title: Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings.
abstract: OBJECTIVE
  To investigate the clinical features of aerobic vaginitis (AV) and mixed infections with AV to achieve efficient diagnosis.
  
  
  METHODS
  From April 2008 to August 2009, 657 consecutive outpatients with vaginal symptoms in gynecology clinic in the General Hospital of Tianjin Medical University were investigated. Samples were taken for examination of vaginal discharge and fresh wet mount microscopy. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonal vaginitis (TV) were diagnosed according to standardized definitions. Sixty patients with single AV were randomly selected over the same period. Each patient accepted moxifloxacin therapy. Two kinds of treatment course (400 mg qd, 6 days or 400 mg qd, 12 days) were given. Clinical features and laboratory test results in the first visit and follow-ups were recorded and statistically analyzed.
  
  
  RESULTS
  Among the 657 cases, AV was found in 23.74 % of the cases (156/657). AV mixed infections were diagnosed in 53.85 % (84/156): the mixed infections included VVC (32/84, 38.10 %), BV (31/84, 36.90 %), and TV (21/84, 25.00 %). Common symptoms of AV were a change in the characteristics of the discharge (44/72, 61.11 %) and increased discharge (30/72, 41.67 %). Vaginal pH was usually higher than 4.5 (63/72, 87.50 %). Enterococcus faecalis, Streptococcus viridans, Escherichia coli, and Staphylococcus epidermidis were frequently isolated. There is no statistically significant difference between two moxifloxacin treatment groups (p > 0.05). Cure rate was 89.7 % in 6-day group, and 71.4 % in 12-day group.
  
  
  CONCLUSIONS
  AV is a common vaginal infection, and it is often mixed with other infections, especially VVC, BV and TV. The symptoms and signs of AV mixed infections are atypical. If a patient has vaginal complaints, it is necessary to determine whether AV or mixed infections are present. Oral moxifloxacin is effective in treating AV, and an appropriate course should be selected taking the severity of AV into consideration.
authors.affiliation: Department of Gynecology, Tianjin Medical University General Hospital, Tianjin 300052, China.
authors.forename: Aiping
authors.initials: A
authors.lastname: Fan
authors.forename: Yingli
authors.initials: Y
authors.lastname: Yue
authors.forename: Nv
authors.initials: N
authors.lastname: Geng
authors.forename: Huiying
authors.initials: H
authors.lastname: Zhang
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Wang
authors.forename: Fengxia
authors.initials: F
authors.lastname: Xue
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use; D001420:Bacteria, Aerobic / Q000302:isolation & purification*; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002681:China; D060085:Coinfection / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D005260:Female; D024841:Fluoroquinolones; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D000077266:Moxifloxacin; D011804:Quinolines / Q000627:therapeutic use; D014247:Trichomonas Vaginitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014627:Vaginitis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin