Oral metronidazole versus clindamycin to treat bacterial vaginosis in pregnancies at risk for preterm labor.

Evaluation of molecular thresholds based quantification of Gardnerella vaginalis and Fannyhessea vaginae for improved diagnosis of Bacterial Vaginosis.

Adolescent girls and young women (AGYW) in Uganda experience a high burden of sexually transmitted infections (STIs), increasing vulnerability to HIV acquisition. Despite the WHO and Uganda's Ministry of Health recommendations, routine integration of STI screening into HIV testing services (HTS) remains limited. We assessed the prevalence of laboratory-confirmed STIs, associated factors and Neisseria gonorrhoeae antimicrobial resistance among AGYW seeking HTS in Entebbe, Uganda. We conducted a cross-sectional study among 321 AGYW aged 15-24 years attending HTS at the Uganda Virus Research Institute (UVRI) clinic. Endocervical swabs were tested for N. gonorrhoeae (culture and sensitivity), Trichomonas vaginalis (wet microscopy) and bacterial vaginosis (BV; Nugent scoring). Syphilis was assessed using the Treponema pallidum haemagglutination assay. Modified Poisson regression was used to estimate adjusted prevalence ratios (aPR) for factors associated with any STI. Overall STI prevalence was 35.2% (n=113, 95% CI 30.0 to 40.5), with 41.6% (47/113) of infections occurring among asymptomatic individuals, driven largely by BV at 31.5% (100/318), followed by T. vaginalis at 7.3% (23/316), syphilis at 5.0% (16/321) and N. gonorrhoeae at 1.3% (4/318). STI prevalence among AGYW who tested positive for HIV was 47.8% (11/23), while among those who tested negative was 34.2% (102/298). In multivariable analysis, having fewer sexual partners was associated with lower STI prevalence (one partner: aPR 0.07, 95% CI 0.03 to 0.14; 2-3 partners: aPR 0.73, 95% CI 0.58 to 0.90, compared with >3 partners); condom use was associated with lower STI prevalence (aPR 0.62, 95% CI 0.45 to 0.84), and intrauterine device use was associated with higher STI prevalence (aPR 1.61, 95% CI 1.24 to 2.08). Among four N. gonorrhoeae isolates, three showed resistance to ciprofloxacin, and all four were resistant to penicillin G; all were susceptible to cefotaxime. A high burden of STIs, including asymptomatic infections, was observed among AGYW seeking HTS in an urban Ugandan setting. These findings support the integration of diagnostic STI screening into HTS.

BackgroundVaginal dysbiosis is associated with HIV acquisition and preterm delivery. Our objective was to evaluate prevalent vaginal infections, and changes in microbiota and cytokines among pregnant and breastfeeding women from 4 African countries using dapivirine vaginal ring (DVR) or oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in 2 parallel nonoverlapping trials.MethodsMTN-042 (NCT03965923) was a randomized trial evaluating daily TDF/FTC or monthly DVR during pregnancy (n = 558), and MTN-043 (NCT04140266) was a randomized study evaluating TDF/FTC or DVR during breastfeeding (n = 197). Women were evaluated for vaginal infections at enrollment and follow-up using Nugent score and BD Max™ Vaginal Panel. Microbiota was evaluated by quantitative PCR for 12 bacterial targets; 5 cytokines and RANTES were evaluated by MAGPIX. Rates of change in vaginal microbiota and cytokines and prevalence of vaginal infections were evaluated using generalized linear mixed models and Benjamini–Hochberg (BH)-adjusted P values.ResultsVaginal infections, microbiota and cytokines did not differ between the 2 study arms at baseline. Lactobacillus crispatus was less frequently detected postpartum and during breastfeeding compared with pregnancy. Bacterial vaginosis (BV) and Candida were common during pregnancy and breastfeeding, but there was no significant difference in the rate of change in these infections by study arm. BV-associated microbiota and cytokines changed over pregnancy and postpartum, but the rate of change by study arm did not differ.ConclusionsVaginal infections, microbiota or cytokines/chemokines changes were similar in women using DVR or TDF/FTC. These data augment the robust safety profile for DVR to support its use during pregnancy and breastfeeding.

