Vaginitis Research Articles

Heterologous expression of the insect SVWC peptide WHIS1 inhibits Candida albicans invasion into A549 and HeLa epithelial cells.

Candida albicans (C. albicans), a microbe commonly isolated from Candida vaginitis patients with vaginal tract infections, transforms from yeast to hyphae and produces many toxins, adhesins, and invasins, as well as C. albicans biofilms resistant to antifungal antibiotic treatment. Effective agents against this pathogen are urgently needed. Antimicrobial peptides (AMPs) have been used to cure inflammation and infectious diseases. In this study, we isolated whole housefly larvae insect SVWC peptide 1 (WHIS1), a novel insect single von Willebrand factor C-domain protein (SVWC) peptide from whole housefly larvae. The expression pattern of WHIS1 showed a response to the stimulation of C. albicans. In contrast to other SVWC members, which function as antiviral peptides, interferon (IFN) analogs or pathogen recognition receptors (PRRs), which are the prokaryotically expressed MdWHIS1 protein, inhibit the growth of C. albicans. Eukaryotic heterologous expression of WHIS1 inhibited C. albicans invasion into A549 and HeLa cells. The heterologous expression of WHIS1 clearly inhibited hyphal formation both extracellularly and intracellularly. Furthermore, the mechanism of WHIS1 has demonstrated that it downregulates all key hyphal formation factors (ALS1, ALS3, ALS5, ECE1, HWP1, HGC1, EFG1, and ZAP1) both extracellularly and intracellularly. These data showed that heterologously expressed WHIS1 inhibits C. albicans invasion into epithelial cells by affecting hyphal formation and adhesion factor-related gene expression. These findings provide new potential drug candidates for treating C. albicans infection.

Sodium Bicarbonate: A New Promising Home Strategy for the Treatment of Vaginal Yeast Infection

Sodium Bicarbonate: A New Promising Home Strategy for the Treatment of Vaginal Yeast Infection

生殖道性传播病原体感染对于阴道微生态及HPV感染的相关讨论

生殖道性传播病原体感染对于阴道微生态及HPV感染的相关讨论

Establishment and Validation of a Mouse Bacterial Vaginosis Model.

Bacterial vaginosis (BV) is a common vaginal infection without a reliable animal model. To establish a novel mouse BV model, we evaluated multiple parameters of various identified bacteria-infected mice, including Staphylococcus aureus (SA), Escherichia coli (EC), Streptococcus agalactiae, β-Hemolytic streptococcus, and Gardnerella vaginalis (GV). Mature female KM mice were randomly allocated to a vehicle group (group A, without any treatment) and experimental groups. After vaginal secretions were harvested, experimental groups were divided into phosphate buffer solution group (PBS, group B), control group including SA, and EC with a 1:1 ratio (group C), SA, EC, and Streptococcus agalactiae with a 1:2:1 ratio group (group D), SA, EC, and β-Hemolytic streptococcus with a 1:2:1 ratio group (group E), and GV group (group F). The vaginal secretions of experimental mice were collected by flushing with 100 mL sterile PBS on days 2, 4, and 6. Vaginal secretions were examined by Gram staining, sialidase assay, ammonia test, and pH value measurement. IL-6 and IL-10 levels in mouse serum were detected by enzyme-linked immunosorbent assay. Hematoxylineosin staining and mouse cervicovaginal tissue histopathological scores were observed. The diagnostic test results were analyzed by logistic regression analysis and receiver operating characteristic curves. The Shapiro-Wilk analysis of variance, or rank-sum test, was used for normal distribution analysis. Pearson's correlation and chi-squared test determined the correlation and comparison data expressed as a percentage or frequency. There was less severe vaginal morphology in GV-infected mice compared to other bacteria-infected mice. The sialidase assay, the ammonia test, and the pH values of vaginal secretions showed significant differences between GV-infected and uninfected mice. Serum IL-6 and IL-10 levels and vaginal histological scoring increased in other bacteria-infected mice, but GV-infected mice showed only a mildly increasing trend of IL-10 levels and vaginal histological scoring compared to control mice. GV-infected mice showed clinical features similar to human BV infection, including vaginal anatomical and pathological indices, and biochemical and immune parameters. Serum IL-10 level has potential for use in BV diagnosis.

A LITERATURE REVIEW ON THE MOST COMMON WOMEN PROBLEM (SAILAN-UR-RAHEM) AND ITS MANAGEMENT IN UNANI SYSTEM OF MEDICINE

Sailan-ur-Rahem, a common problem in women's health, in the context of the Unani medical system. Sailan-ur-Rahem is a term used to describe a range of illnesses affecting the female reproductive system that pose serious health and quality of life difficulties to countless women worldwide.Approximately 20% of patients who visit gynecological clinics report having vaginal discharge, which could be an infection. 90% of the time, the inflammation is only mild, with the remaining 10% including more serious conditions. Due to their increased exposure to sexual activity and frequent childbearing, married women are more likely to experience vaginal infections such as cervical erosion, cervicitis, and pelvic inflammatory diseases, which can result in leucorrhoea.The Unani approach to Sailan-ur-Rahem stresses a holistic view of health, emphasizing the use of specialized therapeutic procedures to correct underlying imbalances and bring physiological humors back into balance. In order to reduce symptoms and enhance general wellbeing, these interventions frequently involve dietary changes, lifestyle adjustments, herbal remedies, and specialist medical care. The management methods and understanding of Sailan-ur-Rahem within the Unani medical system by fusing traditional knowledge with contemporary scientific ideas. This would improve healthcare services and improve women's health outcomes globally.

Effect of Cymbopogon olivieri-based herbal vaginal product on bacterial vaginosis.

Bacterial vaginosis is the most common vaginal infection in reproductive-age women. If it is not treated, the quality of life will be reduced. In this study, the herbal medicine product Cymbopogon olivieri was used for its treatment. This study was conducted with 90 women. The patients were randomly divided into two groups of 45: Cymbopogon olivieri and metronidazole. The treatment period was 7 days for each group. Improvement status was determined by eliminating at least three out of four of Amsel's criteria. A new variable with two order levels (negative and positive) was constructed. This new variable shows the status of the treatment process. Chi-square and Fisher's exact tests were used to examine the relationship between the new variable and treatment status. The results demonstrate that Cymbopogon olivieri and metronidazole significantly reduced the burning, itching, malodor, abnormal vaginal discharge, pH, clue cell, and positive whiff test (p<0.05). The findings also demonstrate that neither treatment was statistically different from the other for at least three of Amsel's criteria. This study shows that the effect of Cymbopogon olivieri on bacterial vaginosis is similar to that of metronidazole. Hence, Cymbopogon olivieri is a suitable option to treat bacterial vaginosis.

Prevalence of Vaginal Inflammation Due to Candida sp., Trichomonas vaginalis and Associated Factors Among Patients Visiting the Gynecology Clinic at Hoang Anh Gia Lai University Medical Hospital

Candida spp., T.vaginalis infections can cause genital inflammation in women, leading to many adverse effects such as increased risk of infertility and severely impacting the patient's health and quality of life. Objective: To determine the prevalence of vaginal inflammation due to Candida spp., T. vaginalis infections and identify associated factors. Subjects and methods: Cross-sectional research. The research subjects were women of reproductive age (18-49 years old) who visited the gynecology clinic at Hoang Anh Gia Lai University Medical Hospital, Gia Lai province. Results: The prevalence of vaginal inflammation due to Candida spp., T.vaginalis infection was 26.7% (of which Candida sp. was 99.1% and T.vaginalis was 0.9%). The group using unsanitary water sources had a 1.6 times higher risk of infection (95% CI: 1.1-2.6), and the group that did not regularly undergo gynecological examinations had a 1.8 times higher risk of infection (95% CI: 1.1-2.9). Conclusion: The prevalence of Candida spp., T.vaginalis infection was 26.7%, and was associated with the use of unsafe water sources and irregular gynecological checkups.

Role of Vaginal microbiota and Human Papillomavirus infection in cervical Oncogenesis: where do we stand?

Vaginal Microbiota has emerged as an important contributing factor for viral persistence, which can lead to the process of oncogenesis. The female reproductive system has a unique microbiome that helps keeping health maintenance and protects against infection. Contrary to other mucosal sites, the vaginal microbiota often exhibits limited diversity and contains few Lactobacilli species, which were categorized into five distinct community state types using high-throughput 16S rRNA gene sequencing. According to current research, Human Papillomavirus (HPV) acquisition, persistence, and cervical cancer development are influenced by increasing vaginal microbiome diversity and decreased Lactobacillus spp. This review explores the intricate relationship between vaginal microbiota and HPV in the context of cervical cancer development. It discusses the impact of microbiota diversity and dysbiosis on the acquisition, persistence, and clearance of HPV. The review also emphasizes the role of vaginal microbiota in maintaining a healthy female reproductive system and explores the potential of various interventions, such as probiotics and prebiotics, in restoring a healthy vaginal environment. Challenges and future directions for a healthy vaginal environment are also revealed in the article.

