Microbiological, behavioral and anamnestic predictor factors of bacterial vaginosis in women with vaginal discharge

Abstract

Introduction. Bacterial vaginosis (BV) is the primary cause of pathological vaginal discharge in women of reproductive age. Gardnerella vaginalis and Atopobium vaginae are considered key components of the vaginal microflora in BV. Etiology, pathogenesis and modes of transmission of BV are actively studied, however these questions still remain unanswered. Objective: investigate predictor factors of BV in women with vaginal discharge. Material and methods. In total, 318 women were included. As clinical material, vaginal samples were used. BV was diagnosed using the Nugent method. For quantitative determination of G. vaginalis and A. vaginae DNA, real-time PCR was used. Behavioral and anamnestic data were obtained from questionnaire filled out by the patients. Results. BV was diagnosed in 27 % of women. G. vaginalis and A. vaginae DNA was detected, respectively, in 93 % and 83 % of patients with BV, 73 % and 59 % - with intermediate microflora, 52 % and 38 % - with normal microflora. Difference between the three types of microflora in the frequency and concentrations of these microorganisms were statistically significant. Detection of G. vaginalis and A. vaginae were significant predictor factors of BV (OR 12.2; 95 % CI 5.1-29.4 and OR 7.9; 95 % CI 4.2-14.9, respectively), with chances to diagnose BV being manifold increased when clinically significant concentrations of these bacteria were detected (≥3×106 and ≥8×105 DNA copies/ml for G. vaginalis and A. vaginae, respectively). Detection of clue cells in Gram stained preparations was shown to be the strongest BV predictor (OR 765.6; 95 % CI 99.6-5883.2). Conclusions. BV is diagnosed in more than one fourth of women with vaginal discharge. Detection of G. vaginalis and A. vaginae, especially in clinically significant concentrations, and clue cells in Gram stained preparations are significant predictor factors of BV.

Clinical And Epidemiological Features Of Bacterial Vaginosis

“…According to Shchypitsinа E. V. et al (2016) DNA of Gardnerella vaginalis and Atopobium vaginae was detected in 93 and 83% of women with BV, respectively. Both microorganisms were also found in many women with normal vaginal microflora (in 52 and 38% of cases, respectively), but the concentration of these bacteria in vaginal samples in women with normal was significantly lower than the concentration in samples in women with BV [9]. ) are also present in significant quantities.…”

“…Special attention should be paid to the identification of two age-related peaks in the incidence of BV -in young women aged 18-25 years and in women after 40 years. The first peak may be associated with higher sexual activity at this age, and the second with the onset of hormonal menopausal changes in women of this age [9].…”

“…Thus, Turner A. N. et al (2016) showed the existence of an Association of unprotected sex with recurrent BV [19]. Furthermore, BV is much more common in women who have had more than one sexual partner in the past 6 months than in women who have not had a single partner or who have had a single partner [9]. A large number of sexual partners is a risk factor for STIs and supports the sexual route of transmission of BV.…”

“…Published: August 30, 2020 | Pages: 140-145 Doi: https://doi.org/10.37547/TAJMSPR/Volume02Issue08-21 IMPACT FACTOR 2020: 5. 286 to 40%, in women with pelvic inflammatory diseases-in 35% [9], in pathological whites -up to 87% [8]. Statistically significant, BV is more common in women under 25 years of age.…”

“…However, the qualitative and quantitative composition of the vaginal microflora can constantly change in response to exogenous and endogenous factors. The composition of the vaginal microbiocenosis of women of reproductive age is influenced by the phases of the menstrual cycle, hormonal changes in the postmenopausal period, pregnancy, hygiene habits, and sexual activity [9].…”