Cytolytic vaginosis: examination of 2947 vaginal smears

The aim of this study is to detect the rate of cytolytic vaginosis (CV) cases in patients with symptoms resembling those ones of candida vaginitis and to distinguish them from candidiasis cases by examining of 2947 Papanicolaou-stained vaginal smears. Fifty four of 2947 patients (1.83%) were diagnosed as having CV based on cytologic criteria such as naked nuclei of intermediate cells (IC), the overgrowth of lactobacilli, cytoplasmic fragmentations due to lysis of the cells. None of these smears contained candidal blastospores and hyphae and polymorphonuclear leucocytes. The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. The study indicated that special attention has to be paid during evaluation the vaginal smears of the patients with presumed vaginal candidiasis in order to prevent an erroneous diagnosis of CV.     

Follow-up of users of intrauterine device with and without bacterial vaginosis and other cervicovaginal infections

This study aimed to assess the prevalence of bacterial vaginosis (BV) and other cervicovaginal infections, as well as the incidence of complications among new users of IUD, 1 and 6 months after its insertion, in the City of Campinas, Brazil. A total of 223 women who had a TCu-380A IUD inserted from May through November 2001, were included in the study. After the IUD insertion all women were scheduled to two additional visits: after 1 month and after 6 months, when they were interviewed and a pelvic examination was performed, along with a collection of specimens from the vagina and the endocervix for laboratory testing. The Nugent's criterion was used for the BV diagnosis. They were also evaluated with regard to presence of complications possibly related to IUD insertion and use, i.e., abnormal bleeding, dysmenorrhea, expulsion and pelvic inflammatory disease. The prevalence of cervicovaginal infections was 29.1%, BV being the most frequent (19.7%). Dysmenorrhea was more frequent among women with BV than among women without BV (p = 0.03). A trend of abnormal bleeding being more frequent among women with BV was also found. In conclusion, BV after 1 month of IUD insertion was not associated with IUD complications, with the exception of dysmenorrhea.     

个人卫生习惯与细菌性阴道病

目的探讨个人卫生习惯与细菌性阴道病的关系,为细菌性阴道病的预防提供帮助。方法选择2009年3-12月到医院门诊就诊的细菌性阴道病患者120例作为观察组,同期在医院健康查体者120例作为对照组,观察不同的个人卫生习惯与细菌性阴道病发病的联系。结果细菌性阴道病的发生与个人的洗浴习惯如淋浴或盆浴以及外阴清洗及用药、内裤材料、经期清洗外阴等因素差异无统计学意义;而非经期使用卫生护垫观察组感染率为69.2%,对照组为48.3%,经常阴道冲洗观察组感染率为50.8%,对照组为16.7%,经期使用卫生棉条观察组感染率为13.3%,对照组为4.2%,差异均有统计学意义(均P<0.05)。结论不良的卫生习惯可以导致细菌性阴道病的发生,去除各种不良的卫生习惯对于降低疾病意义重大。     

The association between copper containing IUCD and bacterial vaginosis

This study was designed to investigate whether there is an association between bacterial vaginosis (BV) and the use of intrauterine contraceptive device (IUCD). Six hundred Papanicolaou stained cervicovaginal smears were analyzed cytologically. 56 of 600 patients (9.3%) were detected as having IUCD. Four of 56 (7,1%) and 10 of 544 (1.8%) were positive for BV [Bv (+)]. The duration of the use of IUCD was higher than 4 years in 3 of 4 patients who were BV (+). This study showed a significant correlation between the use of IUCD and the presence of BV statistically (p < 0.05). Our findings also suggest that time limited BV infection is associated with long term use of this device. It can be suggested that a periodic microscopic examination and use of IUCD (less than 5 years) are convenient to prevent this kind of anaerobic infection.     

妊娠期细菌性阴道病与妊娠结局的关系

目的调查妊娠中晚期细菌性阴道病(BV)的发病情况;观察唯阴康生物栓剂治疗细菌性阴道病对妊娠结局的影响。方法对520例妊娠28~38周的孕妇进行BV筛查,118例BV阳性;对60例筛查阳性孕妇予以唯阴康治疗(设为A组),睡前1枚置阴道,次晨取出,连续用药10 d;比较干预组(A组),非干预组(B组)及阴性组(C组)的不良妊娠结局。结果妊娠中晚期BV的检出率为22.7%,发生胎膜早破、早产、产褥感染、新生儿黄疸、新生儿感染的发生率A组,分别为15.0%、5.0%、5.0%、8.3%、3.3%,B组分别为20.7%、10.3%、8.6%、13.8%、10.3%,两组差异有统计学意义(P<0.01);但A、B两组相应不良发生率均高于C组(C组分别为6.3%、3.7%、1.5%、4.5%、1.9%),两两比较,差异有统计学意义(P<0.01)。结论在妊娠中晚期BV的发病率较高,唯阴康生物栓剂治疗BV阳性孕妇可改善不良妊娠结局。     

Identifying and managing bacterial vaginosis

The diagnosis and management of bacterial vaginosis are discussed, including the role of the nurse and midwife in testing and treatment.     

