Gardnerelli
Last reviewed: 23.04.2024
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[Morphology of the Gardnerella
Gardnerelli - bacteria, small sticks or coccobacilli of 1-2x0.3-0.6 microns in size. In smears, the cells are arranged singly or in pairs. Young 8-12-hour cultures are colored grammatically, and cultures grown on the optimal medium are gram-positive. Capsules, flagella and spores do not.
The cultural properties of the gardnerella
Optional anaerobes, capnophils. Are demanding to nutrient media, on simple nutrient mediums do not grow or give a weak growth on blood agar. They grow on special complex nutrient media with the addition of hemin and at 35-37 ° C.
Biochemical activity of the gardnerella
Metabolism of fermentation type. Split glucose and maltose to an acid. The main product of fermentation is acetic acid, some strains can form amber and formic acids. Enzymatic activity is low: catalase and oxidase do not form, decompose hippurate, hydrolyze starch.
Antigenic structure of the gardnerella
There are 7 serogroups of gardnerella. The total antigen presenting the glycopeptide is determined in the expanded RA and ELISA. In the RIF, general antigens with Candida albicans have been identified.
Factors of pathogenicity of the gardnerella
Some strains of gardnerella produce neuramidiasis, which destroys the glycoproteins of the vaginal mucosa.
Stability In the environment is low. Gardnerelles are sensitive to metronidazole and trimethoprim, commonly used antiseptics and disinfectants.
Pathogenesis of gardnerellosis
The ecological niche is the vagina. Gardnerelli together with bacteroids, mobilnunkasami and other anaerobes cause in women bacterial vaginosis, characterized by violations of the microbiocenosis of the vagina. Predisposing factors are diabetes, pregnancy, the use of hormonal contraceptives, menopause, endocrine disorders, leading to an imbalance of estrogen and progesterone in the body. All this causes a change in the concentration of sugar on the mucous membrane of the vagina and as a result of a decrease in the number of lactobacilli that support the colonization resistance of the vagina, as a result of which the pH in the vagina becomes higher than 4.5, and gardnerelles, in association with anaerobes such as bacteroids, peptostreptococci and mobiluncus, multiply, causing the development of bacterial vaginosis. None of these microbes separately vaginosis does not cause.
Symptoms of gardnerellosis
The symptoms of gardnerellez are characterized by the formation of foamy vaginal secretions of white or gray color with a sharp unpleasant fish smell caused by the formation of abnormal amines. Symptoms of inflammation are absent. Men usually develop nonspecific urethritis or inflammatory processes of the penis. Bacterial vaginosis can lead to severe consequences, such as premature birth, weight loss of newborns, premature rupture of membranes, inflammatory diseases of the pelvic organs, pathological uterine bleeding. Up to one-third of women presenting various complaints of discomfort in the vagina suffer from bacterial vaginosis. When the inflammatory component is attached and the appearance of neutrophils in the vaginal discharge, vaginozovaginitis develops.
Immunity after the transferred disease is not formed.
Laboratory diagnostics of gardnerellosis
The material for the study is a swab of the vagina and cervix. For diagnosis, bacterioscopic and bacteriological methods are used. Usually the diagnosis is made by a bacterioscopic method to detect key cells, i.e. Cells of the vaginal epithelium, covered with a large number of gram-negative and gram-positive bacteria.
Key cells are covered with a huge number of thin rods or coccobacteria, which gives the surface of the cell a granular appearance and an unclear outline. Lactobacilli in Gram stained smears are almost or completely mixed with profuse growing bacterial flora, consisting of anaerobic bacteria.
In addition, the following clinical signs are used: vaginal discharge has a pH above 4.5; increase in the number of sharply watery homogeneous vaginal discharge, absence of leukocytosis of vaginal discharge; the appearance of a sharp odor when added to the secretions of a 10% KOH solution.
Bacteriological examination is rare.