Advertisement

Prevalence and treatment of aerobic vaginitis among non-pregnant women: evaluation of the evidence for an underestimated clinical entity

  • G. S. Tansarli
  • E. K. Kostaras
  • S. Athanasiou
  • M. E. Falagas
Review

Abstract

We sought to evaluate the evidence on the prevalence of aerobic vaginitis (AV) among symptomatic non-pregnant women, as well as the treatment administered for this clinical entity. The PubMed and Scopus databases were systematically searched. Sixteen studies met the inclusion criteria, 11 of which reported on the prevalence of possible AV, two on the prevalence of diagnosed AV, and three on the treatment and outcomes of women with diagnosed AV. The prevalence of diagnosed AV varied from 5 to 10.5 %. Streptococcus spp., Staphylococcus aureus, and coagulase-negative staphylococci were the most commonly identified Gram-positive pathogens among women with possible AV, with prevalences of up to 58.7, 41.7, and 37.4 %, respectively, while Escherichia coli was the most common Gram-negative pathogen identified, with a prevalence of up to 23 % among symptomatic women. Regarding antibiotic treatment for AV, the antibiotic schemes administered, which mainly consisted of suppositories of aminoglycosides, showed good effectiveness without serious adverse events provided by any of the included studies. The currently available data suggest that the prevalence of AV is not negligible, while the prevalence of possible AV is considerable. Well-designed studies comparing the prevalence of aerobic pathogens between symptomatic and asymptomatic women are warranted.

Keywords

Lactobacillus Bacterial Vaginosis Chlamydia Trachomatis Neisseria Gonorrhoeae Vaginitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

None.

Funding

None.

References

  1. 1.
    Donders GG, Vereecken A, Bosmans E, Dekeersmaecker A, Salembier G, Spitz B (2002) Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 109:34–43PubMedCrossRefGoogle Scholar
  2. 2.
    Donders G, Bellen G, Rezeberga D (2011) Aerobic vaginitis in pregnancy. BJOG 118:1163–1170PubMedCrossRefGoogle Scholar
  3. 3.
    Donders GG, Van Calsteren K, Bellen G et al (2009) Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG 116:1315–1324PubMedCrossRefGoogle Scholar
  4. 4.
    Gondo F, da Silva MG, Polettini J et al (2011) Vaginal flora alterations and clinical symptoms in low-risk pregnant women. Gynecol Obstet Investig 71:158–162CrossRefGoogle Scholar
  5. 5.
    Selim SA, El Alfy SM, Aziz MH, Mohamed HM, Alasbahi AA (2011) Effective of metronidazole to bacterial flora in vagina and the impact of microbes on live birth rate during intracytoplasmic sperm injection (ICSI). Arch Gynecol Obstet 284:1449–1453PubMedCrossRefGoogle Scholar
  6. 6.
    Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK (1983) Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 74:14–22PubMedCrossRefGoogle Scholar
  7. 7.
    Nugent RP, Krohn MA, Hillier SL (1991) Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 29:297–301PubMedGoogle Scholar
  8. 8.
    Tempera G, Bonfiglio G, Cammarata E, Corsello S, Cianci A (2004) Microbiological/clinical characteristics and validation of topical therapy with kanamycin in aerobic vaginitis: a pilot study. Int J Antimicrob Agents 24:85–88PubMedCrossRefGoogle Scholar
  9. 9.
    Aleshkin VA, Voropaeva EA, Shenderov BA (2006) Vaginal microbiota in healthy women and patients with bacterial vaginosis and nonspecific vaginitis. Microb Ecol Health Dis 18:71–74CrossRefGoogle Scholar
  10. 10.
    Bologno R, Díaz YM, Giraudo MC et al (2011) Importance of studying the balance of vaginal content (BAVACO) in the preventive control of sex workers. Rev Argent Microbiol 43:246–250PubMedGoogle Scholar
  11. 11.
    Dykhuizen RS, Harvey G, Gould IM (1995) The high vaginal swab in general practice: clinical correlates of possible pathogens. Fam Pract 12:155–158PubMedCrossRefGoogle Scholar
  12. 12.
    Flores-Paz R, Rivera-Sánchez R, García-Jíménez E, Arriaga-Alba M (2003) Etiology of cervical vaginal infection among patients of the Juárez Hospital of Mexico. Salud Publica Mex 45(Supp 5):S694–S697PubMedCrossRefGoogle Scholar
  13. 13.
    Hammann R, Kronibus A, Lang N, Werner H (1987) Quantitative studies on the vaginal flora of asymptomatic women and patients with vaginitis and vaginosis. Zentralbl Bakteriol Mikrobiol Hyg A 265:451–461PubMedGoogle Scholar
  14. 14.
    Iavazzo C, Vogiatzi C, Falagas ME (2008) A retrospective analysis of isolates from patients with vaginitis in a private Greek obstetric/gynecological hospital (2003–2006). Med Sci Monit 14:CR228–CR231PubMedGoogle Scholar
  15. 15.
    Marconi C, Donders GG, Martin LF et al (2012) Chlamydial infection in a high risk population: association with vaginal flora patterns. Arch Gynecol Obstet 285:1013–1018PubMedCrossRefGoogle Scholar
  16. 16.
    Otuonye NM, Odunukwe NN, Idigbe EO et al (2004) Aetiological agents of vaginitis in Nigerian women. Br J Biomed Sci 61:175–178PubMedGoogle Scholar
  17. 17.
    Ozturk CE, Ozdemir I, Yavuz T, Kaya D, Behcet M (2006) Etiologic agents of cervicovaginitis in Turkish women. Saudi Med J 27:1503–1507PubMedGoogle Scholar
  18. 18.
    Padilla CE, Lobos OG, Padilla RE, Fuentes LV, Núñez LF (2007) Isolation of Escherichia coli strains in clinical cases of vaginal infection: association with other microorganisms and antibacterial susceptibility. Rev Chil Obstet Ginecol 72:222–228CrossRefGoogle Scholar
  19. 19.
    Razzak MS, Al-Charrakh AH, Al-Greitty BH (2011) Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis. N Am J Med Sci 3:185–192PubMedCrossRefGoogle Scholar
  20. 20.
    Rowe BR, Logan MN, Farrell I, Barnett AH (1990) Is candidiasis the true cause of vulvovaginal irritation in women with diabetes mellitus? J Clin Pathol 43:644–645PubMedCrossRefGoogle Scholar
  21. 21.
    Von Gruenigen VE, Coleman RL, Li AJ, Heard MC, Miller DS, Hemsell DL (2000) Bacteriology and treatment of malodorous lower reproductive tract in gynecologic cancer patients. Obstet Gynecol 96:23–27CrossRefGoogle Scholar
  22. 22.
    Donders GG, Van Bulck B, Van de Walle P et al (2010) Effect of lyophilized lactobacilli and 0.03 mg estriol (Gynoflor®) on vaginitis and vaginosis with disrupted vaginal microflora: a multicenter, randomized, single-blind, active-controlled pilot study. Gynecol Obstet Invest 70:264–272PubMedCrossRefGoogle Scholar
  23. 23.
    Fan A, Yue Y, Geng N, Zhang H, Wang Y, Xue F (2013) Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings. Arch Gynecol Obstet 287:329–335PubMedCrossRefGoogle Scholar
  24. 24.
    Tempera G, Abbadessa G, Bonfiglio G et al (2006) Topical kanamycin: an effective therapeutic option in aerobic vaginitis. J Chemother 18:409–414PubMedGoogle Scholar
  25. 25.
    Burton JP, Reid G (2002) Evaluation of the bacterial vaginal flora of 20 postmenopausal women by direct (Nugent score) and molecular (polymerase chain reaction and denaturing gradient gel electrophoresis) techniques. J Infect Dis 186:1770–1780PubMedCrossRefGoogle Scholar
  26. 26.
    Hill JE, Goh SH, Money DM et al (2005) Characterization of vaginal microflora of healthy, nonpregnant women by chaperonin-60 sequence-based methods. Am J Obstet Gynecol 193:682–692PubMedCrossRefGoogle Scholar
  27. 27.
    Hyman RW, Fukushima M, Diamond L, Kumm J, Giudice LC, Davis RW (2005) Microbes on the human vaginal epithelium. Proc Natl Acad Sci U S A 102:7952–7957PubMedCrossRefGoogle Scholar
  28. 28.
    Lindner JG, Plantema FH, Hoogkamp-Korstanje JA (1978) Quantitative studies of the vaginal flora of healthy women and of obstetric and gynaecological patients. J Med Microbiol 11:233–241PubMedCrossRefGoogle Scholar
  29. 29.
    Priestley CJ, Jones BM, Dhar J, Goodwin L (1997) What is normal vaginal flora? Genitourin Med 73:23–28PubMedGoogle Scholar
  30. 30.
    Tashjian JH, Coulam CB, Washington JA 2nd (1976) Vaginal flora in asymptomatic women. Mayo Clin Proc 51:557–561PubMedGoogle Scholar
  31. 31.
    Zhou X, Bent SJ, Schneider MG, Davis CC, Islam MR, Forney LJ (2004) Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods. Microbiology 150:2565–2573PubMedCrossRefGoogle Scholar
  32. 32.
    Masood SN, Mumtaz S, Jahan M (2009) Pattern of normal vaginal flora in healthy married non-pregnant women. Pak J Surg 25:128–131Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • G. S. Tansarli
    • 1
  • E. K. Kostaras
    • 1
  • S. Athanasiou
    • 1
    • 3
  • M. E. Falagas
    • 1
    • 2
    • 4
  1. 1.Alfa Institute of Biomedical Sciences (AIBS)Marousi, AthensGreece
  2. 2.Department of Internal Medicine—Infectious DiseasesMitera Hospital, Hygeia GroupAthensGreece
  3. 3.Department of Obstetrics and GynecologyAthens University School of MedicineAthensGreece
  4. 4.Department of MedicineTufts University School of MedicineBostonUSA

Personalised recommendations