Abstract: Objective To study the pathogenic characteristics of female vaginal microecology and mixed vaginitis in Xi'an，and to provide a reference for clinical diagnosis and treatment. Methods A total of 20 218 outpatients in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Xi'an Jiao Tong University from January 2021 to May 2022 were enrolled. The bacterial morphology and function of vaginal secretions were determined. The results of vaginal microecological tests of these patients were analyzed. Results The 50.6% females were with vaginal dysbiosis. The main diseases were bacterial vaginitis（BV）（28.3%），vulvovaginal candidiasis（VVC）（20.0%） and aerobic vaginitis（AV）（15.2%）. In the 10 222 vaginal dysbiosis females，61.6% cases were simple vaginitis（6 293 cases），and 38.4% cases were mixed vaginitis（3 929 cases）. The proportions of mixed infection BV+AV，BV+VVC，AV+BV+VVC and AV+BV+trichomonal vaginitis（TV） were 54.98%，16.14%，13.01% and 8.00%，respectively. Vaginitis recurred in 1 119 cases，with simple vaginitis accounting for 47.6%（533 cases） and mixed vaginitis accounting for 52.4%（586 cases）. Conclusions Mixed vaginitis has a high incidence of clinical infection. Using vaginal microecological tests for the identification of vaginal infection may provide a reference for the diagnosis and treatment of refractory vaginal infection.

Key words: Vaginal microecology, Vaginitis, Mixed vaginitis, Recurrent vaginitis