Laboratory evaluation of the etiology of pathological vaginal dischurge

2019 ◽  
pp. 64-68
Author(s):  
O.A. Burka ◽  
◽  
T.M. Tutchenko ◽  
Keyword(s):  
Bacterial Vaginosis ◽  
Crucial Role ◽  
Inflammatory Process ◽  
Vaginal Discharge ◽  
Vulvovaginal Candidiasis ◽  
Diagnostic Methods ◽  
Laboratory Evaluation ◽  
Aerobic Vaginitis ◽  
Laboratory Confirmation ◽  
Vaginal Secretions

Pathological vaginal discharge is one of the most common complaints in women of all ages. Today, gynecologists are increasingly faced with a problem when, in the absence of laboratory confirmation of vulvovaginal candidiasis, bacterial vaginosis and STIs, women complain of discomfort caused by vaginal secretions. Causes of pathological vaginal discharge can be infectious and non-infectious processes and their combinations. The article analyzes the causes of the difficulties of diagnosing the of pathological vaginal discharge ethiology, demonstrates how the application of adequate volume of modern laboratory diagnostic methods in combination with understanding the multifaceted components of the inflammatory process plays crucial role in finding out the etiology of pathological vaginal secretions and the choice of optimal therapeutic tactics. Key words: pathological vaginal dischurge, vaginal microbiota, vulvovaginal candidiasis, bacterial vaginosis, aerobic vaginitis, cytolytic vaginosis.

The efficacy and safety of using the topical medicine with combined action in patients with opportunistic vaginal infections

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 22-26
Author(s):  
Vera N. Prilepskaya ◽  
Giuldana R. Bairamova ◽  
Elena A. Mezhevitinova ◽  
Andrei E. Donnikov ◽  
Dmitry Yu. Trofimov ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Genital Tract ◽  
Clinical Signs ◽  
Vulvovaginal Candidiasis ◽  
Long Term Results ◽  
Vaginal Infections ◽  
Aerobic Vaginitis ◽  
Laboratory Parameters ◽  
Recommended Treatment ◽  
Gynecological Examination

Relevance.Infections of the lower genital tract are one of the most common reasons for women to visit a gynecologist. According to various authors, among all vulvovaginitis, the highest percentage of patients visiting a doctor is bacterial vaginosis (2050%), vulvovaginal candidiasis (1739%), trichomoniasis (10%) and other genital infections (10%). In the management of patients with infectious processes of the genitals, the choice of the method of therapy is of great importance, which allows not only to influence the microbes-associates, detected in high concentrations in the womans vagina during the initial episode of the disease, but also to prevent the development of relapses. Aim.To evaluate the clinical and laboratory efficacy, adherence and long-term results of benzydamine use in patients with vulvovaginal candidiasis, aerobic vaginitis and bacterial vaginosis Materials and methods.The study included 31 women aged 18 to 49 years, who complained of abundant discharge from the genital tract, itching, burning, dyspareunia. A comprehensive clinical and laboratory examination was carried out, including the collection of anamnestic data, general and special gynecological examination, microscopy of vaginal smears, KOH test, determination of the pH of the vaginal environment, assessment of vaginal microbiocenosis by quantitative PCR in real time. All patients were prescribed benzydamine hydrochloride, which was used as monotherapy in the form of a vaginal solution according to the recommended treatment regimen specified in the instructions for medical use of the drug TantumRosa 1 (irrigation 2 times a day for 10 days). Results.In 1219 days after beginning treatment, 25 (80.6%) of 31 patients with laboratory signs of vaginal microflora alterations showed restoration of the normal vaginal biocenosis laboratory parameters. Of them, 8 patients initially had dysbiosis, 12 patients yeast-like fungi, 4 patients aerobic vaginitis and 1 patient a combination of dysbiosis and fungi. Herewith, all patients also noted clinical signs of improvement. In 1219 days after beginning treatment, 6 (1.4%) of 31 patients with laboratory signs of vaginal biocenosis alterations had unsatisfactory laboratory parameters; that is vaginal biocenosis alterations (a decrease in Lactobacillus spp. percentage). At the same time, there were no clinical signs of pronounced inflammation such as pathological discharge, hyperemia, vaginal swelling. Conclusion.Benzydamine hydrochloride can be widely used in gynecological practice due to its combined effects on inflammation of the vagina, good clinical and microbiological results. It is important to note that additional therapy with drugs which contain lactobacilli is required only in 19.4% of cases. The clinical and laboratory effectiveness of benzydamine hydrochloride (TantumRosa) was 96.8%, since the relapse rate after 3060 days of the study did not exceed 3.2%.

