The vaginal microecology in gynecological outpatients: a report from China

Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China. Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China. 200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed. Results A total of 2 093 specimens were collected in this study. The detection rate of Trichomonas was 5.5% (115/2 093). The detection rate of Candida mycelia was 15.9% (333/2 093), with germinal spores was 4.1% (86/2093). The detection rate of bacterial vaginosis was 18.8% (394/2 093). The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3% (571/2 093). The normal flora with the insufficiency of H2O2 accounted for 23% (480/2 093). The bacteria inhibiting flora accounted for 3.8% (79/2 093). The abnormal microflora (non BV type) accounted for 14.9% (312/2 093). The abnormal microflora (BV intermediate type) accounted for 13.4% (280/2 093). The abnormal microflora (BV type) accounted for 17.6% (369/ 2 093). The average pH of vaginal discharge was 4.58 ±0.495. There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river , while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north. The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors. The patients′ age from bacteria inhibition group was 49.64 + 16.68 which was significantly higher than that of the other microecology groups. The proportion of abnormal microflora of patients from the oral contraceptive group was 40% (20/50). The proportion of abnormal microflora of patients from IUD group was 36.6% (63/172). Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327) which was significantly lower. The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups. Conclusion This study showed the vaginal microecology status of the Chinese outpatient′s clinic and found that the vagina microecology was related to age, region and contraceptive methods. The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med, 2018, 41: 287-291) Key words: Outpatients; Vagina; Microbiota; Dysbiosis; Vaginal discharge; Epidemiologic studies