OBJECTIVE: Presentation of complex information about the vaginal microbiota from historical view to current concepts with focus on latest findings on the structure and functioning of the vaginal microbiome. DESIGN: Review article. SETTING: Department of Clinical Microbiology, University Hospital and Faculty of Medicine in Hradci Králové, Charles University in Prague. METHODS: Literature review using the databases (PubMed, Web of Science, Ovid, etc.) with keywords (vaginal microbiota/ microbiom; vaginal discharge; bacterial vaginosis; vulvovaginitis; vaginal Lactobacillus). RESULTS: The vaginal microbiome is a specific compartment of the human microbiome. Unique conditions of the vagina are characterized by a few microbial species, usually lactobacilli, which are able to utilize glycogen, which is under control of estrogens. Lactobacilli and other fermentative bacteria together with vaginal epithelial cells produce lactic acid and are responsible for acidifying vaginal milieu. Lactic acid occurs in two isomeric forms, and their relative ratio is likely to give the vaginal microbiota a certain degree of stability and ability to withstand some infections. This microbiota is manifested by a low degree of diversity and by the high dynamics of changes of its composition under the influence of various exogenous and endogenous factors. Increase in diversity can be paradoxically associated with a dysbiosis such as bacterial vaginosis. Individual species of lactobacilli mainly Lactobacillus crispatus characterize the main community state types in the vagina. Apart from lactobacilli, healthy women may be colonized with a non-lactobacillary microbiota whose rate is dependent on ethnicity. CONCLUSION: The definition of vaginal microbiota cannot be only related to the presence or absence of individual microorganisms, although the incidence of some of them can be correlated with dysbiosis or eubiosis. The composition of microbiota is important, but it is only one of the basic attributes of normal vaginal microbiota, but not sufficient; that is the functional definition of vaginal microbiota in relation to its structure and dynamics, including the influence of ethnicity, physiological status of the vagina, and genetic disposition of woman.

• Klíčová slova
• (vaginal microbiota/ microbiom; vaginal discharge; bacterial vaginosis; vulvovaginitis; vaginal Lactobacillus). Results: The vaginal microbiome is a specific compartment of the human microbiome. Unique conditions of the vagina are characterized by a few microbial species, H2O2, Lactobacillus, although the incidence of some of them can be correlated with dysbiosis or eubiosis. The composition of microbiota is important, and genetic disposition of woman. Keywords: vaginal microbiome, and their relative ratio is likely to give the vaginal microbiota a certain degree of stability and ability to withstand some infections. This microbiota is manifested by a low degree of diversity and by the high dynamics of changes of its composition under the influence of various exogenous and endogenous factors. Increase in diversity can be paradoxically associated with a dysbiosis such as bacterial vaginosis. Individual species of lactobacilli mainly Lactobacillus crispatus characterize the main community state types in the vagina. Apart from lactobacilli, but it is only one of the basic attributes of normal vaginal microbiota, but not sufficient; that is the functional definition of vaginal microbiota in relation to its structure and dynamics, community state types, dysbiosis, healthy women may be colonized with a non-lactobacillary microbiota whose rate is dependent on ethnicity. Conclusion: The definition of vaginal microbiota cannot be only related to the presence or absence of individual microorganisms, historical and recent concept, including the influence of ethnicity, lactic acid, pH, physiological status of the vagina, sexual hormones, sexual hormones historical and recent concept., usually lactobacilli, vaginal microbiome, which are able to utilize glycogen, which is under control of estrogens. Lactobacilli and other fermentative bacteria together with vaginal epithelial cells produce lactic acid and are responsible for acidifying vaginal milieu. Lactic acid occurs in two isomeric forms,
• MeSH
• bakteriální vaginóza mikrobiologie   MeSH
• kyselina mléčná metabolismus   MeSH
• Lactobacillus * MeSH
• lidé MeSH
• mikrobiota * MeSH
• vagina mikrobiologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• kyselina mléčná MeSH

