The Vaginal Microbial Flora in Non-Specific Vaginitis

Piot, Peter; Dyck, E Van; Godts, P.; Vanderheyden, J.S.

doi:10.1097/00006254-198404000-00018

Cited by 9 publications

(16 citation statements)

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“…Bacterial vaginosis (BV) is a syndrome defined microbiologically by decreased numbers of Lactobacillus spp. and increased numbers of Gardnerella vaginalis, Bacteroides spp., Prevotella spp., Mobiluncus spp., Peptostreptococcus species, and Mycoplasma hominis (7,22). Accumulating evidence indicates that BV may be a risk factor for histologic chorioamnionitis (6), amniotic fluid infection (26,29), postcesarean endometritis (29), and prematurity (14).…”

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confidence: 99%

Sialidases (neuraminidases) in bacterial vaginosis and bacterial vaginosis-associated microflora

et al. 1992

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Bacterial vaginosis, Prevotella species, and Bacteroides species have been associated with prematurity and upper genital tract infection. Prevotella (Bacteroides) species and Bacteroidesfragilis have also been associated with preterm birth. However, the mechanism by which lower genital tract infection causes upper genital tract disease remains poorly understood. Sialidases (neuraminidases) are enzymes which enhance the ability of microorganisms to invade and destroy tissue. Elevated levels of sialidase activity were detected in 42 (84%) of 50 vaginal fluid specimens from women with bacterial vaginosis and none of 19 vaginal fluids from women without bacterial vaginosis (P < 0.001). Vaginal fluid from women with bacterial vaginosis had a median specific activity of 9.8 U compared to 2.5 U of sialidase in women without bacterial vaginosis (P < 0.001). In order to determine the probable source of sialidases in vaginal fluid, the microorganisms recovered from women with bacterial vaginosis before and after treatment were assayed. Of 28 specimens from women with bacterial vaginosis, 27 (961%) yielded sialidase-positive bacteria, at a median concentration of 106.5 CFU/ml of vaginal fluid. PrevoteUla and Bacteroides species accounted for the sialidase activity in 26 of the vaginal fluids, and GardnereUla vaginalis accounted for the sialidase activity in the remaining fluid. After treatment, sialidase was detected in the vaginal fluid of 1 (5%) of 22 women who responded to therapy and in all of 6 women for whom therapy failed. These data suggest that vaginal fluid sialidase is highly correlated with bacterial vaginosis and that the probable sources for this enzyme activity are the Bacteroides and PrevoteUla species present in the vagina.

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Sialidases (neuraminidases) in bacterial vaginosis and bacterial vaginosis-associated microflora

et al. 1992

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“…The explanation for the myriad of findings in patients with BV remains incomplete, although considerable progress has been made in understanding aspects of the pathogenic process (5,7,9,25,27,28). BV is thought to represent a massive overgrowth of vaginal microorganisms, primarily anaerobic gram-positive cocci and gram-negative bacilli, including Prevotella species, Gardnerella vaginalis, and Mobiluncus species (13,19,23,26,30).…”

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Clinical, microbiological, and biochemical factors in recurrent bacterial vaginosis

et al. 1992

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Because so little is known about the pathogenesis of recurrent bacterial vaginosis (BV), a longitudinal microbiological study was conducted on 13 women with recurrent BV treated sequentially with conventional metronidazole therapy. A rapid clinical response characterized by disappearance of mal odor and an improvement in vaginal discharge occurred in 92% of 31 clinical episodes of BV, with patients no longer satisfying the composite clinical criteria for the diagnosis of BV. However, prospective evaluation of these asymptomatic women revealed profound residual biochemical and microbial abnormalities which were best evident on Gram stain and wet mount examination of vaginal secretions. Other common residual abnormalities included mild persistent elevation of vaginal pH and polyamine and fatty acid levels and the presence of clue cells in small numbers. Residual abnormalities could be quantified to create an overall symptom code which predicted recurrence, and it was found that the severity of residual abnormalities was inversely related to the time required until the next recurrence occurred. The severity and prevalence of residual abnormalities following clinically successful therapy support the concept that BV recurrence, especially when it is early, represents a relapse rather than a reinfection. This concept may have important therapeutic implications.

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“…For quantitative culture, a portion of each vaginal wash was used to prepare serial 1:10 dilutions, each of which was inoculated onto human bilayer Tween 80 agar, and incubated for 48 h at 37°C (33). G. vaginalis was identified in cultures on the basis of beta hemolysis, negative catalase reaction, and Gram stain (24). Culture results were expressed as CFU per milliliter of undiluted vaginal fluid.…”

Section: Materlals and Methodsmentioning

confidence: 99%

High levels of Gardnerella vaginalis detected with an oligonucleotide probe combined with elevated pH as a diagnostic indicator of bacterial vaginosis

et al. 1992

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We have demonstrated a new approach to diagnosing bacterial vaginosis (BV) that is based on measuring the concentration of Gardnerella vaginalis in vaginal fluid with DNA probes. G. vaginalis is virtually always present at high concentrations in women who have BV but is also detected frequently in normal women, usually at concentrations of <107 CFU/ml of vaginal fluid. Elevated vaginal pH is another sensitive indicator of BV, although it can occur in conjunction with other conditions. We have proposed that quantitative measurements of G. vaginalis using specific DNA probes can serve as a useful aid in diagnosing BV, provided the vaginal pH is above 4.5. To test this hypothesis, a group of 113 women were first evaluated for BV by the standard set of clinical signs. Vaginal washes were collected, and aliquots were analyzed by quantitative culture for the concentration of G. vaginalis. Portions of these same samples were immobilized on nylon filters, along with standards for quantitation. The filters were incubated with a radiolabelled oligonucleotide specific for G. vaginalis 16S rRNA, and the subsequent autoradiographs were examined to determine levels of G. vaginalis in each sample. G. vaginalis at concentrations of >2 x 107 CFU/ml and vaginal pH of >4.5 were then analyzed for concurrence with the diagnoses based on clinical criteria. Results of this slot blot analysis gave a sensitivity of 95%, correctly categorizing 41 of 43 BV-positive specimens, and a specificity of 99%, correctly identifying 69 of 70 BV-negative specimens, compared with diagnosis based on clinical criteria.

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The Vaginal Microbial Flora in Non-Specific Vaginitis

Cited by 9 publications

References 0 publications

Sialidases (neuraminidases) in bacterial vaginosis and bacterial vaginosis-associated microflora

Sialidases (neuraminidases) in bacterial vaginosis and bacterial vaginosis-associated microflora

Clinical, microbiological, and biochemical factors in recurrent bacterial vaginosis

High levels of Gardnerella vaginalis detected with an oligonucleotide probe combined with elevated pH as a diagnostic indicator of bacterial vaginosis

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