Impact of STI and BV co-infection on genital cytokine profiles in postpartum women living with HIV on ART.

Most Herpes simplex virus type 2 (HSV-2) infection is asymptomatic but increases the risk of HIV acquisition, possibly due to alterations in genital immunology. We examine associations of HSV-2 prevalence and incidence with epithelial barrier disruption. The study was nested within the longitudinal Maisha Fiti cohort of women who sell sex in Nairobi, Kenya. HSV-2 serostatus was assessed by Kalon HSV-2 IgG assay. Socio-behavioural characteristics were assessed by questionnaire and analysed by logistic regression. Immune factors (including soluble E-cadherin (sE-cad)) were assayed in cervicovaginal secretions by multiplex immunoassay, log-transformed and analysed through linear regression. Among 731 HIV-negative participants, 414 (57%) were HSV-2 seropositive. These women were older (median age 35vs 28 years; p<0.001) and reported increased intravaginal washing (64vs 56%; p = 0.027) than those who were HSV-2 seronegative. Genital sE-cad levels were similar, and IL-6 levels were lower in seropositive participants (1.15vs 1.28 pg/mL, p<0.01). Seroincidence was 10.7/100 person (95% CI: 7.3, 15.2) years among the 317 initially seronegative participants. Incident infection was associated with older age (31vs 28 years, p = 0.001), increased number of clients (6vs 4 clients/week, p = 0.005), and bacterial vaginosis (BV) (32vs 15%, p = 0.009). Although women who acquired HSV-2 had higher sE-cad and lower MIP-3α levels, there was no association after controlling for Nugent score. Subclinical epithelial barrier disruption is unlikely to be underpinning HIV acquisition in asymptomatic HSV-2 infection. There was no evidence of genital immune predictors of HSV-2 acquisition, whereas the vaginal microbiome is important.

Bacterial vaginosis (BV) is the leading form of vaginal microbiome imbalance in women of reproductive age and has been associated with dietary patterns and gut microbial profiles. This study investigated the association between a literature-based dietary index for gut microbiota (DI-GM) and BV prevalence in US women. We conducted a cross-sectional analysis of 1169 nonpregnant women aged 20 to 49 years from the National Health and Nutrition Examination Survey 2001 to 2004 with Nugent score measurements and complete dietary data. BV was defined as a Nugent score ≥ 7. Dietary intake was assessed via two 24-hour recalls, and DI-GM was computed based on 14 food groups classified as beneficial or unbeneficial for gut microbial health. Multivariable survey-weighted logistic regression models were used to estimate odds ratios and 95% confidence intervals. BV prevalence was 31.2%. Higher DI-GM scores were associated with lower odds of BV; women with scores ≥6 had reduced odds compared with those with scores of 0 to 3 (adjusted odds ratio = 0.75; 95% confidence interval: 0.60–0.94; P = .015; P-trend = .013). In conclusion, higher DI-GM scores were inversely associated with BV prevalence in this cross-sectional study. These findings should be interpreted cautiously, and prospective studies are needed to confirm causality.

This meta-analysis systematically evaluated the effects of probiotic supplementation on vaginal microbiota and inflammatory factors in women. PubMed, Embase, Web of Science, CNKI, and Wanfang were searched from inception to January 2026 for randomized and controlled studies. Outcomes included vaginal pH, Nugent score, and inflammatory cytokines (IL-4, IL-6, IL-10, TNF-α). Fifteen studies were included. Compared with controls, probiotics did not significantly reduce IL-4, IL-6, IL-10, or TNFα levels, nor did they significantly improve Nugent score. However, probiotic supplementation significantly reduced vaginal pH (OR = 0.36, 95% CI: 0.15-0.89; P = 0.03), indicating improved maintenance of a weakly acidic vaginal environment. Sensitivity analyses showed generally stable results, although heterogeneity remained substantial for several outcomes. Overall, probiotics appear effective in modulating vaginal acid-base balance but show limited evidence for improving inflammatory cytokine profiles or restoring vaginal microbiota structure. Current data are insufficient to support routine probiotic use for optimizing vaginal microbiota and inflammatory status. Further high-quality, well-designed randomized controlled trials are required to clarify their clinical benefits.