• Klíčová slova
• VAGINA/diseases *,
• MeSH
• lidé MeSH
• nemoc * MeSH
• vagina * MeSH
• vaginální onemocnění * MeSH
• vulvovaginitida * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The aim of this study is to detect the rate of cytolytic vaginosis (CV) cases in patients with symptoms resembling those ones of candida vaginitis and to distinguish them from candidiasis cases by examining of 2947 Papanicolaou-stained vaginal smears. Fifty four of 2947 patients (1.83%) were diagnosed as having CV based on cytologic criteria such as naked nuclei of intermediate cells (IC), the overgrowth of lactobacilli, cytoplasmic fragmentations due to lysis of the cells. None of these smears contained candidal blastospores and hyphae and polymorphonuclear leucocytes. The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. The study indicated that special attention has to be paid during evaluation the vaginal smears of the patients with presumed vaginal candidiasis in order to prevent an erroneous diagnosis of CV.

• MeSH
• cytodiagnostika MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• kandidóza vulvovaginální diagnóza   MeSH
• Lactobacillus izolace a purifikace   patogenita   MeSH
• lidé MeSH
• mladiství MeSH
• Papanicolaouův test * MeSH
• vaginální stěr * MeSH
• vaginitida diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Turecko MeSH

Human papillomavirus (HPV) has been directly related to acuminate warts and cervical cancer, the second most common neoplasia among women. Given the lack of treatment against the virus itself, many medications have been utilised, mainly aiming in modifying the host's immunological response. We present the case of a 54 years old postmenopausal patient with a history of vaginal cuff wart and HPV persistence that we managed in our clinic for 6 months with a mix of curcumin, aloe vera, amla and other natural ingredients. As the patient was found to be intolerant to imiquimod (one of the most common conservative methods of treatment) we attempted the use of curcumin, which was applied to the area of the wart three times per week for 6 months. Both clinical and colposcopical improvement was noted in regular clinic visits with regression of the lesion. The outcome of this case encourages our view that curcumin should be considered as a significant treatment modality against HPV infection and acuminate warts.

• Klíčová slova
• CM-β glucans, Docosanol, HPV, Indian Grapefruit (AMLA), SiloffGyn, aloe vera, curcumin, lactic acid, vaginal cuff wart,
• MeSH
• adjuvancia imunologická škodlivé účinky   MeSH
• beta-glukany terapeutické užití   MeSH
• dlaždicová intraepiteliální léze cervixu farmakoterapie   patologie   MeSH
• fixní kombinace léků MeSH
• fytoterapie MeSH
• imichimod škodlivé účinky   MeSH
• infekce papilomavirem farmakoterapie   patologie   MeSH
• kolposkopie MeSH
• kondylomata akuminata farmakoterapie   patologie   MeSH
• kurkumin terapeutické užití   MeSH
• kyselina mléčná terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mastné alkoholy terapeutické užití   MeSH
• Papanicolaouův test MeSH
• Phyllanthus emblica MeSH
• protinádorové látky terapeutické užití   MeSH
• rostlinné přípravky terapeutické užití   MeSH
• vaginální krémy, pěny a želé MeSH
• vaginální onemocnění farmakoterapie   patologie   MeSH
• vaginální stěr MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• adjuvancia imunologická MeSH
• beta-glukany MeSH
• docosanol MeSH Prohlížeč
• fixní kombinace léků MeSH
• imichimod MeSH
• kurkumin MeSH
• kyselina mléčná MeSH
• mastné alkoholy MeSH
• protinádorové látky MeSH
• rostlinné přípravky MeSH
• vaginální krémy, pěny a želé MeSH

The aim of this study is to determine whether there is a relationship between the presence of Lactobacilli and the growth of Candida. For this purpose, 1110 cervico-vaginal smears were examined cytologically and 450 patients who were normally menstruating were subsequently selected among them. Fifty nine of 450 were diagnosed as having Candida and they were accepted as study group. Three hundred and ninety-one patients who were diagnosed as having no infectious agents were accepted as control group. Lactobacilli were present in 50 of 59 in various degree and were absent in 9 of 59. The prevalence rates of the presence of Lactobacilli (84.74%) as well as intermediate cells (98.30%) were higher in study group than in control group. There was also a significant correlation between the presence of Lactobacilli and the growth of Candida (p < 0.05). Statistical analysis was performed with chi 2 test using SPSS package programme. We can suggest that Lactobacilli do not have a protective role when there is Candida growth in the vaginal mucosa.

