Vaginosis Patients Research Articles

Factor Associated to Bacterial Vaginosis in Non-pregnant Women of North Indian Population

Bacterial vaginosis is currently the most prevalent cause of vaginal infection and vaginal discharge among the sexually active women. Bacterial vaginosis is a complex microbiological disease. Therefore, we aimed to determine the association of risk factors for bacterial vaginosis patients. In the prospective study, we enrolled a total of 300 nonpregnant women. One hundred and twenty six women were positive for bacterial vaginosis, confirmed by Amsel's criteria and Nugent's scoring. One hundred and seventy four women were unrelated control. Frequency of intrauterine contraceptive device differed significantly between bacterial vaginosis and healthy individuals (29.4% versus 17.2%, p=0.017; OR=1.70). Individuals with a sexual transmitted disease in partners was conferred significantly higher risk for bacterial vaginosis (p=0.001, OR=8.28). However, use of contraception, vaginal douching, and use of condom did not modulate the risk of bacterial vaginosis. Individuals with the use of intrauterine contraceptive device and presence of sexual transmitted disease in partners conferred a higher risk for bacterial vaginosis.

Novel PCR-Based Methods Enhance Characterization of Vaginal Microbiota in a Bacterial Vaginosis Patient before and after Treatment

Deep characterization, even by next-generation sequencing, of the vaginal microbiota in healthy women or posttreatment bacterial vaginosis patients is limited by the dominance of lactobacilli. To improve detection, we offer two approaches: quantitative PCR (qPCR) using phylogenetic branch-inclusive primers and sequencing of broad-spectrum amplicons generated with oligomers that block amplification of lactobacilli.

P3-S7.10 Composition of vaginal microbiota in bacterial vaginosis patients and healthy women: basis for genetic diagnosis of bacterial vaginosis?

BackgroundBacterial vaginosis (BV) is the most common vaginal infection/disorder. BV is characterised by imbalance in the normal vaginal microbiota with a shift towards higher bacterial diversity and increased pH. The...

Identification and analysis of vaginal lactobacilli in patients with bacterial vaginosis patients and healthy women in nationality of Pastoral area

To identify and analyze the species of vaginal lactobacilli between patients with bacterial vaginosis (BV) and healthy women at childbearing age in Inner Mongolia. From Jun. 2008 to Dec. 2008, 203 Mongolian healthy women, 74 Han healthy women and 102 Mongolian patients with BV from 3 pastoral areas were enrolled in this study. Isolation and culture of lactobacilli from vaginal wall were performed by modified culture medium. DNA of lactobacilli were extracted and sequenced. H₂O₂ were detected by TMB-HRP-MRS. (1) The rate of lactobacilli identification were 76.8% (156/203) in Mongolian healthy women and 21.6% (22/102) in Mongolian patients with BV, which reached statistical difference (P < 0.01). Lactobacilli identification in Han healthy women [82.4% (61/74)] did not show significant difference with that of Mongolian healthy women (P > 0.05). (2) The total of 193 strains and 11 species of Lactobacillus were detected in 203 Mongolian healthy women. Meanwhile, 22 strains and 4 species of Lactobacillus were found in 102 Mongolian BV cases. (3) The rate of H₂O₂ generating Lactobacilli was 27.3% (6/22) in Mongolian BV patients and 75.7% (56/74) in Mongolian healthy women, which showed statistical difference (P < 0.05). The rate of Lactobacillus was not related with the race of women in pastoral area in Inner Mongolian. The amount of lactobacilli and H₂O₂ generating Lactobacilli in the vagina of BV patients was remarkably lower than those of healthy women at childbearing age.

Prevalence of vulvovaginitis and bacterial vaginosis in patients with koilocytosis.

Empirical discussion regarding an association between koilocytosis and vulvovaginitis often occurs. Thus, the objective of this study was to assess the prevalence of microorganisms associated with bacterial vaginosis and vulvovaginitis in women with and without koilocytosis. Analytical cross-sectional study including two cohorts of women (with and without koilocytosis) who attended a cancer hospital in the city of Goiânia, state of Goiás. A total of 102 patients entered the study. The whiff test, Gram and Papanicolaou staining and bacterial and fungal culturing were performed. The results were observed using univariate analysis. The odds ratio and confidence interval (CI) of the variables were calculated; P-values < 0.05 were considered significant. The prevalence of bacterial colonization was similar in patients with and without koilocytosis. The odds ratio for candidiasis was 1.43 (CI 1.05-1.95) and the odds ratio for trichomoniasis was 1.78 (CI 1.49-2.12), in patients with koilocytosis. The prevalence of candidiasis and trichomoniasis seems to be higher in patients with koilocytosis.

