Bacterial Vaginosis Is More Frequently Diagnosed in Women with Inflammatory Changes on Routinely Performed Papanicolaou Smear S

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Bacterial vaginosis is more frequently diagnosed in women with inflammatory changes on routinely performed Papanicolaou smear S. Baka, I. Tsirmpa, A. Chasiakou, E. Politi, I. Tsouma, A. Sianou, V. Gennimata, E. Kouskouni Department of Biopathology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece Background: Usually, most Materials/methods: Asymptomatic nonpregnant Results: A total of 1372 women (774 with laboratories reporting the results of women with or without inflammatory inflammatory and 598 without inflammation on the Pap cervical Papanicolaou (Pap) smears changes on routinely performed Pap smear and smear) with smear tests and vaginal as well tests comment on the possible recalled for cultures in the last four years were as cervical cultures participated in the study. presence of infection based on included in the study. Genital tract samples Out of the 774 women with inflammation on cytological criteria. The clinical (vaginal and cervical) were available for analysis. Pap test, 294 (38%) had negative cultures importance of these findings is Clinical specimens collected from patients were (normal flora present), while 480 (62%) unknown especially in asymptomatic inoculated onto appropriate plates for standard women had positive cultures with different women. This study was conducted to aerobic and anaerobic cultures and incubated at pathogens. In contrast, the group of women assess the possible association 37’0 C for 24h and 48h, respectively. A wet mount without inflammation on Pap test displayed between inflammatory changes as well as a gram-stained smear were examined increased percentage of negative cultures reported on Pap smears with the under microscope to obtain valuable information (63%, p<0.0001) and decreased percentage isolation of pathogens in the genital about the microorganisms present and to apply of positive cultures (37%, p<0.0001). Among tract of asymptomatic women. Nugent criteria for the diagnosis of bacterial the women with genital tract pathogens Conclusion: The results of our study vaginosis. The isolated pathogens were identified detected, bacterial vaginosis was diagnosed suggest that a report of inflammatory using the automated system VITEK 2 (BioMerieux, more frequently in both groups. Interestingly, changes on the cervical Pap smear Marcy l’Etoile, France). Furthermore, the presence in the group with inflammation on Pap smear, cannot be used to reliably predict the of Chlamydia trachomatis as well as Ureaplasma the women diagnosed with bacterial presence of a genital tract infection, urealyticum and Mycoplasma hominis, in the vaginosis were significantly more compared especially in asymptomatic women. specimens studied, was determined using the to the group without inflammation However, bacterial vaginosis was COBAS AMPLICOR Chlamydia trachomatis test (p<0.0001). The isolation of other pathogens diagnosed more often in women with (Roche Diagnostics, USA) and Mycoplasma IST2 such as Candida species, Chlamydia inflammation on the Pap smear. (BioMerieux, Marcy l’Etoile, France), respectively. trachomatis, T. vaginalis and the cases Statistical analysis was performed using chi diagnosed as aerobic vaginitis did not differ square test and values ≤ 0.05 were considered as between the two groups. significant. .

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Aerobic Bacterial Pathogens Causing Vaginitis in Third Trimester of Pregnancy
Original Research Article DOI: 10.18231/2394-2754.2017.0089 Aerobic bacterial pathogens causing vaginitis in third trimester of pregnancy Indu Verma1,*, Sunita Goyal2, Vandana Berry3, Dinesh Sood4 1Associate Professor, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, 2Professor and HOD, Dept. of Obstetrics and Gynecology, 3Professor and HOD, Dept. of Microbiology, Christian Medical College and Hospital, Ludhiana, Punjab, 4Professor, Dept. of Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab *Corresponding Author: Email: [email protected] Abstract Introduction: Aerobic vaginitis is defined as a disruption of the lactobacillary flora, accompanied by signs of inflammation and the presence of predominantly aerobic microflora, composed of enteric commensals or pathogens. The Lactobacilli are replaced by aerobic facultative pathogens like E.coli, Staphylococcus aureus, group B Streptococci, Klebsiella pneumonia, and Enterococcus species which lead to ascending vaginal infections and various complications of pregnancy. Aim and Objectives: To analyze the prevalence of aerobic vaginitis in third trimester of pregnancy and to study different aerobic bacterial vaginal pathogens and their antibiogram. Materials and Method: One hundred and sixty six pregnant women in the third trimester of pregnancy were studied for aerobic pathogens by gram staining and culture- sensitivity. High vaginal swab was taken of all the women and sent for culture and sensitivity. Diagnosis of aerobic vaginitis was made on microscopy and culture report. Results: Out of total 166 women, 88 were asymptomatic and 78 were symptomatic. Significant aerobic growth was seen in 29 women. Seventeen (21.79%) symptomatic women had positive vaginal culture and 12 (13.64%) asymptomatic women showed positive aerobic vaginal cultures.
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Aerobic Vaginitis
AEROBIC VAGINITIS INTRODUCTION Aerobic vagini s (AV) is a newly defined clinical en ty that is dis nct from candidiasis, trichomoniasis and bacterial vaginosis (BV). Because of the poor recogni on of AV, this condi n lead to treatment failures and can be associated with severe complica ons, such as pelvic inflammatory disease, infer ity, preterm birth and fetal infec ns. AV is a bacterial infec on with vaginal discharge that is o en mistaken for bacterial BV. AV is a disrup the normal vaginal flora characterized by a decrease in Lactobacilli as the predominant species, and an increase in aerobic flora accompanied by malfunc oning white blood cells and high levels of TRANSMISSION inflammatory biochemicals. In AV, aerobic bacteria Prevalently by sexual contact with partner. In Iss au cCho lasd Sthoores ea fsryemqupetnotmly ofof uHnerd pine st? he intes nes, addi n, caused by Bacterial Vaginosis, Vulvovaginal including Escherichia coli, Staphylococcus aureus, candidiasis, and Trichomoniasis. There are reports Streptococcus agalac ae (group B Streptococcus that a drop in estrogen may trigger the development (GBS)), and Enterococcus faecalis are recovered. of AV in menopausal women, as well as postpartum However, intermediate forms of AV may exist with a mixed flora type. nursing women. INDICATIONS FOR TESTING: Tradi diagnosis is TREATMENT based on microscopic criteria including the rela ve Based upon diagnosis, combined treatment with any number of leucocytes, percentage of toxic of the following: an bio c (infec ous component), leucocytes, and lactobacillary grade: Grade I - steroids (inflammatory component), and/or estrogen numerous lactobacilli; no other bacterial species (atrophy component).
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