Bacterial vaginosis in a district genitourinary medicine department: significance of vaginal microbiology and anaerobes.
The aim of this study was to correlate the significance of vaginal microbiology, in particular its anaerobic component, to the presence of bacterial vaginosis (BV), and to review the clinical criteria used in the diagnosis of this condition. Ninety-two female patients who received routine STD screening were studied. After routine history, presence and character of vaginal discharge and vaginal pH were noted, an amine test performed, and a wet stain observed microscopically. Routine Gram stain smears and cultures were prepared. BV was diagnosed clinically in 28 (30%) of our sample, and Gardnerella vaginalis was cultured in 41 patients (45%). Both clue cells and anaerobes were closely associated with each other and both mutually exclusive with the presence of lactobacilli on Gram stain (P < 0.001). BV was found to be strongly associated with the presence of clue cells on the wet film, anaerobes and G. vaginalis. In conclusion, bacterial vaginosis is not only strongly associated with the presence of G. vaginalis in the vaginal flora, but more strongly with the presence of anaerobes. The study suggests that the microaerophile G. vaginalis is a commensal organism in a significant proportion of sexually active women. If the aerobic status of the healthy vagina is disrupted, anaerobes (including Gardnerella) will flourish, producing the clinical picture of bacterial vaginosis.
Department of Genito-urinary Medicine, Bolton General Hospital, Lancs, UK.
S A
SA
Saidi
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D
Mandal
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E
Curless
D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D005260:Female; D006194:Gardnerella vaginalis / Q000302:isolation & purification; D006801:Humans; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis*