Abstract
Objectives:
Mixed vaginitis (MV) and the co-occurrence of bacterial vaginosis (BV) and vaginal
Candida
spp. remain insufficiently defined. This study aimed to compare the clinical and microbiological characteristics of women with BV alone and those with concomitant BV and morphologic evidence of
Candida
infection.
Methods:
This cross-sectional study, conducted in accordance with the STROBE guidelines, evaluated women diagnosed using Gram-stained smears and liquid-based cytology: 118 patients with BV alone based on Nugent criteria; and 65 patients with MV (BV based on Nugent criteria and
Candida
species).
Results:
Women in the BV group were more frequently asymptomatic [55.1% (65/118) vs. 26.2% (17/65);
p
=.0001]. Normal colposcopic results were observed more frequently in the BV group [99/118 (83.9%) vs. 17/65 (26.2%);
p
=.0001]. Women in the MV group more commonly reported discharge with itching [21/65 (32.2%) vs. 4/118 (3.4%);
p
=.0001] and exhibited a significantly higher prevalence of colpitis [47/65 (72.3%) vs. 10/118 (8.5%);
p
=.0001).
Megasphaera
type 1 [99/118 (83.9%)],
Mobiluncus
spp. [49/118 (41.5%)], and BV-associated bacteria (BVAB2) [86/118 (72.9%)] were more frequently observed in the BV group (
p
p
Candida albicans
was predominant in the MV group (89%).
Conclusions:
MV was associated with pruritus, vaginal discharge, and colpitis, whereas BV was more often asymptomatic and associated with specific anaerobic bacteria. Both lactobacilli and anaerobes are often present in MV, with
C. albicans
being the most common fungus.