No abstract available.
Gardnerella vaginalis* ; Gardnerella*

No Abstract Available.
Gardnerella vaginalis* ; Gardnerella* ; Vaginosis, Bacterial*

No Abstract Available.
Gardnerella vaginalis* ; Gardnerella* ; Vaginosis, Bacterial*

Gardnerella vaginal is one of the main pathogenic floras of female bacterial vaginosis. Sexually transmitted, it causes fallopian pregnancy, premature rupture of the foetal membrane, neonate premature delivery and other bad pregnancy outcome. Gardnerella vaginal is also involved in male urogenital tract infection. This review summarizes the recent advances in the studies of Gardnerella vaginal in such aspects as its categorization, biocharacteristics, biogrouping, epidemiology, pathogenesis, diagnostic criteria, detection, treatment and clinical significance.
Female ; Gardnerella vaginalis ; Humans ; Male

Gardnerella vaginalis is a normal component of the vaginal flora and is one of the organisms associated with bacterial vaginosis. It is rarely involved in neonatal infection. Although it is possible that G. vaginalis plays an etiologic role in bacteremia, facial cellulitis and abscess, conjunctivitis, infected cephalhematoma, scalp abscess, respiratory disease and meningitis in newborns, G. vaginalis is an uncommon pathogen of neonatal sepsis and meningitis. We report a 3,830 g term neonate with sepsis and meningitis due to G. vaginalis and review the characteristics of neonatal G. vaginalis infection reported in the literatures.
Abscess ; Bacteremia ; Cellulitis ; Conjunctivitis ; Gardnerella vaginalis* ; Gardnerella* ; Humans ; Infant, Newborn ; Meningitis* ; Scalp ; Sepsis* ; Vaginosis, Bacterial

Among 104 patients who visited a local clinic with increased, bad-smelling vaginal discharge, twenty-nine women (27.9%) were found to have bacterial vaginosis (BV) according to the Amsel's composite clinical criteria (homogeneous thin gray discharge, positive amine test, vaginal pH over 4.5, positivity of clue cell by Gram stain). The specificity, sensitivity and positive and negative predictive values of the Amsel's composite clinical criteria were estimated in relation to the G. vaginalis isolation rate. Fifty-two strains of G. vaginalis (50%) were isolated from vaginal swabs taken from 104 patients. The sensitivities of clue cells and G. vaginalis isolation were both 96.6% (28) in the 29 BV patients. The specificities of clue cells and the presence of G. vaginalis were 85.3% and 68.0%, respectively. But the sensitivity, specificity, and positive and negative predictive values of the combination of clue cells and morphotype of G. vaginalis were 93.1%, 92.0%, 81.8% and 97.2%, respectively. The sensitivity, specificity and positive and negative predictive values of amine test were 89.7%, 98.7%, 96.2% and 94.9% in the 29 BV patients. Among 52 strains of G. vaginalis, 34 strains (87.2%) were isolated from the 39 clue cell positive samples and the remaining 18 (27.7%) from the 65 clue cell negative cases. Twenty-four strains (92.3%) were isolated from 26 amine test positive samples and the remaining 28 (35.9%) from 78 amine test negative cases. According to these results, it seems that the amine test is a useful test for the diagnosis of BV. However, we propose the combination criteria of clue cells and G. vaginalis morphotype in vaginal discharge should give more objective results than the amine test for the diagnosis of BV. The sensitivity and specificity of vaginal pH over 4.5 were 86.2% and 57.3%, and those of homogeneous discharge 93.1% and 65.3%, respectively. These two criteria were not as specific as clue cells and amine test for the diagnosis of BV. These results suggest that BV could be diagnosed more simply and precisely with the finding of clue cells spotted with Gram variable polymorphic bacteria by means of Gram stain of vaginal wall swabs.
Bacteria ; Diagnosis* ; Female ; Gardnerella vaginalis* ; Gardnerella* ; Humans ; Hydrogen-Ion Concentration ; Sensitivity and Specificity ; Vaginal Discharge ; Vaginosis, Bacterial*

