Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections

Abstract

Bacterial vaginosis (BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20–30 % of women of reproductive age attending sexually transmitted infection (STI) clinics suffer from BV, and that its prevalence can be as high as 50–60 % in high-risk populations (e.g., those who practice commercial sex work (CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus (HIV), herpes simplex virus type 2 (HSV-2), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among women in the US military. It is essential to conduct large scale cross-sectional or population-based case-control studies to investigate the role of BV as a risk factor for CT/NG infections. These studies could lead to the development of interventions aimed at reducing the burden associated with bacterial STIs worldwide.

Serum vitamin D status and bacterial vaginosis prevalence and incidence in Zimbabwean women

“…36 We obtained the adjusted prevalence ratio (aPR) using a model that controlled for demographics and previously-identified correlates of BV (age, education, parity, partner circumcision status, sexual frequency, vaginal hygiene practices, condom use, and HSV-2 serostatus). 10, 37-38 …”

Prevalence of sexually transmitted infections and vaginal microbiocenosis disorders in asymptomatic patients

“…В работе было показано, что БВ в значительном числе случаев ассоциирован с ИППП, что согласуется с зарубежными и отечественными данными [8,[10][11][12]. Относительно небольшая доля ИППП (2%) мо-жет быть связана с тем, что наибольшее число об-следованных женщин составляло возрастную груп-пу 31-40 лет (группа, в которой распространен-ность ИППП относительно невысока) [2,3].…”

“…БВ может приводить к развитию послеоперационных осложнений, ВЗОМТ, перито-нита, к неблагоприятным исходам беременности (преждевременные роды, внутриутробное инфици-рование плода, развитие послеродового эндометри-та, самопроизвольные аборты, рождение детей с низ-кой массой тела) [1][2][3][4]8]. Доказано, что БВ сопрово-ждается повышением риска инфицирования и пере-дачи ИППП, в том числе ВИЧ-инфекции [2,3,[8][9][10][11]. Указанное определяет эпидемиологическую опасность БВ и снижает репродуктивный потенциал общества.…”

Probiotics for vaginal health in South Africa: what is on retailers’ shelves?

“…Although not considered a STI, BV is the most prevalent condition to influence vaginal health in women of reproductive age, and is considered to be enhanced by sexual activity [18]. It increases risk of endometritis, preterm delivery, chorioamnionitis, spontaneous abortion, maternal/neonatal sepsis [1–3, 19–21] and susceptibility to viral (including HIV, HPV and HSV-2) or bacterial (including Trichomonas vaginalis, Neisseria gonorrhoeae and Chlamydia trachomatis ) infections [4–7, 22, 23]. Its prevalence varies both between and within countries and is thought to be influenced by host genetics and social factors [24].…”