Rapid fluctuation of the vaginal microbiota measured by Gram stain analysis
- 26 July 2010
- journal article
- research article
- Published by BMJ in Sexually Transmitted Infections
- Vol. 86 (4), 297-302
- https://doi.org/10.1136/sti.2009.040592
Abstract
Background The aetiology of bacterial vaginosis (BV) remains unknown. Objective To describe longitudinal changes in vaginal microbiota. Methods Thirty-nine women (mean age 36.8 years; 22 (56.4%) African-American) self-collected vaginal specimens twice weekly for 16 weeks as part of a vaginal douching cessation study. In an analysis where each woman serves as her own control, conditional logistic regression was used to evaluate daily, time-varying factors associated with a woman's incident BV episode(s) as compared with her persistently BV-negative sample(s). BV was defined by a Nugent's Gram stain score ≥7. Results 46.2% of participants had BV in the first 4 weeks of observation. Rapid fluctuation of vaginal microbiota was observed in 226 transitions to BV or spontaneous remission. Duration of BV was often short: 51% of the episodes lasted for only one sample interval (3 days). Among women who had at least one BV episode, the median number of episodes per woman was 8.7 (SD 7.4, range 1–22). Lubricant use 1 day before specimen collection (adjusted OR (aOR)=11.75, 95% CI 1.96 to 70.27) and rectal sex 2 days before (aOR=4.48, 95% CI 2.79 to 7.17) were associated with BV onset. Conclusion Rapid fluctuation of the vaginal microbiota was seen. Longitudinal studies with long intervals between sampling are likely to miss episodes of BV. Recent report of lubricant use and rectal sex were associated with incident BV.Keywords
This publication has 30 references indexed in Scilit:
- The effect of vaginal douching cessation on bacterial vaginosis: a pilot studyAmerican Journal of Obstetrics and Gynecology, 2008
- A Longitudinal Study of Vaginal Douching and Bacterial Vaginosis--A Marginal Structural Modeling AnalysisAmerican Journal of Epidemiology, 2008
- A Delicate Balance: Risk Factors for Acquisition of Bacterial Vaginosis Include Sexual Activity, Absence of Hydrogen Peroxide-Producing Lactobacilli, Black Race, and Positive Herpes Simplex Virus Type 2 SerologySexually Transmitted Diseases, 2008
- A randomized trial of metronidazole in asymptomatic bacterial vaginosis to prevent the acquisition of sexually transmitted diseasesAmerican Journal of Obstetrics and Gynecology, 2007
- The association of psychosocial stress and bacterial vaginosis in a longitudinal cohortAmerican Journal of Obstetrics and Gynecology, 2006
- Colonization of the Rectum byLactobacillusSpecies and Decreased Risk of Bacterial VaginosisThe Journal of Infectious Diseases, 2005
- Influence of the Normal Menstrual Cycle on Vaginal Tissue, Discharge, and MicrofloraClinical Infectious Diseases, 2000
- Bacterial vaginosis and disturbances of vaginal floraAIDS, 1998
- What is normal vaginal flora?Sexually Transmitted Infections, 1997
- Validity of the Vaginal Gram Stain for the Diagnosis of Bacterial VaginosisObstetrics & Gynecology, 1996