Identification of Gardnerella vaginalis and Atopobium vaginae in Women With Bacterial Vaginosis in Northern Iran

Abstract

Background Bacterial vaginosis is the most common lower genital tract infection among women of reproductive age. Its causative agent is often the bacterium Gardnerella vaginalis, which exists in synergism with other mostly anaerobic bacteria such as Atopobium vaginae, Mobiluncus curtisii, and Megasphaera type I. Methods A total of 211 women, who referred to obstetrics and gynecology clinics in Rasht City for suspected vaginal infections, were tested for possible bacterial vaginosis. The presence of G. vaginalis and A. vaginae was verified by 5 different laboratory methods based on the Amsel criteria. These methods included determination of pH, whiff test, and observation of clue cells in a direct smear. Polymerase chain reaction using specific primers was performed on the extracted DNA from the vaginal specimens. Results Sixty cases of bacterial vaginosis, of the 211 women tested for suspected vaginal infections, were confirmed using Amsel criteria. In 44% (29/66) and 29% (19/66) of these bacterial vaginosis cases, the presence of G. vaginalis and A. vaginae was confirmed by polymerase chain reaction, respectively. Conclusions Gardnerella vaginalis had a very high prevalence in the 18- to 35-year-old women suffering from bacterial vaginosis in this region of Iran. Presumably, these cases were recommended for appropriate treatment, but the wider issue is about prevention in this age group and appropriate public health messages to raise awareness.