THE NORMAL VAGINAL FLORA, H2O2-PRODUCING LACTOBACILLI, AND BACTERIAL VAGINOSIS IN PREGNANT-WOMEN

In this study of the vaginal flora of 171 pregnant women in labor at t erm, the flora was categorized as normal (Lactobacillus predominant), intermediate or representative of bacterial vaginosis (BY) on the basi s of a vaginal smear. BY was diagnosed in 39 women (23%); the vaginal flora was classified as normal in 50% of cases and as intermediate in 27%. H2O2-producing lactobacilli were recovered from 5% of women with BY, 37% of those with an intermediate flora, and 61% of those with a n ormal flora. H2O2-negative lactobacilli were equally frequent (57%-65% ) in all three groups. The microorganisms most frequently recovered fr om women with BY included Gardnerella vaginalis, Prevotella bivialdisi ens, Bacteroides ureolyticus, Prevotella corporis/Bacteroides levii, F usobaeterium nucleatum, Mobiluncus species, Peptostreptococcus prevoti i, Peptostreptococcus tetradius, Peptostreptococcus anaerobius, virida ns streptococci, Urea-plasma urealyticum, and Mycoplasma hominis (P <. 05 for each). The presence of all but three of these organisms was inv ersely related to vaginal colonization by H2O2-producing lactobacilli; the exceptions were B. ureolyticus, F. nucleatum, and P. prevotii. Ot her microorganisms were equally frequent among women with and without BY. We conclude that specific groups of anaerobes are associated with BY in this population and that a strong association exists between spe cies associated with BY and those inhibited by H2O2-producing lactobac illi.