Gardnerella vaginalis is a key bacterium in the etiology of bacterial vaginosis (BV) and contributes to biofilm formation. Gardnerella is a facultative anaerobic bacterium, meaning it can grow both in the presence of oxygen and under anaerobic conditions. We conducted a prospective study in 2025, including 160 consecutive vaginal samples from women submitted for pathogenic bacteria. Clinical information on the referral form indicated in 87 women (54.4%), from which colpitis in 64 cases (73.6%). There were 43 pregnant women (26.9%), with an average age of 30.7 years. Each vaginal sample was cultured on Gardnerella agar and incubated in both CO2 and anaerobic atmospheres. The culture plates were examined after 24 and 48 h of incubation, independently of other results. In cases where suspicious colonies with beta-hemolysis were observed, bacterial identification was performed using MALDI-TOF mass spectrometry (Bruker). Gram-stained smears were evaluated according to the Nugent score. The bacteria Gardnerella vaginalis and Gardnerella leopoldii/swidsinskii were detected in 46 (28.8%) samples. The sensitivity of G. vaginalis and G. leopoldii/swidsinskii cultivation on Gardnerella agar in a CO2 atmosphere was 67.4% compared to anaerobic cultivation. Anaerobic cultivation on Gardnerella agar proved to be a superior method for the isolation of G. vaginalis and G. leopoldii/swidsinskii compared to cultivation in a CO2 atmosphere. The diagnosis of BV in clinical practice relies on standard Amsel's criteria, gram-stained vaginal smears evaluated using the Nugent scoring system or Ison-Hay criteria, and the isolation of G. vaginalis and G. leopoldii/swidsinskii.IMPORTANCEBacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age and is associated with significant adverse outcomes, including preterm birth, spontaneous abortion, and increased susceptibility to sexually transmitted infections. Accurate and timely microbiological diagnosis is therefore clinically important. Our study demonstrates that anaerobic incubation on selective Gardnerella agar improves the detection of Gardnerella vaginalis and Gardnerella leopoldii/swidsinskii compared with incubation in a CO2-enriched atmosphere. Under anaerobic conditions, colonies were larger, hemolysis was more pronounced, and overall sensitivity was higher. Although BV diagnosis in clinical practice primarily relies on Amsel's criteria and Nugent scoring, optimized culture conditions provide valuable complementary microbiological evidence. These findings contribute to the optimization of laboratory procedures and may enhance the reliability of routine diagnostic workflows in women with suspected BV.

Introduction. Infectious vaginitis, caused mostly by bacterial vaginosis (BV), Candida vaginitis (CV) and Trichomonas vaginitis (TV), is a common reason for primary care visits. Recent studies demonstrate the potential utility of molecular assays in replacing conventional diagnostic methods.Hypothesis/Gap Statement. Different diagnostic standards are in use for BV; published studies have evaluated molecular diagnostic tests against Amsel criteria, Nugent score or a combination of both. In the UK, Hay/Ison criteria are commonly used, but there are limited studies evaluating molecular diagnostic assays against these criteria.Aim. This study evaluated the performance of Hologic's Aptima® BV and CV/TV assays relative to Hay/Ison criteria for BV and culture for CV in women with symptoms of vaginitis attending primary care centres in the UK.Methodology. Paired vaginal swabs were collected from women ≥18 years of age undergoing testing for Chlamydia trachomatis and Neisseria gonorrhoea using the Hologic Aptima Combo 2 (AC2) assay, alongside standard of care (SOC) testing for vaginitis (Hay/Ison criteria for BV; culture for CV). Samples received for AC2 testing were tested for vaginitis using Hologic Aptima BV and Aptima CV/TV assays. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of Aptima BV and Aptima CV/TV assays relative to SOC methodology were determined. For discrepancy analysis, selected samples were evaluated further using third-party (Thermo Fisher) Vaginal Plus and pan-Candida real-time PCR.Results. This study included 2,152 women. The mean (standard deviation) age of participants was 35.1 (11.5) years. Sensitivity and specificity estimates for the Aptima BV assay were 98.8% and 77.7% and 94.9% and 88.3% for CV detection by Aptima CV/TV, respectively, relative to SOC. Overall diagnostic accuracy values were 80.2% for Aptima BV and 90.0% for Aptima CV/TV. Although not routinely tested for in our population, a limited evaluation of TV detection by the combined Aptima CV/TV assay relative to the monoplex Aptima TV assay in 75 women indicated sensitivity and specificity values of 87.5% and 100%, respectively.Conclusion. The Aptima BV and CV/TV assays demonstrated high sensitivity and specificity relative to SOC methodology in UK laboratories and are a viable alternative to conventional vaginitis testing.

