Bacterial vaginosis - an ecologic mystery

Article Abstract:

Bacterial vaginosis is the most common vaginal infection in the US. Diagnosis is made on the basis of a grey-white vaginal discharge with a foul odor, a pH of 4.5, and, when the discharge is mixed with potassium hydroxide, a fishy odor that is released; clue cells are evident during microscopic evaluation of the discharge. The infection can occur alone or in combination with other pathogenic organisms. Gardnerella vaginalis (previously called Haemophilus vaginalis) is isolated in 95 percent of the women with this infection. Gardnerella is also present in 40 to 50 percent of healthy women without symptoms. Lactobacillus bacteria are found in 95 percent of healthy women, but only 25 to 65 percent of women with bacterial vaginosis have lactobacillus. In addition, patients with bacterial vaginosis have an overgrowth of Bacteroides, Mycoplasma hominis and Mobiluncus species. It is thought that injury to the vagina causes a decrease in protective lactobacilli, while increasing other pathogenic bacteria. The mechanism underlying this bacterial imbalance is not understood. Since bacterial vaginosis is found in virginal girls, the role of sex in the transmission of Gardnerella is not supported. However, Gardnerella has been found in male partners of infected women. Metronidazole is the treatment of choice but its use in pregnant women is limited. Symptoms recur three months after initial treatment in 20 to 30 percent of women receiving therapy. Bacterial vaginosis can cause infection in the fallopian tubes or uterus, and can complicate pregnancy. There is some speculation that bacterial vaginosis can cause premature labor, swelling of the membrane surrounding the fetus, endometriosis and premature rupture of the fetal membranes. Research regarding the interaction between all bacterial flora of the vagina will lead to an understanding of the pathogenesis of bacterial vaginosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Development and progression, Vagina, editorial, Bacterial vaginitis

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Bacterial virulence: an environmental response

Article Abstract:

When bacteria first infect their hosts, they often start to grow without causing harm to the body tissues. However, tissues may occasionally become damaged, and this may result in more widespread bacterial infection and subsequent disease. Much research focuses on how microorganisms adapt to changes in their surroundings and on the development of drugs that counteract virulence (the ability to cause disease). However, microorganisms may change their physical appearance during infection, or may produce toxic substances only under certain conditions. Recent advances in the understanding of the molecular mechanisms by which bacteria respond to changes in the course of infection are reviewed. Most infections start at the epithelial or surface layer, which is normally protected by host defenses consisting of mucus, which block access to cell surfaces and cilia (hair-like structures) that sweep away mucus and bacteria. Bacteria can develop protein adhesins, which permit the bacteria to adhere more effectively to the epithelial surface. The adhesin is contained in structures called pili, which serve as sites of attachment for immune proteins called antibodies. Bacteria have developed genetic mechanisms that enable conversion of the bacteria from a pili to a non-pili form to avoid host defenses. In addition, bacteria have developed genetic mechanisms for sensing changes in the environment with respect to temperature, hydrogen ion levels, osmolarity, or nutrient supply. Bacterial chromosomes are also capable of changes in structural arrangement, such as supercoiling, which improves the response to altered environmental conditions. These molecular mechanisms should be considered when developing bacterial vaccines or other treatment methods. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Analysis, Environmental aspects, Genetic aspects, Adaptation (Biology), Evolutionary adaptation, Virulence (Microbiology), Molecular microbiology

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Bacterial vaginosis

Article Abstract:

Bacterial vaginosis (BV) is a vaginal infection which is linked to pelvic inflammatory disease, infertility and early labour. BV results from a change in vaginal pH from lacto bacilli flora to anaerobic flora and possible causes include using perfumed soap, semen and hormone changes. It is possibly sexually transmitted. Sufferers sometimes experience a bad-smelling discharge although some women have no symptoms. Diagnosis involves a 'whiff' test, pH greater than 4.5, discharge and microscopic examination. BV is treated with antibiotics or vaginal clindamycin cream.

Care and treatment

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