Definitions of infectious and infectious-like conditions in the lower genital tract of the female.

A large number of factors regulate the composition and dynamics of the microbial ecosystems in the lower female genito-urinary tract. Metabolic activities of certain species of e.g. the vaginal microbial community might give rise to symptomatic infectious-like conditions without activation of the host's defense mechanisms. On the other hand, "true" infections might pass without any obvious symptoms. Similar to other mucosal surfaces, the microbial ecosystems on the periurethral, introital, vaginal and urethral mucosa is dominated by anaerobic bacteria. Some of the infectious-like conditions in the lower female genito-urinary tract involve predominantly anaerobic bacteria of the endogenous flora. A "dynamic" thinking including considerations of microbial and host/parasite interactions is currently replacing the concept of "one microorganism-one disease". The traditionally used clinical terminology has not kept pace with the modern ecological views. We have emphasize the need for unequivocal and strictly defined criteria for the clinical definitions of infectious and infectious-like conditions in the lower female genito-urinary tract.