Analysis of bacterial vaginosis-related amines in vaginal fluid by gas chromatography and mass spectrometry

The presence of various amines in vaginal fluid from women with malodorous vaginal discharge has been reported before. The investigations have used se veral techniques to identify the amines. However, an optimized quantificati on, together with a sensitive analysis method in connection with a diagnost ic procedure for vaginal discharge, including the syndrome of bacterial vag inosis, as defined by the accepted "gold standard," has not been done befor e. We now report a sensitive gas chromatographic and mass spectrometric met hod for identifying the amines isobutylamine, phenethylamine, putrescine, c adaverine, and tyramine in vaginal fluid. We used weighted samples of vagin al fluid to obtain a correct quantification. In addition, a proper diagnosi s was obtained using Gram-stained smears of the vaginal fluid that were Nug ent scored according to the method of Nugent et al. (R. P. Nugent et al., J . Clin. Microbiol., 29:297-301, 1991). We found that putrescine, cadaverine , and tyramine occurred in high concentrations in vaginal fluid from 24 wom en with Nugent scores between 7 and 10. These amines either were not found or were found only in very low concentrations in vaginal fluid from women w ith Nugent scores of 0 to 3. There is a strong correlation between bacteria l vaginosis and the presence of putrescine, cadaverine, and tyramine in hig h concentrations in vaginal fluid.