Immunogenicity of the BNT162b2 mRNA COVID-19 vaccine in older residents of a long-term care facility: relation with age, frailty and prior infection status.

Clinical and biological assessment of the COVID-19 vaccine efficacy in the frail population is of crucial importance. The study focuses on measuring the levels of anti-SARS-CoV-2 IgG antibodies before and after BNT162b2 mRNA COVID-19 vaccination among long-term care facility (LTCF) elderly residents. We conducted a prospective, single-center, observational study among LTCF residents. The study protocol was based on three blood sample acquisitions: first taken at baseline-5 days before the first dose of the vaccine, second-20 days after the first dose, and third-12 days after the second shot of the vaccine. The comparison was made for two cohorts: patients with and without prior COVID-19 infection. The data was collected from January to March 2021. A total number of 78 LTCF residents (55 women and 23 men) aged 62-104, 85.72 ± 7.59 years (mean ± SD), were enrolled in the study. All study participants were investigated for the presence of SARS-CoV-2 anti-spike (S) protein IgG, using a chemiluminescent immunoassay. Frailty was assessed with the Clinical Frailty Scale. Among elderly COVID-19 survivors in LTCF, a single dose of vaccine significantly increased anti-SARS-CoV-2 IgG antibody levels. IgG concentration after a single and double dose was comparable, which may suggest that elderly COVID-19 survivors do not require a second dose of vaccine. For residents without a previous history of COVID-19, two doses are needed to achieve an effective serological response. The level of anti-SARS-CoV-2 IgG antibodies after vaccination with BNT162b2 mRNA COVID-19 did not correlate with the frailty and age of the studied individuals.

Outpatient post-partum antibiotic prescription: method of identification of infection control areas demanding improvements and verification of sensitivity of infection registration.

OBJECTIVES: To evaluate data on outpatient antibiotic use in women post-labour as a potential method of monitoring infections in this group of patients. METHODS: Demographic and antibiotic prescription data originated from the registries of the National Health Fund (pol. Narodowy Fundusz Zdrowia). The measure of antibiotic use in this study was the percentage of women who purchased the drugs from prescriptions and DDDs. RESULTS: Among 67917 females who gave birth in the years 2013-14, 5050 (7.4%) purchased antibiotics prescribed by the obstetrician only. The average number of antibiotics bought per person was equivalent to ∼14 DDDs; in most cases (95.7%) these were ß-lactams. Antibiotic use occurred significantly more frequently among younger patients (11.5% patients <18 years of age), those living in rural areas (8.2%) and those who underwent Caesarean section (8.1%). No significant differences were found between the reported day of labour and the post-partum use of antibiotics. CONCLUSIONS: Antibiotic prescribing data can be used to verify/complement the information originating from hospital infection registries to monitor rates of infection in obstetric patients.

Streptococcus group B serotype distribution in anovaginal isolates of women in term pregnancy.

BACKGROUND: To evaluate Streptococcus group B (GBS) serotype distribution in anovaginal isolates of women in term pregnancy and to assess the correlation of the distribution with socio-epidemiological variables and neonatal outcomes. DESIGN: An observational study. SETTINGS: Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, Poland. POPULATION: 80 women between 37 and 40 gestation weeks with preserved fetal membranes and who had not been treated with antibiotics for at least two weeks before the study. MATERIAL AND METHODS: The specimens from the vagina and the rectum of pregnant women were collected. GBS colonization tests were conducted in compliance with Centers for Disease Control and Prevention recommendations. Serotyping of the isolates was performed using the Essum GBS Serotyping Kit (Umea, Sweden) according to manufacturer's instruction. Mein outcome measures. GBS serotype distribution in the population of Polish women in term pregnancy. RESULTS: In the studied group of 80 pregnant women GBS colonization rate was 28.7%. Four GBS serotypes were observed (Ia, V, III and II). Serotype Ia was the most predominant - 43.47%. For GBS Ia, V and III serotypes, no significant difference in the prevalence of diabetes mellitus and neonatal outcomes was observed. Only in one case early-onset sepsis was diagnosed in the neonate and serotype Ia was determined. CONCLUSIONS: 1) From among four identified GBS serotypes in the population of Polish pregnant women, serotype Ia was the most dominant. 2) For GBS serotypes, no significant difference in the prevalence of diabetes mellitus and neonatal outcomes was observed. 3) Active immunization aimed for preventing GBS colonization in mothers should include not only serotypes V, II and III but also Ia in order to be an effective and safe in preventing life threatening neonatal infections.

