Vaginal swab + Gardnerella antigen

General information:

Gardnerella vaginalis is an anaerobic bacterium that resides in the normal vaginal flora. Normally, vaginal flora is predominated by the Lactobacilli species, but when organisms such as Gardnerella begin to overgrow and become the dominant species, this leads to bacterial vaginosis (BV). The bacteria are thought to be sexually transmitted between partners and can create a biofilm that progresses into BV. BV is the most common cause of vaginal discharge. Of clinical consequence, BV is associated with preterm birth and increased risk for acquisition of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs).

Women colonized with G. vaginalis are typically asymptomatic unless they have bacterial vaginosis. Most women with BV present with a complaint of malodorous vaginal discharge, which often becomes more pronounced after sexual intercourse. A diagnosis of BV is suggested by a higher than normal vaginal pH (greater than 4.5), the presence of clue cells on a wet-mount slide, and a positive whiff test. Occasionally a Gram stain of the vaginal fluid is still done to examine the predominant strain of bacteria to make a microbiological diagnosis of BV. This technique is referred  as Nugent criteria.

Most uncomplicated cases of bacterial vaginosis resolve with treatment. However, recurrences are not uncommon. Over time, BV is a risk factor for acquiring HIV. Over the past decade, there have been multiple reports of resistant strains that do not resolve with conventional treatment.

BV can lead to the following:

• Increased risk for endometritis and salpingitis
• Increased risk of post-surgery infections
• Adverse outcomes in pregnancy including premature labor, premature rupture of membranes and postpartum endometritis.
• Pelvic inflammatory disease
• Neonatal meningitis

Sample required:

Vaginal swab