Association between Serum Folate and Vaginal High-Risk Human Papillomavirus Infections in United States Women

BackgroundSerum concentration of folate was inversely associated with cervical intraepithelial neoplasia and cervical cancer in some studies. The association between folate and human papillomavirus (HPV) infection, a necessary cause of cervical cancer, has not been well elucidated. ObjectivesWe evaluated whether serum folate concentrations were associated with high-risk HPV (hrHPV) infection. MethodsThe study population was 11,801 females, aged 18–59 y, enrolled in the National Health and Nutrition Examination Survey (NHANES), from 2003 to 2016, in the United States. In this cross-sectional study, prevalence ratios (PRs) of vaginal hrHPV were calculated using logistic regression models, by quintiles of serum folate. ResultsFemales in the lowest quintile had <21.3 nmol/L of folate. Approximately 23% of the females (2733/11,801) were hrHPV positive. In age-adjusted models, folate was significantly associated with hrHPV infection. The PRs and 95% confidence intervals (CIs) were (PR: 1.52; 95% CI: 1.37, 1.70) for the first, (PR: 1.29; 95% CI: 1.15, 1.44) for the second, (PR: 1.19; 95% CI: 1.06, 1.34) for the third, and (PR: 1.09; 95% CI: 0.96, 1.23) for the fourth quintiles, compared with the females in the highest quintile, with a significant P value for trend, <0.0001. The association remained statistically significant after the models were further adjusted for lifestyle and sexual risk factors for hrHPV infection; the females in the lowest quintile were more likely to have hrHPV infection than those in the highest quintile (PR: 1.40; 95% CI: 1.11, 1.53). ConclusionsResults from this sample of females in the United States suggest that serum folate concentration is inversely associated with hrHPV infection.

Molecular Testing for the Diagnosis of Bacterial Vaginosis.

Previously established diagnostic approaches for the diagnosis of bacterial vaginosis (BV), such as the Amsel criteria or the Nugent scoring system, do not always correspond to modern trends in understanding the etiology and pathogenesis of polymicrobial conditions. Inter-examiner variability and interpretation of data complicate the wet mount microscopy method. Gram staining of smears does not always provide reliable information regarding bacterial taxa, biofilms, or vaginal dysbiosis. Therefore, the introduction of molecular techniques into clinical practice is extremely relevant. Molecular approaches allow not only the diagnosis of BV but also provide an assessment of microbial composition, which is especially important in the differential diagnosis of vaginal infections. The current review represents an expert opinion on BV diagnosis and is based on extensive experience in the field of vaginal infection diagnosis and treatment.

Cotton Fibers with a Lactic Acid-Like Surface for Re-establishment of Protective Lactobacillus Microbiota by Selectively Inhibiting Vaginal Pathogens.

Failure to reconstruct the Lactobacillus microbiota is the major reason for the recurrence of vaginal infection. However, most empiric therapies focus on the efficacy of pathogen elimination but do not sufficiently consider the viability of Lactobacillus. Herein, cotton fibers with a lactic acid-like surface (LC) are fabricated by NaIO4 oxidation and L-isoserine grafting. The lactic acid analog chain ends and imine structure of LC can penetrate cell walls to cause protein cleavage in Escherichia coli and Candida albicans and inhibit vaginal pathogens. Meanwhile, the viability of Lactobacillus acidophilus is unaffected by the LC treatment, thus revealing a selective way to suppress pathogens as well as provide a positive route to re-establish protective microbiota in the vaginal tract. Moreover, LC has excellent properties such as good biosafety, antiadhesion, water absorption, and weight retention. The strategy proposed here not only is practical, but also provides insights into the treatment of vaginal infections.

