Mobiluncus Spp Research Articles

Features of vaginal microbiota in women at different stages of postmenopause

Aim. To study the dynamics of the vaginal microflora depending on the postmenopausal stage according to STRAW+10.
 Materials and methods. After obtaining voluntary informed consent from each patient and determining eligibility criteria, we conducted a survey of 139 postmenopausal women. Participants were divided into 3 groups depending on the duration of postmenopause in accordance with the stages of aging of the reproductive system STRAW+10. Femoflor 16 real-time polymerase chain reaction was used to assess the state of the vaginal microbiome.
 Results. After menopause in women in the group of obligate aerobes Lactobacillus spp. and Enterobacteriaceae were completely replaced by Streptococcus spp. and Staphylococcus spp., which increased in number. A significant depletion of the composition occurred in the group of obligate anaerobes. If at stages +1a and b this group is almost equally represented by 5 communities of microorganisms (Gardnerella vaginalis + Prevotella bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp., Lachnobacterium spp. + Clostridium spp.), then only 3 groups prevailed in the total bacterial mass at the +1c stage (G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp + Corynebacterium spp.). At the postmenopausal stage +2, the total bacterial mass consisted of only 2 groups of microorganisms: G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp.
 Conclusion. Thus, the main result of age-related changes in the vaginal microflora was the impoverishment of the composition of its microbiome.

Bacterial vaginosis - diagnostic dilemma and implications

Background/Aim. Bacterial vaginosis (BV) is one of the most common microbial dysbiosis, characterized by a decrease of Lactobacillus spp. with an increase of other anaerobic bacteria species [Gardnerella (G.) vaginalis, Atopobium (A.) vaginae, Prevotella spp, Mobiluncus spp, etc.] causing serious gynecological and obstetric complications. There-fore, it is particularly important to have accurate and reliable diagnostic standards. The aim of this study was to compare the results of various diagnostic methods for detecting BV, such as Amsel, Nugent, and Ison and Hay criteria, as well as multiplex quantitative real-time polymerase chain reaction (mqRT-PCR) test. Methods. This study involved vaginal swabs from 235 patients of reproductive age. Nugent criteria were used as the ?gold standard? compared with Amsel and Ison/Hay criteria as well as mqRT-PCR test based on the detection and quantification of G. vaginalis, A. vaginae, Lactobacillus spp., and total concentration of bacterial DNA. The kappa coefficient was employed to measure agreement between tests. Results. Our analysis demonstrated excellent agreement between Ison/Hay criteria and Nugent scores (kappa = 0.95), good agreement between Amsel and Nugent criteria (kappa = 0.78), while between Nugent criteria and mqRT-PCR test agreement was moderate (kappa = 0.59). Total agreements of Ison/Hay, Amsel, and mqRT-PCR against Nugent scores were 94.9%, 90.2%, and 74%, respectively. Nugent methods classified the highest number of intermediate patients - 60 (25.2%). The largest number of BV patients was detected by the mqRT-PCR method, while the largest number of healthy patients was detected by Amsel criteria. Conclusion. The mqRT-PCR is the best choice for BV diagnosis because it is more efficient at differentiating patients with intermediate results. Compared to Amsel and Nugent methods that group patients into 2 or 3 categories, the mqRT-PCR method recognizes other conditions of vaginal flora important for correct diagnoses and application of better therapeutic approaches, as well as preventing possible clinical consequences of this dysbiosis.

