Search Results (730)

Background: Streptococcus agalactiae (group B Streptococcus, GBS) remains a leading cause of invasive infections in pregnant women, fetuses, and neonates. Universal screening at 36–37 weeks of gestation and intrapartum antimicrobial prophylaxis are essential to prevent adverse outcomes. This study aimed to determine the prevalence, serotype distribution, and antimicrobial susceptibility of GBS isolates among pregnant women in Greece. Methods: Vaginal and rectal swabs were collected from pregnant women undergoing GBS screening between January 2021 and December 2025. Samples were processed using Todd-Hewitt broth with colistin and nalidixic acid, and cultured on blood agar and chromogenic media. The VITEK2 system was used for GBS identification and antimicrobial susceptibility testing against penicillin, erythromycin, clindamycin, tetracycline, levofloxacin, and vancomycin, according to EUCAST guidelines. The double-disk diffusion test was used for macrolide-lincosamide-streptogramin B (MLS_B) phenotyping. Serotyping for all ten serotypes was conducted using a commercial latex agglutination assay. Results: Among 941 women screened, 118 (12.5%) were colonized with GBS. The most prevalent serotypes were III (29.7%), V (18.6%), Ib (14.4%), IX (10.2%), Ia (9.3%), and II (9.3%). All isolates were susceptible to penicillin. Resistance to erythromycin and/or clindamycin was detected in 37 isolates. In these isolates, the predominant MLS_B phenotype was constitutive (cMLS_B, 78.4%), followed by inducible (iMLS_B, 13.5%), L (5.4%), and M (2.7%) phenotypes. Conclusions: GBS colonization was detected in 12.5% of pregnant women, with serotype III predominating, underscoring its clinical relevance due to its association with invasive neonatal disease. Although penicillin remains fully effective, the observed resistance to macrolides and lincosamides, primarily mediated by the cMLS_B phenotype, raises concerns regarding alternative therapies. Full article

Background/Objectives: Human papillomavirus (HPV) is the leading cause of cervical cancer and anogenital malignancies, yet its clinical presentation, genotype distribution, co-infection patterns, and viral load are poorly characterised in tertiary-care referrals. This study aimed to identify predictors of HPV positivity and describe genotype, co-infection, and relative viral copy number (Cq values) in this setting. Methods: A retrospective case–control study of 234 patients (97 HPV-positive, 137 HPV-negative) used a 37-genotype qPCR platform at a tertiary-care hospital between January-December 2025. Demographic data, clinical diagnosis categories, genotype profiles, co-infection patterns, and cycle quantification (Cq) values were recorded, and multivariable logistic regression identified independent predictors of HPV positivity. Results: HPV positivity was 41.5% (97/234). Only the clinical diagnosis category independently predicted HPV status. Compared with non-specific presentations, patients with anogenital or viral warts (aOR: 4.25; 95% CI: 1.49–12.14; p = 0.007) and vaginal or vulvar inflammation (aOR: 2.08; 95% CI: 1.19–3.63; p = 0.010) had higher odds of positivity. High-risk genotypes were the second most frequently detected category (40.00% of detections), after low-risk genotypes (48.21%), with HPV-16 leading among high-risk types. Co-infection occurred in 44.3% of HPV-positive patients, mostly involving mixed-risk genotypes. Patients with anogenital warts had lower Cq values than those with urinary tract complaints (p = 0.011), reflecting higher relative viral copy numbers per swab. Conclusions: HPV positivity and relative viral copy number (as approximated by Cq values) tracked more closely with clinical presentation than with demographic background. The dominance of low-risk and high-risk genotypes and the prevalence of mixed-risk co-infections were consistent with the symptomatic profile of the cohort. These findings support interpreting HPV results in light of clinical presentation and extended genotyping with relative viral copy number quantification in tertiary settings. Full article

