Palabras clave
desbalance vaginal
vaginosis bacteriana
levaduras
trichomoniasis
Lactobacillus
reacción inflamatoria
Cómo citar
Resumen
Objetivos: Evaluar el desbalance de la microbiota vaginal, la prevalencia de vaginosis bacteriana (VB), levaduras, trichomoniasis y reacción inflamatoria vaginal (RIV). Caracterizar las especies de lactobacilos en pacientes usuarias de distintos métodos anticonceptivos (preservativos, anticonceptivos orales [ACO], dispositivo intrauterino de cobre [DIU-Cu], ligadura tubaria [LT]). Métodos: Se llevó a cabo un estudio consecutivo, prospectivo y transversal. Se examinaron pacientes de 18 - 50 años. Se realizó examen clínico, estudio de balance del contenido vaginal (BACOVA) y cultivo. La identificación de lactobacilos se hizo por MALDI-TOF. Resultados: Se analizaron 1303 pacientes divididas en grupos: Grupo 1 (G1): ACO (n=314); Grupo 2 (G2): preservativo (n=385); Grupo 3 (G3): DIU-Cu (n=92); Grupo 4 (G4): LT (n=26) y Grupo 5 (G5): control (n=486). La prevalencia de estados vaginales básicos (EVB) de desbalance fue: G1: 34,4% (p=0,18); G2: 42,1% (p=0,12); G3: 48,9% (p=0,05); G4: 53,8% (p=0,14); G5: 37,9%. Los grupos con mayor prevalencia de VB fueron G3: 41,3% (p=0,03) y G4: 50% (p=0,05). Los grupos con mayor revalencia de levaduras fueron G3: 31,5% (p=0,01) y G4: 38,5% (p=0, 02). El 82,8% (p=0,01) del G3 con levaduras presentó estados inflamatorios (II/V). G3 presentó mayor prevalencia de RIV: 58,7% (p=0,01). L. crispatus tuvo una prevalencia en G1 de 31,6%; en G2 de 25,4%; en G3 de 39,4%; en G4 de 22,2% y en G5 de 29,9%. Conclusión: Se observó mayor desbalance de microbiota, prevalencia de VB y levaduras en usuarias de DIU-Cu. En las usuarias de ACO, predominó el balance de la microbiota y la prevalencia de L. crispatus respecto de las usuarias de barrera y similar al control. Las usuarias de DIU-Cu presentaron mayor RIV por ser un cuerpo extraño.
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