Стан мікрофлори та ступінь вираженості місцевого імунного захисту в ендометрії жінок з безпліддям, що розвивається на тлі хронічного ендометриту поєднаного з бактеріальним вагінозом

The purpose of the study was to evaluate the taxonomic profile of the microbiota and the state of local immunity in the endometrium of women with infertility under conditions of chronic endometritis combined with bacterial vaginosis. Materials and methods. Diagnosis of chronic form of endometritis was performed on clinical symptoms, medical history, scraping, endoscopic and ultrasound examinations. All women were divided into three groups: Group I – 12 healthy women, who had no signs of chronic endometritis and formed a control group; Group II – patients with severe chronic endometritis (n = 16); Group III – patients with chronic endometritis developed on the background of bacterial vaginosis (n = 12). Diagnosis of bacterial vaginosis in patients was performed by detecting an increase in the pH of vaginal secretions >4.5, the presence of homogeneous vaginal discharge with an unpleasant odor, detection of vaginal epitheliocytes with adherent gram-variable microorganisms, detection of "fishy" odor. The study was performed in the second phase of the menstrual cycle (day 18-23). Endometrial aspirate for the study of microflora was selected using a device for obtaining endometrial cytology Endobrash Standard for Endometrial Cytology. Results and discussion. It was found that the development of chronic endometritis on the background of bacterial vaginosis increases the frequency of detection of opportunistic anaerobic microflora in the endometrium compared to women without bacterial vaginosis. It has been shown that a decrease in the level of T-helpers and an increase in the level of T-suppressors / killers in the endometrium are exacerbated in patients with chronic endometritis developed against the background of bacterial vaginosis. Thus, the level of CD4 + cells decreased by 1.6 times, and the level of CD8 + cells increased by 1.9 times compared to healthy women. Against this background, the level of B-lymphocytes and IgA in the endometrium of women with chronic endometritis and bacterial vaginosis decreased. Conclusion. The development of chronic endometritis is associated with an increase in the frequency of detection and quantitative content in the endometrium of Streptococcus spp., Staphylococcus spp. The development of bacterial vaginosis is accompanied by the detection in the endometrium of new species of microorganisms – Prevotella spp., Mobiluncus spp. The imbalance of the endometrial microflora is accompanied by significant violations of local cellular and humoral immune defense, which is expressed by a decrease in the level of T-helpers, B-lymphocytes and IgA with a simultaneous increase in T-suppressors / killers in women with chronic endometritis. The established changes amplify at a bacterial vaginosis

Types of vaginal microbiomes in PCOS affected females

To evaluate and analyze the microbiomes component of the vagina in females with polycystic ovarian syndrome PCOS, and compare it with that of healthy females. A case- control study included 120 participants, 60 had been diagnosed as having PCOS according to the Rotterdam Criteria for diagnosis of PCOS and the other 60 are healthy females visiting the outpatient private clinics in Hay Aljameaa/ Al-Harthya in Baghdad from October 2020 till march 2021 for different medical problems, statistical analysis was done by using the SPSS computer application for statistical analysis. Both study groups had L. crispatus in their vagina, while for L. jensonii 93.33% of control group have this microbiota while only 66.66% of PCOS group have it, L. gasseri presents in the vagina of 80% of controls and only 38.33% of PCOS. S. aureus in 41.66% of PCOS group and only 3.33% of control group, S. epidermidis presents in 25% of PCOS females while it not presents in control group. Str. Pyogenes presents in 36.67% of PCOS group and absent in control group (p< 0.0001), Str. Agalactiae presents in 26.67% of PCOS group and 1.67% of control group. Bacteroides presents in 30% of PCOS cases and only in 1.67% of controls (p< 0.0001). For other types of vaginal microbiota e.g. Gardnerella vaginalis we found that it presents in high percentage of PCOS group 66.67% and absent in females of control group, Prevotella spp presents in 55% of PCOS group and only 3.33% of control group, Mobiluncus spp and Fusobacterium spp were absent in both study groups. For candida species, C. albicans presents in 30% and 6.67% of vagina of PCOS and control group respectively. There is large diversity in the vaginal microbiota with disruption to normal flora in PCOS affected patients so We need further studies to evaluate the relationship between the microbiota and different PCOS symptoms.

Smoking in women with chronic vaginal discomfort is not associated with decreased abundance of Lactobacillus spp. but promotes Mobiluncus and Gardnerella spp. overgrowth - secondary analysis of trial data including microbio-me analysis.

