Characteristics of aerobic vaginitis among women in Xi'an district: a hospital-based study

Clinical Performance and Safety of Vaginal Ovules in the Local Treatment of Nonspecific Vaginitis: A National, Multicentric Clinical Investigation

PURPOSE

Nonspecific vaginitis is a distinct clinical entity with particular microscopic and immunologic features. There is currently no standard of care for women with nonspecific vaginitis. The aim of our study was to assess the change in vaginal symptoms score after 3 months of treatment with an intravaginal medical device in participants with abnormal vaginal discharge and specific signs and symptoms. As secondary objectives, the study analyzed other clinical and microscopic features, such as vaginal discharge aspect, change in vaginal pH, change in vaginal microbiome, and vaginal inflammation.

METHODS

The study population included 47 participants with symptomatic vulvovaginitis, distinct from candidiasis, trichomoniasis, or bacterial vaginosis. The study design included 2 research sites from Romania. The treatment protocol consisted of 1 ovule per day inserted intravaginally during 15 consecutive days. The total study duration was 3 months.

FINDINGS

The intravaginal medical device had a positive impact on the vaginal symptoms score for 72.34% of the study participants. Topical administration of the ovules balanced vaginal pH values and significantly reduced signs of inflammation between study visits.

IMPLICATIONS

This intravaginal medical device had curative effects that support its use as a stand-alone treatment in women with nonspecific vaginitis. A second clinical investigation is ongoing to evaluate the clinical efficacy of the device in postoperative care of cervical and vaginal wounds traumatic or secondary to surgical interventions.

CLINICALTRIALS

gov identifier: NCT04735705.

Retrospective study of pathogens involved in vaginitis among Chinese women

BACKGROUND

To explore the pathogen distribution in Chinese females with vaginitis.

METHODS

This retrospective study included Chinese females with vaginitis admitted at the outpatient department of the Gynecology Clinic of the Second Affiliated Hospital of Kunming Medical University between January 2013 and June 2013. Data on the vaginal pathogens and inflammation were analyzed.

RESULTS

The vaginal secretions from 15,601 gynecologic outpatients were abnormal, including 8547 (54.78%) with vaginal infection and 7054 (45.22%) without. In patients with vaginal infections, a single infection was observed in 69.72% (5959/8547) of them, and mixed infection was observed in 30.28% (2588/8547). The differences in age and inflammation grade between the infection and no-infection groups were statistically significant (all P < 0.001). In addition, multiple types of vaginitis could be diagnosed in patients with mixed infections.

CONCLUSIONS

About half of the Chinese women with abnormal vaginal secretions are positive for pathogens in the study period. Patients' age and inflammation grade are associated with co-infection. From the public health perspective, this study suggests that the importance of vaginal hygiene should be enforced in Chinese women.

Correlation analysis of vaginal microecology and different types of human papillomavirus infection: a study conducted at a hospital in northwest China

Background

Vaginal microecology has a definite influence on human papillomavirus (HPV) infection and clearance, but the specific correlation is still controversial. This research aimed to investigate the differences in the vaginal microenvironment of different types of HPV infection and also provide data supporting clinical diagnosis and treatment.

Methods

According to strict inclusion and exclusion criteria, the case data of 2,358 female patients who underwent vaginal microecology and HPV-DNA tests at the same time in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Xi'an Jiaotong University from May 2021 to March 2022 were retrospectively analyzed. The population was divided into two groups: an HPV-positive group and an HPV-negative group. HPV-positive patients were further classified into HPV16/18-positive group and HPV other subtypes positive group. The vaginal microecology of HPV-infected patients was analyzed using the chi-square test, Fisher's exact test, and logistic regression.

