Bacterial vaginosis: diagnosis and associations in vaginal discharge

ABSTRACT

Bacterial vaginosis [BV], the commonest cause of vaginal discharge, is thought to be polymicrobial in origin. The objective of this study was to evaluate the prervalence of BV in obstetrics and gynecological clinics, its rapid diagnosis regimen and its possible associations. One thousand and eighty patients, 16-55 years old, attending the outpatient clinics were included. Patients, all complaining of vaginal discharge, were clinically examined and subjected to approved rapid diagnostic techniques, isolation and identification of Gardnerella vaginalis [G. vaginalis] and anaerobes and the detection of urological mycoplasmas. The overall prevalence of BV was relatively low, accounting for 17.1%. G. vaginalis was identified in 95% of those with BV i.e 170/1080 [15.7 of all cases] whereas no anaerobes could be identified. Mycoplasma hominis [M. hominis] and Ureaplasma urealyticum [U. urealyticum] were detected and identified in 29/460 cases, 9 of which were in Gardnerella negative cases adding a 1.4% to the overall prevalence. G. vaginalis was identified in 29% of intrauterine contraceptive device [IUCD] users, 57% of patients with pelvic inflammatory disease [PID], 33% of patients with infertility and 24% of patients presenting with preterm labour. On the other hand, no association could be found between g. vaginalis and other forms of vaginitis, namely trichomonas vaginitis and vaginal candidiasis. Rapid diagnosis using a vaginal discharge pH of > 5 and Gram stained smear was extremely easy and reliable showing acceptable degrees of specificity and sensitivity. In fact these hand tools might give clues to early diagnosis and better management before the results of any cumbersome sophisticated investigations