Nonspecific vaginitis

Amsel, Richard; Totten, Patricia A.; Spiegel, Carol A.; Chen, Kirk C.S.; Eschenbach, David A.; Holmes, King K.

doi:10.1016/0002-9343(83)91112-9

Cited by 1,977 publications

(427 citation statements)

References 38 publications

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“…The role of Gardnerella vaginalis in bacterial vaginosis has been a matter of controversy (Amsel et al, 1983;Easmon & Ison, 1986). A common feature of many studies has been the presence of so-called 'clue cells' (exfoliated vaginal epithelial cells coated with Gram-variable bacilli) in the vaginal discharges of patients with bacterial vaginosis (Amsel ct al., 1983).…”

Section: Introductionmentioning

confidence: 99%

Electron Microscopy of Adhesive Interactions between Gardnerella vaginalis and Vaginal Epithelial Cells, McCoy Cells and Human Red Blood Cells

Scott¹,

Curran

Smyth

1989

Microbiology

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~~ ~Exfoliated vaginal epithelial cells with attached bacteria, termed 'clue cells', which were procured from a patient with non-specific vaginitis, were stained with ruthenium red and examined by transmission electron microscopy. The attached bacteria appeared to adhere by means of an outer fibrillar coat. An epithelial tissue culture cell line (McCoy) and human red blood cells to which strains of Gardnerella vaginalis attached were similarly examined. The adherence of G. vaginalis to the epithelial cell line appeared to be mediated by an outer fibrillar coat while adherence to red cells appeared to be mediated by fimbriae. Transmission electron microscopy was performed on the Gardnerella strains used. Thin sections of tissue-cultureadherent strains revealed a dense outer fibrillar coat whereas the surface of the haemagglutinating strains showed fine fimbriae. Negative staining of haemagglutinating strains demonstrated fimbriae on a minority of organisms.

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Section: Introductionmentioning

confidence: 99%

Electron Microscopy of Adhesive Interactions between Gardnerella vaginalis and Vaginal Epithelial Cells, McCoy Cells and Human Red Blood Cells

Scott¹,

Curran

Smyth

1989

Microbiology

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“…Bacterial infections account for 11-64% of vaginal infections in symptomatic non-pregnant patients 5 while trichomonal infections account for 5-25% of family planning or gynecology clinic visits and up to 32% in STD clinics 6 . Physician or healthcare provider use of vaginal pH testing has been shown to be of utility in diagnosing the causes of vaginitis [7][8][9] . We have shown that subjects can read the package insert and understand the role of a vaginal pH device 10 .…”

mentioning

confidence: 99%

“…The Amsel criteria remain the cornerstone for differential diagnosis of BV today 7 , with vaginal pH alone providing the greatest sensitivity of the four clinical signs, but the lowest specificity 19 . Many clinicians today determine vaginal pH routinely as part of well-woman examinations and as part of the diagnostic process for patients presenting with symptoms of vaginitis 20,21 .…”

mentioning

confidence: 99%

Improving Appropriate Use of Antifungal Medications: The Roleof an Over‐the‐Counter Vaginal pH Self‐Test Device

Roy¹,

Caillouette²,

Faden³

et al. 2003

Infectious Diseases in Obstetrics and Gynecology

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Objectives:To determine whether patients can understand and use the vaginal pH device in the diagnosis of vaginitis. To compare whether vaginal pH readings determined by patients and healthcare providers are similar. To determine whether vaginal pH can reduce inappropriate over-the-counter (OTC) antifungal medication use and improve the correct diagnosis of vaginitis. Methods: One hundred and fifty-one women indicated their belief about the cause of their vaginal infection, read the instructions of the vaginal pH device package insert, used the device and interpreted the findings. The patient interpretations were compared with results obtained by healthcare providers, blinded to patient findings. Results: Over 96% of patients stated that they could easily read the instructions, use the vaginal pH device and interpret the readings. They obtained the same readings as healthcare professionals (Kappa = 0.9). Restricting the use of OTC antifungal medications to those individuals with vaginitis symptoms and vaginal pH ≤ 4.5 significantly reduced inappropriate use by approximately 50%, Fisher's exact test, p-value = 0.018. Conversely, seeking healthcare provider assessment with vaginal pH > 4.5, leads to correct diagnosis of vaginitis. Conclusions: The vaginal pH device can be used as an OTC diagnostic tool by consumers when a vaginal infection is suspected. Vaginal pH readings would direct patients whether to purchase an antifungal medication or seek professional diagnosis from a healthcare provider. Understanding and use of this vaginal pH device could reduce inappropriate use of OTC antifungal medications by approximately 50% and improve the correct diagnosis of vaginitis.

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“…Three out of four Amsel criteria were necessary for the clinical diagnosis of BV: (i) homogeneous, thin, grayish-white vaginal discharge; (ii) vaginal pH > 4.5; (iii) positive whiff-amine test; and (iv) clue cells present on a wet mount of vaginal fluid [35]. The vaginal discharge was subjected to Nugent score determination and to whiff-amine test on two different glass slides.…”

Section: Methodsmentioning

confidence: 99%

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

Pino

Giunta

Randazzo

et al. 2017

Microbial Ecology in Health and Disease

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Background: Bacterial vaginosis is the most frequent condition associated to the vaginal microbiota imbalance, affecting about the 40–50% of women in the world. Even if antibiotics are effcetive for bacterial vaginosis treatment a long-term recurrence rates, higher than 70%, is recorded. Lactoferrin is an iron-binding glycoprotein with bacteriostatic and bactericidal properties. It owns the ability to protect the host against infection, by binding and regulating the iron needed for the bacterial proliferation.Objective: The present study was an open prospective randomized trial (registration no. SHI-EVE-2014.01) aimed at characterizing the bacterial biota of women affected by bacterial vaginosis (BV) and assessing the effects of two different lactoferrin concentrations (100 mg and 200 mg vaginal pessaries) on the composition and dynamics of the vaginal bacterial biota.Design: Sixty women with BV were recruited and randomized into two groups to receive lactoferrin pessaries for 10 days. Clinical evaluation was based on Amsel criteria and Nugent scores. Culture-dependent methods and Ion Torrent PGM sequencing of the 16S rRNA gene were applied to study in depth the overall structure of the vaginal bacterial biota and its dynamics during the treatment.Results: Vaginal lactoferrin administration modified the vaginal microbiota composition in patients with BV. During treatment, both 100 mg and 200 mg lactoferrin vaginal pessaries significantly decreased the occurrence of bacteria associated with BV, such as Gardnerella, Prevotella, and Lachnospira, and increased the occurrence of Lactobacillus species. The bacterial biota balance was maintained up to 2 weeks after treatment only in women treated with 200 mg lactoferrin pessaries.Conclusions: This study indicates that lactoferrin could be proposed as an alternative therapeutic approach for BV. Our data showed, for the first time, the dominance of Lactobacillus helveticus species during and after vaginal lactoferrin treatment.

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Nonspecific vaginitis

Cited by 1,977 publications

References 38 publications

Electron Microscopy of Adhesive Interactions between Gardnerella vaginalis and Vaginal Epithelial Cells, McCoy Cells and Human Red Blood Cells

Electron Microscopy of Adhesive Interactions between Gardnerella vaginalis and Vaginal Epithelial Cells, McCoy Cells and Human Red Blood Cells

Improving Appropriate Use of Antifungal Medications: The Roleof an Over‐the‐Counter Vaginal pH Self‐Test Device

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

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