Gardnerella vaginalis (Bacterial Vaginosis)

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Bacteria - Gram Indeterminate

Gardnerella vaginalis

Characteristics
- Gram-variable rod
- Facultative anaerobe
Transmission/risk factors
- Vaginal douching
  - Disturbs the vaginal microflora, resulting in overgrowth of Gardnerella
- Use of antibiotics
  - Also disrupts vaginal flora, creating open niche for Gardnerella
- Immunosuppression
- Not sexually transmitted disease
  - However, associated with sexual activity
  - Multiple sex partners or unprotected sex
Disease: bacterial vaginosis
- Gray vaginal discharge with “fishy” odor
- Nonpainful (no vaginal inflammation)
Diagnosis
- Clue cells on wet mount microscopy
  - Vaginal squamous epithelial cells covered with Gardnerella
    - Stippled appearance along outer margin
- Vaginal pH >4.5
- Whiff test (KOH)
  - Mixing discharge with KOH increases fishy odor
  - Odor produced by volatile amines produced by Gardnerella
Treatment
- Metronidazole or clindamycin