Vaginal Microflora Associated With Bacterial Vaginosis inNonpregnant Women: Reliability of Sialidase Detection

摘要

Objective:To determine the prevalence ofGardnerella vaginalis, anaerobic bacteria andMycoplasma hominisin vaginal specimens of women with and without bacterial vaginosis (BV) as well as to determine the sensitivity and specificity of the direct sialidase assay of vaginal fluid as a rapid test for diagnosing this syndrome.Methods:Vaginal cultures were obtained from 109 nonpregnant women (mean age 33 ± 7.1 years), 47 of them with clinical signs of BV (BV+) and 62 of them without BV (BV- ). In addition, we determined the vaginal sialidaseactivity in both groups, which may serve as a feature of this syndrome.Results:Anaerobic bacteria were isolated in 91% and 18% of the BV+and BV- groups, respectively (p< 0.001).Peptostreptococcusspp.,Prevotella biviaandPorphyromonasspp. were strongly associated with BV.P. biviaandPrevotellaspp. represented 44% of all the anaerobes isolated in the BV+ group. All the isolatedP. biviastrains presented sialidase activity.G. vaginalisandM. hominiswere isolated in 76% and 42% of the BV+ and 1% and 0%of the BV- women, respectively (p< 0.001).Mobiluncusmorphotypeswere observed in 34% of the BV+and 0%of BV- women. Sensitivity, specificity, positive predictive value and negative predictive value of sialidase activitywere 81%, 94%, 90% and 86%, respectively.Conclusions:Our data demonstrate a strong association betweenG. vaginalis,M. hominis, andP. biviaand BV.Sialidase activity and Gram stain of vaginal fluid represent accurate methods for diagnosing BV.