OBJECTIVE: The aim of this study was to analize the biologic and molecular genetic characteristics of Lactobacillus spp. isolated from vagina of Korean healthy women and to perform a pilot clinical study on the treatment of vaginitis using the best Lactobacillus strain KLB 46. METHODS: Vaginal specimens were obtained from 205 Korean women with healthy vaginal ecosystems. 155 lactobacillus strains were used for catalase test, cell surface hydrophobicity (CSH) test and antimicrobial activity test. Also we identified the species prevalence by PCR-RFLP analysis of 16S rDNA gene and performed the minimal inhibitory concentrationtest using14 antibiotics to determine their patterns of antibiotic susceptibility. A pilot clinical trial of 8 bacterial vaginosis, 1 trichomonas vaginitis and 6 atrophic vaginitis using Lactobacillus crispatus KLB 46 was done by vaginal instillation (10(10)-10(11) cells/mL). RESULTS: 155 lactobacilli strains were isolated and all isolates showed high CSH and 61% of the isolates had higher CSH. L. acidophilus and L. crispatus were the most prevalent species by PCR-RFLP analysis of their 16S rDNA gene. And PCR-RFLP analysis suggested that KLB 46 was L. crispatus. The clinical study showed that the vaginal epithelial adherence rate was high as 77% for bacterial vaginosis and 33.3% for atrophic vaginitis. CONCLUSION: The predominating lactobacilli were L. crispatus and L. acidophilus in Korean women's vaginas. Although further study would be needed, L. crispatus KLB 46 is a good candidate of suitable probiotics for bacterial vaginosis.
Administration, Intravaginal ; Anti-Bacterial Agents ; Atrophic Vaginitis ; Catalase ; DNA, Ribosomal ; Ecosystem ; Female ; Humans ; Hydrophobic and Hydrophilic Interactions ; Lactobacillus* ; Molecular Biology* ; Prevalence ; Probiotics ; Trichomonas Vaginitis ; Vagina* ; Vaginitis* ; Vaginosis, Bacterial

Three common vaginal infections are bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonas vaginitis (TV). However their symptoms and signs are similar and atypical and other non-infectious vaginal inflammations will be the causes of identical symptoms. Hence accurate diagnosis is the first step in management of vaginitis and then appropriate therapy should be conducted. Metronidazole is the drug of choice for the treatment of BV and TV. Topical or oral azole antifungal regimens are highly effective in reliving symptoms of VVC. Physicians who treat the woman having vaginitis should consider the fact that the disease may be chronic, frequent and recurrent due to antibiotics abuse and over the counter antimycotic agents. Also predisposing factors must be removed before medical therapy.
Anti-Bacterial Agents ; Candidiasis, Vulvovaginal ; Causality ; Danazol ; Diagnosis ; Female ; Humans ; Inflammation ; Metronidazole ; Trichomonas Vaginitis ; Vaginitis* ; Vaginosis, Bacterial

The study carries on 1209 female patients from 16 to 55 years old at dermatology of dermatological hospital. These patients were tested to diagnose infected Bacteria vaginosis (BV), in particular, they were candled directly under optical microscope with enlargement 1000X to discover BV. The results were the rate infectious BV is the highest at the age group 26 – 35 (2.58%), and the age group 35 – 45 (2.4%), the possitive rate of the age group 26 – 45 is 4.98%. The total of infected patients is 27/1209 patients (2.23%). The rate infected BV of this research is much less than some studies of European countries as Poland, Swede, Belgium, England...
Vaginitis ; Vulvitis ; Vaginosis, Bacterial

BACKGROUND: Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms. METHODS: A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively. RESULTS: With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G. vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (p<0.05). CONCLUSION: The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.
Candida ; Candidiasis ; Chimera ; DNA ; Female ; Gardnerella ; Gardnerella vaginalis ; Humans ; Trichomonas ; Trichomonas Infections ; Trichomonas vaginalis ; Vaginal Smears ; Vaginitis ; Vaginosis, Bacterial

OBJECTIVE: This randomized, single-blind, two-arm controlled study compared the efficacy, safety, and tolerability of an intravaginal suppository preparation containing metronidazole 750mg + miconazole 200mg (Neopenotran Forte) with another vaginal preparation containing metronidazole 500 mg + nystatin 10000 IU (Flagystatin) in the treatment of bacterial vaginosis (BV), candidal and trichomonial vulvovaginitis (CVV, TV), mixed vaginitis and in the prevention of secondary candidal vulvovaginitis.