Female genital mutilation/cutting (FGM/C) is harmful to physical, mental, and reproductive health, though the effect of this practice on a woman's HIV susceptibility is poorly understood. Despite the known associations of FGM/C with short-term vaginal epithelial damage, neither genital inflammation nor the genital microbiome have been explored in women who have undergone FGM/C. In this study we compare the genital immune milieu and microbiome among female sex workers (FSWs) by FGM/C status, hypothesizing that these biological factors are dysregulated in women who have undergone FGM/C, heightening their risk of HIV acquisition. 1003 FSWs in Nairobi, Kenya, were enrolled in the Maisha Fiti study and visited a study clinic up to three times from June 2019 to March 2021. Participants self-reported any previous exposure to FGM/C as well as other relevant sociodemographic factors. Levels of proinflammatory cytokines and soluble E-cadherin (sE-cad), a biomarker of epithelial barrier disruption, were measured by multiplex immunoassay using self-collected cervicovaginal secretion samples provided by HIV-uninfected participants. Genital inflammation was defined using a composite score of inflammatory cytokines previously associated with HIV acquisition. The presence of inflammation was compared longitudinally between groups using mixed models to control for potential confounders including age, bacterial vaginosis (BV) status as defined by Nugent score, and others. Vaginal bacterial abundance, Shannon diversity, and total levels of key vaginal bacteria were measured by qPCR and compared by FGM/C status in an exploratory analysis. 44 of 1003 (4%) participants had undergone Type I or II FGM/C. These participants were older (p < 0.001) and more likely to test positive for herpes simplex virus-2 (HSV-2; p = 0.04), and less likely to have completed primary education (p = 0.03). Among HIV-uninfected participants, there was no evidence that genital inflammation was associated with FGM/C status after controlling for potential confounders (aOR = 0.70; 95% CI: 0.31-1.59; p = 0.40). There was no evidence of a difference in BV prevalence (p > 0.99), total bacterial abundance (p = 0.96), or Shannon diversity (p = 0.15) by FGM/C status. Type I or II FGM/C was not associated with genital inflammation or microbial dysregulation in the long-term among HIV-negative FSWs in this cohort. This may be due to the duration elapsed since FGM/C occurred or the lowered mucosal immune activation previously observed in FSWs.

Vaginal infections are closely associated with human papillomavirus (HPV) infection, yet research on vaginal microecology and HPV mRNA expression in pregnant women remains limited. This study aimed to explore the prevalence of vaginal microecological disorders and their relationship with HPV infection among pregnant women. A cross-sectional study was conducted involving 630 pregnant women who received prenatal care at Fujian Maternity and Child Health Hospital from 2023 to 2024. All participants underwent both the Aptima HPV E6/E7 mRNA assay and vaginal microecological examinations. Clinical characteristics, virological results, and vaginal microecological alterations were analyzed. Of the 630 participants, 241 (38.3%) exhibited vaginal microecology disorders, with aerobic vaginitis (AV, 12.7%) being the most common subtype. A total of 97 (15.4%) participants had received HPV vaccination. The overall high-risk (HR)-HPV E6/E7 mRNA positivity rate was 28.6 % , including 4.8 % for HPV16/18/45 and 23.8 % for the other 11 high-risk genotypes. Age-adjusted multivariate logistic regression analysis identified the following independent risk factors for HR-HPV E6/E7 mRNA positivity: bacterial vaginosis (BV) (aOR = 2.42, 95% CI = 1.25-4.70, P = 0.009), Nugent score ≥7 (aOR= 2.35, 95% CI = 1.21-4.57, P = 0.012), leukocyte esterase positivity (aOR = 1.49, 95% CI = 1.03-2.15, P = 0.036), and lack of HPV vaccination (aOR = 1.99, 95% CI = 1.27-3.12, P = 0.003). Vaginal microecological disorders-particularly BV and leukocyte esterase-are independent risk factors for HR-HPV E6/E7 mRNA positivity. To optimize the management of HPV-infected pregnant individuals, enhanced focus on the prevention and targeted treatment of BV is warranted.IMPORTANCEThis study addresses the limited evidence linking vaginal microecology to high-risk human papillomavirus (HR-HPV) infection in pregnancy. Bacterial vaginosis, high Nugent score, and leukocyte esterase positivity were independently associated with HPV infection, whereas HPV vaccination offered protection. These results underscore the value of integrating vaginal microecological assessment and HPV testing into routine prenatal care.

BackgroundIrrespective of symptoms, bacterial vaginosis (BV) has been linked to increased risk of sexually transmitted infections (STI) and HIV, yet clinical guidelines recommend treatment only for symptomatic BV (sBV). We compared demographic, clinical, and vaginal microbiota factors between asymptomatic BV (aBV) and sBV.MethodsData from a previously conducted vaginitis cohort study were analyzed. Participants with Amsel-BV were classified as sBV if they reported vaginal symptoms and aBV if asymptomatic. Nugent scores were assigned. Cervicovaginal lavage fluid underwent 16S rRNA gene amplicon sequencing, broad-range qPCR, and lactic acid isomer quantitative assays. Wilcoxon rank-sum, Fisher’s exact, and Chi-squared tests compared factors between aBV and sBV. Taxonomic differences were evaluated using elastic net modeling and differential abundance testing.ResultsAmong 70 participants with sBV and 270 with aBV, clinician-assessed abnormal discharge was more common in sBV (86%) than aBV (71%). In adjusted analyses, recent use of metronidazole or clindamycin, more sex partners, and education beyond high school were associated with increased odds for sBV, and injectable contraception with aBV. No consistent differences were observed between sBV versus aBV for other Amsel’s criteria, Nugent scores, or vaginal microbiota composition. D- and L-lactic acid levels were slightly higher in sBV than aBV.ConclusionsAlthough some demographic, clinical, and behavioral factors differed between sBV and aBV, no consistent differences were found in vaginal microbiota composition; lactic acid isomer levels were low in both groups. Further research is needed to understand why some experience symptoms, to identify whether other biological factors differentiate aBV from sBV, and to evaluate their respective associations with adverse reproductive outcomes.

Syphilis is a leading cause of adverse pregnancy outcomes, excessively affecting sub-Saharan Africa. Early diagnosis and treatment are crucial to prevent mother-to-child transmission. The aims of the present study were to assess prevalence and epidemiological and clinical correlates of active syphilis diagnosed using serological [treponemal and non-treponemal (lipoidal)] assays and the research-use-only (RUO) Aptima Treponema pallidum assay [Hologic; transcription-mediated amplification (TMA) assay] among pregnant women attending four antenatal care facilities in Nchelenge, Zambia in 2023. Syphilis serology was performed using rapid diagnostic test [RDT; Core tests® ONE STEP Syphilis Test Kit (Core Technology, Atlanta, USA)]; positive samples were further evaluated by rapid plasma reagin [RPR; RPR Carbon Antigen Reagent (Eurocarb Products Ltd., Bristol, United Kingdom)] test. Active syphilis was defined as a positive RDT plus a positive RPR test, or a positive RUO Aptima T. pallidum assay. T. pallidum and other non-viral STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis) were detected in clinician-collected vaginal swab samples using Aptima assays on the Panther system (Hologic). HIV testing was performed with the Determine HIV Test Kit, and bacterial vaginosis (BV) was diagnosed using Nugent's score. Active syphilis correlates were identified using univariable and multivariable logistic regression. In total, 996 pregnant women were included in the analysis, of whom 136 women (13.7%) had an active syphilis infection. Of these women with active syphilis, 117 (86.0%) were positive in serology only, 15 (11.0%) in serology plus RUO Aptima T. pallidum assay, and four (2.9%) in RUO Aptima T. pallidum assay only. Rates of other current STIs and reproductive tract infections included: BV (23.3%), T. vaginalis (22.7%), M. genitalium (12.7%), HIV (8.7%), N. gonorrhoeae (8.4%), and C. trachomatis (7.4%). Secundigravidity, history of stillbirth, current concomitant M. genitalium, N. gonorrhoeae, T. vaginalis, and HIV infections were significant risk factors of active syphilis. Advanced gestational age (from 28 to 39 weeks) at enrolment was associated with significantly lower risk of syphilis positivity. A remarkably high burden of syphilis and high co-infection rates with HIV and other non-viral STIs in pregnant women in Zambia underscore the urgent need for integrating syphilis and HIV universal screening programs, as well as to consider concurrent testing for selected other non-viral STIs. Where feasible due to the increased cost, supplementing serological screening with a highly sensitive and specific molecular test such as the RUO Aptima T. pallidum assay for suspected early syphilis can ensure timely detection of both seroconverted and seronegative early syphilis cases, early treatment and effective prevention of mother-to-child transmission.

