ATOPOBIUM VAGINAE:ROLE IN RELAPSING BACTERIAL VAGINOSIS

GOOD MORNING FRIENDS.A short post before going to work.BACTERIAL VAGINOSIS, is usually an easily treatable condition,as mentioned in my previous post about bacterial vaginosis.It usually responds promptly to a course of metronidazole.

But in some instances relapses are seen after a course of metronidazole.In many of these cases co-infection with a recently recognised bacteria atopobium vaginae or yeast[candida albicans] is seen.

Atopobium vaginae is a recently recognised bacteria that has been shown to have a causative role in relapsing bacterial vaginosis.This bacteria is difficult to diagnose, and the problem is it is resistent to metronidazole,the commonly used drug for bacterial vaginosis.Although it is sensitive to treatment with clindamicin,ampicillin/sulbactum,imipenem,meropenem etc.Usually clindamycin is used.

FOR FURTHER INFORMATION ON THIS, PLEASE CONTACT YOUR DOCTOR OR LOCAL HEALTH-CARE PROVIDER.

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BRIEF OVERVIEW:BACTERIAL VAGINOSIS

Vaginitis is a disorder which presents with vaginal discharge,itching and irritation.Three most common causes of vaginitis are bacterial vaginosis,trichomoniasis and candida infection.

Today i will present a brief overview about bacterial vaginosis.Bacterial vaginosis is a disorder of alternation of the normal vaginal flora.The good bacteria of the vagina[Lactobacillus] is replaced by bad bacterias like Prevotella,mobilincus,mycoplasma hominis,Gardenella vaginalis etc.The symptoms are white vaginal discharge,vaginal irritation etc.Many women remain asymptomatic.

The diagnostic criteria are:1.whitish homogenous discharge lining the vaginal wall

2.ph>4.5 measured by narrow range ph paper.

3.CLUE CELLS[epithelial cells lined lined by bacteria]

4.fishy odour of vaginal discharge when mixedwith KOH

The gold standard test is the relative concentration of lactobacilli and the other bad bacterias in gram stain of vaginal discharge.Culture of G.vaginalis is not specific.DNA probe test for G.vaginalis may be helpful in diagnosis.Ph paper test,test for trimethylamine,prolineaminopeptidase may be helpful.

TREATMENT:Metronidazole tablet orally

Metronidazole cream

clindamycin gel

All symptomatic women should be treated

BACTERIAL VAGINOSIS AND PREGNANCY:Bacterial vaginosis causes pre-mature rupture of membrane,pre-term labour,pre-term birth.chorioamnionitis.Any pregnant women with symptoms of bacterial vaginosis should be treated.Pregnant women without symptoms,but with high risk of premature delievery should also be treated.Treatments options are metronidazole,clindamycin tablets.Clindamycin should not be given during the second half of pregnancy.

Treatment of partners is not recommended because it does not reduce recurrence of disease.

In bacterial vaginosis with HIV,the treatment is same but the disease is more persistent.

everybody should consult their respective physicians regarding this topic.Any further querries please ask me.GOOD NIGHT.

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