MATERIALS AND METHODS: Women ages 18-45 years with chief complaints of abnormal vaginal discharge or vaginal/vulvar itching were examined and microbiologic confirmation of BV, VVC, TV or mixed infection was made. They were then randomly assigned to receive either treatment once daily (nightly) for 7 days. A total of 261 subjects had evaluable clinical and microbiological findings at the end of the study. Test of cure by Amsel criteria and Nugent score were performed twice after treatment.

RESULTS: The overall test revealed that microbiological cure rate is significantly different between the two treatment groups.

CONCLUSION: The odds of being cured microbiologically is 2.35 times more in the metronidazole 750mg + miconazole nitrate 200mg group compared to the metronidazole 500 mg + nystatin 10000 IU group. However, no significant difference in the clinical cure between the two groups was found. Both drugs are safe and convenient to use.

Human ; Female ; Adult ; Young Adult ; Vaginosis, Bacterial ; Candidiasis, Vulvovaginal ; Suppositories ; Vaginitis

BACKGROUND: Bacterial vaginitis (BV) and Trichomonas vaginitis are the most frequently recurring infectious diseases in women. Therefore, accurate tests for post-treatment follow-up are required. A multiplex PCR assay allows for the simultaneous detection of multiple pathogens in a single specimen. In this study, we assessed the clinical implications of multiplex PCR detection of fastidious microorganisms causing vaginitis. METHODS: A total of 216 vaginitis patients who presented to Chung-Ang University Yongsan Hospital with more than one positive result on multiplex PCR (Trichomonas vaginalis (TV), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), Mycoplasma hominis (MH)) were retrospectively enrolled in this study. Each patient's clinical symptoms, initial treatment and follow-up for BV, and other related test results were also retrospectively reviewed. RESULTS: The most commonly reported symptom was abnormal discharge, followed by pruritis (73.1%), lower abdominal pain (38.4%), urination difficulties (13%), and others such as fever. According to the multiplex PCR results, there were 116 cases (35.8%) of MH, 86 cases (26.5%) of UU, 62 cases (19.1%) of CT, and 84 cases (38.9%) were mixed infections. Among those patients with single infections, treatment changed for 63 cases (65.6%) while treatment remained unchanged for 17 (17.7%) after PCR results were reported. CONCLUSION: The diagnosis of BV using multiplex PCR is clinically effective and the results of which can be incorporated in antibiotic selection for patients with multiple sexually transmitted diseases (STD). Multiplex PCR may be especially helpful in the diagnosis of patients in whom the differentiation of STD pathogens is difficult using traditional methods.
Abdominal Pain ; Chlamydia trachomatis ; Coinfection ; Communicable Diseases ; Female ; Fever ; Follow-Up Studies ; Humans ; Multiplex Polymerase Chain Reaction ; Mycoplasma genitalium ; Mycoplasma hominis ; Neisseria gonorrhoeae ; Polymerase Chain Reaction ; Pruritus ; Retrospective Studies ; Sexually Transmitted Diseases ; Trichomonas Vaginitis ; Ureaplasma urealyticum ; Urination ; Vaginitis ; Vaginosis, Bacterial

OBJECTIVEIn order to develop plans for effective intervention measures, prevalence and health-seeking behavior related to reproductive tract infection among floating married women of childbearing age in Fengtai district in Beijing were studied.

METHODSCross-sectional study was carried out. Two thousand and sixty-nine eligible women were randomly selected from strata based on their home provinces. From June to July 2001, the subjects were given face-to-face interview at the Fengtai family planning clinic in Beijing using standard questionnaire followed by gynecologic examination and laboratory tests.

