New Etiologic Agent in Nonspecific Bacterial Vaginitis

Gardner, Herman L.; Dukes, Charles D.

doi:10.1126/science.120.3125.853

Cited by 68 publications

(25 citation statements)

References 3 publications

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“…In 1954, Gardner and Dukes first claimed that Gardnerella vaginalis (called Haemophilus vaginalis at the time) was the main etiological agent in nonspecific vaginitis, now known as BV (11). A follow-up report by those investigators in 1955 suggested that a pure culture of G. vaginalis inoculated into the human vagina could produce BV (4, 7, 10).…”

Section: Discussionmentioning

confidence: 99%

Changes in Vaginal Bacterial Concentrations with Intravaginal Metronidazole Therapy for Bacterial Vaginosis as Assessed by Quantitative PCR

et al. 2009

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Several fastidious bacteria have been associated with bacterial vaginosis (BV) using broad-range bacterial PCR methods such as consensus sequence 16S rRNA gene PCR, but their role in BV remains poorly defined. We describe changes in vaginal bacterial concentrations following metronidazole therapy for BV. Vaginal swabs were collected from women with BV diagnosed using Amsel clinical criteria, and vaginal fluid was assessed by Gram stain to generate Nugent scores. Follow-up swabs were collected 1 month after a 5-day course of vaginal 0.75% metronidazole gel and analyzed for 24 subjects with cured BV and 24 subjects with persistent BV. Changes in bacterial concentrations were measured using eight bacterium-specific 16S rRNA gene quantitative PCR assays. DNA from several fastidious BV-associated bacteria (BVAB) were present at high concentrations in the vagina prior to treatment. Successful antibiotic therapy resulted in 3-to 4-log reductions in median bacterial loads of BVAB1 (P ‫؍‬ 0.02), BVAB2 (P ‫؍‬ 0.0004), BVAB3 (P ‫؍‬ 0.03), a Megasphaera-like bacterium (P < 0.0001), Atopobium species (P < 0.0001), Leptotrichia/Sneathia species (P ‫؍‬ 0.0002), and Gardnerella vaginalis (P < 0.0001). Median posttreatment bacterial levels did not change significantly in subjects with persistent BV except for a decline in levels of BVAB3. The presence or absence of BV is reflected by vaginal concentrations of BV-associated bacteria such as BVAB1, BVAB2, Leptotrichia/Sneathia species, Atopobium species, Gardnerella vaginalis, and a Megasphaera-like bacterium, suggesting that these bacteria play an important role in BV pathogenesis and may be suitable markers of disease and treatment response.Bacterial vaginosis (BV) is a very common condition, affecting 10 to 37% of women (24), with particularly high prevalences reported in areas of sub-Saharan Africa (3, 25) and among African-American women (51%) (15). BV is the most common cause of vaginitis and vaginal discharge and has been linked to several adverse health outcomes including preterm labor, pelvic inflammatory disease, and human immunodeficiency virus acquisition (12,18,19).Women with BV experience a loss of vaginal Lactobacillus species that produce hydrogen peroxide (primarily Lactobacillus crispatus) and the acquisition of several facultative or anaerobic bacteria, but no single cultivated bacterium has been conclusively demonstrated to cause BV. The profound shifts in vaginal microbiota that characterize BV and the clinical response to antibiotics such as metronidazole or clindamycin suggest that anaerobic bacteria play a key role. The recent use of cultivation-independent methods (e.g., broad-range 16S rRNA gene PCR) to characterize the vaginal microbiota (5, 26) has identified novel fastidious bacteria that appear to be highly associated with BV, including three bacteria of the order Clostridiales that are not closely related to any previously identified bacteria and that we have designated BV-associated bacterium 1 (BVAB1), BVAB2, and BVAB3 (6). Other fastidious bacteri...

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Section: Discussionmentioning

confidence: 99%

Changes in Vaginal Bacterial Concentrations with Intravaginal Metronidazole Therapy for Bacterial Vaginosis as Assessed by Quantitative PCR

et al. 2009

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“…A year later, it was associated with nonspecific bacterial vaginitis by Gardner and Dukes and named Haemophilus vaginalis (51). It was later classified in the genus Corynebacterium based on metabolic requirements and Gram stain reactions.…”

Section: Gardnerella Vaginalismentioning

confidence: 99%

The Human Microbiome during Bacterial Vaginosis

2016

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SUMMARYBacterial vaginosis (BV) is the most commonly reported microbiological syndrome among women of childbearing age. BV is characterized by a shift in the vaginal flora from the dominantLactobacillusto a polymicrobial flora. BV has been associated with a wide array of health issues, including preterm births, pelvic inflammatory disease, increased susceptibility to HIV infection, and other chronic health problems. A number of potential microbial pathogens, singly and in combinations, have been implicated in the disease process. The list of possible agents continues to expand and includes members of a number of genera, includingGardnerella,Atopobium,Prevotella,Peptostreptococcus,Mobiluncus,Sneathia,Leptotrichia,Mycoplasma, and BV-associated bacterium 1 (BVAB1) to BVAB3. Efforts to characterize BV using epidemiological, microscopic, microbiological culture, and sequenced-based methods have all failed to reveal an etiology that can be consistently documented in all women with BV. A careful analysis of the available data suggests that what we term BV is, in fact, a set of common clinical signs and symptoms that can be provoked by a plethora of bacterial species with proinflammatory characteristics, coupled to an immune response driven by variability in host immune function.

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“…Several investigators (Leopold, 1953;Gardner & Dukes, 1954, 1955Gardner, Dampeer & Dukes, 1957;Amies & Jones, 1957;Brewer, Halpern & Thomas, 1957;Edmunds, 1960a;Lapage, 1961; and others) have reported finding a small Gramnegative bacillus in the human female and male genito-urinary tract. These investigators used various media for the isolation and cultivation of this organism, named Haemophilus vaginalis by Gardner & Dukes (1955).…”

Section: Introductionmentioning

confidence: 99%

Cultural and Serological Studies on Haemophilus vaginalis

Redmond¹,

Kotcher²

1963

Journal of General Microbiology

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SUMMARYWhen several strains of Haemophilus vaginalis were grown on Casman rabbit blood agar, individual morphological and cultural differences were noted between the Amies strains which formed pleomorphic and filamentous organisms and large, umbonate colonies, and the Dukes, Edmunds, King and U/L strains which were microscopically coccobacillary to bacillary, non-filamentous, and formed minute convex smooth colonies. Dukes, Edmunds, King and U/L strains required whole blood for maintenance while a whole blood derivative, e.g. peptic digest or Difco chocolate-yeastolate agar, was sufficient for the maintenance of the Amies strains. Serological studies by tube agglutination, direct, indirect and inhibition immunofluorescent methods showed that Dukes, Edmunds, King and U/L strains reacted in a homologous manner with H . vaginalis antisera nos. 317, 394 and 4984. Amies strains did not react with these antisera. However, Amies strains cross-reacted with H . aegyptius antiserum 1 8 0~, while the Dukes, Edmunds, King and U / L strains did not react with this antiserum.

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New Etiologic Agent in Nonspecific Bacterial Vaginitis

Cited by 68 publications

References 3 publications

Changes in Vaginal Bacterial Concentrations with Intravaginal Metronidazole Therapy for Bacterial Vaginosis as Assessed by Quantitative PCR

Changes in Vaginal Bacterial Concentrations with Intravaginal Metronidazole Therapy for Bacterial Vaginosis as Assessed by Quantitative PCR

The Human Microbiome during Bacterial Vaginosis

Cultural and Serological Studies on Haemophilus vaginalis

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