Microbiological patterns in vaginitis

To determine the incidence and microbial aetiology of vaginitis, and the usefulness of Gram staining of vaginal fluid in detecting the aetiology of vaginitis in Sri Lankan women.

Prospective study with microbiological investigation of high vaginal specimens from symptomatic and healthy groups of women.

A gynaecological clinic of the De Soysa Hospital for Women, and a family planning clinic of the Family Health Bureau, Colombo.

114 untreated patients with symptoms suggestive of vaginitis and 109 healthy controls.

Candida species were isolated from 36% patients and 9% of controls. Gardnerella vaginalis was recovered from 8.8% of patients and 7.3% of controls. The bacterial vaginitis group consisted of several distinct subgroups, viz Gardnerella vaginalis vaginitis, anaerobic vaginitis, non-anaerobic vaginitis and polymicrobial vaginitis. The incidence of trichomoniasis was lower (4.4%) compared to other studies. Other bacteria (anaerobes, enterococci, coliforms, Group B Streptococci) were isolated in significantly higher numbers in the symptomatic group compared to the control group. Microscopy showed that the majority (73%) of the Candida vaginitis patients retained the normal Lactobacillus morphotype. In bacterial vaginitis Lactobacillus morphotype was replaced by other bacterial morphotypes.

In our study 36% had candidiasis, 4.4% had trichomoniasis and 47% had bacterial vaginitis. In 12% there was no detectable pathogen. Microscopy of vaginal fluid is useful in determining the aetiology of vaginitis.