Lactic Acid Bacterial Vaginosis among Outpatients in Addis Ababa

Abstract

Background: Bacterial vaginosis (BV) is a polymicrobial syndrome in which a decrease in vaginal acidity and concentration of lactobacilli is accompanied by an increase of other pathogenic micro-organisms. The distribution of lactic acid bacteria in vaginal environment of Ethiopian women has not been documented.Objective:To assess the frequency of bacterial vaginosis in women visiting a gynecological clinic in Addis Ababa and to characterize the most common lactic acid bacteria isolated from vaginal fluid.Methods: Vaginal samples from a total of 100 women aged between 18 and 60 years and visiting a gynecological clinic in Addis Ababa were collected between January and June, 2008 and analyzed for their microbial flora. Their Nugent score was determined microscopically and Lactic acid bacteria were isolated, characterized and their drug resistance determined.Results: BV frequency among these study women was 32%. Only 15% were symptomatic as detected by the presence of malodor or abnormal discharge. The majority (44%) was in the age group of 18-30 years and less than a quarter of them had BV. It was also detected in about a third of women belonging to the two major religious denominations hadBV. The frequency of BV among pregnant women was low. The frequency of BV in women with prior abortion was slightly higher than 1/3. A total of 350 lactic acid bacterial isolates were obtained and 40% of them belonged toLactococcus species. Lactobacillus, Leuconostoc, and Pediococcus were encountered at different frequencies. Resistance was seen against all drugs at various frequencies among the LAB (Lactic Acid Bacteria) isolates.Resistance of LAB to all antibiotics tested ranged between 20% and 42%, and the least resistance was noted against vancomycin. All women who had been positive for bacterial vaginosis were accordingly treated.Conclusion: Bacterial vaginosis may contribute to adverse reproductive outcomes. Prevalence of bacterial vaginosis in this study compares well with other African studies. The species richness and relative abundance of vaginal lactic acid bacteria in this study may be considered to design better probiotic products as bacterial replacement therapy.