GARDNERELLA-VAGINALIS - TRANSPORT, MICROS COPY, RESISTANCE TESTING

G. vaginalis is an important pathogen in the aetiology of bacterial va ginosis. Therefore, we investigated the influence of transport systems in isolation, a scoring system for Gram stains, and susceptibility to antimicrobial agents. The comparison between a simple (Transwab) and a sophisticated (Port-A-Cul) system showed no differences with regard to for instance Enterococcus faecalis or Escherichia coli; however, is olation of G. vaginalis, a fastidious microorganism, was significantly higher (alpha < 0.0001) in Port-A-Cul. There was a strong correlation (97.5%) using the scoring system indicating bacterial vaginosis and i solation of G. vaginalis. The minimal inhibitory concentrations (MIC) of metronidazole for 60 strains of G. vaginalis were higher than 32 mg /l, some strains showing heteroresistance. This phenomenon may be an e xplanation for treatment failures. Clindamycin and erythromycin were m uch more active, with MIC's between 0.016 and 0.19 mg/l, in-vitro deve lopment of resistance being slower for clindamycin than for erythromyc in. Conclusions: (I) for isolation of G. vaginalis, a sophisticated tr ansport system is mandatory; (II) a scoring system for Gram staining i s helpful in diagnosis of bacterial vaginosis; (III) in patients with metronidazole treatment failures, clindamycin should be used.