Gardnerella

Gardnerella vaginalis are small, capsule-free, immobile, anaerobic actin-like rods. Gardnerella are among the opportunistic microorganisms that inhabit the vagina and urogenital tract, although their percentage relative to other microbes (e.g., lactobacilli) is not high. But under certain conditions, under which most of the normal microflora of the vagina dies, the number of Gardnerella increases first relative to others, and then absolutely, as they cease to be affected by factors that inhibit their growth and reproduction. This leads to the development of a local inflammatory reaction in the form of bacterial vaginosis. Factors contributing to the death of lactobacilli and increased activity of Gardnerella vaginalis:

• Frequent sprays, particularly with chlorinated antiseptics;
• Use of contraceptives with 9-nonoxynol in their composition (suppositories, condoms with spermicidal lubricant);
• Frequent change of sexual partners, unprotected sex;
• Frequent, unjustified use of broad-spectrum antibiotics;
• Decrease in general and local immunity, as a result of long-term inflammatory diseases;
• Immunodeficiency states;
• Treatment of diseases requiring the use of immunosuppressive therapy.

The main way of transmission of Gardnerella vaginalis is sexual, including oral-genital and anal-genital contacts. In addition, contact and household transmission is also possible, through the use of personal hygiene items and contaminated underwear with which an infected person has come into contact. Theoretically, transmission of infection from mother to child is possible during the passage of the child through the birth canal of the mother, but, as a rule, this is observed quite rarely. Many people are carriers of the infection, which as already indicated, can spread through sexual and contact. The most common carriers are men.

The clinical picture is manifested by the following symptoms:

• In women: As a rule, there is an abundant, watery, grayish-white discharge from the vagina, which evenly lines all its walls. The discharge has a very unpleasant odor ("rotten fish smell"). The presence of this smell is due to the release of specific enzymes that break down proteins in the process of Gardnerella's vital activity. When they interact with protein molecules that are part of the vaginal mucosa, they form chemical compounds - diamines (cadaverine), which give a specific smell; Itching and burning are less common.
• In men: Symptoms are poor or absent. In more rare cases, Gardnerella may cause men to develop Gardnerella-associated balanopostitis (inflammation of the glans and foreskin of the penis), which is accompanied by sticky plaque, erythema (redness) of various sizes on the glans and foreskin, as well as unpleasant smell. Often in men, these symptoms disappear quickly even without the use of special treatment, but the infection remains in the urethra, as a result of which the man becomes a carrier of this infection.

The determination of gardnerella by polymerase chain reaction (PCR) is characterized by high sensitivity and specificity (98%). The principle of PCR is to identify a unique DNA fragment belonging to a given microorganism after repeated doubling of the sampling genetic material in a test-tube. In the OLYMP CDL branches, PCR analysis are made in REAL-TIME mode - this means that after each hardware cycle (amplification), the amount of DNA in the biomaterial is measured. This procedure reduces the probability of a false positive result to almost zero!