Background: Vulvovaginal candidiasis, bacterial vaginosis, and mixed vaginal infection are among the most common infectious conditions encountered in gynecological practice. Although intravaginal dequalinium chloride exhibits broad antimicrobial activity, real-world longitudinal data describing treatment-associated clinical and microscopic changes remain limited, particularly in Latin American populations. Objective: We aimed to characterize the short-term longitudinal evolution of clinical manifestations, vaginal pH, and fresh wet-mount microscopic findings in women with vulvovaginal candidiasis, bacterial vaginosis, and mixed vaginal infection treated with intravaginal dequalinium chloride during routine outpatient gynecological care. Methods: This retrospective longitudinal study included non-pregnant women with vulvovaginal candidiasis, bacterial vaginosis, or mixed vaginal infection who received intravaginal dequalinium chloride as the sole anti-infective therapy. Patients were evaluated at baseline, treatment completion (Day 7), and post-treatment follow-up (Day 14). Longitudinal assessment included patient-reported symptoms, physician-assessed clinical findings, vaginal pH, and fresh wet-mount microscopic examination. To ensure consistent evaluation across study visits, predefined protocol-based standardized assessment criteria were applied uniformly to all patients. Repeated-measures non-parametric analyses were performed to compare longitudinal changes over time. Results: Sixty-nine women were included, comprising those with vulvovaginal candidiasis (n = 24), bacterial vaginosis (n = 31), and mixed vaginal infection (n = 14). Significant longitudinal improvement was observed in clinical manifestations, vaginal pH, and fresh microscopic findings across all diagnostic groups (all p < 0.0001). Median composite assessment scores decreased from 8 (IQR 6–10) at baseline to 3 (IQR 1–5) at treatment completion and to 1 (IQR 0–3) at post-treatment follow-up. Improvements in vaginal pH were accompanied by reductions in inflammatory and infection-associated microscopic findings and by increased predominance of Döderlein bacilli during follow-up. Intravaginal dequalinium chloride was generally well tolerated, with only mild transient adverse events documented. Conclusions: In this retrospective longitudinal study, intravaginal dequalinium chloride treatment was associated with short-term changes in clinical manifestations, vaginal pH, and fresh microscopic findings among women with vulvovaginal candidiasis, bacterial vaginosis, and mixed vaginal infection. These findings describe short-term treatment-associated changes observed in routine clinical practice but do not establish comparative efficacy, causality, or microbiological cure. Prospective controlled studies incorporating standardized microbiological endpoints and longer follow-up are warranted to confirm these observations. Full article

The cervicovaginal microflora plays a vital role in maintaining vaginal health, and disturbances can predispose women to opportunistic infections and sexually transmitted infections (STIs). This study examined the prevalence and associated factors of Candida species, bacterial vaginosis (BV), and their co-occurrence among women in the Eastern Cape province of South Africa. A cross-sectional design was employed, enrolling 325 women aged 18–60 years from a health facility in the Eastern Cape, South Africa. Candida species were identified in cervical specimens using a Seegene Allplex™ Candidiasis Assay. BV status and BV-associated bacteria were identified via Seegene Allplex™ Bacterial Vaginosis Plus assays. Overall, 64.51% of participants were HIV-positive, 15.74% tested positive for Candida species, 52.85% tested positive for BV, and 7.10% were positive for BV–Candida species co-occurrence. The highest prevalence of Candida species (23.60%; R² = 0.913; p = 0.015), BV (85.39%; R² = 0.931; p = 0.003), and Candida–BV co-occurrence (7.10%; R² = 0.903, p = 0.041) was observed in the 18–29 age group and declined significantly with age. Women with four to six lifetime sexual partners had higher odds of testing positive for Candida species (AOR: 2.42, 95% CI: 1.21–4.82, p = 0.012). Currently presenting with STI symptoms (AOR: 4.66; 95% CI: 1.29–16.87; p = 0.019), increased (four to six) lifetime sexual partners (AOR: 5.58; 95% CI: 1.16–26.82; p = 0.032), and being HPV-positive (AOR: 7.28; 95% CI: 1.17–45.26; p = 0.033) were independent predictors of Candida–BV co-occurrences. In this current study, having multiple lifetime sexual partners was independently associated with Candida species positivity, while current STI symptoms, HPV infection, and having four to six lifetime sexual partners significantly increased the likelihood of Candida–BV co-occurrence, highlighting the role of sexual behaviour in the vaginal microbial profile. This underscores the need for continued surveillance and longitudinal investigation. Longitudinal studies to further investigate these associations are warranted. Full article

