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The Presence of Lactobacillus spp. and its Effect on the Occurrence of Other Microorganisms in the Reproductive Tract of Polish Women

Aneta Kiecka

Aneta Kiecka

  • Jagiellonian University Medical College, Faculty of Health Sciences, Institute of Physiotherapy, Chair of Biomedical SciencesCracow, Poland
  • Centre of Microbiological ResearchCracow, Poland
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Kiecka, Aneta
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Katarzyna Rak

Katarzyna Rak

Centre of Microbiological ResearchCracow, Poland
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Rak, Katarzyna
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Joanna Białecka

Joanna Białecka

  • Centre of Microbiological ResearchCracow, Poland
  • Jagiellonian University Medical College, Department of Pharmaceutical MicrobiologyCracow, Poland
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Białecka, Joanna
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Anna Białecka

Anna Białecka

Centre of Microbiological ResearchCracow, Poland
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Białecka, Anna
 and 
Marian Szczepanik

Marian Szczepanik

Jagiellonian University Medical College, Faculty of Health Sciences, Institute of Physiotherapy, Chair of Biomedical SciencesCracow, Poland
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Szczepanik, Marian
  
Aug 25, 2024
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Article Category: ORIGINAL PAPER
Published Online: Aug 25, 2024
Page range: 265 - 273
Received: Feb 05, 2024
Accepted: May 24, 2024
DOI: https://doi.org/10.33073/pjm-2024-024
Keywords
© 2024 Aneta Kiecka et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Fig. 1.

Microscope photos showing Lactobacillus categories of 0, 1, 2, and 3. A) 0 – means none, B) 1 – a single bacterium (up to 10 in the field of view), C) 2 – few (11–50 in the field of view), D) 3 – many (> 50 in the field of view) cells of Lactobacillus.
Microscope photos showing Lactobacillus categories of 0, 1, 2, and 3. A) 0 – means none, B) 1 – a single bacterium (up to 10 in the field of view), C) 2 – few (11–50 in the field of view), D) 3 – many (> 50 in the field of view) cells of Lactobacillus.

Fig. 2.

Distribution of pH between Lactobacillus categories.
Distribution of pH between Lactobacillus categories.

Relationship between the presence of Lactobacillus spp_ and other microorganisms_

Microorganisms Presence n (%) Lactobacillus spp.† p-value*
0 1 2 3
Gardnerella vaginalis No 988 (95.1%) 30 (65.2%) 108 (81.8%) 600 (98.2%) 250 (100%) < 0.001
Yes 51 (4.9%) 16 (34.8%) 24 (18.2%) 11 (1.8%) 0 (0%) –
Ureaplasma parvum No 874 (84.1%) 36 (78.3%) 109 (82.6%) 520 (85.1%) 209 (83.6%) 0.542
Yes 165 (15.9%) 10 (21.7%) 23 (17.4%) 91 (14.9%) 41 (16.4%) –
Ureaplasma urealyticum No 959 (92.3%) 40 (87.0%) 119 (90.2%) 566 (92.6%) 234 (93.6%) 0.299
Yes 80 (7.7%) 6 (13.0%) 13 (9.8%) 45 (7.4%) 16 (6.4%) –
Mycoplasma hominis No 1020 (98.2%) 42 (91.3%) 129 (97.7%) 601 (98.4%) 248 (99.2%) 0.0153
Yes 19 (1.8%) 4 (8.7%) 3 (2.3%) 10 (1.6%) 2 (0.8%) –
Mycoplasma genitalium No 1038 (99.9%) 45 (97.8%) 132 (100%) 611 (100%) 250 (100%) 0.0443
Yes 1 (0.1%) 1 (2.2%) 0 (0%) 0 (0%) 0 (0%) –
Chlamydia trachomatis No 1031 (99.2%) 46 (100%) 131 (99.2%) 606 (99.2%) 248 (99.2%) 1.000
Yes 8 (0.8%) 0 (0%) 1 (0.8%) 5 (0.8%) 2 (0.8%) –
Enterobacterales No 984 (94.7%) 36 (78.3%) 112 (84.8%) 590 (96.6%) 246 (98.4%) < 0.001
Yes 55 (5.3%) 10 (21.7%) 20 (15.2%) 21 (3.4%) 4 (1.6%) –
Streptococcus group B No 958 (92.2%) 34 (73.9%) 108 (81.8%) 571 (93.5%) 245 (98.0%) < 0.001
Yes 81 (7.8%) 12 (26.1%) 24 (18.2%) 40 (6.5%) 5 (2.0%) –
Yeast No 862 (83.0%) 39 (84.8%) 111 (84.1%) 506 (82.8%) 206 (82.4%) 0.976
Yes 177 (17.0%) 7 (15.2%) 21 (15.9%) 105 (17.2%) 44 (17.6%) –
Neisseria gonorhoeae No 1039 (100%) 46 (100%) 132 (100%) 611 (100%) 250 (100%) –
Yes 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) –
Trichomonas vaginalis No 1039 (100%) 46 (100%) 132 (100%) 611 (100%) 250 (100%) –
Yes 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) –

The pH values in women with and without the occurrence of microorganisms_

Microorganisms Not prevalent Prevalent p* pH > 4.5 p**
n Q2 (Q1–Q3) n Q2 (Q1–Q3) OR (95% CI)**
Lactobacillus spp. 46 5.5 (5.0; 5.5) 993 4.5 (4.0; 4.5) < 0.001 0.01 (0.00; 0.05) < 0.001
Gardnerella vaginalis 988 4.5 (4.0; 4.5) 51 5.0 (5.0; 5.5) < 0.001 12.18 (6.31; 23.48) < 0.001
Ureaplasma parvum 874 4.5 (4.0; 4.5) 165 4.5 (4.5; 5.0) < 0.001 1.74 (1.21; 2.50) 0.003
Ureaplasma urealyticum 959 4.5 (4.0; 4.5) 80 4.5 (4.4; 5.0) 0.009 2.36 (1.47; 3.78) < 0.001
Mycoplasma hominis 1020 4.5 (4.0; 4.5) 19 4.5 (4.5; 5.0) 0.014 2.88 (1.18; 7.01) 0.020
Mycoplasma genitalium 1038 4.5 (4.0; 4.5) 1 5.0 (5.0; 5.0) 0.203 11.50 (0.46; 284.64) 0.136
Chlamydia trachomatis 1031 4.5 (4.0; 4.5) 8 4.5 (4.4; 4.6) 0.698 1.27 (0.29; 5.52) 0.748
Enterobacterales 984 4.5 (4.0; 4.5) 55 5.0 (4.5; 5.0) < 0.001 6.10 (3.47; 10.74) < 0.001
Streptococcus group B 958 4.5 (4.0; 4.5) 81 5.0 (4.5; 5.0) < 0.001 5.06 (3.17; 8.06) < 0.001
Yeast 862 4.5 (4.0; 4.5) 177 4.5 (4.5; 5.0) 0.001 1.66 (1.16; 2.37) 0.005

Occurrence of individual microorganisms in women with and without symptoms qualified for the study and the microbiological methods used_

Microorganisms Method Total Without symptoms (n = 752) With symptoms (n = 287) p-value* OR# (95% CI) p-value**
n (%) n (%) n (%)
Lactobacillus spp.† 0 microscopic 46 (4.4%) 19 (2.5%) 27 (9.4%) < 0.001 1 (REF.) –
1 132 (12.7%) 90 (12.0%) 42 (14.6%) 0.33 (0.17; 0.66) 0.002
2 611 (58.8%) 451 (60.0%) 160 (55.7%) 0.25 (0.14; 0.46) < 0.001
3 250 (24.1%) 192 (25.5%) 58 (20.2%) 0.22 (0.11; 0.41) < 0.001
Gardnerella vaginalis culture, microscopic 51 (4.9%) 11 (1.5%) 40 (13.9%) < 0.001 10.55 (5.40; 20.63) < 0.001
Ureaplasma parvum PCR 165 (15.9%) 81 (10.8%) 84 (29.3%) < 0.001 3.42 (2.43; 4.82) < 0.001
Ureaplasma urealyticum PCR 80 (7.7%) 27 (3.6%) 53 (18.5%) < 0.001 6.02 (3.71; 9.75) < 0.001
Mycoplasma hominis PCR 19 (1.8%) 0 (0%) 19 (6.6%) < 0.001 109.30 (6.58; 1,816.53) 0.001
Mycoplasma genitalium PCR 1 (0.1%) 0 (0%) 1 (0.3%) 0.276 7.88 (0.32; 193.98) 0.207
Chlamydia trachomatis PCR 8 (0.8%) 1 (0.1%) 7 (2.4%) < 0.001 13.40 (2.31; 77.74) 0.004
Enterobacterales culture 55 (5.3%) 35 (4.7%) 20 (7.0%) 0.162 1.55 (0.88; 2.72) 0.127
Streptococcus group B culture 81 (7.8%) 57 (7.6%) 24 (8.4%) 0.698 1.12 (0.69; 1.84) 0.641
Yeast culture, microscopic 177 (17.0%) 100 (13.3%) 77 (26.8%) < 0.001 2.39 (1.71; 3.34) < 0.001
Neisseria gonorrhoeae culture 0 (0.0%) 0 (0.0%) 0 (0.0%) – – –
Trichomonas vaginalis culture 0 (0.0%) 0 (0.0%) 0 (0.0%) – – –

