Background
Bacterial vaginosis (BV) is a vaginal disorder characterized by a depletion of the normal lactobacillus-dominant microbiota and overgrowth of mainly anaerobic bacteria.
Objectives
The study aimed to evaluate the distribution and abundance of the
Gardnerella vaginalis
clades and sialidase A gene in vaginal samples from Russian women, and investigate if the
G. vaginalis
sialidase A gene count detects an abnormal vaginal microbiota characteristic of BV more accurately than
G. vaginalis
load.
Methods
Vaginal samples from 299 non-pregnant patients of gynecological clinics were examined using Nugent scores and
G. vaginalis
clade and sialidase A gene quantitative real-time polymerase chain reactions (PCRs). Discriminatory power for BV microbiota was evaluated with receiver operating characteristic (ROC) analysis.
Results
The vaginal microbiota was characterized by Nugent scores as normal, intermediate, and BV microbiota in 162, 58, and 79 women, respectively.
G. vaginalis
clades 1, 2, 3, 4, and the sialidase A gene were detected in 56% (51–62%), 40% (34–45%), 20% (16–25%), 94% (91–96%), and 70% (64–75%) of vaginal samples, respectively. The frequency and abundance of clades 1, 2, 4, and the sialidase A gene as well as clade multiplicity were significantly associated with abnormal microbiota. The sialidase A gene was present in all multi-clade samples, in all single-clade samples comprising clades 1, 2, and 3, and in four of 84 (5% [2–12%]) samples comprising clade 4 only. Total
G.
vaginalis
load showed significantly higher discriminatory power for abnormal microbiota than sialidase A gene count (areas under ROC curves 0.933 vs. 0.881;
p
= 0.0306).
Conclusions
Quantifying all four
G. vaginalis
clades discriminates between BV microbiota and normal microbiota more accurately than measuring
G.
vaginalis
sialidase A gene. Clade 4 is strongly associated with BV microbiota, despite most clade 4 strains lacking the sialidase A gene.