Evaluation and Comparison of the Pathogenic Agents and Risk Factors of Bacterial Vaginosis

Document Type : Original Article


1 Assistant Professor of Obstetrics & Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

2 Associate Professor of Obstetrics & Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

3 Resident of Obstetrics & Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.


Introduction: Vaginal infections and discharge are among the most common complaints that bring the patient to the gynecologic clinics.The purpose of the present study is to evaluate pathogenic agents and risk factors of bacterial vaginosis.
Methods: A case- control study was performed on 200 patients. The case group (n=100) complained of vaginal discharge and bacterial vaginosis was the diagnosis , and the control group (n=100), did not have any vaginal discharge and had referred to the clinic just for seeking a contraceptive method. The vaginal samples were examined for vaginal PH and direct microscopic examination was done for gram stains, candidiasis, inflammatory cells, and presence of clue cells, red blood cells and white blood cells so whiff test and culture in different medias were performed.
Results: Anaerobic bacteria including peptostreptococcus, peptococcus, bacterioids, and obligate anaerobic lactobacillus were found in 8% of control group and 63% of study group. Difference in two groups was statistically significant. Lactobacillus was found in %81 of control group and %23 of study group with significant differences. Gardenella vaginalis was found in 88% of study group and 34% of control group. Bacterioid species were found in 15% of study group and 5% of control group. Seventy seven percent of participants were married for 6-20 years.41% of study group and 16% of control group had parity of 3-4 (P<0.05). IUD was used in 27% of study group and 17% of control group, respectively while condom and interrupted coitus were more common in the control group.
Conclusion: Anaerobic bacteria and gardenella vaginalis were more common in patients with non- specific vaginal discharge. Candom and coitus interruptus have protective effect on vaginal discharge, and IUD can increase its incidene.


1. Berek JS. Berek & Novak's Gynecology, 14th ed. Philadelphia:Lippincott Williams & Wilkins; 2007:541­5.
2. Mashburn J. Etiology, diagnosis  and management of vaginitis. J Midwifery Womens Health 2006  Nov­ Dec;51(6):423­30.
3. Mylonas I, Friese K. [Genital discharge in women]. [Article in German]. MMW Fortschr Med 2007 Sep 
6;149(35­36):42­6; quiz 47 
4. Larsen B. Microbiology of the female genital tract. Obstetric and Gynecologic Infectious Disease .1994:11­26.
5. Latino MA, Lanza A, Bello L, Leotta E, Peretto M, Spagnolo E, et al. [Cervico­vaginal infections. Study  of a population in the Turín area]. [Article in Italian]. Minerva Ginecol 2002 Aug;54(4):309­16.
6. Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA 2004 Mar 17;291(11):1368­79.
7. Landers DV, Wiesenfeld HC, Heine RP, Krohn MA, Hillier SL. Predictive value of the clinical diagnosis of
lower genital tract infection in women. Am J Obstet Gynecol 2004 Apr;190 (4):1004­10.
8. Wathne B, Holst S, Hovelius  B, Mardh PA. Vaginal discharge­comparison  of clinical, laboratory and  microbiological findings. Acta Obstet Gynecol Scand 1994 Nov;73(10):802­8.
9. Eschenbach DA, Davick PR, Williams BL, Klebanoff SJ, Young­Smith K, Critchlow CM, et al. Prevalence  of hydrogen peroxide­producing Lactobacillus species in normal women and women with vaginal vaginosis. J Clin Microbiol 1989 Feb;27(2):251­6.
10. Kent HL. Epidemiology of vaginitis. Am J Obstet Gynecol 1991 Oct;165(4 Pt 2):1168­76.
11. Ozturk CE, Ozdemir I, Yavuz T, Kaya D, Behcet M. Etiologic agents of cervicovaginitis in Turkish women. Saudi Med J 2006 Oct;27(10):1503­7.
12. Marrazzo JM, Wiesenfeld HC, Murray PJ, Busse B, Meyn L, Krohn M, et al. Risk factors for cervicitis  among women with bacterial vaginosis. J Infect Dis 2006 Mar 1;193(5):617­24.
13. Martin R, Soberon N, Vazquez F, Suarez JE. [Vaginal microbiota: composition, protective role, associated 
pathologies, and therapeutic perspectives. [Article  in Spanish]. Enferm Infec Microbiol Clin  2008 
14. Farley TM, Rosenberg MJ, Rowe  PJ, Chen JH, Meirik O. Intrauterine  devices and  pelvic inflammatory 
disease: an international perspective. Lancet 1992 Mar 28;339(8796):785­8.
15. De  Vincenzi I. A longitudinal study of human  immunodeficiency virus  transmission  by heterosexual
partners. N Engl J Med 1994 Aug 11;331(6):341­6.