The microbiome has emerged as a critical determinant of female reproductive health and fertility outcomes. Although conventional infertility evaluations, encompassing medical history, ovulation assessment, uterine and tubal evaluation, genetic screening, hormonal profiling, and reproductive tract imaging, provide essential diagnostic information, a substantial proportion of infertility cases remain unexplained, prompting increased attention to microbial factors. This review provides a comprehensive, critical evaluation of the methods for assessing the female reproductive microbiome, spanning traditional culture-based microbiology to contemporary molecular approaches. We systematically discuss the diagnostic performance, clinical utility, and established techniques, including microscopic examination, Nugent scoring, and Amsel criteria, alongside modern molecular methods such as quantitative PCR panels, 16S rRNA gene sequencing, shotgun metagenomics, and other multiomics. Critically, we evaluate the current microbiome testing platforms in clinical validity and utility. We identify significant gaps between research-grade methodologies and clinically actionable diagnostics, including a lack of standardized protocols, inconsistent reporting of absolute bacterial loads vs. relative abundances, and limited validation against reproductive outcomes. We propose evidence-based criteria for selecting appropriate diagnostic approaches on the basis of clinical context and discuss emerging technologies, including multiomics integration for implementing microbiome assessment in fertility care.

Bacterial vaginosis (BV) is a common gynecological condition among women of reproductive age that occurs due to a dysbiosis in the vaginal microbiota. It is associated with several serious obstetric and gynecological complications, such as pelvic inflammatory disease, infertility, postpartum infections, and increased risk of other genital tract infections. This community-based cross-sectional study aimed to determine the BV proportion and associated risk factors among 1133 asymptomatic nonpregnant women in the Philippines. Nugent scoring of the Gram stain of vaginal smears was used to diagnose BV at a score range of 7 to 10. Sociodemographic and behavioral data were collected using a pretested and semistructured questionnaire in Filipino. In this study, the overall proportion of women with BV was 24.18% (95% confidence interval [CI], 21.78-26.76). Multivariable regression analyses showed that older age (adjusted odds ratio [aOR], 1.03; 95% CI, 1.01-1.05), having a part-time work status (aOR, 1.99; 95% CI, 1.04-3.83), and younger age at first vaginal intercourse sex (aOR, 0.93; 95% CI, 0.88-0.97) were associated with higher odds of having BV. On the other hand, being a former alcohol drinker (aOR, 0.42; 95% CI, 0.30-0.59), living in a rural area (aOR, 0.58; 95% CI, 0.35-0.93), and progestin-only contraceptive use (aOR, 0.67; 95% CI, 0.47-0.95) were factors associated with lower odds of BV among nonpregnant women. In conclusion, this study provided updated epidemiologic data on BV among asymptomatic nonpregnant women of reproductive age in the Philippines, with significant associations observed with age, sexual and work history, alcohol use, and place of residence.