One-component lipidic bicontinuous nanospheres as a smart drug loading platform to eradicate candida biofilms in oral and vaginal infection

Bicontinuous nanospheres (BCNs) with a highly twisted network of hydrophobic phases interwoven with a network of hydrated hydrophilic parts are essential for the loading and releasing of therapeutics. However, a facile methodology to construct BCNs with a single lipid molecule is still challenging. Here we report the synthesis of X-shaped lipids that can self-assemble into stable one-component sponge-phase BCNs without the assistance of any stabilizers as a platform for drug delivery. The X-shaped lipids with two hydrophilic heads and two hydrophobic tails are formed via dynamic covalent boronate between the phenylboronic acid-modified polar head and the catechol-containing lipids with different carbon chain lengths. This methodology provides an efficient and convenient way to synthesize lipids with different architectures, and their possibility in fabrication BCNs was further screened. The representative miconazole-loaded prodrug BCNs possess high drug loading content, up to 41.6%, and a fast, zero-order drug release profile after exposure to an acidic/oxidative microenvironment, such as Candida albicans biofilm. Also, the carbon chain lengths of lipids affect the prodrug BCNs' formation and interactions with fungal membranes. The optimal prodrug BCNs with 10-carbon chains hold superb Candida biofilm eradication efficacy in vitro and in vivo without affecting the normal tissues. Therefore, our strategy provides a facile methodology to construct BCNs as a smart drug loading platform for biomedical applications.

Imaging of Perisplenitis as an Unusual Presentation of the Fitz-hugh-curtis Syndrome

Objective − We present the imaging characteristics of an unusual case of Fitz-Hugh-Curtis syndrome (FHCS), a late complication of pelvic inflammatory disease in an adolescent girl with left upper abdominal pain due to perisplenitis seen on contrast-enhanced ultrasound and magnetic resonance imaging.Case Report − A 16-year-old girl presented with acute abdominal pain in the left upper quadrant, vomiting, diarrhoea, and vaginal odour with yellow discharge. She was recently diagnosed with infectious mononucleosis. Abdominal ultrasound showed perisplenic fluid collection that did not enhance post-contrast application, but it did show a mild enhancement of perisplenic tissue. MRI findings indicated perisplenitis. The results of the positive vaginal swab for Chlamydia trachomatis and Ureaplasma parvum and the imaging findings favoured a final diagnosis of FHCS with perisplenitis.Conclusion − Imaging findings, and clinical and laboratory data, including positive vaginal swabs, are crucial to confirm the unusual presentation of FHCS in an adolescent with left upper abdominal pain.

Expression of a recombinant protein by an acetic acid bacterial host

We evaluated the suitability of Komagataeibacter europaeus, a vinegar production organism adept at synthetic media growth, as a host for heterologous gene expression. Cryptic plasmids (pGE1 and pGE2 derivatives) from K. europaeus strain KGMA0119 were employed as vectors for heterologous gene expression. The focus was placed on the groES promoter as a potential inducible switch. The groES promoter was fused with the EGFP gene and introduced into a pGE1 derivative to assess its suitability. Ethanol, acetic acid, and heat stresses were examined under various conditions for induction. EGFP transcription surged 600-fold when late logarithmic phase K. europaeus cells, cultured at 30 °C, endured heat stress at 40 °C, coupled with 20% acetic acid and 30% ethanol stress after an additional 6-hour cultivation. This robust induction system was then applied to express two proteins, Tth pol from the thermophilic bacterium Thermus thermophilus strain M1 and UPV230, a restriction enzyme from the acid-tolerant microorganism Ureaplasma parvum, known to cause vaginal infections and miscarriages. Both Tth pol and UPV230 were successfully expressed in K. europaeus cells and purified. The recovery of Tth pol from K. europaeus cells (480 µg protein per liter culture) was approximately half that from E. coli (960 µg protein per liter culture). In contrast, UPV230 recovery from K. europaeus cells (640 µg protein per liter culture) was nearly 10 times higher than that from Escherichia coli (66 µg protein per liter). The data highlights the potential of acetic acid bacteria as a host for producing acidophilic proteins. The shift in recognition from a 6-base sequence to a 4-base sequence of UPV230 was observed, accompanied by a change in structure as the pH transitioned from acidic pH to near-neutral pH.