Background/Objectives: Recurrent urinary tract infection (rUTI) is common after menopause, but estrogen deficiency alone does not explain variation in recurrence, symptoms, and microbial profiles. This study aimed to synthesize evidence on the interactions among estrogen deficiency, urogenital microbial ecology, diabetes, obesity, microbial reservoirs, and anatomical, neurological, and functional modifiers of postmenopausal rUTI susceptibility. Methods: PubMed and Scopus were searched for original studies published from 1 January 2021 to 15 June 2026. A structured narrative synthesis included 62 original reports comprising clinical interventions, observational cohorts, microbiome and multi-omic studies, and cellular and animal experiments. Evidence was interpreted according to study design, population relevance, and biological directness. Results: Menopause was associated with reduced Lactobacillus dominance, higher vaginal pH, and altered vaginal or urinary communities, although findings were heterogeneous. Vaginal estrogen reduced recurrence and improved the local urogenital environment, but microbiome restoration is not established as its sole mechanism. Gut, rectal, vaginal, urinary, and bladder-wall reservoirs may contribute to persistence or repeated exposure. Diabetes was linked to dysbiosis and impaired urothelial defence, whereas obesity evidence remained less direct. Pelvic organ prolapse with incomplete emptying, elevated postvoid residual urine, age-related detrusor dysfunction, stroke, immobility, functional dependence, incontinence, and catheter exposure may further modify susceptibility. Conclusions: Postmenopausal rUTI is multifactorial. The urogenital microbiome–metabolic interface is a useful integrative framework, but not a validated causal or diagnostic model. Vaginal estrogen, urine culture, metabolic and bladder-function assessment, and antimicrobial stewardship remain the clinical foundation; microbiome-directed strategies require prospective validation. Full article

Gynecological malignancies and breast cancer impose substantial health and economic burdens. This review examines how local and systemic microbiota may affect epithelial integrity, inflammation, estrogen metabolism, and immunity. The vaginal ecosystem is the most extensively studied female microbial niche. Cervical cancer serves as the most illustrative clinical example: loss of stable Lactobacillus crispatus dominance and increased prevalence of anaerobic bacteria (anaerobic dysbiosis) are associated with persistent HPV infection, which directly elevates the risk of cervical precancerous lesions. The estrobolome is particularly relevant in endometrial cancer, where intestinal bacterial beta-glucuronidase activity may increase estrogen reabsorption, particularly in obesity and metabolic disease. In ovarian cancer, microbiota is being studied as a possible risk modifier in BRCA1 carriers, but the evidence remains exploratory. In breast cancer, intratumoral bacteria may shape the immune microenvironment, particularly in triple-negative disease. The primary limitation of current research is methodological heterogeneity. Low-biomass samples, such as those from the ovary or endometrium, are highly susceptible to technical contamination. Most studies are cross-sectional and cannot establish causality. Current evidence supports microbiota as a modifier, not a standalone marker or a substitute for standard diagnosis and treatment. Its most plausible near-term role is in multiparameter risk or response models, pending standardized prospective validation. Full article

Background: Human papillomavirus (HPV) has traditionally been considered a sexually transmitted infection, yet accumulating evidence demonstrates that HPV can be acquired through multiple non-sexual routes. Understanding these alternative transmission pathways is critical for interpreting HPV detection in non-sexually active populations and for refining public health strategies. Methods: This review synthesizes current evidence on non-sexual HPV transmission routes, including vertical (transplacental, intrapartum), perinatal oropharyngeal colonization, fomite contamination, breast milk transmission, and horizontal non-sexual contact. We examine HPV prevalence data from female virgins, neonates, infants, and children, and evaluate metagenomic evidence positioning HPV as a component of the human virome across multiple body sites. Results: Published studies report that vertical transmission occurs in approximately 18.2% of HPV-positive mothers, with neonatal HPV positivity of 3.4% at birth and 100% genotype concordance in transmission pairs. Transplacental transmission has been documented in 10.2% of concordant mother–placenta–newborn triads. Reviewed studies report oropharyngeal colonization at birth reaching 58.2% following vaginal delivery, with 94.3% of colonized neonates clearing infection by 24 months. HPV DNA has been detected on fomites and medical devices, in breast milk (8.6–15%), and across body sites in healthy adults (skin 61.3%, vagina 41.5%, oral cavity 30%, gut 17.3%). Metagenomic studies identify HPV DNA in 68.9% of healthy individuals, with 109 distinct types detected. Female virgins show HPV prevalence ranging from 0–51.1% across studies. Conclusions: The reviewed evidence suggests that HPV exhibits characteristics of a ubiquitous virome component with multiple non-sexual acquisition routes. These findings have important implications for vaccination strategies, screening interpretation, infection control in healthcare settings, and counseling of pediatric cases and non-sexually active individuals. Full article

