Aerobic Vaginitis Caused by Enterococcus Faecalis - Clinical Features and Treatment

Area of Science:

• Gynecology
• Microbiology
• Oncology

Background:

• Aerobic vaginitis (AV) is characterized by an imbalance in vaginal flora, featuring aerobic and intestinal pathogens and inflammation.
• AV affects 12–23.7% of non-pregnant and 4–8% of pregnant symptomatic women, increasing STI risk.
• Key causative agents include Enterococcus faecalis, Escherichia coli, group B Streptococcus, and Staphylococcus aureus.

Purpose of the Study:

• To review the key features of aerobic vaginitis.
• To describe this common clinical issue in Bosnia and Herzegovina and globally.

Main Methods:

• A literature review of scientific papers from indexed databases was conducted.
• Analysis focused on aerobic vaginitis based on existing research.

Main Results:

• Enterococcus faecalis is the most frequent AV pathogen (approx. 31%).
• Evidence suggests a link between E. faecalis, HPV 16, and cervical cancer progression.
• Reduced lactobacilli and increased vaginal pH (above 5) in AV, particularly with E. faecalis and HPV, are associated with cervical intraepithelial neoplasia (CIN).

Conclusions:

• Intensive AV treatment is crucial for preventing precancerous cervical lesions and cancer.
• Recommended AV treatment involves a combination of antibacterial, hormonal, anti-inflammatory, and/or probiotic therapies.
• A standardized treatment strategy for E. faecalis-induced AV is lacking; therapy often includes topical antibiotics, steroids, and estrogen.