VaginistisEtiología, diagnóstico y profilasis

  1. Martín Villena, María José 1
  2. Morales Hernández, María Encarnación 1
  3. Clares Naveros, Beatriz 1
  4. Ruiz Martínez, María Adolfina 1
  1. 1 Universidad de Granada
    info

    Universidad de Granada

    Granada, España

    ROR https://ror.org/04njjy449

Revista:
Ars pharmaceutica

ISSN: 2340-9894 0004-2927

Año de publicación: 2012

Volumen: 53

Número: 4

Páginas: 32-40

Tipo: Artículo

Otras publicaciones en: Ars pharmaceutica

Resumen

La vaginitis es uno de los problemas ginecológicos más frecuentes, diagnosticado por los médicos de atención primaria. En este artículo hemos querido recoger los diferentes tipos de vaginitis, así como la sintomatología que los caracteriza y los posibles tratamientos farmacológicos. Sin embargo, la presencia de episodios recurrentes y la aparición de reacciones adversas por la reexposición a antibióticos ponen de manifiesto la necesidad de una alternativa terapéutica. Numerosos estudios sugieren la utilización de probióticos para el tratamiento de esta patología basándose en la capacidad reguladora que estos tienen sobre la microbiota vaginal, y que se caracterizada por la habilidad que tienen para mantener un pH vaginal ≤ 4,5, la producción de biosurfactantes y el bloqueo de la adhesión de los uropatogenos. El hecho de que la colonización del tracto genitourinario sea más rápida al administrar los probióticos por vía vaginal que por vía oral sugiere que la administración de estos por dicha vía podría ser muy ventajosa.

