Vaginosis, bacterial N76.81

Worldwide occurrence mainly among women of reproductive age. Estimated prevalence in women attending an STI clinic: 20-30%.
For women at higher risk of ST I, such as sex workers, the estimated prevalence is as high as 50-60% (Bautista Ct 2016)

The probability of developing bacterial vaginosis is higher if:

• a higher number of sexual partners is indicated
• for unmarried women
• in women who have had their first sexual intercourse at a very early age
• among sex workers
• for regularly performed vaginal showers

Vulvovaginitis and colpitis with low-viscosity, homogeneous, grey-white fluorine vaginalis. Characteristic, penetrating, fish-like odour (caused by various amines formed by the overgrowing anaerobes).

Diagnostic criteria (after Amsel 1983):

1. Low-viscosity, homogeneous fluorine
2. pH value > 4,5
3. Fishy (amine) odor of vaginal secretion, which increases after addition of 10% potassium hydroxide
4. "Cue cells" or " key cells " (vaginal epithelia covered with bacteria and characteristically spotted) with a proportion of >20% of epithelial cells

the diagnosis of bacterial vaginosis is considered confirmed if at least three of the four criteria listed are met.

Cult detection is not recommended for primary diagnosis (G. vaginalis selective agar; the basis of this is Columbia blood agar containing 5-10% rabbit blood or human blood).

Remember! In men Gardnerella vaginalis can persist asymptomatically in the urethra for months.

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2. Bautista CT et al.(2016) Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res 3:4.
3. Egan ME et al (2000) Diagnosis of vaginitis. On Fam Physician 62: 1095-1104
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11. Nelson DB et al (2003) Self-collected versus provider-collected vaginal swabs for the diagnosis of bacterial vaginosis: an assessment of validity and reliability. J Clin Epidemiol 56: 862-866