Adiponectin to leptin index as a marker of endometrial cancer in postmenopausal women with abnormal vaginal bleeding: an observational study.

OBJECTIVES: To evaluate the correlation between endometrial cancer and adiponectin plasma concentration, leptin plasma concentration as well as adiponectin to leptin index in the population of postmenopausal women with abnormal vaginal bleeding. DESIGN: An observational study SETTINg: Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, Poland. Population. 99 women between 47 and 88 years old, in postmenopausal state. METHODS: The cases (54 women) were females hospitalized due to postmenopausal vaginal bleeding in whom dilation and curettage (D&C) was performed and endometrial intraepithelial neoplasia (EIN) was diagnosed in anathomopathology. Hysterectomy was then performed in all cases and the endometrial cancer diagnosis was confirmed. The controls (45 women) consists of females with no postmenopausal uterine bleeding in whom endometrial thickness in transvaginal ultrasound was greater than 5 mm. D&C was than performed and no endometrial neoplasia was detected in any of the subjects. Adiponectin and leptin plasma concentration was measured in both groups. Mein outcome measures. The area under the curve, sensitivity, specificity and cutoffs for adiponectin, leptin and adiponectin to leptin index. RESULTS: Adiponectin, leptin and adiponectin to leptin index were statistically correlated with the risk of endometrial cancer. At the suggested cutoffs, corresponding to the highest accuracy (minimal false-negative and false-positive results), adiponectin to leptin index resulted in the highest sensitivity and specificity compared to adiponectin and leptin alone. CONCLUSIONS: Adiponectin to leptin index due to the highest sensitivity and specificity may be used as a marker of endometrial cancer in postmenopausal women with abnormal vaginal bleeding.

Identification of pregnant women at risk of Streptococcus group B colonisation.

OBJECTIVES: The aims of the study were: 1) to evaluate the prevalence of recto-vaginal group B streptococci (GBS) colonisation using Todd Hewitt Broth - recommended by the Centers for Disease Control (CDC) - and Granada medium; 2) to establish the sensitivity and specificity of Granada medium for the detection of GBS colonisation; 3) to evaluate each vaginal Gram stained swab for bacterial vaginosis (BV) using Nugent criteria and for determining the amount of polymorphonuclear (PMN) leucocytes. METHODS: Eighty pregnant women between 35 and 40 gestation weeks hospitalised in the Department of Gynecology and Obstetrics, Medical University of Silesia, Poland, were included in the study. Two specimens were collected from each patient: one from the posterior vaginal fornix (Gram stain) and one from both vagina and anus to detect GBS colonisation. Each vaginal Gram stained swab was evaluated for BV using Nugent criteria as well as for PMN leucocyte count. To detect GBS colonisation, the liquid Todd Hewitt Broth, subsequently subcultured to blood agar and direct inoculation onto Granada medium, were used. Isolated GBS were identified by morphological features and by serological (Slidex Strepto-Kit, bioMerieux) and biochemical (rapid ID 32 Strep, bioMerieux) testing. RESULTS: GBS colonisation was observed in 22 (27.8%) patients in both used media. Only in one case were GBS detected in Todd Hewitt Broth and not detected in Granada medium. The sensitivity and specificity of Granada medium were established as: 95.65% and 100%, respectively, compared with Todd Hewitt Broth recommended by CDC. Nugent criteria demonstrated 6.25% of cases of BV; in one case both BV and GBS colonisation were detected. CONCLUSIONS: The selective Granada medium may be used concurrently with liquid Todd Hewitt Broth as a screening tool for prenatal group B streptococcal colonisation in pregnant women.

[Awareness of cervical cancer prevention among patients of gynecological outpatient clinic]. / Swiadomosc profilaktyki raka szyjki macicy wsród kobiet zglaszajacych sie do poradni K.

