Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital: a prospective study

Abstract

Bacterial vaginosis (BV), candidiasis, and trichomoniasis were the three established types of vaginal conditions until aerobic vaginitis (AV) was defined in the early 2000s. We sought to study the prevalence of abnormal vaginal flora (AVF) with inflammation in our hospital and to correlate it with AV. We prospectively collected vaginal smear specimens originated from symptomatic women who were examined at Iaso Obstetrics, Gynecology and Children's Hospital of Athens from April 2014 until September 2015. Amsel's criteria were used for the diagnosis of BV. The presence of leukocytes and lactobacillary grade were evaluated to classify a condition as AVF with inflammation; subsequently, bacterial cultures were performed. A total of 761 women were included. Five hundred and seventy-nine women were diagnosed with candidiasis, BV, trichomoniasis, or other types of vaginitis in which no pathogenic bacterial growth occurred in cultures. One hundred and eighty-two women (23.9 %) were diagnosed with AVF with inflammation (116 non-pregnant, 66 pregnant). Escherichia coli was the most common pathogen among these women (non-pregnant: 45.7 %, pregnant: 34.8 %). Other common pathogens were Group-B-Streptococcus (non-pregnant: 20.7 %, pregnant: 22.7 % respectively), Enterococcus faecalis (14.7 %, 18.2 %), and Klebsiella pneumoniae (6.9 %, 12.1 %). The prevalence of AVF with inflammation may be high. Since inflammation criteria were applied, most cases of BV were eliminated and the majority of cases of AVF are AV. Therefore, clinicians should include AV in the differential diagnosis of vaginitis, while microbiologists should take into account the growth of aerobic bacteria in vaginal cultures originating from women with microscopic findings of AV.

Comparison and Association between Different Types of Vaginitis and Risk Factors among Reproductive Aged Women in Lahore, Pakistan: a Cross-Sectional Study

“…In current study, the strains of genera Enterobacteriaceae, Staphylococcus, Streptococcus, Bacillus, Pseudomonas and Gardnerella were cultured from patients with severe AV and BV while E. faecalis and G. vaginalis (GV) were the dominant pathogens among AV and BV patients, respectively. These findings are consistent with those of Tansarli and coauthors [21], and Aroutcheva and coauthors [22].…”

Aerobic bacteria on cervical cytology

“…Usually, the samples for diagnosis of genital bacterial microbiota are collected from vagina. However, in present study, the samples subjected to culture and cytology were obtained from the cervix of women who underwent annual routine cervical cancer screening …”

The Association between Abnormal Vaginal Flora and Cytological Evidence of HPV with Prematurity in High-Risk Pregnant Women

“…Limited data exist on VV prevalence in high-risk pregnant women. Most of the studies evaluated the prevalence of vaginal flora alterations in pregnant women with low-risk pregnancies, such as the studies performed in Argentina by Mucci et al in which 33% presented VVC, 18% BV and 1.4% TV and the studies in Greece by Tansarli et al who found 50% of pregnant women with candidiasis, 10% with bacterial vaginosis and 0.4% with trichomoniasis (13,14).…”