Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis.
OBJECTIVE
To define an entity of abnormal vaginal flora: aerobic vaginitis.


METHODS
Observational study.


METHODS
University Hospital Gasthuisberg, Leuven, Belgium.


METHODS
631 women attending for routine prenatal care or attending vaginitis clinic.


METHODS
Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect).


RESULTS
Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured. Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-beta and leukaemia inhibitory factor in the vaginal fluid.


CONCLUSIONS
Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.
Donders
Gilbert G G
GG
Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Catholic University of Leuven, Belgium.
Vereecken
Annie
A
Bosmans
Eugene
E
Dekeersmaecker
Alfons
A
Salembier
Geert
G
Spitz
Bernard
B
D004797:Enzyme-Linked Immunosorbent Assay; D004927:Escherichia coli Infections / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006194:Gardnerella vaginalis / Q000302:isolation & purification; D006131:Growth Inhibitors / Q000032:analysis; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D053605:Leukemia Inhibitory Factor; D008222:Lymphokines / Q000032:analysis; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000473:pathology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000382:microbiology* / Q000473:pathology; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D014621:Vagina / Q000737:chemistry / Q000382:microbiology; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000382:microbiology* / Q000473:pathology
D006131:Growth Inhibitors; D007375:Interleukin-1; D015850:Interleukin-6; C507837:LIF protein, human; D053605:Leukemia Inhibitory Factor; D008222:Lymphokines