Abstract
Objectives: To analyze the relative abundance of five Lactobacillus species, Gardnerella vaginalis, and Atopobium vaginae in the vaginal microbiota of pregnant Korean women to establish diagnostic criteria for bacterial vaginosis (BV). Materials and Methods: Pregnant Korean women under antenatal care at Eulji University Hospital were enrolled at 10-14 weeks gestation. Twelve women were diagnosed with BV, nine had intermediate flora, and 93 had normal flora determined by Nugent score. Vaginal samples were collected to determine the quantification of seven microorganisms by qPCR and compared among the three groups. Results: This study indicated that G. vaginalis, A. vaginae, and L. iners were significantly increased specifically in the BV group (p < 0.001). While L. crispatus was significantly decreased in the BV group (p < 0.001). The area under curve (AUC) values for receiver operator characteristic (ROC) analysis were 0.934, 0.918, 0.763, and 0.742 for G. vaginalis, A. vaginae, L. iners, and L. crispatus, respectively, suggesting that patients with a higher quantification of G. vaginalis and A. vaginae were more likely to be diagnosed with BV (91.7% and 83.3%, respectively). Conclusions: The quantification of G. vaginalis and A. vaginae may be more useful diagnostic marker for BV in pregnant Korean women than those of Lactobacillus species.
Highlights
Bacterial vaginosis (BV) results from an imbalance of vaginal flora characterized by a decrease in Lactobacillus species and overgrowth of anaerobes, such as Gardnerella vaginalis and Atopobium vaginae [1-3]
Twelve women were diagnosed as having BV, nine had intermediate flora, and 93 had normal flora
L. crispatus was more prevalent in normal flora (NF) women than in BV and intermediate flora (IF) counterparts (p-value < 0.001), whereas less L. iners was found in the NF group compared to BV patients
Summary
Bacterial vaginosis (BV) results from an imbalance of vaginal flora characterized by a decrease in Lactobacillus species and overgrowth of anaerobes, such as Gardnerella vaginalis and Atopobium vaginae [1-3]. Most clinicians diagnose BV based on the Nugent score [2]; this method is limited in that it requires an experienced microbiologist who is well practiced in BV diagnosis because of the diversity of the vaginal flora [6-8]. It is unable to detect some BV-associated bacteria, Atopobium vaginae [6-9]. For these reasons, some researchers have sought to develop molecular-based methods to accurately diagnose BV. Molecular analysis of Lactobacillus species could be used to diagnose BV since its quantitative reduction is an important aspect of BV development. Jesper, et al reported that the relative prevalence of Lactobacillus species-including L
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