Treatment options for bacterial vaginosis in patients at high risk of preterm labor and premature rupture of membranes

To estimate the efficacy of different therapeutic modalities on proven cases of bacterial vaginosis (BV) in patients at high risk of preterm labor and premature rupture of membranes. This was a longitudinal prospective comparative study set in the antenatal outpatient clinic of the department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. Four hundred and sixty-eight patients with a clinical picture of threatened preterm labor or at high risk of premature rupture of membranes in the third trimester were screened for BV. Positive BV was diagnosed in 156 patients. They were randomly classified into four equal groups according to the line of medical treatment. The treatments were: (i) oral metronidazole, (ii) clindamycin vaginal cream, (iii) oral clindamycin, or (iv) metronidazole vaginal suppositories. The effects of medical treatment on Amsel's criteria as well as maternal and fetal outcomes were measured. Based on Amsel's criteria, 156 patients (33.3%) were diagnosed with BV. There was a significant disappearance of vaginal discharge, with decreased percentages of pH > 4.5, positive amine test, and clue cells after treatment of BV in the four groups without any statistically significant difference between them. There were variable effects of the different treatments on increasing birthweight values, admission to neonatal intensive care units, and prolongation of the gestational age. Some maternal adverse effects have been recorded. There were significant improvements of the outcomes for oral metronidazole and clindamycin compared with outcomes for intravaginal metronidazole and clindamycin. Metronidazole and clindamycin achieve nearly equivalent cure rates when administered orally or vaginally in patients at high risk of preterm labor and premature rupture of membranes. Oral metronidazole is considered the drug of choice in treating BV due its high cure rate, better outcomes, and low cost.

Mannose-Binding Lectin Gene Polymorphism, Vulvovaginal Candidiasis, and Bacterial Vaginosis

To evaluate associations between polymorphisms in the gene coding for mannose-binding lectin (MBL) and the diagnosis of acute or recurrent vulvovaginal candidiasis and bacterial vaginosis Women at two outpatient clinics in Brazil filled out a questionnaire and were examined for the presence of vulvovaginal candidiasis or bacterial vaginosis. A buccal swab was blindly tested for codons 54 and 57 MBL2 gene polymorphisms by polymerase chain reaction and endonuclease digestion. A total of 177 women were enrolled. Vulvovaginal candidiasis was identified in 78 (44.1%) women, 33 (18.6%) had bacterial vaginosis, and 66 (37.3%) were normal controls. Recurrent vulvovaginal candidiasis was present in 50 (64.1%) of the women with vulvovaginal candidiasis; 20 (60.6%) of the bacterial vaginosis patients had recurrent disease. Vulvovaginal candidiasis was associated with white race (P=.007), bacterial vaginosis was associated with nonwhite race (P=.05), and both were associated with a history of allergy (P< or =.02) and having sexual intercourse at least three times a week (P<.001). Carriage of the variant MBL2 codon 54 allele B was more frequent in women with recurrent vulvovaginal candidiasis (25.0%) than in the women with acute vulvovaginal candidiasis (17.9%) or controls (10.6%) (P=.004). Allele B was also more prevalent in women with recurrent bacterial vaginosis (22.5%) than in those with acute bacterial vaginosis (0%) (P=.009). The MBL2 codon 57 polymorphism was infrequent and not associated with vulvovaginal candidiasis or bacterial vaginosis. The incidence of vulvovaginal candidiasis and bacterial vaginosis differs by ethnicity in Brazilian women. The MBL2 codon 54 gene polymorphism is associated with both recurrent vulvovaginal candidiasis and recurrent bacterial vaginosis.

