Abstract
BACTERIAL VAGINOSIS – AN OVERVIEW OF CHANGE IN VAGINAL MICROBIOME, ASSOCIATED CO-MORBIDITIES AND TREATMENT MODALITIES

Shalley Dahiya, Raminder Sandhu, Bijender Singh, Surinder Kumar

ABSTRACT

Bacterial vaginosis remains the most common cause of vaginal discharge with fishy odour due to production of amines by the anaerobic bacteria. The vagina is a microbiologic battleground as different bacterial species try to gain dominance and ensure their survival due to change in external influences which effect their micro environment. Both microbiologic and biochemical studies have outlined the remarkably complex pathophysiologic events that occur in bacterial vaginosis. The condition occurs when desirable vaginal lactobacilli are reduced in number and replaced with anaerobic bacteria which results in reduced levels of hydrogen peroxide and organic acids that usually afford tremendous advantage to maintain the healthy environment of vagina. Several major morbidities accompany this condition, including enhanced susceptibility to other sexually transmitted infections, major post operative infection and adverse pregnancy outcomes. Several antimicrobial agents have been used for treatment of symptomatic bacterial vaginosis but therapeutic success remains inadequate due to lack of clear understanding of etiopathogenesis. The objective of the current review is to highlight the complex changes occurring in vaginal microbiota responsible for bacterial vaginosis along with currently available therapeutic options, recommendations and emerging therapies.

Keywords: Bacterial vaginosis, etiopathogenesis, lactobacilli.


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