Smoking is considered a risk factor for bacterial vaginosis. It is currently unknown which parameters of the vaginal environment are affected and how smoking triggers the disease. The primary objective is to estimate the effect size of smoking on vaginal pH and the Nugent score in patients with chronic vulvovaginal discomfort prior to the development of episode of vaginosis. The secondary goal is to investigate the effect of smoking on individual microscopic parameters of the vaginal environment and on subjectively reported symptoms of vaginal discomfort. Smoking reported by patients was tested as a predictor, using multivariate logistic and ordinal logistic regression analysis on a dataset from the first visit of a randomized trial NCT04171947, which enrolled patients with intermediate vaginal environment. We tested the primary hypothesis (odds ratio (OR) for vaginal pH > 4.5 and Nugent score > 3 in smokers) at the significance level á = 5%. For exploratory analyses of the effect of smoking on the parameters of the vaginal environment, á was corrected as per Bonferoni. In a cross-sectional sample of 250 women after adjusting for other risk factors, smoking had an impact on the Nugent score (OR = 3.3 (1.3-8.5), P = 0.011), while pH was not affected (OR = 1.2 (0.5-2.8), P = 0.698). Smoking was associated with the prevalence of clue cells (P < 0.000), Gardnerella spp. (P = 0.001) and Mobiluncus spp. (P = 0.001), while the prevalence of Lactobacillus remained unchanged (P = 0.049). Contrarily to common assumptions, vaginal Lactobacillus is not directly affected by smoking, which rather promotes the growth of bacteria of Gardnerella and Mobiluncus spp. Given that other parameters remained unaffected, it appears that smoking leads to vaginal dysbio-sis by creating specific favourable conditions for these two opportunistic pathogens.

Etiological and pathogenetic aspects of non-specific bacterial vaginosis

The aim of this review was the biological properties analysis of microorganisms known as the main contributors to the non-specific bacterial vaginosis development. The mechanisms of anaerobic vaginal microflora pathogenic action have been found out to be the main cause of non-specific inflammatory processes. Special attention was given to the genera of Mobilunkus spp., Atopobium spp., Prevotella sp. representatives , which were studied as vaginal flora due to the modern diagnostic methods and techniques development. The homeostasis of the vaginal ecosystem results from complex interactions and synergies among the host and different microorganisms that colonize the vaginal mucosa and healthy vaginal microbiota is generally dominated by Lactobacillus spp. Lactobacilli which have been known to be antagonistic toward a variety of microorganisms. In cases of bacterial vaginoses, the proportion of Lactobacilus spp sharply decreases, while the share of anaerobic microorganisms increases: Gardnerella vaginalis, Atopobium sp., Mobiluncus sp., Prevotella sp . The virulence factors of Gardnerella vaginalis pathogenicity are: its ability to form biofilms; the presence of genes responsible for cytotoxicity. The ability of Gardnerella vaginalis, Atopobium sp., Mobiluncus sp., Prevotella sp . to produce short chain volatile fatty acids isomers results in the vaginal mucosa irritation (itching or burning) and discharge with unpleasant odour in BV associated with these microorganisms. Atopobium vaginae , together with Mobiluncus spp . and Prevotella spp ., provoke the accumulation of pro-inflammatory cytokines. The whole mechanism leads to an inflammation worsening in BV and stimulates the chronic process development. Both microorganisms Mobiluncus spp . and A. vaginae are competitive lactobacilli in relation to the glycogen consumption. Conclusions. Analysis of literature shows that pathogens of non-specific bacterial vaginosis have wide range of pathogenicity factors. This provides pathogenesis and clinical signs of the disease.