The prospects of complementary treatment using Red Piper betle (Piper crocatum) against leucorrhoea: an empirical study

One of the main issues for women in the reproductive age range is leucorrhoea, which causes a woman ongoing distress, and occasionally be the first sign of several of the main gynecological disorders. The widespread use of fluconazole antibiotics has caused Candida sp to become resistant. Alternative non-pharmacological treatments based on natural products are needed, especially P. crocatum which has antioxidant, antifungal, and anti-inflammatory activities. This study analyzed the empirical study of P. crocatum used against leucorrhoea due to C. albicans. The empirical study presented that vaginal discharge was reduced after using P. crocatum formulations. The infection parameter of vaginal pH level, the intensity of pain, and itching were significantly recovered with p values of 0.008, 0.000, and 0.001, respectively, while the reducing C. albicans colonies was 0.001. P. crocatum decoction formulation is effective in reducing vaginal yeast infections in women, close to the results of the positive control, ketoconazole.

Molecular identification of Candida spp. isolated from women withvulvovaginal candidiasis in Koya District, Iraq

Vulvovaginal candidiasis (VVC) is the second most common vaginal infection among women of reproductive age. It is an opportunistic mucosal infection. Candida species causes VVC, which affects millions of women annually. The objective of this study was to isolate and identify the species of Candida from married women who had VVC attending Shahid Doctor Khalid Hospital &amp; Haji Qader Health Centre in Koya, Iraq using traditional and molecular methods. This research was carried out, from December 2021 to May 2022; 150 vaginal swabs from married patients with symptoms of VVC were collected. Swabs were microscopically examined, grown on Sabouraud Dextrose Agar (SDA), and HiCrome™ Candida Differential agar and Germ Tube Test were used to identify Candida isolates. Next, the results were validated using the molecular method called polymerase chain reaction (PCR) to amplify and detect the ITS region in this study. The chitin synthase gene (CHS1) confirmed all C. albicans isolates. Out of the150 vaginal swabs gathered, 84 (56%) cases were positive for vaginal candidiasis. Ages26-30 were found to have the most significant proportion of positive patients, and Women who were pregnant had a more positive culture than women who were not. Identifying six different species of Candida was accomplished through the application of both traditional and molecular techniques in the study; they are C. albicans (88.1%), C. glabrata (4.8%), C. kefyr (2.4%), C. krusei (2.4%), C. parapsilosis (1.2%), and C. tropicalis (1.2%). Finally, we concluded that VVC was shown to be prevalent in Koya city, with the predominant species as C. albicans among all other species.

Infectious vaginitis among women seeking reproductive health services at a sexual and reproductive health facility in Kampala, Uganda

BackgroundInfectious vaginitis is one of the most prevalent conditions affecting women of reproductive age with significant clinical consequences. Bacterial vaginosis (BV), vulvo-vaginal candidiasis (VVC), and trichomoniasis (TV) are the main etiologies. Unfortunately, there is limited data on the prevalence and associated risk factors, especially in sub-saharan Africa. This study, thus, determined the prevalence and risk factors of infectious vaginitis among women seeking reproductive health services at a Marie-stopes health facility in urban areas of Kampala, Uganda.MethodsA cross-sectional study with 361 participants was conducted from July to October 2021. Data on risk factors and infection were collected via a structured questionnaire and laboratory analysis of vaginal swabs, respectively, with data analysis performed using Stata version 14.0 college station, Texas 77,845 US.ResultsThe ages of participants ranged from 18 to 49 years, with a mean age of 29.53 years. Overall, 58.45% were infected, of whom 33.24% had VVC, 24.93% had BV, and 0.28% had TV. Bivariate analysis revealed that women with pruritus (COR: 3.057, 95% CI: 1.940–4.819), pregnancy (COR: 4.914, 95% CI: 1.248–19.36), antibiotic use (COR: 1.592, 95% CI: 1.016–2.494), douching (COR: 1.719, 95% CI: 1.079–2.740), and multiple partners (COR: 1.844, 95% CI: 1.079–2.904) were more likely to have VVC, whereas having higher education status (University; Vocational) (COR: 0.325, 95% CI: 0.134–0.890; COR: 0.345, 95% CI: 0.116–0.905) reduced the risk. On the other hand, women with a smelly discharge (COR: 1.796, 95% CI: 1.036–3.110), IUD use (COR: 1.868, 95% CI: 1.039–3.358), and antibiotic use (COR: 1.731, 95% CI: 1.066–2.811) were more likely to have BV. Multivariable analysis identified pruritus (AOR: 2.861, 95% CI: 1.684–4.863) as the only independent predictor for VVC.ConclusionResults indicate a high prevalence of infection among these women; therefore regular screening and treatment is recommended to curb the high rate of infection. More studies on risk factors of infection are recommended.

