Bacterial vaginosis and Candida albicans vaginitis among women in Ramadi City

Abstract

Abstract
Patients and methods: A prospective study was performed involving 65 women who consecutively attended Gynecological ward in Maternity and Child Hospital in Ramadi for complaints of genital malodour and/or abnormal vaginal discharge. Bacterial vaginosis was diagnosed in 30 women on the basis of four diagnostic criteria: vaginal pH> 4.7, homogenous vaginal discharge, a positive amine test and presence clue cells. This diagnosis was further strengthened by microscopy of wet preparation and stained smears and culture of vaginal discharge under aerobic, facultative anaerobic, and anaerobic cultural condition.
Results: A total of 65 high vaginal specimens, bacterial vaginosis was diagnosed in 30 (46.2%) women, vulvovaginal yeast fungi infection in 12 (18.5%) women, other aetiology in 16 (24.6%) and in Seven (10.8%) women showing sterile vaginal discharge. The sensitivity for in vitro bacterial vaginosis detecting criteria was > 90% with the exception of homogenous discharge (73.3%) and their specificity was > 90% except vaginal pH > 4.5 (56%). Gardenerella vaginalis 27 (90%) was the predominant bacteria isolated in women suffering from bacterial vaginosis followed by Staphylococcus epidermidis (63.3%) and Streptococcus faecalis 13 (43.3%). Candida albicans 11 (91.6%) was the major cause of vulvovaginal yeast fungi infections followed by Saccharomyces cerevisiae 1 (8.3%).
Conclusions: The four diagnostic criteria for bacterial vaginosis supported by gram staining and facultative anaerobic culture should be introduce into laboratory routine procedures to differentiate symptomatic carrier (true infection) caused largely by Gardenerella vaginalis from asymptomatic carrier (colonization).Also, there was a strong association between diagnosis of bacterial vaginosis and the occurrence of Gardenerella vaginalis. Further, there was no difference between women with or without bacterial vaginosis in regards to contraceptive methods used (except for use of an intrauterine device). Further more, Diabetes mellitus, hygienic condition were the most predominant risk factors associated with highly frequently fungal isolates, Candida albicans.