Medline ® Abstracts for References 14-16

of 'Bacterial vaginosis'

14
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Targeted PCR for detection of vaginal bacteria associated with bacterial vaginosis.
AU
Fredricks DN, Fiedler TL, Thomas KK, Oakley BB, Marrazzo JM
SO
J Clin Microbiol. 2007;45(10):3270.
 
Several novel bacterial species have been detected in subjects with bacterial vaginosis (BV) by using broad-range PCR assays, but this approach is insensitive for detecting minority species. We developed a series of taxon-directed 16S rRNA gene PCR assays for more sensitive detection of key vaginal bacteria. We sought to determine the prevalence of each species in the vagina, its association with BV, and the utility of PCR for the microbiological diagnosis of BV. Targeted PCR assays were developed for 17 vaginal bacterial species and applied to 264 vaginal-fluid samples from 81 subjects with and 183 subjects without BV. The results were compared to those of two widely accepted methods for diagnosing BV, the use of clinical findings (Amsel criteria) and the interpretation of vaginal-fluid Gram stains (Nugent criteria). Leptotrichia/Sneathia, Atopobium vaginae, an Eggerthella-like bacterium, Megasphaera species, and three novel bacteria in the order Clostridiales are among the bacterial species significantly associated with BV. PCR detection of either a Megasphaera species or one of the Clostridiales bacteria yielded a sensitivity of 99% and a specificity of 89% for diagnosis of BV compared to the Amsel clinical criteria and a sensitivity of 95.9% and a specificity of 93.7% compared to the Nugent criteria (Gram stain). PCR detection of one or more fastidious bacterial species is a more reliable indicator of BV than detection of bacteria, such as Gardnerella vaginalis, previously linked to BV, highlighting the potential of PCR for the diagnosis of BV.
AD
Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue, North, D3-100, Box 19024, Seattle, WA 98109-1024, USA. dfredric@fhcrc.org
PMID
15
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Analysis of adherence, biofilm formation and cytotoxicity suggests a greater virulence potential of Gardnerella vaginalis relative to other bacterial-vaginosis-associated anaerobes.
AU
Patterson JL, Stull-Lane A, Girerd PH, Jefferson KK
SO
Microbiology. 2010 Feb;156(Pt 2):392-9. Epub 2009 Nov 12.
 
Worldwide, bacterial vaginosis (BV) is the most common vaginal disorder in women of childbearing age. BV is characterized by a dramatic shift in the vaginal microflora, involving a relative decrease in lactobacilli, and a proliferation of anaerobes. In most cases of BV, the predominant bacterial species found is Gardnerella vaginalis. However, pure cultures of G. vaginalis do not always result in BV, and asymptomatic women are sometimes colonized with low numbers of G. vaginalis. Thus, there is controversy about whether G. vaginalis is an opportunistic pathogen and the causative agent of many cases of BV, or whether BV is a polymicrobial condition caused by the collective effects of an altered microbial flora. Recent studies of the biofilm-forming potential and cytotoxic activity of G. vaginalis have renewed interest in the virulence potential of this organism. In an effort to tease apart the aetiology of this disorder, we utilized in vitro assays to compare three virulence properties of G. vaginalis relative to other BV-associated anaerobes. We designed a viable assay to analyse bacterial adherence to vaginal epithelial cells, we compared biofilm-producing capacities, and we assessed cytotoxic activity. Of the BV-associated anaerobes tested, only G. vaginalis demonstrated all three virulence properties combined. This study suggests that G. vaginalis is more virulent than other BV-associated anaerobes, and that many of the bacterial species frequently isolated from BV may be relatively avirulent opportunists that colonize the vagina after G. vaginalis has initiated an infection.
AD
Department of Microbiology and Immunology, PO Box 980678, Virginia Commonwealth University, Richmond, VA 23928, USA.
PMID
16
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The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment.
AU
Verstraelen H, Swidsinski A
SO
Curr Opin Infect Dis. 2013 Feb;26(1):86-9.
 
PURPOSE OF REVIEW: Recent evidence supports the view that bacterial vaginosis presents as a polymicrobial biofilm infection. This has far-reaching implications for the pathogenesis, epidemiology, diagnosis and treatment of bacterial vaginosis.
RECENT FINDINGS: Gardnerella vaginalis is presumably the first species to adhere to the vaginal epithelium and then becomes the scaffolding to which other species adhere. Not all G. vaginalis strains do form biofilms: G. vaginalis can be present in the vagina in a planktonic or in a biofilm mode of growth. The presence of planktonic (dispersed) or biofilm-associated (cohesive) G. vaginalis can be reliably shown in urine sediments in both women and men, and there is an absolute concordance in the carriage of biofilm-associated (cohesive) G. vaginalis between women with bacterial vaginosis and their partners. In-vitro data suggest that selected probiotic lactobacilli might be an effective means to conquer the biofilm.
SUMMARY: Future epidemiological research may benefit from biofilm-based urine diagnosis of bacterial vaginosis to a significant extent. The search for noveltherapeutic agents can now be more directed towards the biofilm-breaking agents, but is at present hampered by the lack of a proper in-vitro model of the bacterial vaginosis biofilm.
AD
Department of Obstetrics and Gynaecology, Vulvovaginal Disease Clinic, Ghent University, Ghent, Belgium. hans.verstraelen@ugent.be
PMID