Results

Among the 2,358 female patients, the HPV infection rate was 20.27% (478/2,358), of which the HPV16/18 infection rate was 25.73% (123/478), and the HPV other subtypes infection rate was 74.27% (355/478). The difference in HPV infection rates between the age groups was statistically significant (P < 0.01). The prevalence of mixed vaginitis was 14.37% (339/2,358), with bacterial vaginosis (BV) paired with aerobic vaginitis (AV) accounting for the majority (66.37%). The difference in HPV infection rates among mixed vaginitis was not statistically significant (P > 0.05). The prevalence of single vaginitis was 24.22% (571/2,358), with the most frequent being vulvovaginal Candidiasis (VVC; 47.29%, 270/571), and there was a significant difference in HPV infection rates among single vaginitis (P < 0.001). Patients with BV had a higher risk of being positive for HPV16/18 (OR: 1.815, 95% CI: 1.050-3.139) and other subtypes (OR: 1.830, 95% CI: 1.254-2.669). Patients with Trichomoniasis were at higher odds of other HPV subtype infections (OR: 1.857, 95% CI: 1.004-3.437). On the contrary, patients with VVC had lower odds of becoming infected with other HPV subtypes (OR: 0.562, 95% CI: 0.380-0.831).

Conclusion

There were disparities in HPV infection among different age groups; therefore, we should pay attention to the prevention and treatment of susceptible individuals. BV and Trichomoniasis are linked to HPV infection; hence, restoring the balance of vaginal microecology could assist in the prevention of HPV infection. As a protective factor for other HPV subtype infections, VVC may provide new insights into the development of immunotherapeutic therapies.

Incidence of symptomatic aerobic vaginitis among some Iraqi women in Baghdad city

Aerobic vaginitis (AV) is a newly adopted type of vaginal infection caused by aerobic bacteria; it was defined by Donders in 2002 and diagnosed according to Donder's criteria. AV is associated with increased vaginal pH, decreased vaginal microbiota and overgrowth of facultative anaerobic or aerobic bacteria, including Gram-positive cocci and Gram-negative bacilli. Because knowledge of the aerobic bacterial types causing AV is very important and only limited studies are available in Iraq about this type of vaginal infection, this study aimed to report the prevalence of AV in symptomatic women in Baghdad City, investigate the aerobic bacterial types associated and to evaluate the most critical symptoms and risk factors associated with AV. One hundred fifteen high vaginal swabs (HVSs) and 115 vaginal swabs (VSs) were collected from women of age 18-50 years attending some hospitals and private clinics in Baghdad City under the supervision of a competent gynecologist. Vaginal swabs were prepared for direct wet mount preparation to test under the microscope and Gram staining for AV identification according to Donders Criteria. High vaginal swabs were cultured on different culture media; the primary diagnosis of obtained colonies was based on phenotypic characteristics, conventional biochemical tests and Gram staining. The diagnosis was confirmed using Gram-positive (GP) and Gram-negative (GN) identification cards of the VITEK 2 System. Statistical analysis was carried out using (SPSS v 20) and p-value ≤ 0.05 at 95% CI was considered statistically significant. Out of the 115 swabs, only 89 (77.3%) swabs showed bacterial growth. Ninety-five bacterial isolates were obtained, including (65.2%) Gram-positive and (34.7%) Gram-negative bacteria. G+ve bacterial isolates included: (46.3%) Staphylococcus spp., (6.3%) Kocuria spp., (6.3%) Enterococcus spp., (5.2%) Micrococcus luteus and (1.0%) of Streptococcus agalactiae. G-ve bacterial isolates included (15.7%) Escherichia coli, (11.2%) Klebsiella pneumoniae, (3.2%) Pseudomonas aeruginosa (3.2%) Pseudomonas aeruginosa, (2.1%) Acinetobacter baumannii and (2.1%) Proteus mirabilis. More than half (58.4%) of patients showed severe AV. Mixed bacterial infections were reported in 6 (6.7%) cases only. Vaginal pH ranged between (5.5- 6.5). The most frequent(100%) testified symptoms were abnormal vaginal discharge and itching, or irritation, the less frequent symptoms (51.6%) was vaginal dyspareunia, and the most significant symptoms in associated with different bacterial types and age groups were foul smelling and burning (p= 0.001, 0.008, 0.0001). Among the risk factors, age was significantly associated with most bacterial types obtained with p values (0.05 and 0.02). Staphylococcus spp. and E.coli were the predominant bacterial types in AV patients in the current study, and the lower rate of bacteria was Streptococcus agalactiae (1.0%). A high prevalence of AV was reported; therefore, regular screening and proper diagnosis of AV using microscopic examinations, culturing of swabs and determining vaginal pH using specific vaginal pH test strips should be stimulated to develop AV management. Keywords: High vaginal swabs, Vaginal swabs, Aerobic vaginitis, aerobic G+ve and G-ve bacteria, Risk factors, Iraq.

