Gram variable Notes

NOTES NOTES GRAM VARIABLE GARDNERELLA VAGINALIS (BACTERIAL VAGINOSIS) osms.it/gardnerella-vaginalis PATHOLOGY & CAUSES DIAGNOSIS ▪ Facultative, anaerobic, gram-variable coccobacilli ▪ Microscopically ▫ Very thin gram-positive cell wall appears gram-positive/negative ▪ Non-spore forming, non-motile ▪ Causative agent for bacterial vaginosis (BV) ▫ Disruption of vaginal microbiome ▪ Most common vaginal infection in individuals who are biologically female, age 15–44 LAB RESULTS RISK FACTORS OTHER DIAGNOSTICS ▪ Multiple sex partners, douching, smoking COMPLICATIONS ▪ ↑ risk of contracting HIV, other STDs ▪ Acute cervicitis, endometritis, postabortal infection ▪ During pregnancy ▫ Premature birth, low birthweight SIGNS & SYMPTOMS ▪ Malodorous (fishy), thin white/gray vaginal discharge ▪ Vaginal pain, itching, burning ▪ Burning with urination ▪ Gram-stain smear of vaginal discharge; using criteria (e.g. Nugent, Hay/Ison) ▪ Affirm VP III ▫ Commercial automated DNA probe assay detects G. vaginalis ▪ OSOM BVBlue test ▫ Chromogenic identifies presence of elevated sialidase enzyme produced by G. vaginalis, other bacteria (e.g. Bacteroides, Prevotella, Mobiluncus) ▪ Requires three of the following Amsel criteria ▫ Characteristic vaginal discharge ▫ pH > 4.5 ▫ Clue cells visible on saline wet mount (vaginal epithelial cells covered with bacteria) ▫ Positive whiff-amine test (combine vaginal discharge sample with 10% KOH → fishy odor) TREATMENT MEDICATIONS ▪ Antibiotics: metronidazole OSMOSIS.ORG 409

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