Sex- and gender-based immune differences have often been interpreted through a male–female biological binary, overlooking how endocrine signaling dynamically shapes immune function. Gender-affirming hormone therapy (GAHT) offers a unique physiological model to disentangle the effects of sex steroids from chromosomal background and examine immune plasticity in contexts relevant to reproductive health. This hormone-informed framework proposes that estradiol and testosterone regulate immune set-points across innate, adaptive, metabolic, and mucosal compartments. Through genomic and non-genomic signaling via androgen and estrogen receptors (AR, ERα/β), these hormones drive distinct immune outcomes: testosterone dampens type I interferon responses in plasmacytoid dendritic cells and reshapes monocyte inflammatory profiles, while estradiol promotes macrophage polarization and enhances T helper1 (Th1) responses. Hormonal effects are closely coupled to cellular metabolism: androgen signaling acts as a “metabolic brake” on Th17 cells by limiting glutaminolysis, a process reinforced by epigenetic remodeling, and is reflected in shifts in the circulating metabolome, positioning metabolomics as a sensitive tool for monitoring hormone-driven immune adaptation. Regardless, hormones also reshape mucosal barriers and reproductive microbiome composition. GAHT alters vaginal and gut microbial communities and their metabolism, influencing mucosal immunity, local inflammation, and reproductive tract homeostasis, with potential implications for fertility preservation, susceptibility to reproductive tract infections, and long-term genital mucosal health. Collectively, this evidence underscores that human immunity is highly responsive to endocrine context. This review synthesizes evidence linking endocrine trajectories, tissue microenvironments, reproductive biology, and social determinants of health, aiming to advance understanding of immune plasticity and contribute to a more inclusive framework of human immune diversity. Full article

Persistent high-risk human papillomavirus (HPV) infection drives cervical cancer, a leading cause of cancer-related mortality among women in low- and middle-income countries; its clinical course is shaped by the cervicovaginal microbiome, in which Lactobacillus-dominated communities are associated with enhanced viral clearance. Despite this, vaginal probiotic interventions often demonstrate limited colonization efficiency, and autochthonous strain libraries from Central Asia remain absent. We applied a tiered functional screening workflow to a collection of 235 vaginal lactic acid bacterial isolates recovered from 400 women undergoing routine gynecological examination in Astana, Kazakhstan. The workflow sequentially filtered isolates on (i) antimicrobial activity against seven urogenital indicator pathogens using the deferred antagonism assay, (ii) surface adhesion by the Brilis erythrocyte assay, and (iii) biofilm-forming capacity by crystal violet retention and laser-capture-microdissection (LCM) microscopy. Species-level identification of the selected candidate was performed by whole-genome shotgun sequencing followed by Kraken2 taxonomic classification. From 235 isolates, three rounds of phenotypic filtering identified four broad-spectrum antimicrobial candidates (127-3, 127-4, 107-2, 107-4) with non-overlapping inhibitory profiles against seven urogenital indicator strains. Adhesion phenotyping segregated candidates into low- and moderate-adhesion groups, with none reaching the high-adhesion threshold. Among all four candidates, only strain 127-4 produced a reproducible biofilm-associated signal (crystal violet retention OD490 = 0.09 ± 0.07 at 24 h; 0.08 ± 0.03 at 48 h), consistent with early surface attachment under static conditions. Whole-genome shotgun sequencing assigned 97.81% of classified reads to Lactiplantibacillus plantarum, supporting preliminary identification of the selected isolate as L. plantarum strain 127-4. Composite ranking confirmed 127-4 as the only isolate combining broad antimicrobial activity (5/7 indicators), moderate adhesion (specific adhesion index, SPA = 2.95), and a detectable biofilm-associated phenotype. We report the first systematic functional screening of autochthonous cervicovaginal lactic acid bacteria from a Central Asian population and identify L. plantarum 127-4 as a probiotic candidate with an integrated trait profile rarely identified through single-criterion screening approaches. Beyond candidate identification, this work establishes a transferable workflow for assembling functionally annotated vaginal Lactobacillus collections from underrepresented populations, providing a foundation for future population-specific probiotic interventions targeting cervicovaginal health. Full article

