Suggested Screening Criteria for Gardnerella vaginalis Based on Established Risk Factors.

Abstract

Vaginal infections in women occur due to the downregulation of lactobacilli and the upregulation of Gardnerella vaginalis (GV), leading to bacterial vaginosis (BV). While certain practices are recognized as risk factors for contracting GV infections, this scoping review highlights the severity and importance of other lesser-known risk factors, such as smoking, ethnicity, socioeconomic status (SES), genetics, and anatomy, which can be used to develop an updated point-based screening tool for clinicians. A total of438 articles were gathered from Embase, Ovid MEDLINE, and Web of Science, and after screening, 31 articles were included. There was a positive association with the presence of GV in those who were sexually active, practiced sexual penetrative vaginal acts, had frequent vaginal and/or receptive oral sexual activity, had unprotected sex, and used insertive contraception (intrauterine device, vaginal rings, and condoms). Women with primary school education levels showed a higher GV colonization increase compared to those with secondary or university education levels, and girls from the highest SES reported the lowestincidence. GV was the predominant bacteria found amongsub-Saharan, South African, African Surinamese, Ghanaian, Tanzanian, and Kenyan women. In the USA, self-identified "black" women had a higher prevalence of GV in their vaginal microbiome compared to self-identified "white" women; however, this was the opposite in pregnant women. Significant data show that nicotine use has a strong correlation with increased incidence of GV. Other factors that were found to be associated with GV infections were the increase of sialidase A gene in GV, short cervix (<25mm), and women who performed vaginal douching. Timely screening of GV is vital, especially in high-risk populations, such as pregnant and immunocompromised patients, who may present with more severe and exaggerated symptoms if they contract BV. This paper proposes a numerical scale for evaluating patients' likelihood of contracting a GV infection during their hospital visit.