Microbiological, behavioral and anamnestic predictor factors of bacterial vaginosis in women with vaginal discharge

Abstract

Introduction. Bacterial vaginosis (BV) is the primary cause of pathological vaginal discharge in women of reproductive age. Gardnerella vaginalis and Atopobium vaginae are considered key components of the vaginal microflora in BV. Etiology, pathogenesis and modes of transmission of BV are actively studied, however these questions still remain unanswered. Objective: investigate predictor factors of BV in women with vaginal discharge. Material and methods. In total, 318 women were included. As clinical material, vaginal samples were used. BV was diagnosed using the Nugent method. For quantitative determination of G. vaginalis and A. vaginae DNA, real-time PCR was used. Behavioral and anamnestic data were obtained from questionnaire filled out by the patients. Results. BV was diagnosed in 27 % of women. G. vaginalis and A. vaginae DNA was detected, respectively, in 93 % and 83 % of patients with BV, 73 % and 59 % - with intermediate microflora, 52 % and 38 % - with normal microflora. Difference between the three types of microflora in the frequency and concentrations of these microorganisms were statistically significant. Detection of G. vaginalis and A. vaginae were significant predictor factors of BV (OR 12.2; 95 % CI 5.1-29.4 and OR 7.9; 95 % CI 4.2-14.9, respectively), with chances to diagnose BV being manifold increased when clinically significant concentrations of these bacteria were detected (≥3×106 and ≥8×105 DNA copies/ml for G. vaginalis and A. vaginae, respectively). Detection of clue cells in Gram stained preparations was shown to be the strongest BV predictor (OR 765.6; 95 % CI 99.6-5883.2). Conclusions. BV is diagnosed in more than one fourth of women with vaginal discharge. Detection of G. vaginalis and A. vaginae, especially in clinically significant concentrations, and clue cells in Gram stained preparations are significant predictor factors of BV.