Bacterial vaginosis: prevalence in outpatients, association with some micro-organisms and laboratory indices.

Abstract

SUMMARY Seven hundred and ninety three women were investigated, aged between 16 and 78 years, to evaluate the prevalence of bacterial vaginosis (BV) and some associated micro-organisms, and to discuss the significance of laboratory indices correlated to this pathology. BV was diagnosed on the basis of four distinct criteria: a positive result of the test for amines with 10% KOH (odour-test), the presence of clue cells on fresh microscopic examination, a pH > 4 5 and direct Gram stain positive (the presence of more than 40 Gram negative or Gram variable coccobacilli per microscopic field by 1000 magnifications under oil immersion). The total prevalence of BV was 20-5% (163); similar percentages were found in both fertile and pregnant women, whereas a lower percentage (12 7%) was found in menopausal women. Gardnerella vaginalis was present in 235 (29-6%) of the 793 women, in 144 (88-3%) of the 163 with BV and in 91 (14-4%) of the 630 women without BV. Mobiluncus species was present in 8-2% (65) ofthe total population, in 38-6% (63) of the women with BV and only in two (0 3%) of the women without BV. In the women with BV lower percentages were found for Trichomonas vaginalis, yeasts, Chlamydia trachomatis and Neisseria gonorrhoeae. The absence of a definite relationship between BV and cultural isolation of G vaginalis is confirmed whereas the role played by Mobiluncus spp still has to be clarified. It is concluded that it is not necessary to screen with all four laboratory indices. Two positive indices from a panel of three (excluding pH > 4 5 and direct Gram stain positive in the same panel) allows the correct diagnosis of BV in almost all cases.Bacterial vaginosis (BV), a syndrome of probably mixed bacterial aetiology without signs of inflammation of the vaginal mucosa (also known as nonspecific vaginitis), has been studied over a long period to establish the aetiological role of a particular microorganism, Gardnerella vaginalis. Gardner and Dukes'2 were the first to establish a connection between the micro-organism and the disorder over 30 years ago.Although G vaginalis has been biochemically identified in eight biotypes,3 there are still no definite findings and no clear pathogenicity for any of these in relation to BV. The association, however, remains between the syndrome and the micro-organism (once called Haemophilus vaginalis or Corynebacterium vaginalis), and is confirmed in a number of studies.'

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

“…Further, between 93 and 100% of women suffering from bacterial vaginosis were heavily colonized by G. vaginalis (8,18,65,89,92,94,167,170,226), and the numbers of CFU in samples from diseased vaginas were much higher than in healthy vaginas according to most (5,182,213,219,233), but not all (25,137), authors. As expected, the finding of a negative G. vaginalis culture had a 97% predictive value for exclusion of bacterial vaginosis (5,46). 17) were important in focusing attention on the joint roles of anaerobes and G. vaginalis in the disease process, and their findings have been amply confirmed (16,26,168,216).…”

“…G. vaginalis and Mobiluncus spp. were found together in cultures from one-third of women with vaginosis (46,94).…”

“…In addition, anaerobic, motile, curved rods (Mobiluncus spp. [220]) were detected in 33% (192), 38% (17), 42% (89), and 85% (95) of vaginal samples from women with vaginosis but from fewer than 5% of healthy women (46,92,95). G. vaginalis and Mobiluncus spp.…”

“…Greenwood (73,74). Substitution of the term bacterial vaginosis was recommended because vaginitis suggests an inflammatory reaction of the vaginal epithelium, which is usually absent (46,73,91,201). This syndrome has also been given more than 15 other names (96,200,235).…”

Correlation of bacterial vaginosis with preterm labour: a case control study

“…Current studies have found the prevalence of BV among non-pregnant women to range from 15-30% and up to 50% of pregnant women have been found to have bacterial vaginosis. [3][4][5][6] Bacterial vaginosis is diagnosed by various methods. These methods are Amsels criteria, Gram stain (Nugent score/Hay Ison grading), Bacterial vaginosis blue test which measures vaginal fluid sialidase activity.…”