Vaginal flora changes associated with Mycoplasma hominis

Objective: The aim of this study was to investigate any association between vaginal carriage of Mycoplasma hominis and genital signs and symptoms, other microbial findings, and some risk behavior factors in women with and without bacterial vaginosis. Study Design: Women who had attended two family planning clinics and a youth clinic for contraceptive advice were divided depending on the result of vaginal culture for Mycoplasma hominis and the occurrence of bacterial vaginosis. The study population included 123 (12.3%) women who harbored Mycoplasma hominis. Those 873 (87.7%) with a negative culture for Mycoplasma hominis served as a comparison group. In the former group, 50 (40.7%) had bacterial vaginosis, which was also the case in 81 (9.3%) of the women in the comparison group. The groups were compared with regard to genital signs and symptoms, results of vaginal wet smear microscopy and other office tests, vaginal flora changes as detected by culture, and other means and detection of sexually transmitted diseases. Any history of sexually transmitted diseases and other genital infections, reproductive history, use of oral contraceptives, and smoking habits were registered. Results: Women who harbored Mycoplasma hominis had significantly more often complained of a fishy odor, had a positive amine test, a vaginal pH>4.7, and clue cells than did the comparison group; all these statements were true before and after bacterial vaginosis had been excluded. Vaginal discharge was not significantly more often complained of, and a pathologic discharge was not more often detected in the Mycoplasma hominis carriers. Ureaplasma urealyticum occurred in 75% of the Mycoplasma hominis-positive women and in 59% of the comparison group (p=0.001). The leukocyte/epithelial cell ratio did not differ significantly from that of the Mycoplasma hominis culture-negative controls. Conclusion: The study suggests that Mycoplasma hominis is associated with a number of genital signs and symptoms even after exclusion of bacterial vaginosis.