INTRODUCTION: Improvement of cervical cancer statistics in Poland is believed to be one of the main goals of all medical services. Cervical cancer is an easily preventable neoplasm thus effective strategies for its prophylaxis should be proposed and introduced to the whole population of Polish citizens. OBJECTIVES: The aim of the study was to measure the extent of knowledge of females about cervical cancer and its prevention. MATERIAL AND METHODS: 250 female patients of gynecological clinic at the Medical Centre in Krakow, Poland, aged 18-60, were included into the retrospective study The research was based on an original questionnaire designed by the authors containing questions concerning general socio-epidemiological status, as well as cervical cancer epidemiology and HPV infection prevention methods. RESULTS: The majority of respondents (68%) rated their knowledge on cervical cancer prevention strategies as medium. The main sources of information on that prophylaxis were: women's magazines (59% of respondents), media (47%) and Internet (38%). Additionally only one in three women acquired that information from gynecologist The main reason for performing the Pap smear test was the request of the respondent (43% of cases). Only 3% of them attended the test as a result of a personal invitation sent by National Health Service. The main reasons for not attending Pap smear test were: fear of pain (39%), lack of any symptoms (18%), carelessness (15%) and embarrassment (12%). CONCLUSIONS: 1. Knowledge on HPV infections and cervical cancer prevention among women attending gynecological outpatient clinic is insufficient. 2. Education, especially in the field of cervical cancer main risk factors as well as the course of pap smear collection, seems to be necessary in order to reduce the cervical cancer morbidity and the fear of performing pap smear tests.

Prevalence and Antimicrobial Susceptibility Profiles of Microorganisms Associated with Lower Reproductive Tract Infections in Women from Southern Poland-Retrospective Laboratory-Based Study.

OBJECTIVE: Female infections affecting the genital tract include sexually transmitted diseases, endogenous infections such as vulvovaginal candidiasis, bacterial vaginosis (BV) or aerobic vaginitis (AV) and healthcare-associated infections. The aim of the study was to analyze the etiological factors of the vaginal dysbacteriosis, and the antimicrobial susceptibility of the dominant bacterial and fungal infections in different age groups of outpatient women from the Silesian Region. MATERIALS AND METHODS: A retrospective laboratory-based multi-center study encompassed 4994 women of different ages in Silesian Voivodeship, in the south of Poland; patients who had vaginal swabs collected as per physicians' orders during the period from 1 January 2017 until 30 June 2018 were included in the study. The inclusion criteria were: non-hospitalized female, aged ≤80, with suspected vulvovaginal candidiasis or bacterial vaginosis and clinical sings of infections. RESULTS: Gram-positive cocci were the ones most often isolated: Enterococcus faecalis (29.2%) and Streptoccoccus agalactiae (13.1%), followed by bacilli from the Enterobacteriaceae group, including Escherichia coli (26.3%). The presence of Streptococcus agalactiae was confirmed in 13.1%, slightly more often in the 45-80 age group, and Gardnerella vaginalis in 6.4%, most often in women aged 15-24. The prevalence of yeast-like infections was 24.3%, Candida albicans accounted for 78.3%, whereas among C. non-albicans spp.-C. glabrata dominated (14.9%) followed by C. parapsilosis (3.8%). The highest resistance was observed only in Streptococcus agalactiae as the MLSB mechanism (Macrolide-lincosamide-streptogramin B) was identified in 38.6% of strains. The prevalence of vulvovaginal candidiasis was 24.3%, the highest in women aged 15-44. CONCLUSIONS: Drug resistance in studied vulvovaginitis was associated only with Streptococcus agalactiae. A high proportion of yeast-like aetiology was found, probably associated with recurrent infections. In the analyzed cases only the Amsel criteria and culture methods were used for diagnosis without preparations and microbiological Nugent criteria.

[HBD-1 and hBD-2 are expressed in cervico-vaginal lavage in female genital tract due to microbial infections]. / Ekspresja hBD-1 i hBD-2 w popluczynach pochwowo-szyjkowych z dróg rodnych kobiet w stanach zapalnych wywolanych drobnoustrojami.