BACKGROUND: Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms. METHODS: A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively. RESULTS: With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G. vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (p<0.05). CONCLUSION: The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.
Candida ; Candidiasis ; Chimera ; DNA ; Female ; Gardnerella ; Gardnerella vaginalis ; Humans ; Trichomonas ; Trichomonas Infections ; Trichomonas vaginalis ; Vaginal Smears ; Vaginitis ; Vaginosis, Bacterial

Vaginitis is one of the most common disease in gynecologic field in recent days. About 90% of these patients suffer from the infection of the vagina caused by Gardnerella vaginalis, Candida, or Trichomonas, either alone or in combination. For the effective diagnosis and management, it is essential to get an accurate identification of the causative agent. Applying simple and easy diagnostic methods such as pH of vaginal discharge, amine test and microscopic examination of wet mount preparation of normal saline and 10% KOH to 549 cases of randomly selected patients visiting Out-patient Department of Obstetrics and Gynecology of Yeungnam University Hospital through May 1st to Sept. 31st, 1987, the following results were obtained. 1. In the Gardnerella vaginitis vaginal pH was more than 5.0 in 81.0% of total cases, positive amine test in 62.8%, decreased lactobacilli in 77.4% & decreased WBC counts in 70.1%, In the Trichomonas vaginitis vaginal pH more than 5.0 was noted in 93.3% of the cases, negative amine test in 90%, decreased showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 90%, decreased lactobacilli in 90% & increased WBC counts in 93.3%, whereas Candida vaginitis and normal groups showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 100%, normal distribution of lactobacilli in 89.7%, normal WBC counts in 72.4%. 2. The accuracy rates of physical diagnosis by wet mount preparation of normal saline and 10% KOH revealed 26.3%, 47.5%, 70.0% in Gardnerella vaginitis, Candida vaginitis, and Trichomonas vaginitis, respectively. The vaginal pH and amine test showed 83.2% of accuracy rate in Candida vaginitis group, 60.6% in Gardnerella vaginitis group and 83.3% in Trichomonas vaginitis group. 3. In 23 cases of Gardnerella vaginitis showing vaginal pH of 3.0 or 4.0 and positive amine test, the clue cells were observed in 10% or less in 12 cases, 30% in 5 cases, 50% in 4 cases and 50% or more in 2 cases. In summary vaginal pH and amine test could be useful in screening and differentiating the different types of infectious vaginitis. Furthermore by adding microscopic examination of normal saline and 10% KOH wet mount preparation to them, they not only could obtain higher diagnostic accuracy rate but would be more valuable in selecting the patients requiring cultures to confirm the diagnoses.
Candida ; Diagnosis ; Gardnerella ; Gardnerella vaginalis ; Gynecology ; Humans ; Hydrogen-Ion Concentration* ; Mass Screening ; Obstetrics ; Outpatients ; Trichomonas ; Trichomonas Vaginitis ; Vagina ; Vaginal Discharge* ; Vaginitis*

