title: Gardnerella vaginalis population dynamics in bacterial vaginosis.
abstract: Bacterial vaginosis (BV) is the leading cause of vaginal discharge and is associated with the facultative Gram-variable bacterium Gardnerella vaginalis, whose population structure consists of four clades. Our goal was to determine if these clades differ with regard to abundance during BV. We performed a short-term longitudinal study of BV. Patients were evaluated according to the Amsel criteria and Nugent scoring at initial diagnosis, immediately after treatment and at a 40- to 45-day follow-up visit. G. vaginalis clade abundance was determined by quantitative real-time polymerase chain reactions (qPCRs). Among all specimens, the abundance of clades 1 and 4 were higher than that of clades 2 and 3 (P < 0.001). In general, the abundance of each clade increased with the degree of vaginal dysbiosis, as determined by the Nugent score and was greater in women with Amsel 4 compared with those with Amsel 0. Only clade 1 abundance was greater when Amsel 0 or 1 specimens were compared with Amsel 2 or 3 specimens (P < 0.01). Following antimicrobial treatment, abundance of clades 1 (P < 0.001) and 4 (P < 0.05) decreased regardless of the clinical and microbiological outcome, whereas clade 2 only decreased in women who had a sustained treatment response for 40-45 days (P < 0.01). Recurrent BV was characterized by post-treatment increases of clade 1 and 2 (P < 0.01). Clades 1 and 4 predominate in vaginal specimens. Clade abundance differs with regard to the Nugent score, the Amsel criteria, and response to therapy and BV recurrence.
authors.affiliation: Femeris Women's Health Research Center, Medical Diagnostic Laboratories, Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ, USA. dhilbert@mdlab.com.
authors.forename: D W
authors.initials: DW
authors.lastname: Hilbert
authors.affiliation: Femeris Women's Health Research Center, Medical Diagnostic Laboratories, Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Schuyler
authors.affiliation: Femeris Women's Health Research Center, Medical Diagnostic Laboratories, Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Adelson
authors.affiliation: Femeris Women's Health Research Center, Medical Diagnostic Laboratories, Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ, USA.
authors.forename: E
authors.initials: E
authors.lastname: Mordechai
authors.affiliation: Division of Infectious Diseases, Wayne State University School of Medicine, 540 E. Canfield Street, Detroit, MI, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Sobel
authors.affiliation: Femeris Women's Health Research Center, Medical Diagnostic Laboratories, Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Gygax
mesh_terms: D000293:Adolescent; D000328:Adult; D058491:Bacterial Load; D005260:Female; D006194:Gardnerella vaginalis / Q000145:classification / Q000235:genetics / Q000254:growth & development*; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011157:Population Dynamics; D060888:Real-Time Polymerase Chain Reaction; D016585:Vaginosis, Bacterial / Q000382:microbiology*; D055815:Young Adult