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Background: Bacterial vaginosis (BV) is a common condition believed to be associated with sexually transmitted infection (STI) susceptibility. Most studies of BV and STIs have come from treatment-seeking or high-risk populations. This study examines the association between 5 viral STIs, human papilloma virus (HPV), HIV, herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2), and Hepatitis C (HCV), and BV among women in the general US population. Methods: Data from the 2001 and 2003-2004 National Health and Nutrition Examination Surveys were combined. Crude and adjusted relative risks and 95% confidence intervals were estimated from logistic regression analyses for rare outcomes (< 10 %) and from Poisson regression with robust error variance for common outcomes. Complex survey design was taken into consideration using the survey functions in Stata. Results: Crude analyses found an association between BV and the prevalence of all 5 STIs. After adjustment for important confounders, only HSV-1 and HSV-2 were significantly associated with the presence of BV. Moreover, crude analyses stratified by race/ethnicity suggested that associations between BV and viral STIs may not be consistent across race/ethnicity subgroups. Conclusion: This population-based study found that BV was significantly associated with the prevalence of HSV-1 and HSV-2 and potentially associated with HIV and HPV. Given the frequency of BV in US women, small increases in STI susceptibility may have important impacts on STI transmission.

Objectives: To evaluate the relationship between douching and bacterial vaginosis (BV) among women with and without prior abnormal vaginal flora. Study Designs: 1193 women had vaginal swabs obtained for Gram stain for BV, culture for vaginal microflora, and DNA amplification for Neisseria gonorrhoeae and Chlamydia trachomatis at baseline and 6, 12, 24, and 36 months. Self-reported douching was queried every 6 months. Results: In cross-sectional analyses, douching at least once per month was associated with BV among women who had BV at the immediately preceding visit but not among women with normal or intermediate flora. In prospective analyses, douching increased the risk of acquisition for BV among women with intermediate flora (adj. HR 1.5, 95% CI 1.1-2.4) but not among women with normal flora. Conclusions: Douching appeared to be associated with BV among women with already imbalanced flora but not among women with normal flora.

Objective: Risk factors for bacterial vaginosis (BV) include douching and sexual activity, although the exact cause of BV is unknown. Goal: The goal of this study was to determine the relative significance of douching as a risk factor for BV. Study Design: Two hundred fifty adolescent women who regularly douched were enrolled into a randomized douching intervention trial. Behavioral questionnaires and testing for sexually transmitted diseases and BV were performed. Associations between baseline characteristics and behaviors were compared for teens who were BV-positive and BV-negative at baseline. Results: Positive correlates of BV included multiple partners, recent sexual intercourse, douching after menses, recent douching, and gonorrhea. Of these, douching after menses showed the strongest association (odds ratio, 5.11; 95% confidence interval, 1.99-13.15) in a multivariate analysis. Conclusions: Douching after menses was strongly correlated with BV; however, difficulty remains in trying to evaluate douching and sexual behavior independently.

The authors discuss the study of vaginal polymorphonuclear leukocytes. The use of these leukocytes as predictors of histologic endometritis among women at risk for acute pelvic inflammatory disease has been investigated, and the results demonstrate that leukocytes have negative predictive value for upper genital tract infection.

Cyclic vaginosis may be caused by extremely long lactobacilli. Cyclic vaginosis is a vaginal disease occurring regularly during the second half of the menstrual cycle and characterized by burning, itching and irritation accompanied by thick discharge. Lactobacilli are rod-shaped bacteria. Researchers evaluated 37 women with symptoms of cyclic vaginosis and 30 women with no symptoms of genital disease (control group). Among the vaginosis patients, the average length of symptoms was almost two years. Physical examination of all 67 women revealed no differences in the appearance of the vulva, vagina and cervix. Microscopic examination of culture specimens detected lactobacilli in 97% of the vaginosis patients and 40% of the controls. However, the average length of lactobacilli in the vaginosis patients was 60 micrometers, compared to 10 micrometers in the controls. In 86% of the patients, treatment with amoxicillin and clavulanate both cured their symptoms and eliminated the long lactobacilli.

Microorganisms like Gardnerella vaginalis are considered markers on grain stain or culture, although the pathogenesis of bacterial vaginosis remains elusive. Gram-positive atopobium vaginae are believed to be a predominant species in disturbed vaginal flora.

Take aim at BV and trichomoniasis Power up the radar when it comes to bacterial vaginosis (BV) and trichomoniasis. The first national data on the subject show high prevalence of [...]

Epidemiologic studies using vertical cuts through a given study population have shown a positive correlation between bacterial vaginosis (BV) and pelvic inflammatory disease (PID) (Obstet Gynecol Clin North Am. 2003;30:685-694; [...]

Background: Mobiluncus spp are highly associated with bacterial vaginosis, but their role in its pathogenesis is unknown. The authors used polymerase chain reaction (PCR) to compare the prevalence of Mobiluncus in women with and without bacterial vaginosis. Goal: To compare the prevalence of Mobiluncus spp among women with and without bacterial vaginosis and to compare the sensitivities of PCR and Gram stain for detection. Study Design: Vaginal specimens from 74 women were analyzed by PCR and Gram stain for the presence of Mobiluncus spp. Comparisons were made between the prevalence of this organism between the two cohorts and between the Gram stain and PCR detection methods. Results: Mobiluncus was detected by PCR in 84.5% of women with bacterial vaginosis and in 38% of women without infection. M curtisii was rarely detected in the latter group, though it was found in 65.3% of women with bacterial vaginosis. The sensitivity and specificity of Gram stain compared with PCR were 46.9% and 100%, respectively. Conclusions: Mobiluncus is more common in healthy women than previously suspected, with M mulieris as the predominant species. The significant difference in the prevalence of M curtisii between women with bacterial vaginosis and uninfected women suggests that this species could be involved in the pathogenesis of bacterial vaginosis.

We hypothesized that the increased vaginal fluid pH and altered vaginal microflora characteristic of bacterial vaginosis might predispose young women to introital colonization with Escherichia coli and to acute cystitis. To evaluate this hypothesis, we studied 291 women who presented with acute urinary symptoms for association of clinically defined bacterial vaginosis and vaginal conditions associated with this syndrome (increased vaginal fluid pH, absence of lactobacilli, and abnormal vaginal fluid gas-liquid chromatographic patterns) with E coil introital colonization and urinary tract infection. Escherichia coli introital colonization and urinary tract infection were both significantly more frequent among women with a high vaginal fluid pH, an absence of vaginal lactobacilli, or an abnormal vaginal fluid gas-liquid chromatographic pattern characteristic of bacterial vaginosis. Escherichia coli introital colonization was also more frequent in women with bacterial vaginosis. These associations and an association of bacterial vaginosis and E coli urinary tract infection were strong only among the 144 women who were diaphragm users. We conclude that bacterial vaginosis, or an altered vaginal microflora as reflected by an abnormal gas-liquid chromatographic pattern characteristic of bacterial vaginosis, is associated with E coli introital colonization and acute symptomatic urinary tract infection in women who use diaphragms. (Arch Intern Med. 1989;149:1932-1936)

Bacterial vaginosis is different from yeast infection and is a result of overgrowth of anaerobic organisms due to hormonal changes, stress and antibiotic use. Bacterial vaginosis in pregnant women may be treated with clindamycin. Details on vaginosis symptoms and clindamycin treatment are provided.