[Gardnerella vaginalis: transport, microscopy, testing resistance].
G. vaginalis is an important pathogen in the aetiology of bacterial vaginosis. Therefore, we investigated the influence of transport systems in isolation, a scoring system for Gram stains, and susceptibility to antimicrobial agents. The comparison between a simple (Transwab) and a sophisticated (Port-A-Cul) system showed no differences with regard to for instance Enterococcus faecalis or Escherichia coli; however, isolation of G. vaginalis, a fastidious microorganism, was significantly higher (alpha < 0.0001) in Port-A-Cul. There was a strong correlation (97.5%) using the scoring system indicating bacterial vaginosis and isolation of G. vaginalis. The minimal inhibitory concentrations (MIC) of metronidazole for 60 strains of G. vaginalis were higher than 32 mg/l, some strains showing heteroresistance. This phenomenon may be an explanation for treatment failures. Clindamycin and erythromycin were much more active, with MIC's between 0.016 and 0.19 mg/l, in-vitro development of resistance being slower for clindamycin than for erythromycin.


CONCLUSIONS
(I) for isolation of G. vaginalis, a sophisticated transport system is mandatory; (II) a scoring system for Gram staining is helpful in diagnosis of bacterial vaginosis; (III) in patients with metronidazole treatment failures, clindamycin should be used.
Altrichter
T
T
Institut für Virologie, Infektiologie und Epidemiologie e.V. Stuttgart.
Heizmann
W R
WR
D001431:Bacteriological Techniques; D002981:Clindamycin / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D006194:Gardnerella vaginalis / Q000187:drug effects / Q000302:isolation & purification* / Q000648:ultrastructure; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D013048:Specimen Handling; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology
D008795:Metronidazole; D002981:Clindamycin; D004917:Erythromycin
Gardnerella vaginalis: Transport, Mikroskopie, Resistenztestung.