Perfil epidemiológico de mulheres com vaginose bacteriana, atendidas em um ambulatório de doenças sexualmente transmissíveis, em São Paulo, SP

FUNDAMENTOS - A vaginose bacteriana é doença de grande relevância devido à sua alta prevalência e suas complicações obstétricas e ginecológicas. OBJETIVO - Descrever o perfil epidemiológico das pacientes com diagnóstico de vaginose bacteriana, atendidas em um ambulatório de São Paulo, segundo variáveis de interesse social, demográfico e clínico. MÉTODOS - Estudo transversal descritivo, baseado nos prontuários de 658 mulheres atendidas de janeiro de 1999 a dezembro de 2004. Foram coletadas as seguintes informações: idade, cor, estado civil, procedência, grau de escolaridade, preferência sexual, número de parceiros e presença de doença sexualmente transmissível associada. RESULTADOS - A prevalência encontrada foi de 29%. Com relação ao perfil da mulher com vaginose bacteriana, observou-se maior ocorrência em jovens entre 10 e 19 anos (40%), negras (37,1%), viúvas (62,5%), com segundo grau incompleto (39,5%), heterossexuais (29,5%), com dois ou mais parceiros sexuais nos últimos 30 dias (50%) e nos últimos cinco anos (32,3%). A associação com outras doenças sexualmente transmissíveis, concomitante, foi encontrada em 31,9% dos casos. CONCLUSÃO - A distribuição dos casos segundo faixa etária, raça, número de parceiros sexuais e associação com outras doenças encontradas nas pacientes com diagnóstico de vaginose bacteriana foi semelhante aos dados encontrados na literatura. A ocorrência está dentro dos limites descritos (10 e 36%).

367 Diagnosis of bacterial vaginosis in patients at increased risk of preterm birth

367 Diagnosis of bacterial vaginosis in patients at increased risk of preterm birth

Is Mycoplasma hominis a vaginal pathogen?

Objective: To evaluate the role of Mycoplasma hominis as a vaginal pathogen. Design: Prospective study comprising detailed history, clinical examination, sexually transmitted infection (STI) and bacterial vaginosis screen, vaginal swabs...

Use of antibiotics to prevent preterm birth

Our purpose is to review recent data and provide a clinical opinion on the use of antibiotics to prevent preterm birth or related maternal-neonatal complications. A literature review and a synthesis of opinion are provided. During prenatal care, standard practices should be applied regarding Neisseria gonorrhoeae, Chlamydia trachomatis, and bacteriuria. In addition, screen for and treat bacterial vaginosis in patients at high risk for preterm birth but do not treat Ureaplasma urealyticum or group B streptococci genital colonization. With preterm labor and intact membranes, standard practices should be applied regarding group B streptococci prophylaxis. Do not give antibiotics routinely to prolong pregnancy, but in patients with bacterial vaginosis and Trichomonas vaginalis specific treatment should be given. With preterm premature rupture of membranes, standard practices should be applied regarding group B streptococci prophylaxis, but additional antibiotics should also be given to prolong pregnancies at 24 to 32 weeks' gestation. Reported adverse effects have been few to date. However, increased diligence is needed for resistant organisms. In selected clinical settings antibiotic therapy is now indicated to prolong pregnancy and prevent maternal-neonatal complications associated with preterm birth. (Am J Obstet Gynecol 1997;177:375-80.)

Observations Concerning the Microbial Etiology of Acute Salpingitis

Abstract OBJECTIVES : The specific aims of this study were (1) to describe the microbiologic characteristics of patients with acute salpingitis and (2) to determine the incidence of bacterial vaginosis in patients with acute salpingitis and whether bacterial vaginosis microorganisms were common upper-genital-tract isolates in these patients. STUDY DESIGN: Women with pelvic inflammatory disease underwent laparoscopy to confirm the diagnosis of acute salpingitis and for culture of the fallopian tubes and cul-de-sac. Endometrial and minute fimbrial biopsies were performed, and specimens were evaluated for evidence of inflammation. Bacterial vaginosis was diagnosed by vaginal Gram stain. RESULTS : Eighty-four patients had visually confirmed acute salpingitis. Neisseria gonorrhoeae or Chlamydia trachomatis was isolated from 65 (77.4%) patients. Vaginal microorganisms were isolated from the endometrium in 16 (31.4%) of 51 cases and from the cul-de-sac in 12 (14.3%) of 84 cases. Bacterial vaginosis was present in 61.8% of patients with acute salpingitis, and 100% of anaerobes isolated from the upper genital tract of patients with acute salpingitis were bacterial vaginosis micororganisms. These anaerobes were isolated from the upper genital tract in the absence of a concurrent gonococcal, chlamydial, or Haemophilus influenzae infection in only two cases. CONCLUSIONS : The initiation of acute salpingitis is predominantly due to the ascending spread of sexually transmitted microorganisms. Bacterial vaginosis is a common concurrent disorder of women with acute salpingitis, and bacterial vaginosis microorganisms are commonly isolated from the upper genital tracts of patients with pelvic inflammatory disease. (AM J OBSTET GYNECOL 1994; 170:1008-17.)