Acceptability of a self-sampling technique to collect vaginal smears for gram stain diagnosis of bacterial vaginosis.

To diagnose asymptomatic bacterial vaginosis (BV), self-sampled vaginal smears were collected during a study of risk factors for preterm birth in African American women. More than 90% of those women who were willing to participate in the interview portion of the study were also willing to provide a self-sampled vaginal smear. The smears are an acceptable and efficient way of detecting BV in an urban minority population.     

细菌性阴道病危险因素分析

目的分析细菌性阴道病患病的相关因素,探讨其预防措施。方法选择上海市黄浦区妇幼保健所门诊检测细菌性阴道病阳性患者106例为病例组,106例细茵性阴道病阴性者作为对照组,对其细菌性阴道病相关因素进行分析;其中相关危险因素包括：其他性传播疾病（衣原体感染史、淋病史及滴虫阴道炎史）、外阴阴道假丝酵母茵病、避孕方式、相关行为因素（阴道清洁次数与方式、内裤消毒、洗澡地点及方式、性卫生习惯、流产次数）。结果经单因素分析显示,淋病史、外阴阴道假丝酵母茵病史、滴虫阴道炎史、多次流产及经常清洗阴道与细菌性阴道病发病有关,选择避孕套避孕及有良好卫生习惯者细菌性阴道病发病率低。经多因素Logistic回归分析结果提示,滴虫阴道炎史（OR=10．05,P〈0．05）、人流次数（OR=1．72,P〈0．05）、清洗阴道（OR=3．89,P〈0．05）可升高细菌性阴道病患病风险;使用避孕套（OR=0．03,P〈0．05）、良好性卫生习惯（OR=0．39,P〈0．05）则具有保护作用。结论选择避孕套避孕和有良好性卫生习惯可降低细菌性阴道病的发病风险。     

孕期细菌性阴道病与不良妊娠结局关系的探讨

目的通过对孕妇进行细菌性阴道病(bacterial vaginosis,BV)筛查及治疗,探讨孕期BV与不良妊娠结局的关系。方法选取150例妊娠合并BV给予治疗的患者为A组;选取年龄、孕周与之匹配因故未治疗的81例妊娠合并BV的患者为B组;选取同期行围产监测的150例正常孕妇为C组,比较3组不良妊娠结局及宫内感染率。结果 B组中流产、早产、胎膜早破、产褥感染、新生儿窒息、新生儿感染的发生率均高于A、C组,差异有统计学意义(P﹤0.05)。结论孕期BV可导致不良妊娠结局,治疗后可降低宫内感染率,减少妊娠不良结局的发生。     

细菌性阴道病与胎膜早破的关系探讨

探讨细菌性阴道病(BV)与胎膜早破的关系及胎膜早破合并BV的检出率,了解胎膜早破合并BV给母儿带来的不良妊娠结局。方法:将2002年8月~2004年9月来我院分娩的胎膜早破孕妇336例作为观察组并随机选择足月妊娠336例作为对照组,进行BV筛查。结果:胎膜早破孕妇BV阳性率为48.2%,足月妊娠孕妇BV阳性率为31.3%,胎膜早破合并BV与早产、宫腔感染、胎儿窘迫、产褥感染、新生儿窒息、低体重儿、新生儿感染、新生儿黄疸等有密切关系。结论:胎膜早破与BV有密切关系,胎膜早破合并BV可给孕产妇及围产儿带来不良后果,有必要对妊娠合并BV孕妇进行治疗。     

孕妇细菌性阴道病与羊膜腔感染相关性分析

目的探讨孕晚期细菌性阴道病(BV)与羊膜腔感染的关系对BV正规治疗,以降低感染率。方法选取2012年8月-2013年8月在医院产检诊断为BV并在医院分娩的孕妇355例,将其分为A组115例未治疗的孕妇与B组正规治疗的孕妇240例,对其绒毛膜羊膜炎发生率及羊水培养病原菌检出率进行比较分析。结果 A组孕妇发生绒毛膜羊膜炎13例,发生率11.3%,羊水培养阳性率5.2%;B组孕妇发生绒毛膜羊膜炎8例,发生率3.3%,羊水培养阳性率1.7%;A组绒毛膜羊膜炎发生率及羊水培养阳性率明显高于B组;羊水培养共检出10株病原菌,大肠埃希菌4株、阴道加德纳菌3株、类杆菌、消化链球菌、动弯杆菌各1株。结论孕晚期细菌性阴道病增加羊膜腔感染的发生率,正规治疗细菌性阴道病能使羊膜腔感染发生率明显降低。     

Adverse obstetric sequelae of bacterial vaginosis

Bacterial vaginosis is increasingly associated with adverse sequelae in obstetrics such as preterm prelabour rupture of membranes, preterm labour and preterm birth. It is important to diagnose the condition early in pregnancy where appropriate treatment can be administered to women who are symptomatic or who are at high risk of adverse sequelae.     