RESULTSThirty point three percent of the subjects were found to have reproductive tract infections (RTI) by laboratory tests. Prevalence rates of bacterial vaginosis, candida and trichomonas vaginitis were 22.2%, 4.9% and 2.1% respectively. Prevalence rates of chlamydia, gonorrhea, condyloma acuminatum and syphilis were 2.2%, 1.6%, 0.5% and 0.2% respectively. Of these infected women, only 43.1% (270/626) were symptomatic, and 61.5% (166/270) of these women with symptoms had sought treatment.

CONCLUSIONCompared to other results in the literature, we found a relatively high prevalence of RTI in our study population. Only a small proportion of these infected women were symptomatic but only few of them sought treatment. We suggested that the provision of more family planning service and promotion of RTI knowledge to the floating women of childbearing age.

Adolescent ; Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Infection ; epidemiology ; Middle Aged ; Prevalence ; Surveys and Questionnaires ; Travel ; Trichomonas Vaginitis ; epidemiology ; Urban Health ; Vaginitis ; epidemiology ; microbiology ; Vaginosis, Bacterial ; epidemiology ; Women's Health Services

Background: Vulvovaginal Candidiasis (VVC) is one of the frequent infections of the female genital tract and is the second most common cause of vaginal infections after bacterial vaginosis. According to the Centers for Disease Control and Prevention, azoles are the first‑line treatment for VVC. Among the azoles available in the Philippines, only miconazole and clotrimazole are recommended for both pregnant and non‑pregnant women. Objective: Compare the effect of miconazole versus clotrimazole in the treatment of vulvovaginal candidiasis among patients seen at the out‑patient department in a tertiary hospital Materials and Methods: This involved review of the records of patients diagnosed with VVC in a tertiary medical center from 2016 to 2020. All records of women, pregnant and non‑pregnant, wherein single‑dose 1200 mg miconazole or 6‑day 100 mg clotrimazole given vaginally were included Results: Eleven out of the 316 records (3.46%) remained symptomatic after treatment, about 18.1% (2/161) from those who used miconazole and 81.8% (9/155) from those treated with clotrimazole (p 0.027). In terms of failure rate, for miconazole it was 1.2% (2/161), whereas for clotrimazole it was 5.8% (9/155). None of the charts were found to have recorded adverse reaction to the given treatment Conclusion Single‑dose miconazole intravaginal regimen has a higher clinical cure rate than the 6‑day clotrimazole intravaginal treatment. Thereby, single‑dose intravaginal miconazole has the potential to improve patient compliance and treatment outcome at a lower cost
Clotrimazole ; Miconazole ; Vaginitis ; Candidiasis, Vulvovaginal

Candidiasis, Vulvovaginal ; microbiology ; Communicable Diseases ; microbiology ; Female ; Humans ; Microbiota ; physiology ; Vagina ; microbiology ; Vaginitis ; microbiology ; Vaginosis, Bacterial ; microbiology

The clinical usefulness of polymerase chain reaction (PCR) for the diagnosis of trichomoniasis was evaluated in comparison with other conventional tests. PCR was used for specific detection of Trichomonas vaginalis by primers based on the repetitive sequence cloned from T. vaginalis (TV-E650). Between June 1996 and August 1997, 426 patients visited the department of obstetrics and gynecology, Hanyang University Kuri Hospital and were examined for trichomoniasis using wet mount examination, Papanicolaou (Pap) smear, culture and PCR. One hundred and seventy-seven patients (group A) visited with the symptoms of vaginal discharge and 249 patients (group B) visited for regular cervical Pap smear with no vaginal symptoms. From group A (n = 177), 3 infections (2.0%) were detected by wet mount, 6 infections (3.3%) by Pap smear and culture, and 17 infections (10.4%) by PCR. From group B (n = 249), 4 patients (1.6%) were found to have T. vaginalis by culture and 6 infections (2.4%) were detected by PCR. Therefore, in both groups, PCR for T. vaginalis showed a higher detection rate compared with conventional wet mount, Pap smear or culture. The detection by PCR was specific for T. vaginalis since no amplification was detected with DNAs from other protozoa and Candida albicans. The sensitivity and specificity of PCR were 100%. This method could detect T. vaginalis in vaginal discharge at a concentration as low as 1 cell per PCR mixture. These results indicate that PCR could be used as a specific and sensitive diagnostic tool for human trichomoniasis.
Female ; Human ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Trichomonas Vaginitis/diagnosis*