• MeSH
• Candida albicans izolace a purifikace   MeSH
• dospělí MeSH
• kandidóza vulvovaginální diagnóza   MeSH
• Lactobacillus izolace a purifikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• rozdělení chí kvadrát MeSH
• vagina mikrobiologie   MeSH
• vaginální stěr MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The original purpose of vaginally applied microbicides was to slow down the HIV epidemic among the population until an effective vaccination was developed. Nowadays, antiretrovirals applied in the form of gels or vaginal rings are considered most prominent in this field and are tested via vaginal or, rarely, rectal applications in numerous clinical studies (9 different antiretroviral drugs in 33 clinical studies, especially in Africa). Only tenofovir (1 % gel) and dapivirine (25 mg in vaginal ring) progressed into the phase III clinical testing. Their efficiency depended on the user´s strict adherence to the application regimen (for tenofovir 54 %, for dapivirine 61 % in participants over 25 years of age). Despite this, they are expected to be important and effective tools of preventive medicine in the near future. This review summarizes the results obtained during long-term clinical testing (2005-2018) of antiretroviral drugs against vaginal and rectal transmission of HIV infection.

• Klíčová slova
• HIV prevention, anti-retro viral drugs, clinical trials, microbicides,
• MeSH
• antikoncepční prostředky ženské virologie   MeSH
• antiretrovirové látky terapeutické užití   MeSH
• HIV infekce farmakoterapie   MeSH
• klinické zkoušky, fáze III jako téma MeSH
• lidé MeSH
• rektum virologie   MeSH
• vagina virologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antiretrovirové látky MeSH

Lactobacilli in the vaginal tract are essential to protect against microbial infections. We therefore focused on isolating vaginal lactobacilli from pregnant women and testing their functional properties. Lactobacilli were isolated from 50 vaginal swabs and the purified isolates were identified by MALDI-TOF MS. Functional properties (antimicrobial activity, organic acids and hydrogen peroxide production, antibiotic susceptibility, auto-aggregation, and hydrophobicity) of selected isolates were tested. Lactobacilli (41 strains) were identified in 58% of swabs with a predominance of Lactobacillus crispatus (48%) followed by L. jensenii (21%), L. rhamnosus (14%), L. fermentum (10%), and L. gasseri (7%). The highest antibacterial activity was determined for L. fermentum and L. rhamnosus. Strong anti-Candida activity was observed for strains L. crispatus, L. fermentum, and L. rhamnosus. Strain L. jensenii 58C possessed the highest production of hydrogen peroxide (6.32 ± 0.60 mg/l). The best lactic acid producer was strain L. rhamnosus 72A (11.6 ± 0.2 g/l). All strains were resistant to fluconazole and metronidazole. The highest auto-aggregation was observed for strain L. crispatus 51A (98.8 ± 0.1% after 24 h). Strain L. rhamnosus 68A showed the highest hydrophobicity (69.1 ± 1.4%). Strains L. fermentum and L. rhamnosus showed high antibacterial activity and hydrophobicity, and strains L. crispatus possessed high auto-aggregation and anti-Candida activity. Thus, these strains alone or in a mix could be used for the preparation of probiotic products for treatment and prevention of vulvovaginal infections of pregnant and non-pregnant women.

• Klíčová slova
• Lactobacilli, Probiotics, Vaginal microbiome, Vulvovaginal infections,
• MeSH
• Candida růst a vývoj   MeSH
• dospělí MeSH
• kandidóza * mikrobiologie   terapie   MeSH
• Lactobacillus * MeSH
• lidé MeSH
• těhotenství MeSH
• vagina mikrobiologie   MeSH
• vaginitida * mikrobiologie   terapie   MeSH
• vulvitida * mikrobiologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• TRICHOMONAS INFECTIONS/statistics *, VAGINA/diseases *,
• MeSH
• lidé MeSH
• nemoc * MeSH
• trichomonádová vaginitida * MeSH
• Trichomonas * MeSH
• trichomoniáza statistika a číselné údaje   MeSH
• vagina * MeSH
• vaginální onemocnění * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AIM: This work describes the human papillomavirus (HPV) prevalence and the HPV type distribution in a large series of vaginal intraepithelial neoplasia (VAIN) grades 2/3 and vaginal cancer worldwide. METHODS: We analysed 189 VAIN 2/3 and 408 invasive vaginal cancer cases collected from 31 countries from 1986 to 2011. After histopathological evaluation of sectioned formalin-fixed paraffin-embedded samples, HPV DNA detection and typing was performed using the SPF-10/DNA enzyme immunoassay (DEIA)/LiPA25 system (version 1). A subset of 146 vaginal cancers was tested for p16(INK4a) expression, a cellular surrogate marker for HPV transformation. Prevalence ratios were estimated using multivariate Poisson regression with robust variance. RESULTS: HPV DNA was detected in 74% (95% confidence interval (CI): 70-78%) of invasive cancers and in 96% (95% CI: 92-98%) of VAIN 2/3. Among cancers, the highest detection rates were observed in warty-basaloid subtype of squamous cell carcinomas, and in younger ages. Concerning the type-specific distribution, HPV16 was the most frequently type detected in both precancerous and cancerous lesions (59%). p16(INK4a) overexpression was found in 87% of HPV DNA positive vaginal cancer cases. CONCLUSIONS: HPV was identified in a large proportion of invasive vaginal cancers and in almost all VAIN 2/3. HPV16 was the most common type detected. A large impact in the reduction of the burden of vaginal neoplastic lesions is expected among vaccinated cohorts.

• Klíčová slova
• Human papillomavirus, Vaccine, Vaginal cancer, Vaginal intraepithelial neoplasia,
• MeSH
• DNA virů analýza   MeSH
• imunoenzymatické techniky MeSH
• infekce papilomavirem komplikace   epidemiologie   virologie   MeSH
• inhibitor p16 cyklin-dependentní kinasy metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lidský papilomavirus 16 izolace a purifikace   MeSH
• mezinárodní spolupráce MeSH
• nádory vaginy komplikace   epidemiologie   virologie   MeSH
• Papillomaviridae izolace a purifikace   MeSH
• Poissonovo rozdělení MeSH
• prekancerózy epidemiologie   virologie   MeSH
• prevalence MeSH
• průřezové studie MeSH
• regresní analýza MeSH
• retrospektivní studie MeSH
• senioři MeSH
• spinocelulární karcinom komplikace   epidemiologie   virologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• DNA virů MeSH
• inhibitor p16 cyklin-dependentní kinasy MeSH

The use of vaginal tampons during menstruation may be associated with the proliferation of bacteria on their uneven surface, unless the instructions for use provided by the manufacturer are followed. A healthy young woman presented with a false aneurysm of infectious origin, caused by Staphylococcus aureus, in connection with the use of vaginal tampons. The aneurysm manifested after the menstruation when tampons were used and during which the patient experienced an untreated feverish epizode. Vaginal colonies of Streptococcus and Staphylococcus are present in nearly 40% of healthy menstruating women. Staphylococcal septicemia with the subsequent appearance of an arterial infected false aneurysm in a formerly healthy woman has not yet been described in relation to the use of vaginal tampons.

• MeSH
• lidé MeSH
• mladý dospělý MeSH
• nepravé aneurysma diagnóza   etiologie   terapie   MeSH
• stafylokokové infekce diagnóza   etiologie   terapie   MeSH
• Staphylococcus aureus * MeSH
• výrobky dámské intimní hygieny škodlivé účinky   MeSH
• zánětlivé aneurysma diagnóza   etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH