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Bacterial vaginosis and vaginal leukorrhoea: an association with concomitant vaginal and cervical infections

Abstract number: P2162

Fokas Sp., Fokas St., Altouvas G., Tsironi M., Kalkani M., Dionysopoulou M.

Objectives: Bacterial vaginosis (BV) is a vaginal condition characterised by the absence or scarcity of white blood cells (WBCs) in the vaginal discharge. We aimed to evaluate whether an increased vaginal WBCs in women with BV is associated with fungal, bacterial, or protozoan vaginal and cervical infections.

Methods: Our study was carried out over a 3-years period (9/2004–8/2007) and included 135 new nonpregnant premenopausal patients who attended the outpatient gynaecology dpt of our general hospital. All these women were diagnosed as having BV based on the Nugent scoring system. Vaginal leukorrhoea was defined as more than 10 WBCs per field X 400. Swabs were taken from posterior vaginal vault and the endocervical canal. Culture media included BAP, CHOC with IsoVitaleX, MTM, Sabouraud and MAC agar. Trichomonas vaginalis and Candida spp. detection was achieved by direct wet mount examination and testing for Chlamydia trachomatis was performed using chromatographic immunoassay.

Results: Of the 135 women enrolled in the study, 91 (67%) were symptomatic, while 44 (33%) were asymptomatic. The mean age was 26 years (range 17–48) and most of these women were less than 30 years old (98, 73%). Elevated vaginal WBC count was found in 19 (14%) women and the majority of them (15/19, 79%) were symptomatic. The prevalence of Candida spp.-C. trachomatis-T. vaginalis-N. gonorrhoeae in women with both BV and leukorrhoea was 21% (4/19), 37% (7/19), 21% (4/19), and 0% (0/19) respectively, whereas, in women without leukorrhoea the prevalence rates were 3.4% (5/116), 6.9% (8/116), 0% (0/116), and 0% (0/116) respectively. Leukorrhoea was statistically associated with Candida spp. (c2 = 7.35, P < 0.01; OR 5.9, 95% CI 1.43 to 24.2), C. trachomatis (c2 = 14.8, P < 0.001; OR 7.87, 95% CI 2.4 to 25.2), and T. vaginalis (c2 = 25.1, P < 0.001). Women with both BV and leukorrhoea were significantly more likely to be co-infected (c2 = 45.5, P < 0.001; RR = 7.04, 95% CI 4 to 12.2).

Conclusions: In the studied population, we found that among nonpregnant women with BV, vaginal leukorrhoea is strongly associated with co-infection with Candida spp.–C. trachomatisT. vaginalis and these women were 7.04 times more likely to be co-infected than women without leukorrhoea. The prevalence of C. trachomatis in women with both BV and leukorrhoea (37%) is high and further tests should be performed to promote early detection and treatment.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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