Background: Bacterial vaginosis is a prevalent and often asymptomatic vaginal condition affecting women of reproductive age, posing significant reproductive health risks. Despite its importance, data on BV prevalence, microbial profiles, and associated factors at Kilimanjaro Christian Medical Centre, a major tertiary hospital in northern Tanzania, remain limited. Therefore, this study aimed to address these gaps. Methods: This was a three-year retrospective laboratory based study of 891 high vaginal swab samples collected from women aged 15–49 years at KCMC between January 2021 and December 2023. Bacterial vaginosis was diagnosed using Amsel criteria and Nugent scoring. Demographic and clinical data were retrieved from the hospital electronic medical system. Data were analysed using descriptive and inferential statistics. P value of &lt;.05 was considered statistically significant. Results: Overall prevalence of bacterial vaginosis was 324 (36.4%). The majority of the studied vaginal samples belonged to women aged 25–34 years 359 (40.3%), and most samples were collected from the Outpatient Department 618 (69.4%). Microbiological analysis revealed that no bacterial growth was the most common finding 565 (63.4%), followed by Candida albicans 205 (23.0%) and Escherichia coli 58 (6.5%). In multivariable logistic regression, attendance at the Labour Ward was significantly protective against BV (AOR = 0.096; 95% CI: 0.012–0.787; P= .029), while the year of sample collection also predicted BV: samples from 2022 had reduced odds (AOR=0.63; 95% CI: 0.40–0.96; P=.035), and samples from 2023 had increased odds (AOR=2.24; 95% CI: 1.51–3.32; P&lt;.01) compared to 2021. Age category and individual microorganisms were not independent predictors of BV. Conclusion: This study showed a high prevalence of bacterial vaginosis (36.4%) with flactating trend among women of reproductive age at KCMC. The most affected were women of reproductive age attending labour ward. The high prevalence among pregnant women has important reproductive health implications, highlighting the need for routine screening to prevent adverse pregnancy outcomes.

To evaluate and compare the efficacy, impact on vaginal microbiota, changes in inflammatory/immune/proliferation biomarkers, and safety profile of Anti-HPV gel versus Interferon α-2b gel as adjuvant therapies after LEEP in patients with HSIL and HR-HPV infection. This retrospective cohort study included 207 eligible patients diagnosed with HSIL and HR-HPV infection who underwent initial LEEP between January 2023 and January 2025. Patients were divided into a control group (n=102, Interferon α-2b gel) and an observation group (n=105, Anti-HPV gel), both receiving two standardized treatment courses post-operatively. Outcome measures included total clinical effective rate, vaginal microecological recovery (pH, Nugent score), serum inflammatory cytokines (IL-17, TNF-α, IFN-γ, TGF-β), immunoglobulins (IgA, IgG, IgM), cell proliferation markers (serum Survivin, cervical tissue Ki-67), adverse events, and 6-month HR-HPV recurrence rate. An exploratory model was constructed using post-treatment indicators to predict recurrence. Compared with the control group, the observation group showed superior outcomes across multiple domains: a higher total clinical effective rate (87.62% vs. 75.49%, P = 0.024); better restoration of vaginal microecology with lower post-treatment pH (4.29 ± 0.37 vs. 4.78 ± 0.42, P<0.001) and Nugent score (2.96 ± 1.15 vs. 4.52 ± 1.37, P<0.001); greater reductions in serum inflammatory markers (IL-17, TNF-α, IFN-γ, TGF-β, all P<0.001); greater increases in immunoglobulins (IgA, IgG, IgM, all P<0.001); more pronounced decreases in cell proliferation markers (serum Survivin and tissue Ki-67, both P<0.001); a lower 6-month HR-HPV recurrence rate (6.67% vs. 16.67%, P = 0.024) with comparable overall adverse event incidence (10.48% vs. 13.73%, P = 0.473). The exploratory predictive model based on post-treatment indicators demonstrated good discrimination for recurrence (AUC = 0.812, 95% CI: 0.747-0.878). In conclusion, as a postoperative adjuvant, Anti-HPV gel demonstrated superior clinical and biomarker outcomes compared to Interferon α-2b gel, with a favorable safety profile and lower short-term recurrence risk, suggesting its promising clinical value pending prospective confirmation.