Clinical and laboratory evaluation of the effectiveness of a personified approach to treating bacterial vaginosis and its concurrence with vulvovaginal candidiasis

2020 ◽  
Vol 3_2020 ◽  
pp. 198-202
Author(s):  
Pestrikova T.Yu. Pestrikova ◽  
Yurasova E.A. Yurasova ◽  
Kotelnikova A.V. Kotelnikova ◽  
Strelnikova N.V. Strelnikova N ◽  
Voronova Yu.V. Voronova ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Vulvovaginal Candidiasis ◽  
Laboratory Evaluation

scholarly journals PROFIL DUH TUBUH VAGINA DI POLIKLINIK KULIT DAN KELAMIN RSUP PROF. DR. R.D KANDOU MANADO TAHUN 2009–2011

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Youlanda Emelia Moeri ◽  
Pieter Levinus Suling ◽  
Herry E. J. Pandeleke
Keyword(s):  
Bacterial Vaginosis ◽  
Trichomonas Vaginalis ◽  
Vaginal Discharge ◽  
Daily Life ◽  
Descriptive Study ◽  
Vulvovaginal Candidiasis ◽  
Common Cause ◽  
Vulvovaginal Candidosis ◽  
Abnormal Vaginal Discharge ◽  
Age Range

Abstract: Vaginal discharge is a problem for most women because it can cause discomfort, anxiety, and interfere with daily life. Bacterial vaginosis, trichomonas vaginalis, and candida infection are the most common cause of abnormal vaginal discharge, and brought about 20–25% of women to the doctor. The purpose of this study is to found out vaginal discharge profiles in Dermatovenereology Polyclinic Prof Dr. R.D Kandou General Hospital in 2009–2011. A retrospective descriptive study method was performed by taking all new  patients data of vaginal discharge complaint and diagnosis with bacterial vaginosis,  vulvovaginal candidiasis and trichomoniasis. noted based on medical record including the visitation patients, diagnose, age and work. The results obtained are 131 new patients vaginal discharge complaint and diagnosis with bacterial vaginosis  were 80 patients (61.07%), vulvovaginal candidosis were 44 patients (33.59%), and trichomoniasis were 7 patients (5.34%). Age range mostly 25–44 years old is 68 patients (51,91%).  housewife is the mostly work in patients there were 45 patients (34,35%). The conclusions,  based on the result obtained are more cases in bacterial vaginosis compared with vulvovaginal candidiasis and trichomoniasis. Keywords: bacterial vaginosis, , trichomoniasis , vaginal discharge, vulvovaginal candidiasis. ABSTRAK: Duh tubuh vagina merupakan masalah bagi sebagian besar wanita karena dapat menimbulkan rasa tidak nyaman, cemas dan mengganggu kehidupan sehari-hari. Vaginosis bakterial, infeksi candida dan trichomonas vaginalis merupakan penyebab paling sering dari duh tubuh vagina yang abnormal pada wanita dan yang membawa sekitar 20–25% wanita ke dokter. Tujuan penelitian ini yaitu untuk mendapatkan  profil duh tubuh vagina di Poliklinik Kulit dan Kelamin RSUP Prof. Dr. R.D Kandou Tahun 2009–2011. Metode penelitian ini dilakukan secara retrospektif deskriptif dengan mengambil data seluruh kasus baru dengan keluhan duh tubuh vagina yang didiagnosa vaginosis bakterial, kandidosis vulvovaginalis, dan trikomoniasis. Dari catatan medik pasien dicatat meliputi jumlah kunjungan, diagnosa, umur dan pekerjaan. Hasil yang didapatkan yaitu 131 pasien baru dengan duh tubuh vagina dengan diagnosa vaginosis bakterial sebanyak 80 pasien (61,07%), kandidosis vulvovaginal sebanyak 44 pasien (33,59%), dan trikomoniasis sebanyak 7 pasien (5,34%). Kelompok umur terbanyak pada usia 25–44 tahun yaitu  68 pasien (51,91%). Pekerjaan pasien terbanyak yaitu ibu rumah tangga yaitu 45 pasien (34,35%). Kesimpulan yang diambil yaitu berdasarkan hasil  penelitian ditemukan kasus vaginosis bakterial lebih banyak dibandingkan dengan kandidosis vulvovaginalis dan trikomoniasis. Kata kunci: duh tubuh vagina, kandidosis vulvovaginal, trikomoniasis, vaginosis bakterial.  