Referencias bibliográficas

  • Amsel A, Totten PA, Spiegel Cam Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Mede. 1998; 74:14-22.
  • Aroutcheva A, Gariti D, Simon M, et al. Defense factors of vaginal Lactobacilli. Am J Obstet Gynecol. 2001; 185:375-9.
  • Austin MN, Beigi RH, Meyn LA, Hillier SL. Microbiologic response to trearment of bacterial vaginois with topical clindamycin or metronidazole. J Clin Microbiol. 2005; 43:4492-7.
  • Beigi RH, Austin MN, Meyn LA, Krohn MA, Hilleir SL. Antimicrobial resistnace associated with the treatment of bacterial vaginosis. Am J Obstet Gynecol. 2004; 191:1124- 9.
  • Beigi RH, Meyn LA, Moore DM, Krohn MA, Hillier SL. Vaginal yeast colonization in nonpreganant women: a longitudinal study. Obstet Gynecol. 2004; 104:926-30.
  • Bornstein j, Lakovsky Y, Lavi I, Bar- AM A, Abramocici H. The classis approach to diagnosis of vulvovaginitis: a critical analysis. Infect Dis Obstet Gynecol. 2001; 105-11.
  • Brown HL, Fuller DD, Jasper LT, Davs TE, Wright JD. Clinical evaluation of Affirm VPIII in the detection and identification of Trichomonas Vaginalis, Gardnerella vaginalis, and Candida species in vaginitis/vaginosis. Infect Dis Obstet Gynecol. 2004:10-7.
  • Burtin P, Taddio A, Einarson TR, Koren G. Safety of metronidazole in pregnancy: a meta-analysis. Am J Obstet Gynecol. 1995; 172:525-9.
  • Cadiex P, Burton J, Gardiner G, et al. Lactobacillus strains and vaginal ecology. JAMA. 2002; 287:1940-1.
  • Eschenbach DA. Chronic vulvovaginal candidiasis. N Engl J Med. 2004; 351:851-2.
  • Fiscella K, Klebanoff MA. Are racial Differences in vaginal pH explained by vaginal flora? Am J Obstet Gynecol. 2004; 191:747-50.
  • Forsum U, Holst E, Larsson PG, et al. Bacterial vaginosis a microbiological and immunological enigma. APMIS. 2005; 113:543-52.
  • Gardiner GE, Heinemann C, Bruce AW, et al. Persistence of Lactobacillus fermentum RC-14 and Lactobacillus rhamnosus GR-1 but not L. Rhamnosus GG in the human vagina as demonstrated by randomly amplified polymorphic DNA. Clin Diagn Lab Immunol. 2002; 9:92-6.
  • Gutman RE, Peipert JF, Weitzen S, Blume J. Evaluation of clinical methods for diagnosing bacterial vaginosis. Obstet Gynecol. 2005; 105:551-6.
  • Hammill HA. Normal vaginal flora in relation to vaginitis. Obstet Gynecol Clin North Am. 1989; 16:329-336.
  • Hilton E, Isenberg HD, Alperstein P, Borenstein MT. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxix for cnadidal vaginitis. Ann Intern Med. 1992; 116:353-7.
  • Kane KY, Pierce R. What are the most effective treatments for bacterial vaginosis in nonpregnant women? J Fam Pract. 2001; 50:339-400.
  • Klebanoff MA, Carely JC, Hauth JC, Hillier SL, Nugent RP, Thom EA, et al. Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic trichomonas vaginalis infection. N Eng J Med. 2001; 345:487-93.
  • Kloumans EH, Markowitz LE, Hogan V. Indications for therapy and treatment recommendations for bacterial vaginosis in nonpregnant and pregnant women: a Synthesis of data. Clin Infect Dis. 2002; 35:5152-72.
  • Mardh PA. The vaginal ecosystem. Am j Obstet Gynecol. 1991; 165:1163-8.
  • Martin Quan, MD. Vaginitis: Meeting the clinical Challenge. Clinical Cornerstone. 2000; 3:36-47.
  • Mastromarino P, Brigidi P, Macchia A, et al. Characterizaion and selection of vaginal lactobacillus strains for the preraprrion of vaginal trablets. J Appl microbial. 2002; 93:884-93.
  • McCue JD. Evaluation and management of vaginitis. An update for primary care practitioners. Arch Intern Med. 1989; 149:565-8.
  • Mclean NW, Rosenstein IJ. Characterization and selection of Lactobacillus species to re-colonise the vaginal of women with recurrent bacterial vaginoisi. J Med Microbiol. 2000; 49:543-52.
  • Morelli L, Zonenenschain , Del Piano M, Cognein p. Utilization of the intestinal trat as a delivery system for urogenital probiotics. J Clin Gastroenterol. 2004; 38:S107-S110.
  • Ness RB, Hillier SL, Kip KE, Soper DE, Stamm CA, McGrefor JA, et al. Bacterial vaginosis and risk of pelvic inflammatory disease. Obstet Gynecol. 2004; 104:761-9.
  • Nishijima K, Shukunami K, Kotsuji F. Natural history of bacterial vaginosis and intermediate flora in pregnancy and effect of oral clindamycin. Obstet Gynecol. 2004; 104:1106-07.
  • Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician. 2004; 70:2125-32, 2139-40.
  • Peeters M, Piot P. Adhesion of Gardnerella vaginalis to vaginal epithelial cells: variables affecting adhesion and inhibiotion by metronidazole. Genitourin Med. 1985; 61:391-5.
  • Reid G, Beurman D, Heinemann C Bruce AW. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol Med Microbiol. 2001; 185:375-9.
  • Reid G, Burton J. Use of Lactobacillus to prevent infection by pathogenic bacteria. Microbes Infec. 2002; 4:319-24.
  • Reid G, Charbonneau D, Erb J, et al. Oral use of Lactobacillus rhamnosus GR-1 and L. Fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol. 2003; 35:131-4.
  • Riggs MA, Klebanoff MA. Treatrment of vaginal infections to prevent preterm birth: a meta-analysis. Clin Obstet Gynecol. 2004; 47:796-807.
  • Sanchez S, Garcia PJ, Thomas KK, Catlin M, Holmes KK. Intravagianl metronidazole gel versus metronidasole plus nystatin ovules for bacterial vaginosis: a randomized controlled trail. Am J Obstet Gynecol. 2004; 191:1898-1906.
  • Scahff VM, Perez-Stable E, Borchart K. The limited value of Symptoms and sings in the diagnosis of vaginal infections. Arch Intern Med. 1990; 150:1929-33.
  • Sch webke JR, Desmond RA, Oh MK. Predictors of bacterial vaginosis in adolescent women who douche. Sex Transm Dis. 2004; 31:443-6.
  • Sexually transmitted diseases treatment guidelines 2010. Centers for Diseae Control and Prevention. MMWR Recomm Rep 2010; 55(RR-12):1-110. Disponible en: http://www.cdc.gov.
  • Skarin A, Sylwan F. Vaginal lactobacilli inhibiting growth of gardnerella vagianlis, Mobiluncus and other bacterial species cultures grom vaginal constent of women with bacterial vaginosis. Acta Pathol Microbiol Immunol Scand. 1986; 94:399-403.
  • Sobel JD. What´s new in bacterial vaginosis and trichomonas? Infect Dis Clin N Am. 2005:387-406.
  • Soper DE. Taking the guesswork out of diagnosing and managing vaginitis. Contemporary OB/ GYN. 2005; 50:32-9.
  • Swygard H, Miller WC, Kaydos- Daniels SC, Cohen MS, Leone PA, Hobbs MM, et al. Targeted screening for Trichomonis Vaginalis with culture using a two-step method in women presenting for STD evaluation . Sex Transm Dis. 2004; 31:659-64.
  • Velraeds MM, van der Mei HC, ReidG, Busscher HJ. Inhibition of initial adhesion of uropathogen Enterococcus faecalis by biosurgactants from lactobacillus isolates. Appl environ microbial. 1996; 62:1958:63
  • Weir E. Bacetrial vaginosis: more question than answers. Can med Assoc J. 2004; 171:448-501.
  • Zhan g J, Hatch M, Zhang D, Shulman J, Harville E, Thomas AG. Frequency of douching and risk of bacterial vaginosis in African Amderican women. Obstet Gynecol. 2004; 104:756-60.