Citation link:
Authors:
Telbiyska, K.; Angelova, M.
Title:
Concepts on asymptomatic bacterial vaginosis
Date of Issue:
2024
Is Part of:
Trakia Journal of Sciences: Series Biomedical Sciences, Vol. 22, No 3, pp 234-240
Publisher:
Тракийски университет - Стара Загора
Identifiers:
1313-3551 [issn]
Type:
Article
Language:
eng
Subject:
bacterial vaginosis; bacterial biofilm; asymptomatic; metronidazole; antibiotic resistance
Abstract:
Bacterial vaginosis is a state of imbalance of the vaginal microbiota with prevalence of anaerobes and a relative lactobacilli deficit. The main pathogens are Gardnerella vaginalisspecies of heterogeneous phenotypic characteristics and virulence, forminga bacterial polymicrobial biofilm on vaginal epithelial cells.A symptomatic infection clinically manifested by a homogeneous grey-white vaginal discharge with a fishy smell by all means requires a treatment regimen.The concepts on asymptomatic bacterial vaginosis have not reached a definite consensus regarding the fact whether treatment is required –the interpretation of its sexual transmission is ambivalent and it is unclear whether there are any differences in the pathogenesis and levels of complications between the two clinical manifestations of bacterial vaginosis.An early therapeutic approach is available for asymptomatic pregnant women; however, it does not demonstrate a significant difference in the incidence of obstetric complications.Fluctuations and transitoriness in vaginal microbiota composition, manifested by spontaneous transition to verified lack of infection destabilizes the view point that treatment is mandatory in asymptomatic non-pregnant women. Recommendations are availableconcerning preoperative regimens, prevention of gynaecological and obstetric complications aiming at prevention of sexual transmission and infection with other sexually transmitted diseases.The treatment approaches to verified bacterial vaginosis involving combined standard and alternative regimens have shown unsatisfactorylong-term results, and the evidence so far is insufficient to absolutely confirm or refute the usefulness of treating an asymptomatic infection.