Vaginal microbiota in menopause

The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of menopause. Vulvovaginal atrophy is often found in postmenopausal women, and dominated by L. iners, Anaerococcus sp, Peptoniphilus sp, Prevotella sp , and Streptococcus sp . The normal vaginal microbiota’s imbalance in menopause will cause diseases such as bacterial vaginosis, and recurrent vulvovaginal candidiasis due to hormonal therapies. Changes in the vaginal microbiota due to bacterial vaginosis are characterized by decrease in H 2 O 2 -producing Lactobacillus . They are also caused by the increase in numbers and concentration of Gardnerella vaginalis, Mycoplasma hominis, and other anaerob species such as Peptostreptococci, Prevotella spp, and Mobiluncus spp. Keywords : v agina, microbiota, menopause, Lactobacillus, bacterial vaginosis Normal 0 false false false EN-US X-NONE X-NONE

Vaginal infections in pregnant women at the Regional Hospital of Sokode (Togo) in 2010 and 2011

The aim of this study was to evaluate the prevalence of the major microorganisms causing vaginal infections in pregnant women consulting at the Regional Hospital of Sokodé and to assess their sensitivity to antibiotics. This prospective study took place from June 2010 through August 2011 and included 302 pregnant women from whom a sample was taken by a vaginal swab. Samples were processed for parasitic, bacterial, and fungal agents, by microscopic examination and culture. We isolated 273 germs, alone or in association in 221 women. These germs were distributed as follows: Gardnerella vaginalis (55.31%), Candida spp (30.77%), Staphylococcus aureus (5.49%), Enterobacteriaceae (4.40%), Trichomonas vaginalis (3.66%) and Mobiluncus spp (0.37%). No Streptococcus strain was isolated during the study. Over 40% of women had bacterial vaginosis and 23.08% of them were coinfected. The occurrence of coinfection was statistically influenced by the stage of pregnancy (P = 0.05). The susceptibility tests revealed that S. aureus developed a strong resistance to aminopenicillins (66.67%) and cephalosporins (>44.44%), while Enterobacteriaceae was resistant to cephalosporins and quinolones. (16.67%). This study showed that pregnant women in Sokode are still exposed to vaginal infection, caused mostly by G. vaginalis and Candida species. These results underline the need for at least one vaginal swab culture for each woman during pregnancy.

How important are the newly described bacteria in bacterial vaginosis?

Traditionally several bacterial species including Gardnerella vaginalis , Mycoplasma hominis , Mobiluncus spp, and Prevotella spp have been associated with bacterial vaginosis (BV). In culture, other organisms can grow but...

Association of Mobiluncus curtisii With Recurrence of Bacterial Vaginosis

Association of Mobiluncus curtisii With Recurrence of Bacterial Vaginosis

Treatment and Management of Bacterial Vaginosis in Pregnancy: Current and Future Perspectives

Bacterial vaginosis accounts for the majority of cases of vaginal discharge and has been consistently linked to an increased risk of preterm delivery. Bacterial vaginosis is characterized by the reduced number or absence of hydrogen peroxide-producing Lactobacillus spp., which promotes the overgrowth of anaerobic bacteria, including Gardnerella vaginalis, Mycoplasma hominis, Bacteroides spp., and Mobiluncus spp. Black race, higher-risk sexual activity, frequent vaginal douching and the substantial reduction of hydrogen peroxide-producing Lactobacillus spp. are the main predictors of bacterial vaginosis development. Clinical- and laboratory-based bacterial vaginosis diagnostic tests are widely used to screen for bacterial vaginosis but, more recently, office-based bacterial vaginosis screening tools have been developed. Although systemic treatment for bacterial vaginosis with metronidazole or clindamycin has been demonstrated to be effective in the short-term cure of bacterial vaginosis, recurrence of bacterial vaginosis within 3 months of treatment is common, and treatment for bacterial vaginosis using these strategies has not been effective in reducing the risk of preterm delivery.

Variation in microbiologic profiles among pregnant women with bacterial vaginosis

The purpose of this study was to determine if clinical findings and sociodemographic variables among bacterial vaginosis (BV)-positive pregnant women are associated with different microbiologic profiles. Pregnant women were assessed for BV by Nugent criteria. BV+ women were separated into 6 mutually exclusive microbiologic groups. In unadjusted analyses, we compared (1) sociodemographic and behavioral characteristics, and (2) 3 clinical characteristics among BV+ women with and without Mobiluncus (M+ vs M-). Unadjusted data were analyzed using the chi-square test. Multiple logistic regression was used to assess the likelihood of having clinical signs of BV in women with and without Mobiluncus spp while controlling for confounders. A total of 1756 BV+ pregnant women were followed. The M+ group (n=702) was significantly more likely than the M- group (n=1054) to be non-Hispanic black (80.9% vs 66.2%; P < .0001), older than 21 years (61.7% vs 48.7%; P < .0001), and to have had more than 3 lifetime sexual partners (66.4% vs 54.9%; P < .0001). The M+ group was also more likely to have clue cells on wet mount (63.9% vs 47.2%; P < .0001) and a positive amine odor after addition of KOH (57.2% vs 45.0%; P=.001). There was no difference in other demographic variables or physician diagnosis of abnormal vaginal discharge. In the adjusted analyses for each clinical outcome, all findings were consistent with the unadjusted analyses. BV+ pregnant women with Mobiluncus spp are more likely to have clue cells present on wet mount, a positive amine odor after KOH preparation, and to be older, non-Hispanic black, and have had more lifetime sexual partners compared to BV+ women without any Mobiluncus species.

Intravaginal bacterial flora in patients with uterine cervical cancer. High incidence of detection of Gardnerella vaginalis

Gynecological diseases may affect the growth of vaginal bacterial flora. We investigated the relationship between uterine cervical cancer and the vaginal bacterial flora. In 20 patients with uterine cervical cancer, we investigated the intravaginal bacterial flora, including Gardnerella vaginalis and Mobiluncus spp. In the patients with uterine cervical cancer, there was a mixed flora of aerobes and anaerobes and, of special note, G. vaginalis was detected in 50% of the patients with uterine cervical cancer (10/20). Bacterial vaginosis was present in 8 of these 10 patients (80%). The count of G. vaginalis detected was higher than that of the other coexisting species and was higher in both pre- and postmenopausal patients with uterine cervical cancer than in a control group of pre- and postmenopausal women with benign gynecological diseases. In contrast, none of Mobiluncus spp. was detected. G. vaginalis was detected at a high incidence in patients with uterine cervical cancer, suggesting that the lesions of uterine cervical cancer provide favorable conditions for the growth of G. vaginalis and anaerobes, which leads to bacterial vaginosis.

Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: Results of a controlled trial of topical clindamycin cream

OBJECTIVE: The pathogenesis of preterm birth and other adverse pregnancy outcomes linked with reproductive tract infection remains poorly understood. Mucolytic enzymes, including mucinases and sialidases (neuraminidase), are recognized virulence factors among enteropathogens and bacteria that cause periodontal infection. Perturbation of maternal cervicovaginal mucosal membrane host defenses by such enzyme-producing microorganisms may increase the risk of subclinical intrauterine infection during pregnancy and thus increase risks of preterm birth. STUDY DESIGN: We prospectively evaluated vaginal fluid mucinase and sialidase and selected cervicovaginal bacteria along with pregnancy outcomes in 271 women. Within this study, women with bacterial vaginosis (16 to 27 weeks' gestation) were treated with 2% clinadmycin vaginal cream or placebo. Enzyme, microbial findings, treatment effects, and pregnancy outcomes were compared among drug- and placebo-treated women and control women without bacterial vaginosis. RESULTS: Presence of bacterial vaginosis at intake was associated with increased risk of preterm birth (relative risk 3.3, 95% confidence interval 1.2 to 9.1, p = 0.02), premature rupture of membranes (relative risk 3.8, 95% confidence interval 1.6 to 9.0, p = 0.002), and preterm premature rupture of membranes. Mucinase and sialidase activities were more commonly identified, and they occurred in higher concentrations, if present, in women with bacterial vaginosis (mucinase: 44.3% with bacterial vaginosis vs 27.4% without, p = 0.007; sialidase: 45% with bacterial vaginosis vs 12% without, p < 0.001). Sialidase activity was associated with bacterial vaginosis - linked organisms (Gardnerella vaginalis, Mobiluncus spp, and Mycoplasma hominis) and Chlamydia trachomatis and yeast species; mucinase activity was associated only with bacterial vaginosis - linked microorganisms. Clindamycin, 2% cream, was effective treatment for bacterial vaginosis and temporarily reduced mucinase and sialidase activities. Topical treatment of bacterial vaginosis did not reduce risks of perinatal morbidity. Women with persistent or recurrent sialidase 8 weeks after treatment were at increased risk of preterm birth (15.6% vs 7.4%) premature rupture of membranes (30% vs 15%), and low birth weight (20% vs 3%, relative risk 6.8, 95% confidence interval 1.6 to 28.1). CONCLUSIONS: Persistence of sialidase-producing vaginal microorganisms in numbers sufficient to increase vaginal fluid sialidase activity may be a risk factor for possibly preventable subclinical intrauterine infection and preterm birth. This study confirms and further informs our understanding of the association of bacterial vaginosis and preterm birth; studies to evaluate whether systemic treatment for bacterial vaginosis can effectively reduce vaginal mucolytic enzymes and risks of prematurity and other morbid outcomes are continuing. (AM J OBSTET GYNECOL 1994; 170:1048-60.)

The susceptibility of organisms associated with bacterial vaginosis to spermicidal compounds, in vitro.

Bacterial vaginosis (BV) is a prevalent vaginal infection that is now regarded as a risk factor in more serious pelvic and obstetric complications. Spermicides are known to have antimicrobial activity against other sexually transmitted diseases and the aim of this study was to test whether the causative organisms of BV were also susceptible to spermicides, in vitro. Minimal Inhibitory Concentrations of five spermicidal compounds were determined for the organisms associated with BV, in an agar dilution technique. The Department of Experimental and Clinical Microbiology, University of Sheffield Medical School, UK. SPERMICIDES AND ORGANISMS: Nonoxynol-9, Nonoxynol-11, Docusate sodium, Benzalkonium chloride and Menfegol were tested against 20 strains each of Gardnerella vaginalis, Bacteroides and Mobiluncus organisms, isolated from patients with BV who attended the Department of Genitourinary Medicine, the Royal Hallamshire Hospital, Sheffield. The susceptibility of BV-associated organisms to spermicidal compounds, in vitro. G vaginalis, Mobiluncus spp, Bacteroides bivius and Bacteroides disiens were all susceptible to the five spermicides tested, with MICs ranging between less than or equal to 19 and 5000 mg/l (0.0019%-0.5%). The concentrations of spermicides incorporated in contraceptive preparations are usually between 3% and 8%, which are far in excess of the MICs found for BV organisms. Their usage could exert a significant antimicrobial effect and be a useful prophylactic in preventing the infection.

Identification of two new antigenic subgroups within the genus Mobiluncus

Classifications of 48 atypical clinical isolates of Mobiluncus spp. were determined on the basis of biochemical reactions, morphology, antigenic profiles, and DNA hybridization studies. Two new subgroups with unique antigenic profiles are described. Like typical Mobiluncus species, the antigenic variant of M. mulieris is associated with bacterial vaginosis. The atypical isolates of M. curtisii were frequently recovered from women with normal vaginal flora and were also recovered from sterile body sites. These isolates may be incorrectly identified if current biochemical and morphological criteria are used for identification. Gram stain morphology, however, correctly identifies these isolates to the species level. The characterization of these atypical isolates has important implications for future investigations in which serological methods are used for diagnosis, epidemiology, and determination of pathogenicity of Mobiluncus spp.

