Molecular and Microbiological Characterization of Aerobic Vaginitis Among Women of Reproductive Age in Basrah, Iraq
DOI:
https://doi.org/10.56714/bjrs.51.2.18Keywords:
Aerobic vaginitis, Enterococcus faecalis, Bacterial vaginosis, productive-age women, Molecular diagnosisAbstract
This study assessed the microbial and molecular aspects of aerobic vaginitis (AV) in women of reproductive age who visited Obstetrics and Gynecology Clinics in Basrah, Iraq, in 2024. Symptomatic women contributed 100 vaginal swab samples, in addition to 50 control samples. For bacterial characterization, traditional culture and PCR assays for the 16S rRNA gene were applied. Among patients, 93% had positive bacterial infections, which included E. faecalis (36.9%), coagulase-negative staphylococci (19.8%), E. coli (8.5%), and K. pneumoniae (3.4%). Furthermore, the bacterial profile indicated the presence of aerobic vaginitis, which suggested the presence of classic bacterial vaginosis, since it was devoid of anaerobic BV-associated organisms. E. faecalis and coagulase-negative staphylococci were the most predominant bacterial isolates in culture. Most at-risk socio-demographic groups were 16-35 years of age. The results indicate that frequent vaginal douching, past infections, and wrong use of antibiotics are some of the main causes. More educated people seem to be less likely to get sick. The findings recommend a focus on public health education to deter detrimental vaginal hygiene practices and encourage appropriate reproductive care, consequently diminishing the prevalence of vaginal dysbiosis and its related reproductive complications
Downloads
References
[1] L. Abou-Chacra, F. Fenollar, K. Diop, “Bacterial Vaginosis: What Do We Currently Know?” Frontiers in Cellular and Infection Microbiology, vol. 12, 2022. DOI: https://doi.org/10.3389/fcimb.2022.804892. DOI: https://doi.org/10.3389/fcimb.2021.672429
[2] L. Cordiero, S. Tursi, “Bacterial Vaginosis: Pathophysiology, Etiology, Epidemiology. Medscape, 2025.
[3] M. T. France, H. Mendes-Soares, L. J. Forney, “A review of the biology of the vaginal microbiome,” NPJ Biofilms and Microbiomes, vol. 8, pp.1-13, 2022. DOI: https://doi.org/10.1038/s41522-022-00283-8.
[4] E. Kaambo, C. Africa, R. Chambuso, J. Passmore, “Vaginal Microbiomes Associated With Aerobic Vaginitis and Bacterial Vaginosis,” Frontiers in Public Health, vol. 6. 2018. DOI: https://doi.org/10.3389/fpubh.2018.00078. DOI: https://doi.org/10.3389/fpubh.2018.00078
[5] N. Kairys, M. Garg, “Bacterial Vaginosis,” StatPearls Publishing, 2024.
[6] N. Kalia, J. Singh, M. Kaur, “Microbiota in vaginal health and pathogenesis of common vaginal infections,” Annals of Clinical Microbiology and Antimicrobials, vol. 19, no. 1. 2020. DOI: https://doi.org/10.1186/s12941-020-00357-w. DOI: https://doi.org/10.1186/s12941-020-0347-4
[7] M. S. Coudray, P. Madhivanan, “Bacterial vaginosis-A brief synopsis of the literature,” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 245, pp. 143–148. 2020. DOI: https://doi.orgorg/10.1016/j.ejogrb.2019.12.035. DOI: https://doi.org/10.1016/j.ejogrb.2019.12.035
[8] C. A. Muzny, J. R. Schwebke, “Updated Conceptual Model on the Pathogenesis of Bacterial Vaginosis,” Clinical Infectious Diseases, vol. 72, no. 1, pp. 143–150. 2019. DOI: https://doi.org/10.1093/cid/ciz794. DOI: https://doi.org/10.1093/cid/ciz794
[9] Centers for Disease Control and Prevention (CDC ), “Bacterial Vaginosis (BV) Statistics,” 2024. Available:https://www.cdc.gov/std/bv/stats.htm.
[10] H. Qasim, “Effect of chemical factors on the biofilms of bacteria isolated from women with genital diseases,” Master's thesis, College of Science, University of Basrah. 2024.
[11] S. Pal, N. Singh, “The role of probiotics in vaginal health,” Frontiers in Physiology, vol. 13. 2022. DOI: https://doi.org/10.3389/fphys.2022.963872.
[12] D. Paudyal, H. Jo, K. Lee, “Use of probiotic lactobacilli in the treatment of vaginal infections: In vitro and in vivo investigations,” Frontiers in Pharmacology, vol. 15. 2024. DOI: https://doi.org/10.3389/fphar.2024.1359338.