OBJECTIVES: The aim of this study was to evaluate and compare concentration of selected human beta-defensins (hBD-1, hBD-2) in cervico-vaginal lavage (CVL), obtained from women with candidiasis, chlamydiasis and other bacterial infections. MATERIAL AND METHODS: beta-defensins were detected quantitatively by RT-PCR (7000 Taqman, Applied Biosystems) in cervico-vaginal lavage collected from 120 (79 women in the study group and 41 controls) non-pregnant women, aged 18-40 (mean age 28.5 +/- 6.29). The study group patients were divided into three subgroups on the basis of clinical and microbiological diagnosis: women with candidiasis (n=13); with chlamydiasis (n=13), and with other bacterial infections (n=12). RESULTS: The highest count of hBD-1 RNA copies was found in women with bacterial infections and candidiasis (335.84 and 320.10 respectively), and hBD-2--with chlamydiasis. The difference between RNA copies of hBD-1/microg in candidiasis, chlamydiasis and bacterial pathogens was statistically significant; for hBD-2 only in case of chlamydiasis. CONCLUSIONS: Chlamydia trachomatis infection activates the production of hBD-2. Candida albicans, Chlamydia trachomatis, and bacterial pathogens induced variable increases of hBD-1 concentration.

Occurrence of Ureaplasma parvum and Ureaplasma urealyticum in women with cervical dysplasia in Katowice, Poland.

The aim of this study was to evaluate the occurrence of genital mycoplasmas, especially Ureaplasma parvum and Ureaplasma urealyticum, in women with atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL), compared to women with normal cytology living in Katowice, Poland. Two sterile swabs were used to obtain material from the posterior vaginal fornix of 143 women with squamous intraepithelial lesions and 39 healthy women: first for general bacteriology, second for detection of urogenital mycoplasmas using Mycoplasma IST2 kit. From each positive Mycoplasma IST2 culture DNA was isolated and PCR was performed for identification of U. parvum and U. urealyticum. Mycoplasma IST was positive in 34.1% cases. Urogenital mycoplasmas were demonstrated in women with HSIL significantly more often compared to women with LSIL, ASCUS, and with normal cytology. DNA of U. parvum was demonstrated in majority of Mycoplasma IST2-positive cases, U. urealyticum DNA-only in 9 (4.9%). Predominance of 3/14 serovars of U. parvum was demonstrated. U. urealyticum biovar 2 was present more often in women with squamous intraepithelial lesions.

[Pregnancy and delivery course in overweight and obese women]. / Przebieg ciazy i porodu u ciezarnych z nadmierna masa ciala.

INTRODUCTION: Pregnancy and delivery in case of overweight women require special care. The main means of preventing obstetrical complications is promoting healthy lifestyle and pregnancy weight gain control among females planning the pregnancy as well as prenatal diagnosis and pregnancy/delivery course monitoring. OBJECTIVES: The aim of the study was to evaluate the pregnancy and delivery course in overweight and obese pregnant women. MATERIAL AND METHODS: The study was based on a retrospective analysis of medical files of 132 pregnant women delivering in Gynecology and Obstetrics Clinic in Tychy, Poland. The investigated group was divided into subgroups based on pre-pregnancy body mass index according to World Health Organization Criteria for obesity. The comparative analysis was then performed between the subgroups. RESULTS: The prevalence of bleedings in pregnancy pregnancy induced hypertension, diabetes and urinary tract infections was statistically higher in obese pregnant females. Similarly the rate of shoulder dystocia was statistically higher in the obese and overweight subgroups of women. There were no significant differences between subgroups in mean neonate body length or mean Apgar scores. However the highest neonate body weight was observer in subgroup of overweight females and those with pre-pregnancy normal BMI who gained more than 16 kilograms during pregnancy. CONCLUSIONS: 1. Excessive weight gain in pregnancy is associated with higher risk of pregnancy and delivery complications. 2. Both excessive pre-pregnancy body weight and excessive weight gain in pregnancy increase the risk of perinatal complications.

Human neutrophil peptides in vaginitis/cervicitis of different etiology.

