The purpose of the work was to monitor the composition of the microbiota of certain biotopes of the urogenital system and to identify antibiotic-resistant strains of microorganisms that cause infectious diseases in patients of different ages and sexes for the period 2017-2019. Material and methods. We studied qualitative and quantitative composition of the microbiota of certain biotopes of the urogenital tract of 2086 people of different age and sex who were patients of the Medical Diagnostic Center on the basis of the Dnieper Medical Academy (Dnipro) during 2017-2019. Results and discussion. The results of the comparative analysis showed the development of infectious lesions in 563 people, which amounted to 28.89% in 2017, 25.13% in 2018, and 27.32% of cases in 2019. A comparative analysis revealed a high degree of damage to individual biotopes: vulva (41.75-48.53% of cases) in girls and urethra (25.0-100%) in boys of 1-5 years; vagina (45.83-65.98%) and cervical canal (7.22-14.71%) in women 17-35 years; urethra (14.28-37.04%) and ejaculate (14.28-19.05% of cases) in men 17-35 years. In the study of the microbial landscape of the reproductive tract of the examined patients, the spectrum of priority pathogens of urogenital infections was determined: in children and adolescents it was Escherichia coli, Streptococcus pyogenes, Haemophilus spp., Candida spp.; in women: Ureaplasma spp., Candida albicans, Streptococcus agalactiae, Mycoplasma hominis, Escherichia coli; in men: Escherichia coli, Enterococcus faecalis, Candida albicans and Staphylococcus aureus. When determining the effectiveness of the antimicrobial action of a number of antibiotics of different pharmacological groups on the isolated clinical isolates of microorganisms which are the causative agents of infectious processes, high levels of resistance were established in the studied groups of microorganisms in relation to drugs of the tetracycline class, in particular to doxycycline – 34.85-46.43% of cases; cephalosporins, especially to cefepime – 6.06-42.86% and fluoroquinolones, in particular to ciprofloxacin – 10.60-25.0% of cases. Conclusion. Monitoring of the circulation of antibiotic-resistant variants of uropathogenic microorganisms during 2017-2019 showed a tendency to increased manifestations of drug resistance: ciprofloxacin – by 14.4%, clindamycin – by 7.82%, aztreonam – by 7.07%, ampicillin – by 3,80%, imipinem and vancomycin – by 2.82%, erythromycin – by 1.86%, amikacin – by 1.09%. At the same time, there was a positive trend in reducing resistance to cefepime – by 36.26%, doxycycline – by 11.58%, chloramphenicol – by 4.56%, co-trimoxazole – by 2.92%, linezolid – by 1.52 %, furadonin – by 0.65%. The presented data indicated the need for constant microbiological monitoring in order to increase the effectiveness of treatment of patients with inflammatory processes in the genitourinary organs.

Keywords: biotopes, urogenital tract, microbial landscape, antibiotic resistance, age and gender categories

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1. Aragón IM, Herrera-Imbroda B, Queipo-Ortuño MI, Castillo E, Del Moral JS, Gómez-Millán J, et al. The Urinary Tract Microbiome in Health and Disease. Eur Urol Focus. 2018; 4(1): 128-38. https://doi.org/10.1016/j.euf.2016.11.001. https://www.ncbi.nlm.nih.gov/pubmed/28753805
2. Wolfe AJ, Brubaker L. "Sterile urine" and the presence of bacteria. Eur Urol Focus. 2018; 68(1): 173-74. https://doi.org/10.1016/j.eururo.2015.02.041. https://www.ncbi.nlm.nih.gov/pubmed/25774008. https://www.ncbi.nlm.nih.gov/pmc/articles/4659483
3. Schneeweiss J, Koch M, Umek W. The human urinary microbiome and how it relates to urogynecology. Int Urogynecol J. 2016; 27(1): 1307-12. https://doi.org/10.1007/s00192-016-2944-5. https://www.ncbi.nlm.nih.gov/pubmed/26811114
