Microbiological patterns in vaginitis.

OBJECTIVES: 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. DESIGN: Prospective study with microbiological investigation of high vaginal specimens from symptomatic and healthy groups of women. SETTING: A gynaecological clinic of the De Soysa Hospital for Women, and a family planning clinic of the Family Health Bureau, Colombo. PATIENTS: 114 untreated patients with symptoms suggestive of vaginitis and 109 healthy controls. RESULTS: 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. CONCLUSIONS: 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.