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

Fig. 1.

Fig. 2.

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)