Background: High-risk human papillomavirus (HPV) is a leading cause of cervical cancer, particularly in settings with high-risk sexual behaviours and limited preventive care. HPV prevalence peaks in adolescence and early adulthood due to early sexual initiation, multiple partners, inconsistent condom use, anal intercourse, and oral–genital contact. To assess the prevalence and associated risk factors for high-risk HPV infections among female students in Benin City, Nigeria. A faith-based college in Benin City, Nigeria. Methods: A cross-sectional study was conducted among 133 female nursing students. Self-collected genital swabs were analysed using real-time fluorescence quantitative PCR to detect 14 high-risk HPV types. Participants completed a structured questionnaire on sexual behaviour, contraceptive use, and HPV knowledge. Results: The overall high-risk HPV prevalence was 45/133 (33.8%), with 39 (29.3%) presenting multiple infections. HPV66, 58, and 56 were the most common types detected. Significant associations were observed with oral contraceptive use (OR = 3.2, 95% CI = 1.01–9.97) and abnormal vaginal discharge (p = 0.028). Conclusions: The predominance of HPV66, HPV58, and HPV56 highlights the increasing importance of non-vaccine HPV genotypes and shows the need for targeted screening and vaccination. Associations with abnormal vaginal discharge and oral contraceptive use emphasize the importance of sexual health education and routine gynaecological care among young women. This study underscores the need for targeted HPV screening, vaccination, and sexual health education to reduce cervical cancer risk among young women in Nigeria. Full article

Candida albicans (C. albicans) is a commensal of the vaginal mucosa and the main etiological agent of acute and recurrent vulvovaginal candidiasis (VVC/RVVC). Disease severity is thought to depend on a dysregulated host inflammatory response to Candida, not necessarily associated with increased fungal burden and/or morphogenesis. The role of strain-specific differences leading to epithelial immune response or tolerance remains undefined. In this study, we compared the virulence profile of vaginal C. albicans isolates from women with acute VVC/RVVC (VVC/RVVC), asymptomatic colonizer (Colonizing), and VVC/RVVC associated with microbial co-infections (Co-infections). Isolates were evaluated for growth and biofilm formation under standard culture conditions and tested in an in vitro vaginal epithelial cell (VEC) infection model to assess fungal shedding, epithelial damage, and cytokine production. Corresponding vaginal samples were analyzed for C. albicans morphology, polymorphonuclear neutrophil presence, microbiota composition, cytokines levels, and anti-C. albicans IgA production. No significant differences in growth or biofilm formation were observed among isolates under culture conditions. However, VEC infection revealed strain-dependent differences: acute VVC/RVVC and Co-infections isolates induced greater fungal shedding, while VVC/RVVC isolates caused increased epithelial damage and showed a trend toward higher cytokine production. Vaginal samples from symptomatic groups displayed increased neutrophils, hyphal morphology, elevated IL-1α, IL-1β, and anti-Candida IgA, but not IL-1Ra, without differences in lactobacilli abundance or Community-State-Type (CST) distribution. These findings suggest that C. albicans pathogenicity in VVC depends on strain-specific interactions with VEC driving differential host responses. Full article

Background and Objectives: Persistent human papillomavirus (HPV) infection is associated with the development of cervical intraepithelial neoplasia and cervical cancer. In women with low-grade cervical lesions, a conservative management approach is commonly recommended. However, a subset of patients may experience lesion progression, which can also be accompanied by psychological distress. Adjuvant therapies during the surveillance period have gained increasing clinical interest. This consensus aims to provide multidisciplinary, expert-based recommendations on the use of a Coriolus versicolor-based vaginal gel in HPV-positive women with low-grade cervical lesions. Materials and Methods: A rapid systematic review was conducted in accordance with PRISMA guidelines, and the level of evidence was assessed using SIGN criteria. Subsequently, a multidisciplinary panel of experts formulated and evaluated consensus statements and recommendations using the nominal group technique and a voting process. Results: All statements reached consensus, with agreement levels exceeding 80%. Experts concluded that available evidence reports potential benefits of a Coriolus versicolor-based vaginal gel in HPV-positive women with low-grade cervical lesions, since it has demonstrated increased lesion regression and viral clearance rates. These benefits may be more pronounced in specific subgroups, particularly women over 40 years of age. Limited studies also suggest a positive effect on vaginal microbiota, which may contribute to both vaginal health and HPV clearance, as well as a reduction in perceived stress. The experts emphasized the importance of patient education, shared decision-making, and addressing psychosocial aspects, including emotional well-being and sexual health. Conclusions: This consensus provides a multidisciplinary perspective on the management of HPV-positive women with low-grade cervical lesions, highlighting the adjuvant role of a Coriolus versicolor-based vaginal gel during surveillance. Although current evidence suggests potential clinical benefits, further high-quality, independent studies are needed to corroborate these findings. Full article