Antibiosis between bacteria isolated from the vagina of women with and without signs of bacterial vaginosis

Lactobacilli from women with and without bacterial vaginosis (BV) were tested for H2O2 production. Thirty-seven (79%) of the 47 strains of lactobacilli isolated from the women without BV produced H2O2, while only nine (23%) of the 39 strains of lactobacilli obtained from women with BV did so. Five of 20 H2O2-producing and two of 26 non-producing strains of Lactobacillus exhibited antibiosis against four of 12 strains of peptostreptococci and two of 10 strains of Mobiluncus spp. None of a further 41 different anaerobic and facultative anaerobic bacterial strains were inhibited by any of the isolates of lactobacilli tested. Some strains of Gardnerella vaginalis, Bacteriodes spp., Mobiluncus spp. and Peptostreptococcus spp. inhibited the growth of three strains of lactobacilli belonging to different species. When the pH of the culture medium was increased from 6.0 to 6.5 this led to a decrease in the number of strains inhibited and/or the size of the growth-inhibitory zones. Different concentrations of H2O2 did not inhibit any of the strains tested. The growth-inhibitory effect of lactobacilli could not be related to their bacteriocin production. Increasing the iron content of the medium by adding FeCl3 (0.01 mM-1 mM) decreased or completely abolished the antibiosis.

Contemporary Pathogens of the Genitourinary System

Identification of new organisms, association of known organisms with genitourinary tract diseases, and developments in technology that make isolation or detection of known but fastidious pathogens possible for clinical microbiology laboratories are discussed. Correlation of Mobiluncus (spp) with bacterial vaginosis, differential diagnosis of genital ulcers including culture for Hemophilus ducreyi and darkfield examination for syphilis, and testing for human papillomavirus are among the topics covered in this update on contemporary genitourinary pathogens.

Bacterial vaginosis: prevalence in outpatients, association with some micro-organisms and laboratory indices.

Seven hundred and ninety three women were investigated, aged between 16 and 78 years, to evaluate the prevalence of bacterial vaginosis (BV) and some associated micro-organisms, and to discuss the significance of laboratory indices correlated to this pathology. BV was diagnosed on the basis of four distinct criteria: a positive result of the test for amines with 10% KOH (odour-test), the presence of clue cells on fresh microscopic examination, a pH greater than 4.5 and direct Gram stain positive (the presence of more than 40 Gram negative or Gram variable coccobacilli per microscopic field by 1000 magnifications under oil immersion). The total prevalence of BV was 20.5% (163); similar percentages were found in both fertile and pregnant women, whereas a lower percentage (12.7%) was found in menopausal women. Gardnerella vaginalis was present in 235 (29.6%) of the 793 women, in 144 (88.3%) of the 163 with BV and in 91 (14.4%) of the 630 women without BV. Mobiluncus species was present in 8.2% (65) of the total population, in 38.6% (63) of the women with BV and only in two (0.3%) of the women without BV. In the women with BV lower percentages were found for Trichomonas vaginalis, yeasts, Chlamydia trachomatis and Neisseria gonorrhoeae. The absence of a definite relationship between BV and cultural isolation of G vaginalis is confirmed whereas the role played by Mobiluncus spp still has to be clarified. It is concluded that it is not necessary to screen with all four laboratory indices. Two positive indices from a panel of three (excluding pH greater than 4.5 and direct Gram stain positive in the same panel) allows the correct diagnosis of BV in almost all cases.

Mobiluncus species and other anaerobic bacteria in non-puerperal breast abscesses

Samples of 109 breast masses were cultured aerobically and anaerobically for Mobiluncus spp. using selective and non-selective media. Two of the 103 evaluable samples were sterile and 57 (55%) yielded facultative bacteria only. The remaining 44 (43%) contained anaerobic growth alone or mixed infections. Seven (16%) of the 44 samples with anaerobes, six from women and one from a man, yielded Mobiluncus spp. Six were identified as Mobiluncus curtisii and one as Mobiluncus mulieris. There were two types of breast abscesses: one with Staphylococcus aureus predominating and one with anaerobes predominating. Most of the anaerobes belonged to the normal vaginal flora, but some were members of the normal oral flora. These results support the hypothesis that breast infections with these anaerobes result from sexual activities.