BACKGROUND: Bacterial vaginosis (BV) is the most prevalent cause of symptomatic vaginitis. In the Philippines, prevalence of BV is at 28.16%. The mainstay for the treatment of BV is Metronidazole. Although antibiotic therapy has been shown to eliminate BV associated organisms, there is extremely high recurrence rate.
OBJECTIVE: To compare the efficacy of metronidazole and metronidazole plus lactobacilli tablet in the treatment of bacterial vaginosis among non-pregnant patients seen at the outpatient department of a tertiary medical center.
METHODOLOGY: The population included non-pregnant women ages 15 t0 44 years old, with bacterial vaginosis diagnosed by Amsel's criteria and Nugent's scoring. The participants were randomly assigned to their treatment group, one is Metronidazole only and other received Metronidazole plus Lactobacillus tablet. All participants followed up on day 8,15,22 and 56 from initiation of treatment resolution or persistence of symptoms and collection of vaginal specimen for gram stain and inquire on adverse effects.
RESULTS: On day 8 treatment, there were significantly more participant in the metronidazole plus probiotic arm with an estimated lactobacilli count of more than 30/hpf as comapred to metronidazole alone. On day 15 post treatment, there was no statistically significant difference with the estimated Gardnerella vaginalis count, lactobacilli count, presence or absence of malodorous vaginal discharge between the metronidazole plus probiotic and the metronidazole alone arm. With metronidazole plus probiotic group, the proportion of women with less than 30 per hpf Gardnella vaginalis count and absent foul smelling vaginal discharge were accounted among 100% of the participants from day 8 to 56 post treatment. The early reduction in the causative agent and symptoms can be attributed to an increase in the estimated lactobacilli count sustained until 56 days post treatment metronidazole plus probiotic. However, from day 15 to 22 and 56 post- treatment, the proportion of participants who had a nugent's score of less than 4 were greater for both the metronidazole plus probiotic (100%) and metronidazole alone (95%) arm, when compared to day 8 post-treatment. This finding for the metronidazole plus probiotic group is due to sustained reduction in the Gardnella vaginalis count and increase in lactobacilli counts. Potentially , the metronidazole plus probiotic treatment was found to be more favorable in sustaining the normal flora and probiotic can be used as an adjunct may enhance the efficacy of metronidazole in the treatment of BV.
CONCLUSION: Metronidazole plus probiotic and metronidazole only treatment are comparable in treating bacterial vaginosis. In terms of restoring and maintaining the normal flora, metronidazole plus probiotic appears to be more significantly efficacious. Probiotic in the form of lactobacilli is a promising adjunct to enhance the efficacy of metronidazole in the treatment of bacterial vaginosis.

Human ; Female ; Adult ; Adolescent ; Gardnerella Vaginalis ; Vaginosis, Bacterial ; Metronidazole ; Lactobacillus ; Gardnerella ; Probiotics ; Vaginal Discharge ; Gentian Violet ; Phenazines ; Tablets ; Anti-bacterial Agents

BACKGROUND: To the best of our knowledge, there has been no any report on the antibiotic susceptibility profile of Gardnerella vaginalis, determined in domestic area by the agar dilution method. Therefore, we studied on 49 strains of G. vaginalis by the agar dilution method. METHODS: One standard strain (ATCC 14018) and Forty-eight strains isolated from patients with increased vaginal discharge were included in this study. Columbia agar base containing 1% proteose peptone No. 3 was supplemented with horse serum (5%) and human erythrocyte lysate (5%) which was prepared by a new method, and this medium was used for the antibiotic susceptibility test. RESULTS: The MICs90 of clindamycin and ciprofloxacin were 0.3 g/mL and 0.6 g/mL, respectively. Amoxicillin, cefazolin, doxycycline, and erythromycin were hardly effective against most strains of G. vaginalis (NCCLS, U.S.A., 2001). Especially, MICs90 of both metronidazole and tinidazole were 80 g/ mL under micro-aerobic condition of 5% O2. CONCLUSION: For the treatment of Bacterial vaginosis, it is suggested that clindamycin or ciprofloxacin should be combined with vaginal tablet or gel of metronidazole rather than single administration of metrondazole or tinidazole.
Agar* ; Amoxicillin ; Cefazolin ; Ciprofloxacin ; Clindamycin ; Doxycycline ; Drug Resistance ; Erythrocytes* ; Erythromycin ; Gardnerella vaginalis* ; Gardnerella* ; Horses* ; Humans* ; Metronidazole ; Peptones ; Tinidazole ; Vaginal Creams, Foams, and Jellies ; Vaginal Discharge ; Vaginosis, Bacterial