[13] M. I. Petrova, E. Lievens, S. Malik, N. Imholz, S. Lebeer, “Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health,” Frontiers in Physiology, vol. 6. 2015. DOI: https://doi.org/10.3389/fphys.2015.00081. DOI: https://doi.org/10.3389/fphys.2015.00081
[14] J. Sherrard, J. Wilson, G. Donders, W. Mendling, J. S. Jensen, “2018 European (IUSTI/WHO) Guideline on the Management of Vaginal Discharge,” International Journal of STD & AIDS, vol. 29, no. 13, pp. 1258–1272. 2018. DOI: https://doi.org/10.1177/0956462418785451. DOI: https://doi.org/10.1177/0956462418785451
[15] G. Tachedjian, M. Aldunate, C. S. Bradshaw, R. A. Cone, “The role of lactic acid production by probiotic Lactobacillus species in vaginal health,” Research in Microbiology, vol. 168, no. 9–10, pp. 782–792. 2017. DOI: https://doi.org/10.1016/j.resmic.2017.04.001. DOI: https://doi.org/10.1016/j.resmic.2017.04.001
[16] L. Hardy, N. Cerca, V. Jespers, M. Vaneechoutte, T. Crucitti, “Bacterial biofilms in the vagina,” Research in Microbiology, vol. 168, no. 9-10, pp. 865–874. 2017. DOI: https://doi.org/10.1016/j.resmic.2017.01.001. DOI: https://doi.org/10.1016/j.resmic.2017.02.001
[17] A. França, N. Cerca, “The Role of Gardnerella Species in the Pathogenesis of Bacterial Vaginosis,” Pathogens, vol. 13, no. 3, p. 229. 2024. DOI: https://doi.org/10.3390/pathogens13030229. DOI: https://doi.org/10.3390/pathogens13030229
[18] W. S. Al-Asadi, A. Abdul-Wahab, “Bacterial Vaginosis and vaginal pathogens and their relation to preterm birth,” The Medical Journal of Basrah University, vol. 36, no. 2, pp. 115-121. 2018. DOI: https://doi.org/10.33762/mjbu.2018.125091.
[19] L. O. Abdel-Salam, E. A. El-Kholy, M. M. El-Sokkary, “Prevalence of bacterial vaginosis, vulvovaginal candidiasis and trichomoniasis in a cohort of Egyptian women with vaginitis,” Microbiology and Immunology, vol. 66, no. 10, pp. 480–486. 2022. DOI: https://doi.org/10.1111/1348-0421.13014. DOI: https://doi.org/10.1111/1348-0421.13014
[20] V. Badha, F. Gona, N. Gurnani, “A study of the prevalence and antibiotic susceptibility pattern of bacterial isolates from a tertiary care hospital in Central India,” Cureus, vol. 15, no. 9, p. e45942. 2023. DOI: https://doi.org/10.7759/cureus.e45942.
[21] Q. S. Al-Mayah, N. K. Al-Khafaji, “Molecular detection of some virulence genes in Acinetobacter baumannii isolated from various clinical sources in Basrah city, Iraq,” Gene Reports, vol. 26, p. 101490. 2022. DOI: https://doi.org/10.1016/j.genrep.2022.101490.
[22] I. Bunyan, A. K. Gatea, A. K. Hameed, “Molecular detection of bacterial vaginosis and its association with miscarriage in Al-Hillah City,” Annals of Tropical Medicine and Public Health, vol. 23, no. 5, pp. 11–23. 2020. DOI: https://doi.org/10.36295/ASRO.2020.2353. DOI: https://doi.org/10.36295/ASRO.2020.2353
[23] M. Jahic, et al., “Aerobic Vaginitis Caused by Enterococcus Faecalis - Clinical Features and Treatment,” Materia Socio-Médica, vol. 34, no. 4, pp. 291-295. 2022. DOI: https://doi.org/10.5455/msm.2022.34.291-295. DOI: https://doi.org/10.5455/msm.2022.34.291-295
[24] E. Ranjit, B. R. Raghuvanshi, S. Maskey, P. Parajuli, “Prevalence of bacterial vaginosis and its association with risk factors among nonpregnant women: A hospital-based study,” International journal of microbiology, 2018. DOI: https://doi.org/10.1155/2018/8486935. DOI: https://doi.org/10.1155/2018/8349601
[25] E. Tamrat, et al., “The global prevalence of biofilm-forming Enterococcus faecalis in clinical isolates: a systematic review and meta-analysis,” BMC Infectious Diseases, vol. 25, p. 981. 2025. DOI: https://doi.org/10.1186/s12879-024-09199-5. DOI: https://doi.org/10.1186/s12879-025-11399-z
[26] A. Daca, T. Jarzembowski, “From the Friend to the Foe—Enterococcus faecalis Diverse Impact on the Human Immune System,” International Journal of Molecular Sciences, vol. 25, no. 4, p. 2422. 2024. DOI: https://doi.org/10.3390/ijms25042422. DOI: https://doi.org/10.3390/ijms25042422
[27] P. A. Achdiat, et al., “Aerobic vaginitis caused by Streptococcus β-hemolyticus and Staphylococcus epidermidis in a 26-year-old woman,” International Journal of Women's Health, vol. 17, pp. 1437-1444. 2025. DOI: https://doi.org/10.2147/IJWH.S426125. DOI: https://doi.org/10.2147/IJWH.S516616