scholarly journals Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 191
Author(s):  
Giuseppina Campisciano ◽  
Nunzia Zanotta ◽  
Vincenzo Petix ◽  
Manuela Giangreco ◽  
Giuseppe Ricci ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Reproductive Age ◽  
P Value ◽  
Gram Stain ◽  
Aerobic Vaginitis ◽  
Nugent Score ◽  
Sexually Transmitted ◽  
Gram Staining ◽  
Reproductive Age Women

Bacterial vaginosis (BV) affects one-third of reproductive age women, increasing the risk of acquiring sexually transmitted infections (STIs) and posing a risk for reproductive health. The current diagnosis with Gram stain (Nugent Score) identifies a transitional stage named partial BV or intermediate microbiota, raising the problem of how to clinically handle it. We retrospectively analyzed cervicovaginal swabs from 985 immunocompetent non-pregnant symptomaticspp. women (vaginal discharge, burning, itching) by Nugent score and qPCR for BV, aerobic or fungal vaginitis, and STIs (Mycoplasmas spp., Chlamydia t., Trichomonas v., and Neisseria g.). Nugent scores 0–3 and 7–10 were confirmed in 99.3% and 89.7% cases, respectively, by qPCR. Among Nugent scores 4–6 (partial BV), qPCR identified 46.1% of BV cases, with 37.3% of cases negative for BV, and only 16.7% of partial BV. Gram staining and qPCR were discordant (p value = 0.0001) mainly in the partial BV. Among the qPCR BV cases, the presence of aerobic vaginitis and STIs was identified, with a significant association (p < 0.0001) between the STIs and partial BV/overt BV. qPCR is more informative and accurate, and its use as an alternative or in combination with Gram staining could help clinicians in having an overview of the complex vaginal microbiota and in the interpretation of partial BV that can correspond to vaginitis and/or STIs.

scholarly journals Comparison of intravaginal and oral metronidazole in patients with bacterial vaginosis

2017 ◽  
Vol 6 (10) ◽  
pp. 4213
Author(s):  
Sang Won Han ◽  
Jae Eun Chung
Keyword(s):  
Bacterial Vaginosis ◽  
Group Treatment ◽  
Vaginal Discharge ◽  
Patient Characteristics ◽  
Vulvovaginal Candidiasis ◽  
Study Patient ◽  
Oral Preparation ◽  
The Mean ◽  
Gel Preparation ◽  
Oral Metronidazole

Background: Metronidazole is considered an effective treatment for bacterial vaginosis. Only oral preparations were available until 2014, but an intravaginal gel preparation recently became commercially available in South Korea. In this report, the efficacy and safety of metronidazole intravaginal gel application was compared to that of the conventional oral metronidazole preparation.Methods: Patients who were treated with either intravaginal metronidazole or oral metronidazole after diagnosis of bacterial vaginosis were included in this study. Patient characteristics, mode of treatment, recurrence rate, and complications including gastro-intestinal discomfort and concomitant vulvovaginal candidiasis were analyzed.Results: There were no differences in patient characteristics, except the mean age was older in the intravaginal group. Treatment outcomes were similar in both groups. In the oral metronidazole group, 6.3% of patients reported ongoing symptoms of bacterial vaginosis within one month of treatment and required a refill, while 7.3% of the intravaginal group required a refill. Significantly more patients on oral metronidazole treatment complained about gastro-intestinal discomfort including nausea (13.4%) and diarrhea (9.4%). Patients who took intravaginal metronidazole complained about increased watery vaginal discharge (26.8%). The comparatively high cost of metronidazole intravaginal gel was another factor that could affect patient access to this treatment versus the oral preparation. The incidence of vulvovaginal candidiasis was similar between groups (oral 3.9%, intravaginal 4.9%).Conclusions: Intravaginal metronidazole usage can be considered as an effective alternative treatment for bacterial vaginosis in patients with gastro-intestinal complications. However, the increased incidence of watery vaginal discharge and high cost remain obstacles to widespread use of the intravaginal preparation.

Diagnosis of bacterial vaginosis by wet mount identification of bacterial morphotypes in vaginal fluid

2000 ◽  
Vol 11 (3) ◽  
pp. 150-155 ◽  
Author(s):  
H Schmidt ◽  
J G Hansen
Keyword(s):  
Bacterial Vaginosis ◽  
Clinical Diagnosis ◽  
Vaginal Discharge ◽  
Intermediate Phase ◽  
Weighted Kappa ◽  
Diagnostic Methods ◽  
Vaginal Fluid ◽  
Wet Mount ◽  
New Criterion ◽  
Bacterial Morphotypes

In order to develop a more practical way of diagnosing bacterial vaginosis (BV), we evaluated a scoring system, weighting small bacterial morphotypes versus lactobacillary morphotypes in wet mounts, assessed criteria for BV and normalcy from this scoring, and then evaluated their reproducibility and accuracy. We examined 754 women for pH, homogeneous vaginal discharge, amine odour, clue cells and the composite clinical diagnosis. We also examined wet mounts for small bacterial morphotypes and lactobacillary morphotypes, and weighted their quantitative presence as a bacterial morphotype score. The term 'small bacterial morphotypes' denotes a group of small bacillary forms comprising coccobacilli, tiny rods, and mobile curved rods. The different characteristics of BV were all gradually associated with increased bacterial morphotype scoring. We deemed a score of 0-1 as normal, 2-4 as intermediate phase, grade I, 5-6 as intermediate phase, grade II, and 7-8 indicative of BV. Reproducibility of the interpretation was high, both for the new grading system (weighted Kappa 0.90 in women perceiving and 0.81 in women not perceiving abnormal vaginal discharge) and for the new criterion for BV (non-weighted Kappa 0.91 and 0.84 in the 2 groups of women). The new criterion also proved highly concurrent with the composite clinical diagnosis (Kappa 0.91 and 0.81 in the 2 groups). In conclusion, the wet mount bacterial morphotype scoring is valid for grading of the disorder of the vaginal microbial ecosystem, and the new criterion for BV a more practical option than existing diagnostic methods.

scholarly journals Epidemiologic Features of Vulvovaginal Candidiasis among Reproductive-Age Women in India

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Sujit D. Rathod ◽  
Jeffrey D. Klausner ◽  
Karl Krupp ◽  
Arthur L. Reingold ◽  
Purnima Madhivanan
Keyword(s):  
Risk Factors ◽  
Bacterial Vaginosis ◽  
Correct Diagnosis ◽  
Structured Interview ◽  
Vulvovaginal Candidiasis ◽  
Reproductive Age ◽  
Predictive Values ◽  
Laboratory Confirmation ◽  
Women In India ◽  
Epidemiologic Features

Background. Vulvovaginal candidiasis is characterized by curd-like vaginal discharge and itching, and is associated with considerable health and economic costs.Materials and Methods. We examined the incidence, prevalence, and risk factors for vulvovaginal candidiasis among a cohort of 898 women in south India. Participants completed three study visits over six months, comprised of a structured interview and a pelvic examination.Results. The positive predictive values for diagnosis of vulvovaginal candidiasis using individual signs or symptoms were low (<19%). We did not find strong evidence for associations between sociodemographic characteristics and the prevalence of vulvovaginal candidiasis. Women clinically diagnosed with bacterial vaginosis had a higher prevalence of vulvovaginal candidiasis (Prevalence 12%, 95% CI 8.2, 15.8) compared to women assessed to be negative for bacterial vaginosis (Prevalence 6.5%, 95% 5.3, 7.6); however, differences in the prevalence of vulvovaginal candidiasis were not observed by the presence or absence of laboratory-confirmed bacterial vaginosis.Conclusions. For correct diagnosis of vulvovaginal candidiasis, laboratory confirmation of infection withCandidais necessary as well as assessment of whether the discharge has been caused by bacterial vaginosis. Studies are needed of women infected withCandidayeast species to determine the risk factors for yeast’s overgrowth.

scholarly journals Diagnosis of bacterial vaginosis in cases of abnormal vaginal discharge: comparison of clinical and microbiological criteria

2010 ◽  
Vol 5 (05) ◽  
pp. 353-360 ◽  
Author(s):  
Tamonud Modak ◽  
Preeti Arora ◽  
Charan Agnes ◽  
Raja Ray ◽  
Sebanti Goswami ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Vaginal Discharge ◽  
Laboratory Method ◽  
Diagnostic Methods ◽  
Clinical Method ◽  
Microbiological Parameters ◽  
Microbiological Criteria ◽  
Abnormal Vaginal Discharge ◽  
Amsel Criteria

