocervical swab was taken and immediately placed in Stuart medium. Culture was performed on blood agar, chocolate agar, and MacConkey agar, and incubated at 35–378 for 24–48 hours. VITEK 2 grampositiveGP ID and gram-negative GN ID cards (bioM erieux, Marcy l’ Etoile, France), based on colorimetric detection, were used for identification of bacteria according to the manufacturer’s instructions. The samples for conventional cervical cytology were collected from ectocervix and endocervix with Ayre’s spatula and cytobrush, respectively. The smears were immediately fixed in 95% ethanol and stained by the Papanicolaou method. Individual squamous cells with a layer of coccobacilli along the margins of the cell membranes were considered “clue cells.” Coccobacilli, characterized by small bacilli and cocci organisms, were found both isolated and as microcolonies. Lactobacilli were characterized by the presence of elongated bacillary structures. The smears were analyzed by one pathologist who was blinded to the culture