Gardnerella Vaginalis, Several Detection Methods Evaluation Of The Diagnostic Value Of Bacterial Vaginosis

Objective To evaluate the detection methods of gardnerella vaginalis(GV) in laboratory as to the diagnosis of bacterial vaginosis and to provide the foundation of the bacterial vaginosis(BV) in diagnosis . To examine drug sensitivities of GV to several clinical traditional drugs and to give the clinical doctors advices that which drug should be selected.Methods To use polymerase chain reaction (PCR) method to detect gardnerella vaginalis's specific gene fragment. Grams staining and bacterial culture were also used to detect GV . And a rapidly diagnosis test of BV were used to detect the product of BV.Results There were 237 samples of vaginal secretion to be examined in total. According to the gold standard (Amsel standard), there were 174 cases in BV group, 63 cases in nonbacterial vaginosis(NBV) group and 40 persons in healthy control group . The positive rates of the four laboratory methods of GV were significantly higher in BV group than those in NBV group and those in healthy control group.( x2= 14.72, 33.37, 86.89, 88.43 and 16.17, 17.64, 84.07, 132.32,respectively ,P<0.05) In Grams staining there were difference of the positive rates of GV , Clue-cell and WBC in statistics between BV group and NBV group.( x2= 65.38, 44.91, 9.50,respectively, P<0.05) 23 isolates of GV were examined for sensitivities to metronidazole, tinidazole, clindamycin, azithromycin, roxithromycin. There were 2 isolates of GV to be sensitive to metronidazole, 3 isolates of GV to be sensitive to tinidazole , 3 isolates of GV to be sensitive to roxithromycin , 4 isolates of GV to be sensitive to azithromycin and 1 isolates of GV to be sensitive to clindamycin .Except for those isolates of GV above, they were all resistant to the traditional drugs.Conclusion GV plays an important role in microbiota of BV because it consists of 1/3~1/2 microbiota of BV. The rapid diagnosis test of bacterial vaginosis is a rapid and good sensitivity method that is fit for the screening of the crowd. Grams staining is a simple method which could be easily finished in clinical laboratory. If the quality of the method could be guaranteed , the method is also a good way. Bacterial culture is a gold standard of bacterial identification, which is dependable. But its positive rate is lower and the test can be interfered by many factors such as drugs. There are important value in bacterial culture with the treatments of recurrent and lasting BV. The PCR method is a high sensitivity and specificity way and cannot be effected by drugs ,et al. So it can be used as a major laboratory method for GV detection. The drug sensitivity test of GV to those traditional drugs shows that the major bacterium in the BV was the more resistant to the traditional drugs. And the drug sensitivity of GV has changed.