Aerobic Vaginitis Flyer

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Test 182: Aerobic Vaginitis (AV)
Panel by Real-Time PCR

Includes:
Group B Streptococcus (GBS)
Enterococcus faecalis
Escherichia coli
Staphylococcus aureus

•     Up to 20% of patients with Bacterial Vaginosis (BV) will fail to
respond to metronidazole treatment.
•     Aerobic Vaginitis (AV) has overlapping symptoms with BV and
may account for a subset of such patients.
•     The utilization of the AV panel for a differential diagnosis can be
used to prescribe an effective treatment regimen.
•     Published reports indicate an association of AV with PROM and
Preterm delivery.
•     Highly sensitive and specific real-time PCR technology.
•     24 – 48 hour turnaround time.

NEW
Medical Diagnostic Laboratories, L.L.C.
2030 Avon CT. Suite #5, Charlottesville VA, 22902
Dermatopathology | Cytopathology | Oral | Surgical and Clinical Pathology
Routine and Consultative Laboratory Services
Professional
Personalized & Prompt
That’s Our Way!
ProDia Laboratories
Phone: 434-563-7392 – Fax: 888-249-0039 – www.ProDiaLab.com

AV IS NOT BV

A Comparison of Bacterial Vaginosis and Aerobic Vaginitis

Clinical Characteristics Bacterial Vaginosis  Aerobic Vaginitis (1)
Lactobacilli     Displaced     Displaced
Pathogen
Gardnerella vaginalis,    Atopobium vaginae,
Megasphaera species,    BVAB2
Escherichia coli,    Group    B    Streptococcus,
Staphylococcus aureus,    Enterococcus faecalis
Vaginal    epithelial    inflammation     None     Present
Elevation    of    pro-inflammatory    cytokines
(IL-1?,    IL-6,    IL-8)
Moderate    elevation     High    elevation
Immune    reaction    (cytotoxic    leukocyte)     Non-reactive     Reactive
pH                [Normal    =    3.8    –    4.2]
T=    4.2-4.5
BV    >    4.5
>    4.5;    usually    >6
Shed    vaginal    epithelial    cells     Clue    cells     Parabasal    cells
Vaginal    discharge    characteristic     White,    homogenous         Yellowish
10%    KOH    Whiff    Test    (fishy    amine    odor)     Positive     Negative
Treatment
Metronidazole
b
Clindamycin
b
Kanamycin    ovule.    (1)
2%    clindamycin    topical.    (2)
Fluoroquinolones    are    reported    to    have    clinical
success.    (1)
GBS    is    uniformly    sensitive    to    penicillin,    ampicillin,
amoxicillin,    amoxicillin/    clavulanic    acid.    (3)
E. faecalis    is    traditionally    treated    with    ampicillin.    (4)

 

Fluoroquinolones,    such    as    ciprofloxacin,    ofloxacin,    and    levofloxacin,    are    contraindicated    in    pregnant    women.
Levofloxacin    has    improved    efficacy    against    Streptococci    compared    to    ciprofloxacin.    T=    Transitional.

 

References:

1.     Larsson PG. 1992.    Treatment    of    bacterial    vaginosis.    Int J STD AIDS 3:    239-247.
2.     Sobel JD, Reichman O, Misra D, Yoo W.    2011.    Prognosis    and    Treatment    of    Desquamative    Inflammatory    Vaginitis.    Obstet Gynecol 117:    850-855.
3.     Tempera, G, Bonfiglio G, Comparata E, Corsello S, Cianci A. 2004.    Microbiological/clinical    characteristics    and    validation    of    topical    therapy    with    kanamycin    in    aerobic    vaginitis:    a    pilot    study.    Int J
Antimicrob Agents 24:    85-88.
4.     Tempera G, Furneri PM. 2010.    Management    of    Aerobic    Vaginitis.    Gynecol Obstet Invest 70:    244-249.

Medical Diagnostic Laboratories, L.L.C.
2030 Avon CT. Suite #5, Charlottesville VA, 22902
Dermatopathology | Cytopathology | Oral | Surgical and Clinical Pathology
Routine and Consultative Laboratory Services
Professional
Personalized & Prompt
That’s Our Way!
ProDia Laboratories
Phone: 434-563-7392 – Fax: 888-249-0039 – www.ProDiaLab.com