How Can I Treat Vaginal Bacterial Infections?

Bacterial vaginitis (BV) is a mixed infection of G. vagina and some anaerobic bacteria in the vagina, which leads to an imbalance in the micro-ecological balance of the vagina, an increase in vaginal secretions, a fishy odor on the leucorrhea, and a burning itching vulva Syndrome. Can be divided into Haemophilus vaginitis, Corynebacterium vaginitis, anaerobic vaginitis, Gartnerella vaginitis and so on. The disease can also be transmitted through sexual contact, and has a higher incidence in people with confusion. Secretion smear examination can find a large number of pus bulbs, find pathogenic bacteria.

Basic Information

English name: bacterial vaginosis
Visiting department: Obstetrics and Gynecology
Multiple groups: Sexual Disorders

Common causes: Caused by Gardnerella vaginalis and anaerobic infections
Common symptoms: Vaginal burning and itching. Leucorrhea, fishy smell
Contagious: Have
way for spreading: Indirect contact, sexual transmission

Causes of bacterial vaginitis

Indirect contact infection

Contact with toilets, bathtubs, bath chairs, towels in public toilets contaminated with bacteria, and the use of dirty toilet paper can cause infections.

2. Sexual transmission

It is one of the causes of the onset. At least 10% of the men with symptoms in the woman have bacterial urethritis.

3. Take a lot of antibiotics

Antibiotics changed the microenvironment of the vagina, causing a large number of pathogenic bacterial pathogens to multiply, leading to localized bacterial vaginitis.

4. Excessive hygiene

In order to maintain hygiene, some women often use medicated lotions to irrigate the vagina, which can easily destroy the acid and alkali environment of the vagina and easily become infected with bacterial vaginitis.

Clinical manifestations of bacterial vaginitis

10% to 50% of the patients are asymptomatic, and those with symptoms report a grayish white leucorrhea with fishy smell, vaginal burning sensation, and itching.

Most of the patients with this disease are women of childbearing age, with slow onset and unconscious symptoms, mainly manifested by increased vaginal discharge. Vaginal discharge examination has the following characteristics: The pH value is 5.0 to 5.5, which is higher than normal. The leucorrhea is gray or gray-green, homogeneous, and may have bubbles like batter-like consistency. There is a bad fish-like stench. The foul odor worsens after menstruation or sexual intercourse in women, and the genitals of sexual partners can also emit the same foul odor. People who are infected with trichomoniasis or candidiasis may experience pruritus, vaginal burning, or pain during intercourse.

This disease can often be combined with other vaginal sexually transmitted diseases, and its clinical manifestations can be affected by comorbidities and vary. When gonococcal infections are combined, vaginal secretions are obviously purulent and urinary tract irritation symptoms such as dysuria and dysuria can occur; when combined with trichomoniasis, foamy vaginal discharges can occur, and itching becomes worse, and itching is strange; When combined with Candida infection, vaginal secretions can be curd-like or tofu-like.

Bacterial vaginitis check

Smear microscopy

Take the secretion as a smear to find clue cells. The clue cells are epithelial cells with a large number of Gartner bacteria attached to the surface, which are characterized by rough or fine particles on the surface of the epithelial cells. The bacteria are Gram-negative spheroids.

2. Amine test

Take a drop of 10% potassium hydroxide solution and add it to the vaginal secretion. It can be smelled that "fishy" ammonia is released. Because the secretion of the amine is high, ammonia can be released in the presence of alkali.

3. Culture method

Isolate before culturing, visible 0.5mm diameter round, opaque, smooth surface colonies.

4. Biochemical method

Taking vaginal secretions for biochemical measurement, normal women had high lactate and low succinate levels, while women with this disease had opposite values.

5. Fluorescent antibody method

After smearing, microscopic examination was performed with fluorescent antibody staining.

Diagnosis of bacterial vaginitis

1. Vaginal discharge is gray-white, sticky, batter-like, uniform, non-purulent discharge.

2. The amine content in the secretion is high, showing a fishy smell. It promotes the release of amine during sexual intercourse or after activities to make the odor worse. 10% potassium hydroxide can be released into the secretion to release the amine smell.

3. The ph value in vaginal secretions increased from 5.0 to 5.5, compared with 3.7 to 4.5 in normal people.

4. Clue cells can be detected in smears of vaginal secretions.

Complications of bacterial vaginitis

Common complications occur simultaneously with gynecological cervicitis and pelvic inflammatory disease, and often occur simultaneously with trichomonas vaginitis. Bacterial vaginosis in pregnancy can cause adverse perinatal outcomes, such as chorioamnionitis, amniotic fluid infection, premature rupture of the membranes, preterm labor and endometrial infection after cesarean section or vaginal delivery.

Pelvic inflammatory disease

The most commonly isolated flora of female genital tract secretions with pelvic inflammatory disease is consistent with the BV flora, including Bacteroides, the number of digestive streptococci, and Gartnerella vaginalis.

2. Abnormal uterine bleeding and endometritis

Abnormal uterine bleeding is caused by endometritis. Abnormal uterine bleeding is caused by the abnormal response of the infected endometrium to ovarian hormones or by the direct destruction of the endometrium by infection or inflammation.

3. Gynecological infections

Among women who have terminated their pregnancy, the incidence of pelvic inflammatory disease in pregnant women with BV is 3.7 times that of women without BV.

4. Cervical cancer

BV, cervical intraepithelial neoplasia, and genital tract human papilloma virus infections share the same epidemiological relationship. BV's anaerobic metabolism produces ammonia in the vaginal secretions and ammonia nitrite that is carcinogenic.

5. HIV infection

BV patients can increase the risk of HIV transmission. As the pH increases, the viability and adhesion of HIV also increase and may make transmission easier.

6. Infertility and miscarriage

The incidence of infertility due to fallopian tube factor is increased in patients with BV. In assisted pregnancy treatment, the embryo implantation rate of BV patients and non-BV patients is similar, but the abortion rate of BV patients in early pregnancy is higher than that of non-BV patients.

Bacterial vaginitis treatment

General treatment

Keep the vulva clean and dry to avoid scratching. Do not eat spicy spicy food. Change your underwear frequently and wash with warm water. Do not mix with other clothes to avoid cross infection.

2. Drug treatment

(1) Metronidazole is currently believed to have a reliable effect, twice daily for 7 days.

(2) Methamycin (Crimalin) was shared for 3 days.

(3) Methanesulfomycin (ximycin) is effective for a variety of Gram-negative and positive bacteria, and has good curative effect on anaerobic bacteria. It can also be used.

(4) Jiemycin and ampicillin Jiemycin and ampicillin can still be used. In recent years, no treatment is required for asymptomatic patients.

3. Topical Therapy

Can be treated with topical drugs, such as metronidazole suppositories, once a night for 7 days.

4. Complications Treatment

Those who detect other pathogens should take drugs against other pathogens to avoid abuse of antibiotics. Pay attention to systemic medication, support and immunotherapy can be given at the same time, pay attention to adverse drug reactions.

5. Sexual partner treatment

Sex partners are treated at the same time.

Bacterial vaginitis prevention

This disease can cause infertility, affect fetal development, induce other diseases (genital infections, pelvic inflammatory disease, periphritis, sexual intercourse pain, etc.), and affect the quality of life of couples.

Prognosis of bacterial vaginitis

Because the onset of non-specific vaginitis is related to personal hygiene and mutual infection, you should always pay attention to personal hygiene to prevent invasion of pathogenic bacteria, eliminate sources of infection, enhance physical fitness, and prevent recurrence.