Effectiveness of current therapy of bacterial vaginosis

The study was conducted in order to evaluate effectiveness of the treatment of bacterial vaginosis (BV) with different therapeutic regimes according to recommendations of the World Health Organization (WHO). During a one-year period (February 2000-February 2001) the Sexually Transmitted Diseases (STD) Center was visited by 482 women aged 14-51. The diagnosis of BV was established by standard methods: Amsel's clinical criteria and Gram stain of vaginal discharge. The first-line treatment was oral Metronidazole 2 g single dose. Second line was Metronidazole 500 mg twice daily orally for 7 days or oral Clindamycin 300 mg twice daily for seven days. BV was confirmed in 74 women (15.4%). Most often it was observed in women aged 17-30 years of age. Thirty-three (44.6% of total) were young women 14-21 years of age. Thirty-one (42%) women received a follow-up examination and of those, 11 (38.7%) needed a repeat treatment for BV due to unsatisfactory results of this treatment. It is concluded that treatment of BV with standard methods was not always effective with no significant difference between women under 21 years and older women found in regards to response to treatment. Besides antibiotic treatment, the so-called Probiotics (Lactobacillus acidophilus) can be taken into consideration as an alternative treatment. Additional research about the therapeutic effect of this type of drugs is needed.     

妊娠期细菌性阴道病筛查分析

目的:探讨不同妊娠期细菌性阴道病(BV)发病、自然转归及对胎膜早破、早产的影响。方法:对662例孕妇在妊娠早、中、晚期进行BV检查,跟踪随访至分娩,分析不同妊娠期BV发病、缓解、病程对胎膜早破、早产的影响。结果:662例妊娠期妇女中检出BV患者98例(14.80%),妊娠期BV患者胎膜早破、早产发病率明显高于正常妊娠妇女(P<0.01),妊娠中、晚期BV发病率明显高于妊娠早期(P<0.01),妊娠早期BV自然缓解率明显高于妊娠中期(P<0.05)。随着妊娠期BV病程延长胎膜早破、早产发生率增加。结论:妊娠中、晚期妇女应进行BV筛查,妊娠期BV患者应及时治疗、跟踪随访以减少胎膜早破、早产等不良妊娠结局的发生。     

Condom use and its association with bacterial vaginosis and bacterial vaginosis-associated vaginal microflora

BACKGROUND: Previous studies have been inconsistent with regard to whether condom use is associated with bacterial vaginosis. We evaluated this association using case-crossover analyses. METHODS: A total of 871 women at high risk for sexually transmitted diseases were followed for a median of 3 years. At baseline and at 6, 12, 24, and 36 months thereafter, vaginal swabs were obtained for gram stain diagnosis of bacterial vaginosis, culture of microflora, and DNA amplification of Neisseria gonorrhoeae and Chlamydia trachomatis. Case-crossover analyses using incident and recurrent incident case periods were used to assess the associations among condom use, bacterial vaginosis, and vaginal microflora. RESULTS: Consistent condom use (10 out of 10 sexual encounters) was associated with a decreased frequency of bacterial vaginosis (adjusted odds ratio = 0.55 [95% confidence interval 0.35-0.88]). When we excluded women with intermediate flora, consistent condom use was even more strongly protective against bacterial vaginosis (0.37 [0.20-0.70]). Consistent condom use was similarly protective against carriage of anaerobic gram-negative pigmented rods (0.58 [0.36-0.94]). Results were similar when analyses were repeated to capture only first occurrences of outcomes among women without bacterial vaginosis at baseline, suggesting a protective effect against the acquisition of bacterial vaginosis. CONCLUSIONS: Consistent condom use was associated with a decrease in the risk for bacterial vaginosis and associated vaginal microflora.     

五联法检测阴道炎临床效果分析

随着临床医学的快速发展,临床妇科疾病的诊断对实验室的要求是越来越高,尤其是阴道分泌物的常规检查已不能满足临床的需要,因而急需寻求新的方法来满足临床对妇科疾病的诊断需求.为此宜昌市妇幼保健院采用阴道炎五联法试剂盒对370例阴道分泌物进行临床对照检测,将结果报道如下. 1资料与方法 1.1 资料来源 370例已婚女性来自宜昌市妇幼保健院妇科门诊的检查者及妇女保健科的健康妇检者,年龄在20～58岁,平均年龄39岁.