4. Radzinskiy VE, Khamoshina MB, Kaygorodova LA. Korrektsiya narusheniy biotsenoza vlagalishcha: marsh na meste ili dvizhenie vpered? [Correction of vaginal biocenosis disorders: march in place or forward movement?]. Reproduktivnaya endokrinologiya . 2014; 4 (18): 92-100. [Russian]
5. Gottschick C, Deng ZL, Masur C, Abels C, Pieper DH, Wagner-Döbler I. The urinary microbiota of men and women and its changes in women during bacterial vaginosis and antibiotic treatment. Microbiome. 2017; 5 (99): 1-15. https://doi.org/10.1186/s40168-017-0305-3. https://www.ncbi.nlm.nih.gov/pubmed/28807017. https://www.ncbi.nlm.nih.gov/pmc/articles/5554977
6. Bao Y, Al KF, Chanyi RM, Whiteside S, Dewar M, Razvi H, et al. Questions and challenges associated with studying the microbiome of the urinary tract. Ann Transl Med. 2017; 5(2): 33-6. https://doi.org/10.21037/atm.2016.12.14. https://www.ncbi.nlm.nih.gov/pubmed/28217698. https://www.ncbi.nlm.nih.gov/pmc/articles/5300849
7. Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015; 109(1): 309-18. https://doi.org/10.1179/2047773215Y.0000000030. https://www.ncbi.nlm.nih.gov/pubmed/26343252. https://www.ncbi.nlm.nih.gov/pmc/articles/4768623
8. Richard JF, Yitzhak T. Antibiotics and bacterial resistance in the 21st century. Perspect Medicin Chem. 2014; 6(1): 25-64. https://doi.org/10.4137/PMC.S14459. https://www.ncbi.nlm.nih.gov/pubmed/25232278. https://www.ncbi.nlm.nih.gov/pmc/articles/4159373
9. Cosgrove SE, Carmeli Y. The impact of antimicrobial resistance on health and economic outcomes. Clinical Infect Dis. 2003; 36(1): 1433-7. https://doi.org/10.1086/375081. https://www.ncbi.nlm.nih.gov/pubmed/12766839
10. Friedman ND, Temkin E, Carmeli Y. The negative impact of antibiotic resistance. Clin Microbiol Infect. 2016; 22(1): 416-22. https://doi.org/10.1016/j.cmi.2015.12.002. https://www.ncbi.nlm.nih.gov/pubmed/26706614
11. Yusuf EO, Kemjou TS. Antibiotic resistance among genital tract isolates from sexually-transimitted disease patients. Med Lab Sci J. 2005; 14(1): 63-8. https://doi.org/10.4314/jmls.v14i1.35321
12. Amin ET, Njumkeng C, Kika BT, Fualefac A, Njukeng P. Pattern of antimicrobial resistance among bacterial isolates from urogenital clinical specimens: a descriptive study from the Buea Health District, Cameroon. Drugs-Real World Outcomes. 2018; 5(1): 101-8. https://doi.org/10.1007/s40801-018-0132-2. https://www.ncbi.nlm.nih.gov/pubmed/29651691. https://www.ncbi.nlm.nih.gov/pmc/articles/5984608
13. Rampersaud R, Randis TM, Ratner AJ. Microbiota of the upper and lower genital tract. Semin. Fetal Neonatal Med. 2012; 17(1): 51-7. https://doi.org/10.1016/j.siny.2011.08.006. https://www.ncbi.nlm.nih.gov/pubmed/21920833. https://www.ncbi.nlm.nih.gov/pmc/articles/3242913
14. Moreno I, Simon C. Deciphering the effect of reproductive tract microbiota on human reproduction. Reprod Med Biol. 2019; 18(1): 40-50. https://doi.org/10.1002/rmb2.12249. https://www.ncbi.nlm.nih.gov/pubmed/30655720. https://www.ncbi.nlm.nih.gov/pmc/articles/6332752
15. Franasiak JM, Scott RT. Introduction: microbiome in human reproduction. Fertil Steril. 2015; 104(6): 1341-3. https://doi.org/10.1016/j.fertnstert.2015.10.021. https://www.ncbi.nlm.nih.gov/pubmed/26515381
16. Franasiak JM, Scott RT. Reproductive tract microbiome in assisted reproductive technologies. Fertil Steril. 2015; 104(6): 1364‐71. https://doi.org/10.1016/j.fertnstert.2015.10.012. https://www.ncbi.nlm.nih.gov/pubmed/26597628
17. Whitman WB, Holt JG. Bergey's manual of systematic bacteriology. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. 787 p.
18. CLSI. Performance standards for antimicrobial susceptibility testing. 30th ed. Wayne PA: Clinical and Laboratory Standards Institute; 2019. 332 p.
19. American Society for Microbiology. ASM style manual for journals and books. Washington, DC: American Society for Microbiology; 1985. 190 p.
20. Naber KG, Holfstetter A. Recommended standards in diagnosis and therapy of urinary tract infections. Eur Urol. 1998; 34(1): 1-6.
21. Stricker T, Navratil F, Sennhauser FH. Vulvovaginitis in the prepubertal girls. Archives of disease in childhood. 2019; 88(4): 324-6. https://doi.org/10.1136/adc.88.4.324. https://www.ncbi.nlm.nih.gov/pubmed/12651758. https://www.ncbi.nlm.nih.gov/pmc/articles/1719516
22. Chang SL, Shortliffe LD. Pediatric urinary tract infections. Pediatr Clin. North Am. 2006; 53(3): 379-400. https://doi.org/10.1016/j.pcl.2006.02.011. https://www.ncbi.nlm.nih.gov/pubmed/16716786
23. Simões e Silva A.C, Oliveira EA. Update on the approach of urinary tract infection in childhood. J Pediatr. 2015; 91(6): 2-10. https://doi.org/10.1016/j.jped.2015.05.003. https://www.ncbi.nlm.nih.gov/pubmed/26361319
24. Karmazyn BK, Alazraki AL, Anupindi SA, Dempsey ME, Dillman JR, Dorfman SR, et al. Expert panel on pediatric imaging: ACR appropriateness criteria, urinary tract infection-child. J Am Coll Radiol. 2017; 14(5): 362-71. https://doi.org/10.1016/j.jacr.2017.02.028. https://www.ncbi.nlm.nih.gov/pubmed/28473093
25. Stephens GM, Akers S, Nguyen H, Woxland H. Evaluation and management of urinary tract infections in the school-aged child. Prim Care. 2015; 42(1): 33-41. https://doi.org/10.1016/j.pop.2014.09.007. https://www.ncbi.nlm.nih.gov/pubmed/25634703
26. Larcombe J. Urinary tract infection in children. Am Fam Physician. 2010; 82(10): 1252-6.
27. Hickey RG, Zhou X, Settles ML, Erb J, Malone K, Hansmann MA, et al. Vaginal microbiota of adolescent girls prior to the onset of menarche resemble those of reproductive-age women. MBio. 2019; 6(2): 75-9. https://doi.org/10.1128/mBio.00097-15. https://www.ncbi.nlm.nih.gov/pubmed/25805726. https://www.ncbi.nlm.nih.gov/pmc/articles/4453513
28. Zhou Y, Mihindukulasuriya KA, Gao H, La Rosa PS, Wylie KM, Martin JC, et al. Exploration of bacterial community classes in major human habitats. Genome Biology. 2019; 15(5): 66-9. https://doi.org/10.1186/gb-2014-15-5-r66. https://www.ncbi.nlm.nih.gov/pubmed/24887286. https://www.ncbi.nlm.nih.gov/pmc/articles/4073010
29. Zakharova IN, Osmanov IM, Mumladze EB, Svintsitskaya VI, Bekmurzaeva GB. Infektsiya mochevykh putey u detey: chto nuzhno znat pediatru i nefrologu [Urinary tract infection in children: what a pediatrician and nephrologist need to know]. Meditsinskiy Sovet . 2015; 1(14): 114-8. [Russian]
30. Magistro G, Stief CG. The urinary tract microbiome: the answer to all our open questions? Eur Urol Focus. 2018; 5(1): 36-8. https://doi.org/10.1016/j.euf.2018.06.011. https://www.ncbi.nlm.nih.gov/pubmed/30042043
31. Whiteside SA, Razvi H, Dave S, Reid G, Burton JP. The microbiome of the urinary tract - a role beyond infection. Nat Rev Urol. 2018; 12(1): 81-90. https://doi.org/10.1038/nrurol.2014.361. https://www.ncbi.nlm.nih.gov/pubmed/25600098
32. Brubaker L, Wolfe AJ. The new world of the urinary microbiota in women. Am J Obstet Gynecol. 2015; 213(1): 644-9. https://doi.org/10.1016/j.ajog.2015.05.032. https://www.ncbi.nlm.nih.gov/pubmed/26003055. https://www.ncbi.nlm.nih.gov/pmc/articles/4876712
33. González A, Vázquez‐Baeza Y, Knight R. SnapShot: the human microbiome. Cell. 2014; 158(3): 690-5. https://doi.org/10.1016/j.cell.2014.07.019. https://www.ncbi.nlm.nih.gov/pubmed/25083877
34. Stein R, Dogan HS, Hoebeke P, Kočvara R, Nijman RJ, Radmayr C, et al. Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 2015; 67: 546-58. https://doi.org/10.1016/j.eururo.2014.11.007. https://www.ncbi.nlm.nih.gov/pubmed/25477258
