Incidence of infections by Gardnerella vaginalis in sexually active women: A survey of cytological reports

Eixo temático: Temas gerais com interface à Saúde Única

Abstract

In the human vaginal microbiota, fungi and bacteria cohabit, mainly Lactobacillus spp. that are fundamental for the balance of the female reproductive tract. Population dynamics of this microbiota provide opportunities for vaginitis and vaginosis that account for 90% of vaginal discharge, typical symptoms in both pathologies. However, inflammation occurs in vaginitis, due to the predominance of aerobic bacteria (Escherichia coli, Streptococcus agalactiae and S. aureus), unlike bacterial vaginosis (BV), mostly caused by Gardnerella vaginalis (characterized by the "fish-like" odor). Both are diagnosed by the Pap test and treated with antibiotics, but relapses have increased self-medication and, therefore, Antimicrobial Resistance (AMR). In this context, the aim of this study was to verify the incidence of infections by G. vaginalis in sexually active women, through the results of cytological reports from two private laboratories in two cities in Bahia, Brazil. The 345 cytological reports of elective Pap smears in this study allowed us to categorize the total microbiota of patients into 'normal', with 211 reports, indicating a predominance of Lactobacillus spp. and 134 reports with results of 'altered' microbiota, when pathogens are observed, such as: G. vaginalis, Candida vaginalis and Trichomonas vaginalis. Considering the research period in pre-pandemic (January to December 2019) and pandemic (January 2020 to March 2021), there was a 32.22% reduction in reports, with an incidence of BV among women aged 20 to 41 years (20.32%), in both laboratories included in the research, during the COVID-19 pandemic. However, the frequency of positive reports for G. vaginalis increased by 17.97%. These results are essential for adequate BV pharmacotherapy, antibiotic-associated with the balances of the Lactobacillus spp.