Palabras clave
microbiota
enfermedad vaginal
Lactobacillus
Lactobacillus crispatus
Lactobacillus gasseri
Cómo citar
Resumen
Objetivos: Analizar la prevalencia de desbalance del contenido vaginal, vaginosis bacteriana (VB), candidiasis, tricomonosis, vaginitis microbiana inespecífica (VMI), y caracterizar la microbiota lactobacilar en pacientes menopáusicas, comparadas con premenopáusicas. Métodos: A través de un estudio consecutivo, prospectivo y transversal, estudiamos pacientes pre y posmenopáusicas mediante examen clínico, estudio de balance del contenido vaginal y cultivo. La identificación de lactobacilos se realizó por MALDI-TOF. Resultados: Se analizaron 2180 pacientes divididas en: grupo 1 (G1 - n=477) y grupo 2 (G2 - n=1703). La prevalencia de desbalance fue para G1: 23,1% (110/477) y para G2: 40,9% (697/1703) (p<0,01). G1 presentó mayor prevalencia de Lactobacillus gasseri (60,7% versus 34,1%; p<0,01), menor prevalencia de L. crispatus (17,6% versus 31,1%; p<0,01) y de L. jensenii (10,6% versus 24,6%; p<0,01). VB fue más prevalente en G2 (33,9% - 577/1703) que en G1 (20,1% - 96/477) (p<0,01). VMI fue más prevalente en G1 (8,4% - 40/477) que en G2 (3,4% - 58/1703) (p <0,01). Las etiologías más prevalentes de VMI en G1 fueron Streptococcus agalactiae (17,5% - 7/40), Escherichia coli (12,5% - 5/40) y Staphylococcus aureus (12,5% - 5/40). Conclusiones: VMI fue la entidad con mayor prevalencia en menopáusicas. Se observó elevado porcentaje de menopáusicas con microbiota lactobacilar. L. gasseri fue la especie predominante, relacionada con disfunción vaginal por su escaso rol protector y por disminución de L. crispatus y L. jensenii, que predispondría a VMI.
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