Gardnerella vaginalis

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Gardnerella vaginalis
vaginal epithelial cells colonized by Gardnerella vaginalis (clue cells), 400 times enlarged

vaginal epithelial cells colonized by Gardnerella vaginalis (clue cells), 400 times enlarged

Systematics
Domain : Bacteria (bacteria)
Department : Actinobacteria
Order : Bifidobacteriales
Family : Bifidobacteriaceae
Genre : Gardnerella
Type : Gardnerella vaginalis
Scientific name
Gardnerella vaginalis
( Gardner & Dukes 1955)
Greenwood & Pickett 1980

Gardnerella vaginalis is a gram-negative , but gram-positive , facultatively anaerobic, immobile bacterium , which morphologically resembles a short (cocoid) rod. Thebacterium,initially erroneously called " Haemophilus vaginalis ", was discovered in the 1950s by Hermann L. Gardner (1918–2005) and CD. Dukes, a microbiologist and a gynecologist , discovered and characterized. Due to its staining behavior, it can also appear gram-negative.

G. vaginalis is part of the normal vaginal flora with a small number of germs and is the main germ to be detected in high numbers of germs (lead germ) in bacterial vaginosis , a bacterial overgrowth of the vagina. Initially relatively harmless - it can be detected in around 40% of all asymptomatic women - however, it can subsequently lead to inflammation of the vagina, colpitis (vaginitis), which occurs all the more easily as the protective Döderlein flora is no longer due to the existing incorrect colonization is fully intact. The germ can rise into the upper genital tract (ascension) and lead to severe infections there.

Usually G. vaginalis is not the sole cause of colpitis; rather, it is a mixed infection after atypical colonization of the vagina with other ( usually anaerobic ) bacteria, such as B. Bacteroides spp., Peptostreptococci and mycoplasmas , especially Mycoplasma hominis . If G. vaginalis and anaerobic bacteria are present in high numbers, the resulting vaginitis is more precisely referred to as amine colpitis . With a share of around 10%, this is the most common vaginal infection.

Gardnerella vaginalis , but also other pathogenic bacteria, are the cause of the typical foul-fishy smell of vaginal discharge in women who suffer from bacterial vaginitis.

In the case of colpitis, key cells ( clue cells ) are visible in the vaginal swab . These are vaginal epithelial cells that have a dense bacterial lawn on their surface. The second criterion is an increased number of leukocytes (> 10 / visual field ). The pH value has increased to over 4.5.

Prolonged vaginosis / colpitis can lead to progressive infections and ultimately infertility . Such infections are particularly dangerous during pregnancy and childbirth .

A colonization / infection with G. vaginalis can occur with metronidazole (e.g. Clont ®, Vagimid ®) or, depending on the antibiotic sensitivity tested in the laboratory, with penicillin G + V, ampicillin , amoxicillin (/ clavulanic acid) or Clindamycin can be treated successfully.

Gardnerella vaginalis has also been linked to recurrent urinary tract infections .

literature

  • HL Gardner, CD Dukes: Haemophilus vaginalis vaginitis. A newly defined specific infection previously classified 'Non specific vaginitis'. In: Am J Obstet Gynecol. 69, 1955, pp. 962-976.
  • P.-A. Mardh, S. Elshibly, I. Kallings, D. Hellberg: Vaginal flora changes associated with Mycoplasma hominis. In: Am J Obstet Gynecol. 176, 1997, pp. 173-178.
  • A. Ahmed, J. Earl et al .: Comparative Genomic Analyzes of 17 Clinical Isolates of Gardnerella vaginalis Provide Evidence of Multiple Genetically Isolated Clades Consistent with Subspeciation into Genovars. In: Journal of bacteriology. Volume 194, Number 15, August 2012, pp. 3922-3937, ISSN  1098-5530 . doi: 10.1128 / JB.00056-12 . PMID 22609915 .
  • WG Lewis, LS Robinson et al. a .: Degradation, foraging, and depletion of mucus sialoglycans by the vagina-adapted Actinobacterium Gardnerella vaginalis. In: The Journal of biological chemistry. Volume 288, Number 17, April 2013, pp. 12067-12079, ISSN  1083-351X . doi: 10.1074 / jbc.M113.453654 . PMID 23479734 . PMC 3636892 (free full text).

Individual evidence

  1. ^ BD Gardnerella
  2. ^ Nicole M. Gilbert, Valerie P. O'Brien, Amanda L. Lewis: Transient microbiota exposures activate dormant Escherichia coli infection in the bladder and drive severe outcomes of recurrent disease . In: PLOS Pathogens . tape 13 , no. 3 , March 30, 2017, ISSN  1553-7374 , p. e1006238 , doi : 10.1371 / journal.ppat.1006238 ( plos.org [accessed April 5, 2017]).