Bacterial Vaginosis Is not a Simple Ecological Disorder

Fredricsson, B.; Englund, Katarina; Weintraub, Leon; Ölund, Anders; Nord, Carl‐Erik

doi:10.1097/00006254-199004000-00020

Cited by 6 publications

(16 citation statements)

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“…5,1992 To appreciate the significance of G. vaginalis in bacterial vaginosis, it is necessary to consider the character of vaginal fluids and their bacterial populations. The (70,88,127,137,159,199). These bacteria constitute the endogenous (88,140) (88,159).…”

Section: Significance Of G Vaginalis Inmentioning

confidence: 99%

“…The cultural, microscopic, and biochemical findings taken together show that G. vaginalis does not act alone to produce the various clinical features of bacterial vaginosis. There is now widespread agreement that this disease is caused by G. vaginalis in concert with certain nonsporeforming anaerobic bacteria and mycoplasmas (17,26,36,65,70,94,95,116,132,167,202,206,216,219). Additional support for this conclusion was obtained in a study of the grivet monkey as a model for bacterial vaginosis.…”

Section: Significance Of G Vaginalis Inmentioning

confidence: 99%

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Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis," a common disease of women which is now called bacterial vaginosis. The organism was named G. vaginalis when taxonomic studies showed that it was unrelated to bacteria in various genera including Haemophilus and Corynebacterium. Electron microscopy and chemical analyses have elucidated the organism's gram-variable reaction. Controversy over the etiology of bacterial vaginosis was largely resolved by (i) studies using improved media and methods for the isolation and identification of bacteria in vaginal fluids and (ii) standardization of criteria for clinical and laboratory diagnosis. Besides G. vaginalis, Mobiluncus spp., Mycoplasma hominis, and certain obligate anaerobes are now acknowledged as participants in bacterial vaginosis. The finding that G. vaginalis, Mobiluncus spp., and M. hominis inhabit the rectum indicates a potential source of autoinfection in addition to sexual transmission. Extravaginal infections with G. vaginalis are increasingly recognized, especially when the toxic anticoagulant polyanetholesulfonate is omitted from blood cultures and when urine cultures are incubated anaerobically for 48 h. The finding that mares harbor G. vaginalis suggests that an equine model can be developed for studies of Gardnerella pathogenesis.

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Section: Significance Of G Vaginalis Inmentioning

confidence: 99%

Section: Significance Of G Vaginalis Inmentioning

confidence: 99%

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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“…This is to some extent remarkable although not clinically acceptable, par ticularly since metronidazole has given cure rates of about 80% in our hands employing identical criteria [3][4][5][6]. Of course, the present study was not designed to define treat ment efficacy with this drug, but it may be of interest that in a previous study [3] treatment with three different vagi nal preparations other than metronidazole cured only 5 out of 43 patients. Since this is less than was obtained with ciprofloxacin, some benefit from the drug cannot be excluded.…”

Section: Discussionmentioning

confidence: 68%

“…Garclnerella vaginalis was first [1] and Mobiluncus last [2] suggested as the microorgan ism more or less specifically causing BV. Also, the possi bility that BV is an expression of an ecological distur bance has been suggested [3].…”

Section: Introductionmentioning

confidence: 99%

“…The reason for the lacto bacilli to loose their predominance could be a disorder of their own or a disorder of the vaginal epithelial cells, which by improper hormonal stimulation or otherwise may loose proper attachment sites. With this in mind we tried to change the environmental conditions of the va gina in BV patients by introducing lactobacilli or estro gens or by lowering the intravaginal pH, but all these mea sures were inadequate [3], Now, the possibility remains to be tested that aerobic, probably nonpathogenic, microorganisms, capable to at tach to the same sites as lactobacilli, could competitively suppress the lactobacilli. This might then result in more favorable conditions for the growth of various anaerobic bacteria, thus secondarily resulting in the picture of BV.…”

Section: Introductionmentioning

confidence: 99%

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Could Bacterial Vaginosis Be Due to the Competitive Suppression of Lactobacilli by Aerobic Microorganisms?

Fredricsson¹,

Englund²,

Nord³

et al. 1992

Gynecol Obstet Invest

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Bacterial vaginosis (BV) is characterized by lack of lactobacilli and predominance of anaerobic species. Ciprofloxacin is active against a great number of aerobic bacteria. The effect of ciprofloxacin on the vaginal microbial flora was studied both in healthy subjects and in patients with BV in order to test if BV may be due to competitive suppression of lactobacilli by aerobic species. About half of the patients were relieved of their symptoms. No adverse effects on the microbial profile or colonization by lactobacilli were produced by the drug. Lactobacilli known to be able to produce hydrogen peroxide were found to be significantly more common in healthy women than in women with BV. The species most frequently related to vaginal health were Lactobacillus jensenii and Lactobacillus rogosae.

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Vaginal microbiological flora and sexually transmitted diseases in women with recurrent or current vulvovaginal candidiasis

et al. 1995

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A history of recurrent vulvovaginal candidiasis (RVVC) was reported by 102 women, while current vulvovaginal candidiasis (VVC) was diagnosed in 83 of the same 996 women. They had all attended two family planning and one youth clinic, respectively. Two women, without RVVC or VVC, matched for age for each case of RVVC, were selected as a comparison group (COMP). Recurrent, but not current VVC, was associated with a history of sexually transmitted disease. Those with current, but not with recurrent, VVC had significantly more often genital warts and bacteriuria (> 10(5) bacteria/ml), but significantly less often bacterial vaginosis than the COMP women. Both VVC and RVVC were inversely correlated to a vaginal flora change with a mixed anaerobic vaginal flora. Those with VVC had a greater number of lactobacilli on vaginal cultures, than those with RVVC and the women in the COMP group. VVC and a history of RVVC both occurred more frequently in women with a lactobacilli-predominated vaginal flora, as compared with those with a flora change with a mixture of anaerobic and facultative anaerobic bacteria.

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Bacterial Vaginosis Is not a Simple Ecological Disorder

Cited by 6 publications

References 0 publications

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Could Bacterial Vaginosis Be Due to the Competitive Suppression of Lactobacilli by Aerobic Microorganisms?

Vaginal microbiological flora and sexually transmitted diseases in women with recurrent or current vulvovaginal candidiasis

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