35. Johnson J, Neas B, Parker DE, Fortenberry J, Cowan LD. Screening for urethral infection in adolescent and young adult males. Journal of Adolescent Health. 2019; 14(5): 356-61. https://doi.org/10.1016/S1054-139X(08)80007-9
36. Jungwirth A, Giwercman A, Tournaye H, Diemer G, Kopa Z, Dohle G, et al. European Association of Urology Guidelines on male intertility: the 2012 update. Eur Urol. 2012; 62(2): 324-32. https://doi.org/10.1016/j.eururo.2012.04.048. https://www.ncbi.nlm.nih.gov/pubmed/22591628
37. Serov VN. Lechenie urogenitalnykh infektsiy u zhenshchin v sovremennykh usloviyakh [Treatment of urogenital infections in women in modern conditions]. Russkiy meditsinskiy zhurnal. 2017; 8(8): 564-70. [Russian]
38. Benyuk VO, Shcherba OA. Mikroekosistema pikhvi u zhinok reproduktivnogo viku i metodi yiyi korektsiyi [Vaginal microecosystem in women of reproductive age and methods of its correction]. Zdorove zhenshchiny. 2017; 1(8): 44-50. [Ukrainian]
39. Beckman C. Ethics in obstetrics and gynecology. 9 th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. 174 p.
40. Tsizina EA. Mikroflora vlagalishcha zhenshchin pri bakterialnom vaginoze [The microflora of the vagina of women with bacterial vaginosis]. V: Materialy I Mezhdunar nauch konf "Novye zadachi sovremennoy meditsiny". [Internet]. 2012 Jan; Perm. Perm: «Merkuriy»; 2012 [tsitirovano 2020 May 11]; s. 38-40. Available from: https://moluch.ru/conf/med/archive/51/1483/
41. Odoki M, Almustapha Aliero A, Tibyangye J, Maniga JN, Wampande E, Kato CD, et al. Prevalence of bacterial urinary tract infections and associated factors among patients attending hospitals in Bushenyi District, Uganda. Int J Microbiol. 2019; 1(10): 62-70. https://doi.org/10.1155/2019/4246780. https://www.ncbi.nlm.nih.gov/pubmed/30906323. https://www.ncbi.nlm.nih.gov/pmc/articles/6397969
42. Yu F, Tang YT, Hu ZQ, Lin XN. Analysis of the vaginal microecological status and genital tract infection characteristics of 751 pregnant women. Med Sci Monit. 2018; 24(1): 5338-45. https://doi.org/10.12659/MSM.909051. https://www.ncbi.nlm.nih.gov/pubmed/30065240. https://www.ncbi.nlm.nih.gov/pmc/articles/6085980
43. Sherrard J, Wilson J, Donders G, White D, Jensen JS, European IUSTI. European (IUSTI/WHO) guideline on the management of vaginal discharge. Int J STD AIDS. 2019; 23(13): 1258-72. https://doi.org/10.1177/0956462418785451. https://www.ncbi.nlm.nih.gov/pubmed/30049258
44. Gillet E, Meys JF, Verstraelen H, Verhelst R, De Sutter P, Temmerman M, et al. Association between bacterial vaginosis and CIN: systematic review and meta-analysis. PLoS One. 2019; 7(10): 452-6. https://doi.org/10.1371/journal.pone.0045201. https://www.ncbi.nlm.nih.gov/pubmed/23056195. https://www.ncbi.nlm.nih.gov/pmc/articles/3462776
45. Kozlyuk VA, Kozlyuk AS. Uretrity u muzhchin: infektsii, peredavaemye polovym putem: aktualnye voprosy diagnostiki: tsitomorfologiya: lechenie [Urethritis in men: sexually transmitted infections: current diagnostic issues: cytomorphology: treatment]. Kiev: Stil Prem'yer; 2006. 172 s. [Russian]
46. Mändar R. Microbiota of male genital tract: Impact on the health of man and his partner. Pharmacological Research. 2019; 69(1): 32-41. https://doi.org/10.1016/j.phrs.2012.10.019. https://www.ncbi.nlm.nih.gov/pubmed/23142212
47. Rowe M, Veerus L, Trosvik P, Buckling A, Pizzari T. The reproductive microbiome: an emerging driver of sexual selection, sexual conflict, mating systems, and reproductive isolation. Trends in Ecology & Evolution.2020; 1(1): 1-10. https://doi.org/10.1016/j.tree.2019.11.004. https://www.ncbi.nlm.nih.gov/pubmed/31952837
48. Ruggeri M, Cannas S, Cubeddu M, Molicotti P, Piras GL, Desole S, et al. Bacterial agents as a cause of infertility in humans. New Microbiol. 2016; 39(2): 206-9.
