Abstract
The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13.5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20.5% of women with subjective problems of vaginal infection, and in 48.80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2.58% of cases it was solitary, while in 1.28% it was found in combination with other aerobic and anaerobic bacteria and, in 1.28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0.05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2.58% cases. Following Benit biotype scheme, biotypes IVa, IVc and IIc were identified in 12.90% cases, while biotypes IIIa, IIa, Ia, IVb, IIb were found in 6.45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.
Highlights
BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2008; 8 (3): 271-276 found that lipase-positive biotypes were more frequently associated with clinical signs of bacterial vaginosis
Based on finding of three or more clinical signs of bacterial vaginosis according to Amsel, bacterial vaginosis was diagnosed in, of women who were examined at the Department for Women Health Care in Tuzla, after complaining of subjective discomfort, characteristic of this disease
This study showed that biotypes ., . and . of G. vaginalis were significantly more frequently isolated in women diagnosed with bacterial vaginosis
Summary
BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2008; 8 (3): 271-276 found that lipase-positive biotypes were more frequently associated with clinical signs of bacterial vaginosis. Certain biotypes of G. vaginalis are accompanied by clinical signs of bacterial vaginosis ( ). It is known nowadays that bacteria morphotypes G. vaginalis, Bacterodes spp., and Prevotella spp. excrete enzymes: mucinase, sialidase and IgA protease. These enzymes are factors of virulence since they destroy mucines, which play a significant role in functioning of female reproductive tract, and they facilitate adherence of bacteria to epithelial cells of urogenital tract. ( ) Previous studies ( , , , ) did not establish any significant differences in distribution of certain biotypes of G. vaginalis among women with clinical signs of vaginosis (increased vaginal discharge of fishy odor, test result “clue cells”, positive amino odor test, pH above , ) and those without signs of vaginosis. Frequent recurrence of bacterial vaginosis, which appear in - of women during a three-month treatment, is explained with reinfection caused by other biotype of G. vaginalis, different from the source biotype, or as a consequence of wrong treatment
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