Development of female genito-urinary infections depends on many factors, such as immune system activity, virulence of microorganism and production of factors inhibiting the growth of microorganisms. Taking into account the possibility of relapses or severe complications, it is very important to appropriately diagnose and treat infections. Because of recently observed increase of microbial resistance to antibiotics, researchers are looking for alternatives. In our study we evaluated and compared the concentration of human neutrophil peptides (HNP 1-3) in cervico-vaginal lavages (CVL), obtained from women with vaginitis/cervicitis. Swabs from the posterior vaginal fornix and from the endocervical canal as well as CVL samples were obtained from 32 patients with vaginitis/cervicitis and 29 healthy women (control group). Supernatants of CVL were used for determination of concentration of HNP by ELISA. The difference between concentrations of HNP 1-3 in studied and control groups was statistically significant (p = 0.018). The maximal concentration was determined in patients with mixed infections (28.41 ng/ml), and Group B Streptococci, GBS, (28.06 ng/ml), the minimal concentrations in cases of C. trachomatis (mean concentrations did not differ from those in the control group: 16.93 ng/ml and 16.39 ng/ml, respectively). Maximal correlation was determined for control-studied group with isolation of GBS (r = 0.79), and very high negative correlation for group of GBS - C. trachomatis (r = -0.98).

[Streptococcus group B--association with Aerobic vaginitis and ability to human cell lines activation]. / Paciorkowce grupy B--zwiazek z Aerobic vaginitis oraz zdolnosc do aktywacji ludzkich linii komórkowych.

The aim of this study was to estimate: the frequency of aerobic vaginitis, susceptibility of the GBS isolated from vagina of non-pregnant women with and without cervicitis to selected antibiotics and chemotherapeutics and the proinflammatory cytokines production by HeLa, THP-I, U - 937 cells after stimulation by vaginal GBS. Our results indicated low frequency of the aerobic vaginitis -4.5% among non-pregnant young women and ability of the vaginal GBS to release proinflammatory cytokines by human cell lines in vitro.

[Cervical dysplasia and microflora of sexual tract]. / Zmiany dysplastyczne nablonka szyjki macicy a mikroflora dróg rodnych.

The aim of this study was to evaluate microflora of the vaginal part of the cervix uteri (including high-oncogenic HPV types and C. trachomatis) in women with ASCUS, LSIL comparing with women with normal cytology. The results demonstrated that infections with high-oncogenic HPV types and C. trachomatis don't reduce significantly Lactobacillus spp.

[Aerobic vaginitis--diagnostic problems and treatment]. / Zapalenie pochwy powodowane przez bakterie tlenowe--problemy diagnostyki i leczenie.

The diagnostic criteria and treatment of aerobic vaginitis--AV--have been summarized in this review. An expansion of mixed aerobic microflora, especially Group B Streptococcus--GBS, Escherichia coli--E. coli, Enterococcus spp., and the development of inflammation of the vaginal mucous membrane due to a decreasing amount of Lactobacillus spp., have been observed in women with AV. Disruptions of the vaginal ecosystem during AV cause an increase in pH to >6, a decrease in lactates concentration and an increase in proinflammatory cytokines concentration in vaginal discharge. An optimal treatment scheme for AV, which includes antibacterial agents and simultaneously normalizes the vaginal ecosystem, has not been established until today.

[Co-occurence of indol-producing bacterial strains in the vagina of women infected with Chlamydia trachomatis]. / Wspóllwystwpowanie szczepów bakterii wytwarzajqcych indol w pochwie kobiet zakazonych Chlamydia trachomatis.

OBJECTIVES: The aim of this study was to determine if cervicitis, caused by Chlamydia trachomatis (C. trachomatis), has an influence on the frequency of occurrence of selected aerobic and anaerobic bacterial strains, connected with etiology of aerobic vaginitis (AV) and bacterial vaginosis (BV). Indole-producing bacteria have received particular attention due to their possibly inductive role in chronic cervicitis caused by C. trachomatis. MATERIAL AND METHODS: The swabs from vagina and cervical canal have been obtained from 122 women (aged 18-40). The presence of C. trachomatis antigen had been detected and diagnosed with the help of direct immunofluorescence, BV with Amesl and Nugent criteria, whereas the AV with Donders criteria. The identification of the bacterial strains isolated from vagina has been performed according to classical microbiological diagnostics. RESULTS: Disruption of vaginal microflora (4-10 in Nugent score) was determined in 11,5% of observed women. AV was diagnosed in 4.5% women with chlamydial cervicitis, BV was diagnosed in 10.9% and 5.45% of these women, on the basis of Amsel and Nugent criteria respectively. CONCLUSIONS: Indole-producing bacterial strains connected with BV and AV (Peptostreptococcus anaerobius, Propionibacterium acnes, Escherichia coli) have been isolated significantly more often from vagina of women infected with C trachomatis (p = 0.0405, chi2 = 4.20) and these findings confirm co-importance of indole-producing bacterial strains in cervicitis caused by C trachomatis .

