Risk factors for cervicitis among women with bacterial vaginosis.
BACKGROUND
Cervicitis commonly occurs in women with bacterial vaginosis (BV), often without concomitant chlamydial or gonococcal infection. The risk factors for cervicitis have not been described.


METHODS
We characterized the risk factors for cervicitis, which is defined as endocervical mucopurulent discharge or easily induced bleeding, among women with BV who were 14-45 years of age. Associations between cervicitis and the characteristics of the subjects, including the presence of specific vaginal bacteria and chlamydial or gonococcal infection detected by strand displacement assay, were analyzed.


RESULTS
Of 424 women with BV, 63 (15%) had cervicitis. Of these 63 women, only 8 (13%) had chlamydia or gonorrhea. The risk factors for cervicitis, adjusted for variables, included older age (P<.001, for trend), <or=12 years of education (odds ratio [OR], 2.4 [95% confidence interval {CI}, 1.3-4.6]; P=.006), new male sex partner (OR, 2.7 [95% CI, 1.4-5.4]; P=.004), female sex partner (OR, 6.2 [95% CI, 1.3-28.3]; P=.02), recent oral sex (OR, 2.3 [95% CI, 1.2-4.2]; P=.008), and absence of vaginal H2O2-producing Lactobacillus species (OR, 2.7; 95% CI, 3.3-5.9; P=.01). No association with cervicitis was seen for current douching or smoking, race, time since or frequency of intercourse, or presence or quantity of vaginal bacteria other than H2O2-producing Lactobacillus species.


CONCLUSIONS
Cervicitis is common among women with BV and is associated with some risk factors that are distinct from those associated with endocervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. Absence of H2O2-producing lactobacilli may contribute to the development of cervicitis.
Marrazzo
Jeanne M
JM
Department of Medicine, University of Washington, Seattle 98104, and Department of Pediatrics, Children's Hospital of Pittsburgh, PA, USA. jmm2@u.washington.edu
Wiesenfeld
Harold C
HC
Murray
Pamela J
PJ
Busse
Barbara
B
Meyn
Leslie
L
Krohn
Marijane
M
Hillier
Sharon L
SL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000032:analysis; D004522:Educational Status; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000378:metabolism; D007778:Lactobacillus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000235:genetics / Q000302:isolation & purification; D021141:Nucleic Acid Amplification Techniques; D012307:Risk Factors; D012725:Sexual Behavior; D002575:Uterine Cervicitis / Q000209:etiology*; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000150:complications*
D004269:DNA, Bacterial; D006861:Hydrogen Peroxide