Relationship between the occurrence microorganisms and symptoms_

Microorganisms Model 1 Model 2 Model 3
OR# (95% CI) p-value** OR# (95% CI) p-value** OR# (95% CI) p-value**
Lactobacillus spp.† 1 0.31 (0.15; 0.61) < 0.001 0.42 (0.20; 0.87) 0.019 0.33 (0.16; 0.69) 0.003
2 0.23 (0.12; 0.43) < 0.001 0.38 (0.19; 0.76) 0.006 0.27 (0.13; 0.54) < 0.001
3 0.20 (0.10; 0.38) < 0.001 0.38 (0.18; 0.81) 0.012 0.23 (0.10; 0.50) < 0.001
Gardnerella vaginalis 10.47 (5.36; 20.47) < 0.001 7.83 (3.93; 15.61) < 0.001 10.03 (4.92; 20.47) < 0.001
Ureaplasma parvum 3.40 (2.42; 4.79) < 0.001 3.18 (2.25; 4.50) < 0.001 2.93 (2.06; 4.16) < 0.001
Ureaplasma urealyticum 5.98 (3.69; 9.69) < 0.001 5.69 (3.49; 9.28) < 0.001 5.56 (3.40; 9.09) < 0.001
Mycoplasma hominis 111.18 (6.71; 1,842.58) 0.001 98.35 (5.93; 1,631.18) 0.001 94.56 (5.72; 1,563.34) 0.001
Chlamydia trachomatis 13.21 (2.28; 76.60) 0.004 13.56 (2.31; 79.70) 0.004 10.12 (1.69; 60.80) 0.011
Yeast 2.38 (1.70; 3.32) < 0.001 2.24 (1.59; 3.14) < 0.001 1.93 (1.36; 2.74) < 0.001

The association between presence of Lactobacillus and other microorganisms – multivariable logistic regression models_

Microorganisms Lactobacillus as ordered variable† Lactobacillus as dichotomous variable††
Per 1 category level increase Not present Present Not present Present
Model 1 Model 2 Model 1 Model 2
Yeast 1.04 (0.83; 1.30) 1.32 (1.02; 1.71) 1 (REF.) 0.97 (0.43; 2.18) 1 (REF.) 1.69 (0.70; 4.07)
Enterobacterales 0.35 (0.25; 0.48) 0.54 (0.37; 0.81) 1 (REF.) 0.19 (0.09; 0.40) 1 (REF.) 0.78 (0.31; 1.97)
Streptococcus group B 0.40 (0.30; 0.52) 0.63 (0.45; 0.89) 1 (REF.) 0.23 (0.11; 0.47) 1 (REF.) 0.99 (0.42; 2.29)
Gardnerella_vaginalis 0.14 (0.09; 0.21) 0.20 (0.12; 0.32) 1 (REF.) 0.05 (0.02; 0.11) 1 (REF.) 0.21 (0.09; 0.51)
Chlamydia_trachomatis 1.12 (0.45; 2.79) 1.39 (0.52; 3.75) 1 (REF.) 0.67 (0.04; 11.0) 1 (REF.) 1.19 (0.06; 24.33)
Mycoplasma_hominis 0.47 (0.28; 0.78) 0.61 (0.32; 1.16) 1 (REF.) 0.16 (0.05; 0.49) 1 (REF.) 0.32 (0.08; 1.32)
Ureaplasma_parvum 0.91 (0.72; 1.13) 1.16 (0.89; 1.50) 1 (REF.) 0.58 (0.28; 1.19) 1 (REF.) 1.02 (0.46; 2.26)
Ureaplasma_urealyticum 0.75 (0.56; 1.01) 0.88 (0.62; 1.25) 1 (REF.) 0.45 (0.19; 1.07) 1 (REF.) 0.70 (0.26; 1.90)
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