Vaginal Infections' Etiologies in South-Eastern Gabon - An Overview

Introduction

Discomfort in women of childbearing age associated with vaginal infections, namely bacterial vaginosis (BV), aerobic vaginitis (AV), vulvovaginal candidiasis (VVC), and trichomoniasis (TV), represent a serious and ongoing gynecological complication throughout the world.

Objective

This study aimed to investigate the etiologies of vaginal infections among outpatients in south-eastern Gabon.

Methodology

A cross-sectional study was designed using participants referred directly by their treating doctor for a vaginal swab. Socio-demographic data were collected using a structured questionnaire. Microscopic examinations were used for TV and BV diagnostic. All vaginal swabs were cultured for AV and VVC isolates using standard microbiology methods.

Results

A total of 573 women of reproductive age participated in the study. The most common identified vaginal infections were BV (62.8%) and AV (51.1%) followed by VVC (34.1%). No significant difference was observed for each etiology compared to socio-demographic data. Streptococcus B (23.9%), Staphylococcus aureus (17.7%), Klebsiella spp. (11.6%), and E. coli (5.8%) were the bacteria most associated with AV. A high incidence of non-C. albicans Candida (NCAC) strains causing vulvovaginitis were found. The prevalence of TV (2.1%) was low. Mixed infections had been common among participants. No association was found with TV and other vaginal infections, unlike others studies. The present study identified BV 228 (83.5%) and AV 227 (83.2%) as the main cause of mixed infections. The mixed infection AV-BV 113 (41.4%) was the most represented.

Conclusion

Also that simultaneous AV-BV-VVC represented 69 (25.3%) of mixed infections. Molecular analyses would be needed to identify the key species commonly associated with these vaginal infections.

Vulvovaginitis Prevalence Among Women in Gondar, Northwest Ethiopia: Special Emphasis on Aerobic Vaginitis Causing Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors

Background

Genital tract infections are posing a series of public health challenges for women in both developed and developing countries. Microbial infections of the vagina can lead to serious medical complications such as preterm labor, amniotic fluid infection, premature rupture of the fetal membranes, and low birth weight of the neonate, leading to high perinatal morbidity and mortality. In Ethiopia, limited information is found on the burden, antimicrobial susceptibility profile and associated factors for aerobic vaginitis. Thus, this study was aimed to determine the burden of AV, antimicrobial susceptibility profile of aerobic bacterial isolates and associated factors among women attending Gondar town health facilities, northwest Ethiopia.

Methods

A health facility-based cross-sectional study was conducted on 214 study participants from February 1 to May 31, 2019. For all consecutive women, demographic variables were collected using a structured questionnaire and two vaginal swabs for each were collected. The diagnosis of AV and BV was based on the composite score of Donders and Nugent criteria, respectively. All bacteria were isolated and characterized by conventional culture techniques. The antimicrobial susceptibility pattern was performed using the disc diffusion technique. Logistic regression, univariate and multivariate analysis were carried out. A p-value ≤ 0.05 at 95% CI was considered as statistically significant.

Results

The overall prevalence of vulvovaginitis among women was 50%. The identified aetiologies of vulvovaginitis were bacterial vaginosis (35.5%), candidiasis (23.8%), aerobic vaginitis (22.9%) and trichomoniasis (3.3%). Aerobic bacteria, especially Enterococcus faecalis and Escherichia coli, were predominantly isolated in the vaginal samples. The prevalence of the multidrug resistance rate was 38.98%. The isolated Gram positive bacteria were sensitive to antibiotics like vancomycin, cefoxitin, ciprofloxacin, clindamycin, and gentamicin, whereas the Gram negative bacteria isolates were sensitive to ciprofloxacin, gentamicin and meropenem.

Conclusion

The high burden of bacterial vaginosis and aerobic vaginitis was reported. Therefore, regular screening of women using microbiological diagnosis should be promoted. The common bacteria isolated were Enterococcus faecalis and Escherichia coli. Additionally, antibiotics like vancomycin, cefoxitin, ciprofloxacin, clindamycin, gentamicin, and meropenem were shown to have good action against the majority of bacteria isolates.