Bacteremia of Gardnerella vaginalis after endometrial ablation

McCool, Randy A.; DeDonato, Donald M.

doi:10.1007/s00404-012-2447-7

Cited by 11 publications

(5 citation statements)

References 9 publications

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“…LaRocca et al (2014) reported that the hCD59-dependent cytolysins VLY and ILY induced programmed necrosis in mature human erythrocytes. Although erythrocytes are not the primary targets, they may come in contact with cytolysins during menses (Santiago Lopes dos Santos et al, 2012;Schwebke et al, 2014b) and in bacteremia (McCool and DeDonato, 2012;Tankovic et al, 2017). Bacterial growth in vitro (including Gardnerella spp.)…”

Section: Interpretations Of the Physiological Roles Of Inerolysin And Vaginolysinmentioning

confidence: 99%

Cholesterol-Dependent Cytolysins Produced by Vaginal Bacteria: Certainties and Controversies

Plečkaitytė

2020

Front. Cell. Infect. Microbiol.

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Bacterial vaginosis (BV) is a vaginal anaerobic dysbiosis that affects women of reproductive age worldwide. BV is microbiologically characterized by the depletion of vaginal lactobacilli and the overgrowth of anaerobic bacterial species. Accumulated evidence suggests that Gardnerella spp. have a pivotal role among BV-associated bacteria in the initiation and development of BV. However, Gardnerella spp. often colonize healthy women. Lactobacillus iners is considered as a prevalent constituent of healthy vaginal microbiota, and is abundant in BV. Gardnerella spp. and L. iners secrete the toxins vaginolysin (VLY) and inerolysin (INY), which have structural and activity features attributed to cholesterol-dependent cytolysins (CDCs). CDCs are produced by many pathogenic bacteria as virulence factors that participate in various stages of disease progression by forming lytic and non-lytic pores in cell membranes or via pore-independent pathways. VLY is expressed in the majority of Gardnerella spp. isolates; less is known about the prevalence of the gene that encodes INY. INY is a classical CDC; membrane cholesterol acts a receptor for INY. VLY uses human CD59 as its receptor, although cholesterol remains indispensable for VLY pore-forming activity. INY-induced damage of artificial membranes is directly dependent on cholesterol concentration in the bilayer, whereas VLY-induced damage occurs with high levels of membrane cholesterol (>40 mol%). VLY primarily forms membrane-embedded complete rings in the synthetic bilayer, whereas INY forms arciform structures with smaller pore sizes. VLY activity is high at elevated pH, which is characteristic of BV, whereas INY activity is high at more acidic pH, which is specific for a healthy vagina. Increased VLY levels in vaginal mucosa in vivo were associated with clinical indicators of BV. However, experimental evidence is lacking for the specific roles of VLY and INY in BV. The interplay between vaginal bacterial species affects the expression of the gene encoding VLY, thereby modulating the virulence of Gardnerella spp. This review discusses the current evidence for VLY and INY cytolysins, including their structures and activities, factors affecting their expression, and their potential impacts on the progression of anaerobic dysbiosis.

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Section: Interpretations Of the Physiological Roles Of Inerolysin And Vaginolysinmentioning

confidence: 99%

Cholesterol-Dependent Cytolysins Produced by Vaginal Bacteria: Certainties and Controversies

Plečkaitytė

2020

Front. Cell. Infect. Microbiol.

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“…Other clinical situations where Gardnerella spp. has been detected was in bloodstream infections in women in the context of vaginal infections (Tankovic et al 2017), pregnancy (Flórez et al 1994), gynecological procedures that may introduce the bacterium in the bloodstream (Agostini et al 2003;McCool and DeDonato 2012), or in immunocompromised patients (Saikali et al 2017). Curiously, there has been one reported case of bacteremia in a newborn, where the mother was diagnosed with endometritis and the transmission of Gardnerella spp.…”

Section: Gardnerella Spp Beyond Bvmentioning

confidence: 99%

Gardnerella and vaginal health: the truth is out there

Roșca

Castro

Sousa

et al. 2019

FEMS Microbiology Reviews

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The human vagina is a dynamic ecosystem in which homeostasis depends on mutually beneficial interactions between the host and their microorganisms. However, the vaginal ecosystem can be thrown off balance by a wide variety of factors. Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age, but its etiology is not yet fully understood, with different controversial theories being raised over the years. What is generally accepted is that BV is often characterized by a shift in the composition of the normal vaginal microbiota, from a Lactobacillus species dominated microbiota to a mixture of anaerobic and facultative anaerobic bacteria. During BV, a polymicrobial biofilm develops in the vaginal microenvironment, being mainly composed of Gardnerella species. The interactions between vaginal microorganisms are thought to play a pivotal role in the shift from health to disease and might also increase the risk of sexually transmitted infections acquisition. Here we review the current knowledge regarding the specific interactions that occur in the vaginal niche and discuss mechanisms by which these interactions might be mediated. Furthermore, we discuss the importance of novel strategies to fight chronic vaginal infections.

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“…One study reported thirty cases of bacteremia caused by G. vaginalis among obstetric patients over a 4-year period and suggests that bacteremia caused by this organism may be significantly underreported [293]. Although cases of G. vaginalis bacteremia are enriched in the gynecologic setting, occurring after birth [294–296] or following procedures such as endometrial ablation [297] or vaginal myomectomy [298], G. vaginalis bloodstream infection is not limited to women [299–304]. Indeed, the evidence suggests that female to male transmission of G. vaginalis can occur during sexual encounters and that regular condom use reduces the likelihood that G. vaginalis can be isolated from male urine [305, 306].…”

Section: Rare Emerging and Under-reported Gram-positive And Polymicmentioning

confidence: 99%

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract

2016

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Gram-positive bacteria are a common cause of urinary tract infection (UTI), particularly among individuals who are elderly, pregnant, or who have other risk factors for UTI. Here we review the epidemiology, virulence mechanisms, and host response to the most frequently isolated Gram-positive uropathogens: Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. We also review several emerging, rare, misclassified, and otherwise underreported Gram-positive pathogens of the urinary tract including Aerococcus, Corynebacterium, Actinobaculum, and Gardnerella. The literature strongly suggests that urologic diseases involving Gram-positive bacteria may be easily overlooked due to limited culture-based assays typically utilized for urine in hospital microbiology laboratories. Some UTIs are polymicrobial in nature, often involving one or more Gram-positive bacteria. We herein review the risk factors and recent evidence for mechanisms of bacterial synergy in experimental models of polymicrobial UTI. Recent experimental data has demonstrated that, despite being cleared quickly from the bladder, some Gram-positive bacteria can impact pathogenic outcomes of co-infecting organisms. When taken together, the available evidence argues that Gram-positive bacteria are important uropathogens in their own right, but that some can be easily overlooked because they are missed by routine diagnostic methods. Finally, a growing body of evidence demonstrates that a surprising variety of fastidious Gram-positive bacteria may either reside in or be regularly exposed to the urinary tract and further suggests that their presence is widespread among women, as well as men. Experimental studies in this area are needed; however, there is a growing appreciation that the composition of bacteria found in the bladder could be a potentially important determinant in urologic disease, including susceptibility to UTI.

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Bacteremia of Gardnerella vaginalis after endometrial ablation

Cited by 11 publications

References 9 publications

Cholesterol-Dependent Cytolysins Produced by Vaginal Bacteria: Certainties and Controversies

Cholesterol-Dependent Cytolysins Produced by Vaginal Bacteria: Certainties and Controversies

Gardnerella and vaginal health: the truth is out there

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract

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