Non-specific (anaerobic) vaginitis: relevance of clinical and laboratory studies in a practice population

Non-specific vaginitis is a commonly diagnosed condition defined in a similar manner by most authors. Although assumed to be of infective aetiology, no single organism has yet been accepted as the primary agent. This syndrome was studied in two groups of women presenting to general practitioners or attending a family planning clinic. The two groups were of similar ages and had similar markers of sexual activity. Of the 173 women studied, 90 had symptoms. Of the symptomatic women 9.5% could be categorized as having non-specific vaginitis and 36.7% as having an alternative cause for their discharge. Gardnerella vaginalis were found to be associated with anaerobes, clue cells and staphylococci more frequently than by chance.The isolation of G. vaginalis or anaerobes was assessed for their ability to help confirm the diagnosis of non-specific vaginitis and to distinguish this from other possible pathology. In patients with clinical non-specific vaginitis, the isolation of G. vaginalis proved the most sensitive (100%) though not a very specific (77.4%) indicator, whereas anaerobes were more specific (93.2%). The presence of anaerobes was a better predictor of non-specific vaginitis (30.8%) than G. vaginalis (18.9%). It was concluded that providing laboratory facilities specifically for the isolation of G. vaginalis would be of little benefit to the general practitioner in diagnosing non-specific vaginitis since it would add to the cost of processing specimens, whereas reporting the presence of heavy growths of anaerobes provides some confirmation and adds little to the cost.