Bacterial Vaginosis Is a Strong Predictor of Neisseria gonorrhoeae and Chlamydia trachomatis Infection

• Published in: Clinical infectious diseases Vol. 36; no. 5; pp. 663 - 668
• Main Authors: Wiesenfeld, Harold C., Hillier, Sharon L., Krohn, Marijane A., Landers, Daniel V., Sweet, Richard L.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.03.2003; University of Chicago Press
• Subjects: Adolescent; Adult; Bacterial diseases; Bacterial diseases of the genital system; Bacterial vaginosis; Biological and medical sciences; Chlamydia Infections - diagnosis; Chlamydia trachomatis; Condoms; Female; Flora; Gonorrhea; Gonorrhea - diagnosis; HIV/AIDS; Human bacterial diseases; Humans; Hydrogen; Infections; Infectious diseases; Male; Medical sciences; Neisseria gonorrhoeae; Prognosis; Sexual partners; Sexually transmitted diseases; Urethritis; Vaginosis, Bacterial; Human; Chlamydiaceae; Neisseriaceae; Vaginal diseases; Chlamydia trachomatis; Female genital diseases; Infection; Sexually transmitted disease; Gonococcal infection; Neisseria gonorrhoeae; Bacteriosis; Chlamydiales; Bacteria; Micrococcales; Chlamydiosis; Predictive factor
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/367658

To evaluate whether bacterial vaginosis predicts the acquisition of sexually transmitted diseases (STDs), we studied 255 nonpregnant female subjects aged 15–30 who reported recent sexual contact with a male partner in whom either gonococcal or chlamydial urethritis or nongonococcal urethritis was diagnosed. Compared to subjects with normal vaginal flora, subjects with bacterial vaginosis were more likely to test positive for Neisseria gonorrhoeae (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.7–9.7) and Chlamydia trachomatis (OR, 3.4; 95% CI, 1.5–7.8). Subjects colonized vaginally by hydrogen peroxide–producing lactobacilli were less likely to receive a diagnosis of chlamydial infection or gonorrhea than subjects without such lactobacilli. Bacterial vaginosis was a strong predictor of gonorrhea and chlamydial infection among subjects who reported recent exposure to a male partner with urethritis. These data support the importance of vaginal flora in the defense against STD acquisition.