[The bacterial vaginosis--treatment problems]. / Waginoza bakteryjna - problemy terapii.

The changes in vaginal ecosystem (decreasing number of H2O2 producing Lactobacillus spp. and increasing number of Mobiluncus spp., Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., Mycoplasma hominis, Peptostreptococcus spp.) appears to be a major cause of bacterial vaginosis (BV). Bacterial vaginosis is associated with infectious complications in pregnant and non-pregnant women and increasing risk of STI. The preventive role of natural vaginal microflora and problems of BV treatment are discussed in the light of the recent publications.

[Atopobium vaginae: characterization and association with pathogenesis of bacterial vaginosis]. / Atopobium vaginae: charakterystyka i rola w patogenezie waginozy bakteryjnej.

Atopobium vaginae was described in 1999 by Rodriguez et al. It is a Gram-positive bacterium producing organic acids (lactic acid, acetic acid, formic acid) as a results of glucose fermentation. It was first found in vaginal swab taken from a healthy woman using 16S rRNA analysis. A. vaginae is associated with bacterial vaginosis and its consequences in upper part of women reproductive organs.

Co-occurrence of urogenital mycoplasmas and group B streptococci with chlamydial cervicitis.

The aim of our study was to evaluate whether in women with chlamydial cervicitis urogenital mycoplasmas and group B streptococci (GBS) colonization is found more often than among women with non-chlamydial cervicitis. This study included 351 (mean age 31.7 +/- 6.82) not pregnant, menstruating, sexually active women. We confirmed a high frequency (49.3%) of C. trachomatis infection among women with cervicitis. Cervical ectopia was confirmed in 26.5% of examined women, in half of them ectopia was associated with chlamydial infection. We did not notice differences in frequency of colonization by urogenital mycoplasmas and GBS among women with chlamydial and non-chlamydial cervicitis.

[Chlamydia trachomatis and human papillomavirus (HPV) infections in teenage sexually active girls]. / Zakazenia chlamydia trachomatis i wirusem brodawczaka ludzkiego u nastoletnich dziewczat.

OBJECTIVE: The purpose of the study was to determine the frequency of C.trachomatis and HPV infections in teenage, sexually active girls. MATERIAL AND METHODS: 48 non-pregnant, sexually active young women (between 16-19 years of age), who submitted for periodical check-up during oral contraceptive use. Patients had periodical mild pain in the lower abdominal area and increased amount of mucigenous secretion. They had their first sexual intercourse before 16 years of age, multiple partners (>3), unprotected intercourse. The direct immunofluorescence (DIF) was used for C. trachomatis antigen detection (Chlamydia Direct IF (bioMérieux, France). DNA HPV presence and oncogenic potential was assessed using hybridization method (Hybrid Capture I HPV Assay, Digene Corp. Beltsville, MD U.S.A.). RESULTS: C. trachomatis antigen was detected in 13 aut of 48 swabs (27%), presence of HPV DNA was detected in 2 teenage girls with normal cytology (4.2%). In cytological evaluation LSIL (low grade squamous intraepithelial lesions) was described in 5 cases. In 4 of them along with LSIL coexisted C. trachomatis infection.

[Frequency, diagnostic criteria and consequences of bacterial vaginosis in pregnant women]. / Czestosc wystepowania, kryteria diagnostyczne i nastepstwa bakteryjnego zakazenia pochwy u kobiet ciezarnych.

Vaginal discharge based on changes in a vaginal ecosystem (decreasing number of Lactobacillus and increasing number of Mobiluncus spp., Gardnerella vaginalis, Prevotella spp., Mycoplasma hominis, Peptostreptococcus spp) appears to be a major cause of bacterial vaginosis. Bacterial vaginosis is associated with: preterm delivery, premature rupture of membranes, chorioamnionitis, amniotic fluid infection, endometritis, low-weight neonates. The role of natural microflora of vagina, the most important diagnostic criteria, epidemiology and immunological changes in pregnant women with bacterial vaginosis are discussed in the light of the recent publications.