Association between hepatitis B virus replication during pregnancy and perinatal outcomes: a retrospective cohort study

Background The effect of hepatitis B virus (HBV) replication during pregnancy on the outcomes of pregnancies remains to be elucidated. Objectives This study aimed to investigate the association between HBV replication and adverse maternal and infant outcomes. Methods We retrospectively analysed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in the Fujian province between June 2016 and October 2020. Results The incidence of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infections did not differ in the HBV replication and non-replication groups (p > 0.05); however, the rates of caesarean section (p = 0.017; OR, 1.423; 95% CI, 1.065–1.902) and neonatal jaundice (p < 0.001; OR, 2.361; 95% CI, 1.498–3.721) were higher in the replication group than that in the non-replication group. After using propensity score analysis to adjust for alanine transaminase and aspartate aminotransferase levels in both groups, the replication group was still found to have an increased risk for caesarean section (p < 0.001; OR, 2.367; 95% CI, 1.668–3.359) and their infants had higher rates of neonatal jaundice (p < 0.001; OR, 12.605; 95% CI, 4.456–35.656). Conclusions Our findings contribute to a better understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with HBV replication face an increased risk of caesarean section, and their infants appear to have a higher risk for neonatal jaundice.

Genital Infections and Associated Risk Factors in Women on Contraception Monitored at the Bacteriology and Virology Laboratory of Aristide Le Dantec Hospital

Background: Contraception is a strategy of choice for spacing births but also for avoiding early and unwanted pregnancies. However, through hormonal modification, this contraception constitutes a favorable state for the proliferation in the genital tract of agents responsible for vaginal infections. The objective of this study was to evaluate the prevalence of genital infections in women on contraception followed up at the bacteriology-virology laboratory of Aristide Le Dantec Hospital. Methods: This is a retrospective descriptive study conducted over a one-year period between January 2019 and December 2020. Microbial assessemnets were performed on genital secretions according to standard bacteriology laboratory procedures. Sociodemographic data and bacteriological examination results obtained were entered using File Maker Pro Advanced (version 16) software. Statistical analyses were performed using SPSS software (version 20). Results: This research studied 1771 women, of whom 1609 were on contraceptives. The most represented age group was over 40 years (27.06%). The majority of patients were women on oral contraceptives (32.07%). Women with secondary education (31.45%) and women with 1 to 3 children (43.03%) were most often on contraception. The germs most frequently detected in women on contraception were Gardnerella vaginalis (51.78%) and Candida albicans (24.19%) and the use of intrauterine device (IUD) as a means of contraception was statistically associated with vaginal infection (p=0.0004). Conclusion: This study showed a high frequency of vaginal infections in women on contraception and that the intrauterine device was significantly associated with the occurrence of these infections.

Dequalinium Chloride for the Treatment of Vulvovaginal Infections: A Systematic Review and Meta-Analysis.

Women at reproductive age frequently experience vulvovaginal infections and vaginitis. The most common etiologies are vulvovaginal candidiasis (VVC), bacterial vaginosis (BV), desquamative inflammatory vaginitis/aerobic vaginitis, and trichomoniasis. Various treatment options are available for these infections, such as specific antimicrobial or antiseptic agents. Dequalinium chloride (DQC) is a local antiseptic agent with a broad antimicrobial and antifungal spectrum. Multiple studies suggest that DQC is an efficient treatment for vaginal infections; however, it is not widely recommended as a first-line treatment. This systematic review and meta-analysis aims to evaluate the efficacy of DQC compared with that of standard treatment. Our systematic review was conducted according to the PRISMA guidelines. PubMed/MEDLINE, EMBASE, CENTRAL, and clinicaltrials.org were searched to retrieve relevant reports up to October 2022. Four randomized controlled studies and 1 observational study were included in this review. Overall, DQC showed noninferiority to the reference treatments for BV and VVC, and to the evaluated treatment options for desquamative inflammatory vaginitis/aerobic vaginitis. For BV and VVC, this could also be confirmed in a meta-analysis including 3 randomized controlled studies. No serious adverse events were reported in any of these studies. Dequalinium chloride offers a safe, well-tolerated, and efficient treatment option for vulvovaginal infections of different etiologies. However, further studies are needed to confirm our findings and allow inclusion of DQC as a first-line treatment into guidelines.