A Study on Bacterial Vaginosis and Other Vaginal Infections in Women of Reproductive Age Groups

Abstract

Aim: This study was done to evaluate the different types of infectious vaginitis occurring among women in the reproductive age group, to identify the common etiological agents responsible for vaginitis by isolating and characterizing the pathogens through microbiological methods. Study Design: prospective cross-sectional study Place and Duration of Study: Institute of Microbiology, Madras Medical College, 6 months (September 2018 to February 2019) Methodology: Patients of the age group 18–45 years presenting with one or more of the following symptoms, which include increased vaginal discharge with foul smell, lower abdominal pain, itching or irritation in the vagina, and pain during sexual intercourse. A total of 2 high vaginal swabs were collected using sterile cotton swab from each patient. The first vaginal swab was used for testing pH, Gram stain for culture on blood agar. Bacterial vaginosis was diagnosed based on Amsel criteria.and Gram stain done for identification of morphotype. A second swab was used for wet mount preparation, KOH examination and inoculation on Sabouraud’s Dextrose Agar. Wetmount was examined for the presence of motile Trichomonas vaginalis. Yeast identification was done by germ tube test, sugar fermentation and assimilation tests. Results: A total of 120 patients were included in the study. 48 patients had Bacterial vaginosis which is 40% of the total number of patients included in the study. The most common criteria found in patient was homogenous white vaginal discharge, followed by a vaginal pH greater than 4.5, positive amine test and clue cells in gram stain. Among these 28 samples were microbiologically positive of which Gardnerella (33.33%) is the most commonly seen morphotype followed by peptostreptococcus(20.8%) and Mobiluncus (4.2%). There were two cases of trichomonal infection. The potential risk factors are level of education, lack of awareness and prior surgeries. Conclusion: This study emphasizes timely diagnosis of vaginitis and its etiology, which would enable to start early specific treatment. The results of this study demonstrate that bacterial vaginosis and candidiasis are the most common causes of infectious vaginitis among women of reproductive age, with BV accounting for a substantial proportion of cases. The study reinforces the utility of Amsel criteria for clinical diagnosis in resource-limited settings, while emphasizing the importance of microbiological confirmation for precise identification of causative organisms. Early diagnosis and targeted treatment are essential to prevent recurrent infections and complications such as pelvic inflammatory disease.