Factors associated with absence of H2O2-producing Lactobacillus among women with bacterial vaginosis

Background. Women with bacterial vaginosis have different microbiological profiles. Our objective was to identify risk factors for an absence of H2O2-producing lactobacilli among women with bacterial vaginosis. Methods. We performed a retrospective analysis of 947 women with bacterial vaginosis who were enrolled in prospective studies investigating vaginal colonization and genital-tract infections. Results. Women were categorized into 2 groups: those with H2O2-producing lactobacilli present (n = 191; 20.2%) and those with H2O2-producing lactobacilli absent (n = 756; 79.8%). Multivariate logistic regression demonstrated that douching greater than or equal to2 times during the past month ( odds ratio [OR], 2.5; 95% confidence interval [CI], 1.1 - 6.0) and having greater than or equal to3 sex partners during the past year (OR, 4.5; 95% CI, 1.8 - 11.7) were predictive of an absence of H2O2-producing lactobacilli. Conclusion. Among women with bacterial vaginosis, H2O2-producing lactobacillus colonization is influenced by sexual activity and douching habits. These findings may have important implications for response to treatment, relapse rate, and risk for sexually-transmitted-disease acquisition among women with bacterial vaginosis.