Gardnerella vaginalis is a facultatively anaerobic. These are small gram-negative or gram-viable encapsulated, immobile polymorphic rods, often coccobacilli 1-2 μm in length, 0.3-06 μm thick, often producing amino acids and acetic acid. G. vaginalis is a pathogenic microorganism, often found in inflammatory diseases of the urogenital organs in women of reproductive age, less often in men.
Infection occurs during sexual intercourse, which is confirmed by the lack of G. vaginalis in healthy virgins. The possibility of infection is limited by the low virulence of the pathogen, but it increases with intrauterine contraceptives, hormonal status, immunological reactivity, intestinal microbiocenosis, antimicrobial therapy, and inflammatory diseases of the genitourinary tract. The most important risk factors for infection are frequent changes in sexual partners and the presence of vaginitis. Gardnerellez in 50% of cases in men is asymptomatic. Gardnerellez is also complicated with other pathogens STI: yeast-like fungi of the genus Candida, chlamydia, gonococcus, trichomonas, etc. The incubation period is from 5 days to 3 weeks (an average of 7-10 days).
Classification of gardnerellez is similar to that of gonorrhea.
The most important clinical manifestation of gardnerellosis in women is bacterial vaginosis - a polymicrobial clinical syndrome characterized by specific abnormalities of vaginal discharge and a violation of vaginal ecology. In bacterial vaginosis, the lactobacilli flora is replaced by anaerobic microorganisms: Bacteroides, Peptococcus, Peptostreptococcus, Streptococcus gr. B, Mobiluncus spp., Micoplasma hominis, etc. Bacterial vaginosis is manifested by hyperemia of the mucous membranes of the vagina, cervix, urethra. In fresh acute cases, the vaginal discharge is abundant, white-gray, homogeneous, dense, from the cervical canal and urethra, usually uninvolved.
In the process, the uterine cavity and the appendages (salpingitis) can be involved, while the patients complain of itching, burning, profuse vaginal discharge with a sharp fishy smell intensifying after sex. In the case of fresh torpid and chronic processes, these manifestations are less apparent and absent.
Bacterial vaginosis can be complicated by chorioamnionitis, postpartum endometritis, bacteremia. Men sick with gardnerellosis suffer from torpid urethritis, which can be complicated by prostatitis, epididymitis, etc.
Gardnerellez is diagnosed by testing the “clue cells,” which are vaginal epithelial cells , that are coated with the small gram -variable coccobacteria (identified in the native preparation or in Gram stain) and a positive sample with 10% KOH (fish odor resulting from the transition of abnormal amines into free volatile compounds). Additional criteria are the pH of discharge from 5.0 to 6.5, a significant decrease or absence of lactic acid bacteria and leukocytes.