The making of a nurse entrepreneur

BACKGROUND: The aim of the present study was to evaluate the prevalence of bacterial vaginosis (BV) and correlate it with the data from the patient history and clinical manifestations in women attending an STD clinic and to compare two methods of diagnosis. MATERIAL AND METHODS: On hundred and fifty-six women, aged 15 to 45, attending the STD clinic of the Higher Medical Institute in Plovdiv, Bulgaria were enrolled in the study. All women were evaluated for the presence of BV using standard criteria and Gram stain of vaginal secretions. Symptoms, clinical manifestations, methods of contraception and sexual life and smoking were analyzed. RESULTS: Using clinical criteria and Gram's stain, BV was diagnosed in 59 women (37.8%). BV was associated with age younger than 25 years, risk sexual behaviour, e.g. lack of a permanent sexual partner during the preceding 6 months, use of an intrauterine device, other STDs and smoking. Symptoms are not a reliable way of diagnosing BV, but the presence of a homogeneous vaginal discharge on examination, a positive amine test and pH > or = 4.7 are common in BV. A negative correlation was found between the number of lactobacilli and BV. CONCLUSIONS: BV is common in women attending STD clinic and is associated with other STDs, e.g. infection with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, human papilloma virus. The Gram stain method is inexpensive and easy to perform for the laboratory diagnosis of BV; it can be used reliably as an indicator of the changes preceding BV.