ObjectiveTo investigate whether vaginal microecological imbalance and group B Streptococcus (GBS) colonization are correlated with premature rupture of membranes (PROM) by activating the maternal systemic inflammatory response and to construct an individualized risk prediction model.MethodThis study was a prospective single-center cohort study. A total of 162 singleton pregnant women at 28–37 weeks of gestation who were admitted to Jilin Provincial Maternal and Child Health Hospital from January 2023 to June 2024 were included. Among them, 81 cases were in the PROM group, and 81 cases were in the matched control group. Vaginal secretions were collected for microbiological testing (Nugent score, H2O2, and leukocyte esterase), and GBS colonization was detected by the constant temperature amplification method; serum levels of CRP, PCT, IL-6, and IL-10 were determined by electrochemiluminescence and chemiluminescence methods. LASSO-penalized multivariable logistic regression analysis was used to identify independent risk factors, and a nomogram model was constructed with internal validation by bootstrap resampling (1,000 iterations).ResultThe GBS colonization rate in the PROM group was significantly higher (16.0% vs. 3.7%, aOR = 4.87, 95% CI 1.89–12.56). The incidence rates of abnormal vaginal microscopic evaluation (grades III–IV), H2O2 depletion, and leukocyte esterase positivity were all significantly higher than those in the control group (P < 0.01). The ratio of IL-6/IL-10 in the PROM group was significantly increased (P < 0.001). The multivariate model showed that GBS colonization, IL-6 >12 pg/mL, and H2O2 depletion were independent risk factors. The nomogram model constructed based on these indicators had an apparent AUC of 0.89 (95% CI 0.83–0.95) and a bootstrap-corrected AUC of 0.86 (95% CI 0.80–0.92) and excellent calibration (Brier score 0.158, Hosmer–Lemeshow P = 0.423).ConclusionGBS colonization is associated with a higher incidence of PROM by inducing vaginal microecological imbalance and systemic inflammatory responses. The “microecology–inflammation” nomogram model we have developed shows potential for individualized prediction of the risk of PROM pending external validation, providing a basis for early intervention.

Bacterial vaginosis is a dysbiosis of the vaginal microbiome, typically characterized by a loss of Lactobacillus. Lactobacillus plays a crucial role in vaginal immunity and protection against sexually transmitted infections. Herpes simplex virus 2, the primary cause of genital herpes, impacts 13% of people worldwide. We undertook this systematic review and meta-analysis to examine the risk of herpes simplex virus 2 acquisition in women with bacterial vaginosis. Secondarily, we examined the impact of bacterial vaginosis on herpes simplex virus 2 shedding, reactivation, and symptoms. We searched PubMed, EMBASE, Cochrane, Web of Science, Google Scholar, and ClinicalTrials.gov for articles published before 1 July 2023 for microbiome and herpes simplex virus type 2. Studies were limited to human subjects and the English language. An updated search was performed in January 2026. This study was registered on PROSPERO (CRD42023439139). Studies on non-pregnant, reproductive-aged cisgender women that diagnosed bacterial vaginosis by Amsel Criteria, Nugent Scoring or used molecular techniques, and those that detected herpes simplex virus 2 by serological assay or PCR testing were included. Our search identified 863 results with four publications eligible for inclusion. For our secondary outcomes, 40 results were identified regarding herpes simplex virus 2 shedding, with two publications eligible for inclusion, which did not meet our threshold for meta-analysis. There were 21 results identified for herpes simplex virus 2 reaction and 115 results for herpes simplex virus 2 symptoms, with no articles being eligible for inclusion. Quality assessment was performed following data extraction using the quality assessment scales from the Joanna Briggs Institute. Results were extracted, and the pooled hazard ratio was calculated with 95% confidence interval. A total of 1906 women were included in this analysis, and 255 acquired herpes simplex virus 2. The pooled unadjusted hazard ratios produced an effect size of 1.91, (95% confidence interval 1.4649-2.4980), and a p-value of <0.0001, while the pooled adjusted hazard ratios produces an effect size of 1.85, (95% confidence interval of 1.3556-2.5162), and a p-value of 0.0001 indicating that bacterial vaginosis is associated with a increased risk of herpes simplex virus 2 acquisition. This systematic review with meta-analysis indicates that bacterial vaginosis is associated with a significantly increased risk (91% unadjusted, 85% adjusted) of herpes simplex virus 2 acquisition, indicating that bacterial vaginosis treatment may reduce herpes simplex virus 2 acquisition. A notable limitation of these findings is the relatively small number of studies eligible for inclusion in this systematic review and meta-analysis.