Introduction: Bacterial vaginosis is a polymicrobial syndrome involving replacement of normal vaginal hydrogen peroxide producing lactobacilli by a variety of mycoplasmas and Gram-negative rods. Bacterial vaginosis has been conventionally diagnosed using Amsel criteria (a clinical method) or Nugent's score (a laboratory method with higher reproducibility). This study was undertaken to compare the diagnostic ability of the Amsel criteria with that of Nugent's score among patients presenting with abnormal vaginal discharge. Methodology: The study was conducted at the Medical College in Kolkata, India to determine the prevalence of patients with bacterial vaginosis and their demographic profile. Subjects attending the outpatient department presenting with abnormal vaginal discharge were evaluated for the presence of bacterial vaginosis by Amsel criteria and Nugent's score. Results: Prevalence of bacterial vaginosis was 24% by Nugent's score. In comparison, Amsel criteria had sensitivity of 66.67%, specificity of 94.74%, positive predictive value of 80% and negative predictive value of 90%. There was no perfect inter-rater agreement between the Amsel criteria and Nugent's score (Kappa = 0.58). Presence of clue cells correlated best with a positive diagnosis by Nugent's score while the amine test (whiff test) had the lowest correlation. Conclusion: Although the Amsel criteria method is a convenient and inexpensive means of diagnosing bacterial vaginosis, it is not always reliable.  Alternative reliable and inexpensive diagnostic methods that unify clinical and microbiological parameters, thus increasing sensitivity while retaining specificity, are needed.

scholarly journals Prevalence and Antimicrobial Susceptibility Profiles of Microorganisms Associated with Lower Reproductive Tract Infections in Women from Southern Poland—Retrospective Laboratory-Based Study

2021 ◽  
Vol 18 (1) ◽  
pp. 335
Author(s):  
Jadwiga Wójkowska-Mach ◽  
Monika Pomorska-Wesołowska ◽  
Małgorzata Romanik ◽  
Dorota Romaniszyn
Keyword(s):  
Bacterial Vaginosis ◽  
Antimicrobial Susceptibility ◽  
Streptococcus Agalactiae ◽  
Fungal Infections ◽  
Age Groups ◽  
Vulvovaginal Candidiasis ◽  
Gardnerella Vaginalis ◽  
Culture Methods ◽  
Aerobic Vaginitis ◽  
Tract Infections

Objective: Female infections affecting the genital tract include sexually transmitted diseases, endogenous infections such as vulvovaginal candidiasis, bacterial vaginosis (BV) or aerobic vaginitis (AV) and healthcare-associated infections. The aim of the study was to analyze the etiological factors of the vaginal dysbacteriosis, and the antimicrobial susceptibility of the dominant bacterial and fungal infections in different age groups of outpatient women from the Silesian Region. Materials and methods: A retrospective laboratory-based multi-center study encompassed 4994 women of different ages in Silesian Voivodeship, in the south of Poland; patients who had vaginal swabs collected as per physicians’ orders during the period from 1 January 2017 until 30 June 2018 were included in the study. The inclusion criteria were: non-hospitalized female, aged ≤80, with suspected vulvovaginal candidiasis or bacterial vaginosis and clinical sings of infections. Results: Gram-positive cocci were the ones most often isolated: Enterococcus faecalis (29.2%) and Streptoccoccus agalactiae (13.1%), followed by bacilli from the Enterobacteriaceae group, including Escherichia coli (26.3%). The presence of Streptococcus agalactiae was confirmed in 13.1%, slightly more often in the 45–80 age group, and Gardnerella vaginalis in 6.4%, most often in women aged 15–24. The prevalence of yeast-like infections was 24.3%, Candida albicans accounted for 78.3%, whereas among C. non-albicans spp.—C. glabrata dominated (14.9%) followed by C. parapsilosis (3.8%). The highest resistance was observed only in Streptococcus agalactiae as the MLSB mechanism (Macrolide-lincosamide-streptogramin B) was identified in 38.6% of strains. The prevalence of vulvovaginal candidiasis was 24.3%, the highest in women aged 15–44. Conclusions: Drug resistance in studied vulvovaginitis was associated only with Streptococcus agalactiae. A high proportion of yeast-like aetiology was found, probably associated with recurrent infections. In the analyzed cases only the Amsel criteria and culture methods were used for diagnosis without preparations and microbiological Nugent criteria.

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