Observations concerning the microbial etiology of acute salpingitis

OBJECTIVES: The specific aims of this study were (1) to describe the microbiologic characteristics of patients with acute salpingitis and (2) to determine the incidence of bacterial vaginosis in patients with acute salpingitis and whether bacterial vaginosis microorganisms were common upper-genital-tract isolates in these patients. STUDY DESIGN: Women with pelvic inflammatory disease underwent laparoscopy to confirm the diagnosis of acute salpingitis and for culture of the fallopian tubes and cul-de-sac. Endometrial and minute fimbrial biopsies were performed, and specimens were evaluated for evidence of inflammation. Bacterial vaginosis was diagnosed by vaginal Gram stain. RESULTS: Eighty-four patients had visually confirmed acute salpingitis. Neisseria gonorrhoeae or Chlamydia trachomatis was isolated from 65 (77.4%) patients. Vaginal microorganisms were isolated from the endometrium in 16 (31.4%) of 51 cases and from the cul-de-sac in 12 (14.3%) of 84 cases. Bacterial vaginosis was present in 61.8% of patients with acute salpingitis, and 100% of anaerobes isolated from the upper genital tract of patients with acute salpingitis were bacterial vaginosis micororganisms. These anaerobes were isolated from the upper genital tract in the absence of a concurrent gonococcal, chlamydial, or Haemophilus influenzae infection in only two cases. CONCLUSIONS: The initiation of acute salpingitis is predominantly due to the ascending spread of sexually transmitted microorganisms. Bacterial vaginosis is a common concurrent disorder of women with acute salpingitis, and bacterial vaginosis microorganisms are commonly isolated from the upper genital tracts of patients with pelvic inflammatory disease. (AM J OBSTET GYNECOL 1994; 170:1008-17.)

Vaginal lactobacillosis

OBJECTIVES: Our purpose was to study a cyclic condition characterized by vaginal discharge and discomfort occurring 7 to 10 days before menses and associated with the occurrence of long serpiginous rodlike organisms, visible in wet mount preparations. STUDY DESIGN: Thirty-seven patients and 30 controls were studied prospectively. The vaginal flora was analyzed, including isolation of anaerobic bacteria and fungi. Species of lactobacilli isolated from some of the women were identified and the antibiotic susceptibility was determined. Recent episodes of vaginitis and therapy were recorded. RESULTS: Ninety-two percent of the patients had a history of recent episodes of vaginosis lasting for an average of 22.2 months, and 57% had received triazole or imidazole antifungal therapy. Anaerobic lactobacilli were isolated from 97% of the vaginosis patients and from 40% of the controls. The average length of the organisms seen was 60 μm in the patients and 10 μm in the comparison group. Amoxicillin and clavulanate potassium proved to be an effective therapy symptomatically and resulted in disappearance of the extremely long organisms in vaginal smears. CONCLUSIONS: Lactobacilli vaginosis is associated with extremely long lactobacilli. The cause of this morphologic transformation is unknown. The condition can be effectively treated with antibiotics. (AM J OBSTET GYNECOL 1994;170:857-61.)

Quantitative studies on the vaginal flora of asymptomatic women and patients with vaginitis and vaginosis

Vaginal washings of 22 patients with vaginitis, 11 with vaginosis, and 12 healthy subjects were investigated quantitatively and qualitatively for aerobic and anaerobic bacteria and yeasts. Gardnerella vaginalis was recovered from 9 of the vaginitis patients, 7 of the vaginosis patients, and 4 of the asymptomatic subjects. Obligate anaerobes were found in 11 of the vaginitis patients, 4 of the vaginosis patients, and none of the control subjects. Bacteroides bivius was the anaerobe most frequently isolated from symptomatic subjects. Anaerobic vibrios were recovered twice from symptomatic subjects. The counts for Gardnerella vaginalis and anaerobes when present were generally very high. The most frequent aerobes were beta-hemolytic streptococci (group B) and staphylococci.