Prevalence of vaginal infections and compliance of empirically prescribed therapy with the results of vaginal swabs in the female population at the level of primary health care

Abstract

Introduction. Vaginal infections are the most common reason for gynecological exams. Due to the absence of national guidelines on screening and treatment, therapy is prescribed empirically. The aim of this study is to determine (1) the prevalence of vaginal infections in community practice setting, (2) infection prevalence across different groups, and (3) appropriateness of empirical therapy. Material and Methods. Results from 1770 vaginal swabs collected between June 2021 and June 2023 were classified into three groups: group 1 - young adult women (? 25 years), group 2 - women of reproductive age (26-45 years), group 3 - peri- and postmenopausal women (?46 years). The study analyzed the population prevalence of vaginal infections, including bacterial vaginosis, vulvovaginal candidiasis, and pathogenic bacterial groups, as well as the appropriateness of the prescribed empirical therapy. Results. The prevalence of vaginal infection was 41.07%, with 24.07% of the population exhibiting symptomatic infections, and the remaining 17% having positive swab results subsequently. The population prevalence of bacterial vaginosis, vulvovaginal candidiasis, and pathogenic bacteria was 41.95%, 35.62% and 22.42%, respectively. The highest prevalence was observed in group 1, followed by group 3, and the lowest in group 2 (51.02%, 42.6%, 38.7%, respectively, p=0.175). The prevalence of bacterial vaginosis and vulvovaginal candidiasis in group 1 was 54.95%/45.04%, in group 2 was 53%/46.93%, and in group 3 was 57.69%/42.3% (p=0.028). Pathogenic bacteria isolation was highest in group 3 (49.4%) and lowest in group 1 (21.79%). Correction of empirical therapy was required in 36.55% of symptomatic women. Conclusion. Bacterial vaginosis and vulvovaginal candidiasis exhibit similar prevalence rates in groups 1 and 2, while pathogenic bacteria infections are most common group 3. When choosing therapy, it is important to consider patient age in relation to other predisposing factors associated with vaginal infections.