Gardnerella vaginalis: characteristics, clinical considerations, and controversies.
Abstract: The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis," a common disease of women which is now called bacterial vaginosis. The organism was named G. vaginalis when taxonomic studies showed that it was unrelated to bacteria in various genera including Haemophilus and Corynebacterium. Electron microscopy and chemical analyses have elucidated the organism's gram-variable reaction. Controversy over the etiology of bacterial vaginosis was largely resolved by (i) studies using improved media and methods for the isolation and identification of bacteria in vaginal fluids and (ii) standardization of criteria for clinical and laboratory diagnosis. Besides G. vaginalis, Mobiluncus spp., Mycoplasma hominis, and certain obligate anaerobes are now acknowledged as participants in bacterial vaginosis. The finding that G. vaginalis, Mobiluncus spp., and M. hominis inhabit the rectum indicates a potential source of autoinfection in addition to sexual transmission. Extravaginal infections with G. vaginalis are increasingly recognized, especially when the toxic anticoagulant polyanetholesulfonate is omitted from blood cultures and when urine cultures are incubated anaerobically for 48 h. The finding that mares harbor G. vaginalis suggests that an equine model can be developed for studies of Gardnerella pathogenesis.
Publication Date: 1992-07-01 PubMed ID: 1498765PubMed Central: PMC358241DOI: 10.1128/CMR.5.3.213Google Scholar: Lookup
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Summary
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This research presents an in-depth analysis of the characteristics, clinical considerations, and controversies surrounding Gardnerella vaginalis, a bacteria which has been associated as a cause of bacterial vaginosis in women. The study not only helps clarify the organism’s genus affiliation and Gram stain reaction, but also recognises other organisms participating in bacterial vaginosis and presents possible sources of autoinfection.
Introduction to Gardnerella vaginalis
- Gardnerella vaginalis is an organism identified as one of the causes of a common disease in women known as “nonspecific vaginitis”, or more currently referred to as bacterial vaginosis.
- The bacterium was assigned its specific name following taxonomic studies that established that it was unrelated to bacteria in various other genera like Haemophilus and Corynebacterium.
- Electron microscopy and chemical analysis aided in understanding the organism’s gram-variable reaction, addressing the previously controversial Gram stain reaction.
Bacterial Vaginosis Controversy
- The controversy over the etiology, or the cause and origin, of bacterial vaginosis has been largely resolved due to improvements in methodologies of isolation and identification of bacteria in vaginal fluids, along with standardized criteria for clinical and laboratory diagnosis.
- Other than G. vaginalis, organisms like Mobiluncus spp., Mycoplasma hominis, and certain obligate anaerobes are now acknowledged as contributing to the disease.
Potential Sources of Autoinfection
- This study highlights potential sources of autoinfection, wherein an organism infects the host from which it originated. It suggests that G. vaginalis, Mobiluncus spp., and M. hominis inhabit the rectum, thus serving as a potential autoinfection source in addition to sexual transmission.
Extravaginal Infections & Future Studies
- Recognizing G. vaginalis in cases of extravaginal infections has become increasingly common, especially when the toxic anticoagulant polyanetholesulfonate is excluded from blood cultures and when urine cultures are anaerobically incubated for 48 hours.
- The detection of G. vaginalis in mares (female horses) suggets that an equine model could be developed for deep-dive studies on Gardnerella pathogenesis, broadening the knowledge on disease mechanisms and potentially leading to further effective treatments.
Cite This Article
APA
Catlin BW.
(1992).
Gardnerella vaginalis: characteristics, clinical considerations, and controversies.
Clin Microbiol Rev, 5(3), 213-237.
https://doi.org/10.1128/CMR.5.3.213 Publication
Researcher Affiliations
- Department of Microbiology, Medical College of Wisconsin, Milwaukee 53226.
MeSH Terms
- Bacterial Adhesion
- Female
- Gardnerella vaginalis / isolation & purification
- Gardnerella vaginalis / physiology
- Genitalia, Female / microbiology
- Genitalia, Male / microbiology
- Humans
- Male
- Microbial Sensitivity Tests
- Vaginosis, Bacterial / etiology
- Vaginosis, Bacterial / immunology
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