Cervicitis as a cause of preterm birth in women

The aim: To evaluate the prevalence of preterm birth and to determine the role of cervicitis as a cause of preterm birth in women in Ukraine. Materials and methods: We conducted a retrospective multicentre cohort study from January 1st, 2019 to December 31st, 2021. This study included pregnant women aged 17-50 years admitted to the labor ward at the 13 hospitals from 10 regions of Ukraine. Results: Of the 8151 participants, the prevalence of preterm birth was 2226 (27.3%, [95% CI 26.8 – 27.8]) whereas 5925 (72.7% [95% CI 72.2-73.2]) delivered at term. Preterm birth associated with cervicitis was 76.3% (4,388/2666). History of cervicitis, maternal age, previous preterm labor or premature birth, and pregnancy with twins, triplets or other multiples were identified as independent risk factors of preterm birth. Conclusions: Preterm birth in Ukraine is widespread, the number of which tends to increase. Infection and inflammation of the cervix seem to play a significant role for preterm birth. Early detection and treatment of cervicitis can reduce the risk of preterm birth. Women who have a history of poor pregnancy outcomes are at greater risk of poor outcomes in following pregnancies. Health providers should be aware of this risk when treating patients with a history of poor pregnancy outcomes

Prevalence of healthcare-associated cervicitis and antimicrobial resistance of the responsible pathogens in Ukraine: results of a multicenter study (2019-2021)

The aim: To obtain the first estimates of the current prevalence of healthcare-associated cervicitis (HACs) and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We conducted a retrospective multicentre cohort study was based on surveillance data from January 1st, 2019 to December 31st, 2021 in Ukraine. Antibiotic susceptibility testing was determined by Kirby–Bauer disc diffusion test according to the protocol of the European Committee on Antimicrobial Susceptibility Testing. Results: Of the 6,885 participants in this study, 1746 women (25.5%) met the clinical definition of cervicitis. Prevalence of HACs and cervcits caused sexually transmitted pathogens were 12.7% and 8.3%, respectively. The incidence of HACs among women with a history of gynecological procedures was 25.4%. The main causes of HACs were legal induced abortions (28.8%), vaginal hysterectomy (23.9%), and postpartum instrumental examination (12.8%). The predominant pathogens of HACs were: Escherichia coli, Enterobacter spp., Klebsiella spp., Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis. Methicillin-resistance was observed in 20.8% of S. aureus (MRSA). Vancomycin resistance was observed in 7.4% of isolated enterococci (VRE). Resistance to third-generation cephalosporins was observed in 13.1% Klebsiella spp. and E.coli 17.5% isolates. Carbapenem resistance was identified in 11.6% of P.aeruginosa isolates. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (33.5%, vs 8.7%). The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 34.6%. Conclusions: This study showed that the prevalence of healthcare-associated cervicitis in Ukraine is high, and many cases were caused by antibiotic-resistant pathogens

Hyperplasia of the female reproductive organs in Ukraine

The aim: To determine the role of infectious diseases as the cause of the Cervical, Ovarian and Breast hyperplasia in Ukraine. Materials and methods: We conducted a retrospective multicenter cohort study from January 1st, 2020 to December 31st, 2022. This study included patients aged 20-59 years with a diagnosis of hyperproliferative pathology of the women reproductive organs without atypia, who sought medical care for hyperplastic processes admitted to the 12 hospitals from 9 regions of Ukraine. Results: We had examined 4,713 women; out of which 81.1% met the clinical definition of female reproductive organs hyperplasia. Of all hyperplasia cases, most frequently recorded types were breast hyperplasia (41,7%), followed by cervical hyperplasia (31,1%) and ovarian hyperplasia (27,2%). History of Cervicitis (p<0.001), Vaginal cuff infection (p<0.001), Oophoritis (p<0.001), and Mastitis (p<0.001) were identified as independent risk factors of Cervical, Ovarian and Breast hyperplasia. Conclusions: This study showed that surgical site infections after obstetric and gynecological operations are is the cause of Cervical, Ovarian and Breast hyperplasia. Therefore, early detection and treatment SSIs can reduce the risk of hyperplasia these organs