Background/Objectives: Abnormal vaginal discharge (AVD) is a common complaint among women of reproductive age, often involving multiple, overlapping etiologies, most commonly bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic vaginitis (AV), and sexually transmitted infections (STIs). We aimed to evaluate a syndromic diagnostic approach by developing qPCR-derived dysbiosis indices for BV, VVC, and AV, subsequently comparing their performance against established reference methods and clinician-assigned diagnoses. Methods: Vaginal swabs were collected in a case–control design from 74 symptomatic and 64 asymptomatic women at two clinics in Slovenia. Commercial qPCR assays quantified the microbial species associated with AVD. Relative abundances were integrated into novel dysbiosis indices. Diagnostic performance was validated against the Nugent scoring system (for BV), semiquantitative Candida culture with clinical symptoms (for VVC), and Hay–Ison criteria (for AV). Results: In this internally validated study, dysbiosis indices demonstrated high agreement with their respective reference tests and outperformed clinician-assigned diagnoses across all three conditions. The syndromic approach further revealed that mixed etiologies were frequent, leading to a diagnostic resolution for this patient subset. Conclusions: qPCR-based microbial dysbiosis indices offer a robust alternative to microscopy, particularly in settings where microscopy is not routinely performed. This method improves the accuracy of AVD evaluation and supports more targeted clinical management. Full article

This study describes extracellular vesicles (EVs) isolated from the culture supernatant of a Kluyveromyces marxianus strain deriving from an artisanal sourdough. Previous work had clearly shown the probiotic properties of the yeast isolate and its antagonistic activities against clinical fluconazole-resistant Candida albicans strains. Characterization of the isolated EVs by nanotracking particle analysis showed they had a mean diameter of 157.7 nm. Proteomic characterization of the purified EVs identified a complex array of 100 proteins. Both C. albicans planktonic growth and biofilm formation were inhibited by K. marxianus EVs, as well as adhesion and invasion of Candida cells in the vaginal epithelial A-431 cells. In the same cell model, K. marxianus EVs exerted an immunomodulatory effect affecting the secretion of pro-inflammatory and anti-inflammatory cytokines. Further, the expression of C. albicans SAP2 and SAP6 genes, coding for two aspartyl proteases involved in the invasion and damage of the epithelial mucosa, was affected by the presence of the yeast EVs. Overall, the results of this study show that K. marxianus EVs retain, at least in part, the beneficial features of the live microorganism, representing a postbiotic cell-free alternative preparation potentially useful for the management of C. albicans vaginal infections. Full article

Background: Aerobic vaginitis (AV) is characterized by dysbiotic vaginal microflora with overgrowth of aerobic pathogens of enteric origin, presence of vaginal inflammation and immature epithelial cells. This study aimed to evaluate, over a period of 10 years, women of reproductive age (non-pregnant and pregnant) as well as menopausal women affected by AV. Methods: We included non-pregnant, pregnant and menopausal women diagnosed with AV over a period of 10 years. Diagnosis of AV was determined according to the criteria proposed by Donders in 2002. The isolated pathogens were identified with the rapid identification system I-dOne (Alifax S.r.l, Polverara, Italy) and the automated system VITEK2 (Biomerieux, Marcy l’Etoile, France), which was used for antimicrobial susceptibility testing. Results: The overall aerobic vaginitis prevalence rate during the studied period was 9.5%. The most common isolated pathogens were Escherichia coli 27.3%, Enterococcus faecalis 25.0%, Streptococcus agalactiae 22.2%, Klebsiella pneumoniae 8.9%, Proteus spp 4.7%, and Staphylococcus aureus 3.5%. E. coli infection significantly increased the odds of mild AV by 1.65 times (p = 0.002) and Proteus species infection was over 6 times more likely to progress to severe disease (p < 0.001). Furthermore, pregnant women were more likely to be infected with E. faecalis (p < 0.001) while menopausal women were diagnosed significantly more with severe AV (p < 0.001) compared to the other groups. Conclusions: The prevalence of aerobic vaginitis in the population studied was in concordance with global rates. Menopausal women displayed increased severe AV cases while, in contrast, mild cases were recorded during pregnancy. The most commonly isolated pathogens were of enteric origin. Full article