prevalence of bacterial vaginosis and vaginosis-associated pathogens in pregnant women in Kuwait

ABSTRACT

To establish the prevalence of bacterial vaginosis [BV] and vaginosis-associated pathogens in pregnancy and to assess the role of Gram-stained smear in the diagnosis of By. Two sets of high vaginal and cervical swabs were collected from 165 pregnant women attending the antenatal clinic of the Maternity Hospital, Kuwait, during the 2nd and 3rd trimesters. Vaginal secretions from 30 healthy non-pregnant female volunteers were also investigated. One set was Gram-stained for morphotype and semi-quantitative scores and the other cultured on appropriate culture media for growth of Gardnerella vaginalis, Lactobacillus spp., Mycoplasma spp. and other vaginosis-associated pathogens. Of the 165 pregnant women, only 44 [27%] satisfied the clinical diagnosis of BV. Twenty one [48%] were Kuwaitis and 23 [52%] non-Kuwaitis. The majority of the 44 women with BV had grade III vaginal flora and a few had grade II flora. The Gram-stained smear from all 44 women had typical Gardnerella morphotypes characteristic of BV, and C. vagina/is was isolated from all of them. The overall prevalence rates of Mycoplasma hominis, Urea plasma urealyticum and Mobiluncus spp. were 4%, 29% and 61%, respectively. Compared with the isolation rates in non-pregnant women, Mobiluncus and M. hontinis were significantly associated with pregnancy [P < 0.001]. This study provides evidence of a high prevalence of BV [27%] and other selected vaginosis-associated genital tract pathogens among pregnant women in Kuwait and confirms that direct Gram staining of smear is adequate for the diagnosis of BV in any clinical setting with little need for confirmation by culture