49. Ranđelović G, Mladenović V, Ristić L, Otašević S, Branković S, Mladenović-Antić S, et al. Microbiological aspects of vulvovaginitis in prepubertal girls. Eur J Pediatr. 2012; 171(1): 1203-8. https://doi.org/10.1007/s00431-012-1705-9. https://www.ncbi.nlm.nih.gov/pubmed/22383074
50. Bumbulienė Ž, Venclavičiūtė K, Ramašauskaite D, Arlauskiene A, Bumbul E, Drąsutiene G, et al. Microbiological findings of vulvovaginitis in prepubertal girls. Postgrad Med J. 2014; 90(1): 8-12. https://doi.org/10.1136/postgradmedj-2013-131959. https://www.ncbi.nlm.nih.gov/pubmed/24191064
51. Yilmaz AE, Celik N, Soylu G, Donmez A, Yuksel C. Comparison of clinical and microbiological features of vulvovaginitis in prepubertal and pubertal girls. J Formos Med Assoc. 2012; 111(1): 392-6. https://doi.org/10.1016/j.jfma.2011.05.013. https://www.ncbi.nlm.nih.gov/pubmed/22817817
52. Larsen B, Monif GR. Understanding the bacterial flora of the female genital tract. Clin Infect Dis. 2001; 32(4): 69-77. https://doi.org/10.1086/318710. https://www.ncbi.nlm.nih.gov/pubmed/11181139
53. Scaldazza CV, Morosetti C. Urethral and vaginal infections, age of patients and state of the pelvic floor in the aetiology of the irritative symptoms of the lower urinary tract in women. Arch Esp Urol. 2006; 59(5): 554-60. https://doi.org/10.4321/S0004-06142006000500020. https://www.ncbi.nlm.nih.gov/pubmed/16903564
54. Nadi HM, Shalan YA, Al-Qatan HY, Alotaibi S. Urinary tract infection in boys less than five years of age: a general pediatric perspective. Kuwait Med J. 2006; 38(3): 220-5.
55. De Seta F, Guaschino S, Larsen B, Donders G, Andabati G. The infections of lower genital tract. Infect Dis Obstet Gynecol. 2012; 10(3): 53-9. https://doi.org/10.1155/2012/926435. https://www.ncbi.nlm.nih.gov/pubmed/23226934. https://www.ncbi.nlm.nih.gov/pmc/articles/3513728
56. Bondar MV, Pilipenko MM, Svintukovskiy MYu, Kharchenko LA, Previsla OM, Tsvik IM. Antibiotikorezistentnist mikroorganizmiv: mekhanizmi rozvitku y shlyakhi zapobigannya [Antibiotic resistance of microorganisms: mechanisms of development and ways of prevention]. Meditsina neotlozhnykh sostoyaniy. 2016; 3(3): 11-7. [Ukrainian] https://doi.org/10.22141/2224-0586.3.74.2016.76136
57. Andrukh VS, Andrukh VN. Antibiotiki i antibiotikorezistentnist: problemi i shlyakhi virishennnya [Antibiotics and antibiotic resistance: problems and solutions]. Dityachiy likar. 2017; 4(4): 32-6. [Ukrainian]
58. Gumenyuk MI, Denisov OS, Feshchenko YuI. Antibiotikorezistentnist mikroorganizmiv. Stan problemi ta shlyakhi virishennya [Antibiotic resistance of microorganisms. The state of the problem and solutions]. Ukrayinskiy khimioterapevtichniy zhurnal. 2010; 1(23): 4-10. [Ukrainian]
59. Supotnitskiy MV. Mekhanizmy razvitiya rezistentnosti k antibiotikam u bakteriy [Mechanisms for the development of antibiotic resistance in bacteria]. Biopreparaty. 2011; 2(2): 4-44. [Russian]