[28] A. Aklilu, et al., “Aerobic vaginitis, bacterial vaginosis, and vaginal candidiasis among women of reproductive age in Arba Minch, southern Ethiopia,” Scientific Reports, vol. 14, p. 9813. 2024. DOI: https://doi.org/10.1038/s41598-024-60539-5. DOI: https://doi.org/10.1038/s41598-024-58654-y
[29] A. M. Soliman, et al., “Microbiological studies on Escherichia coli and Klebsiella pneumoniae causing vaginal and urinary tract inflammation,” Diagnostic Microbiology and Infectious Disease, vol. 110, p. 116474. 2024. DOI: https://doi.org/10.1016/j.diagmicrobio.2024.116474. DOI: https://doi.org/10.1016/j.micpath.2024.107000
[30] K. Hussein, B. Tesfai, O. Frezgi, H. Hayelom, Y. Gebremeskel, A. Werede, H. Gebremariam, F. Kibreab, M. E. Hamida, “Antimicrobial resistance patterns in patients with vaginal discharge: A 2019-2022 analysis at the National Health Laboratory in Eritrea,” BioMed Research International, 2024, p. 7193490. DOI: https://doi.org/10.1155/2024/7193490. DOI: https://doi.org/10.1155/2024/7193490
[31] F. T. Zahra, M. Khanam, N. Sultana, M. M. Rahman, M. S. Islam, “Overview of menstrual hygiene management and other risk factors associated with bacterial vaginosis among women of reproductive age in Bangladesh,” Discover Public Health, vol. 2, p. 416. 2025. DOI: https://doi.org/10.1186/s12982-025-00416-w. DOI: https://doi.org/10.1186/s12982-025-00416-w
[32] M. K. Hassan, A. G. Al-Dahhan, D. J. Al-Timimi, M. A. Al-Tufaili, A. K. Al-Graitty, A. F. Al-Dahhan, A. M. Al-Abbasi, “Bacterial vaginosis and preterm labour,” The Medical Journal of Basrah University, vol. 23, no. 1, pp. 23-26. 2005. DOI: https://doi.org/10.33762/mjbu.2005.47320. DOI: https://doi.org/10.33762/mjbu.2005.47320
[33] L. Kan, L. Cheng, X. Xu, Y. Liu, S. Wang, Y. Zhao, H. Zhang, “Factors associated with Nugent-bacterial vaginosis in pregnant women: A cross-sectional study in China,” PLOS Global Public Health, vol. 5, no. 1, p. e0004768. 2025. DOI: https://doi.org/10.1371/journal.pgph.0004768. DOI: https://doi.org/10.1371/journal.pgph.0004768
[34] E. E. Chukwu, D. Abuh, I. E. Idigbe, P. Omoregha, C. K. Onwuamah, R. A. Audu, O. C. Ezechi, N. N. Odunukwe, “Prevalence and associated risk factors of bacterial vaginosis among women of reproductive age living with and without HIV in Lagos, Nigeria,” BMC Women's Health, vol. 25, p. 24. 2025. DOI: https://doi.org/10.1186/s12905-025-04024-3. DOI: https://doi.org/10.1186/s12905-025-04024-3
[35] Centers for Disease Control and Prevention, “Bacterial vaginosis - STI treatment guidelines,” 2021. Available:https://www.cdc.gov/std/treatment-guidelines/bv.htm.
[36] S. Wireko, R. O. Kumi, R. K. Gyasi, E. Obeng-Gyasi, W. Agyemang-Duah, “Vaginal douching and health risks among young women: A cross-sectional study in Ghana,” Reproductive Health, vol. 21, p. 25. 2024. DOI: https://doi.org/10.1186/s12978-024-01745-2. DOI: https://doi.org/10.1002/hsr2.1882
[37] N. M. Gilbert, W. G. Lewis, A. L. Lewis, “Social, microbial, and immune factors linking bacterial vaginosis-associated bacteria to women's health,” Nature Reviews Microbiology, vol. 23, no. 2, pp. 89-105. 2025. DOI: https://doi.org/10.1038/s41579-024-01106-3.
[38] N. Sethi, M. Sharma, A. Sharma, G. Singh, A. Kumar, “Prevalence, risk factors, and adverse outcomes of bacterial vaginosis during pregnancy: A systematic review and meta-analysis,” International Journal of Gynecology & Obstetrics, vol. 168, no. 2, pp. 245-258. 2025. DOI: https://doi.org/10.1002/ijgo.15234. DOI: https://doi.org/10.1002/ijgo.15234
[39] P. Zarmakoupi, D. Gialamprinou, E. Alexopoulos, D. Kassanos, “Cracking the code: Investigating the correlation between aerobic vaginitis and preterm labor,” Medicina, vol. 60, no. 4, p. 648. 2024. DOI: https://doi.org/10.3390/medicina60040648. DOI: https://doi.org/10.3390/medicina60040648
[40] R. Zhang, X. Liu, Y. Wang, L. Chen, M. Li, “Probiotics reduce the recurrence of asymptomatic bacterial vaginosis: A systematic review and meta-analysis of randomized controlled trials,” Scientific Reports, vol. 15, p. 92843. 2025. DOI: https://doi.org/10.1038/s41598-025-92843-7. DOI: https://doi.org/10.1038/s41598-025-92843-7
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Basrah Researches Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.





