Prevalence of Gardnerella vaginalis in Prepubertal Males

Abstract

To determine the rate of occurrence of Gardnerella vaginalis in the genital tract and rectum of the asymptomatic prepubertal boy and to examine the effect of circumcision on the rate of recovery. Design: A prospective survey design was used. Cultures for G vaginalis were obtained from the urethral meatus, surrounding glans, and rectum of prepubertal boys. Boys who had a history of sexual abuse, current urogenital symptoms, or who had taken antibiotics in the preceding 2 weeks were excluded from this study. Setting: The study was conducted in ambulatory clinical settings at a children's hospital within a major medical center that serves as a statewide referral center. Participants: A group of 99 circumcised and uncircumcised prepubertal boys participated in the study. The participants ranged in age from 1 month to 7 years 4 months. Main Outcome Measure: Results of cultures for G vaginalis. Results: No cultures were positive for G vaginalis from the urethra, glans, or rectum in any of the participants in this study. Conclusions: The findings of this study provide preliminary evidence that G vaginalis is not an organism that commonly colonizes the urogenital or gastrointestinal tract in asymptomatic prepubertal boys. Based on these findings, it does not seem prudent to apply the concept of asymptomatic colonization to prepubertal boys unless further studies refute these findings.

The epidemiology of bacterial vaginosis in relation to sexual behaviour

“…In addition, a female-to-male route of transmission may further be consistent with the observation that G. vaginalis is not present in prepubertal boys, as apparent from one study involving 99 boys with negative cultures for G. vaginalis from the urethra, glans, and rectum [65]. In accordance, in a study comprising 50 adolescent males who had not engaged yet in sexual activity/who were sexually inexperienced, G. vaginalis was isolated from the urethra in only one [66] and in a study by the same authors, involving 50 recently married, young men in monogamous relationships with no history of STDs, G. vaginalis was isolated from none of them [66].…”

“…Furthermore, there is convincing evidence ensuing from condom studies [63,64], from studies among heterosexual versus homosexual men [30], and from studies among young, monogamous men [65,66], that transmission of BV-associated micro-organisms may occur, however that female-to-male transmission may be a far more common route than male-to-female transmission. This sheds a completely different light on the high concordance rates of G. vaginalis carriage among couples of whom the female partner has BV, which has been a longstanding argument in favour of BV as an STD.…”

Gardnerella vaginalis and Mollicute detection in rectal swabs from men who have sex with men

“…Previous studies have failed to isolate G. vaginalis from the rectum of prepubertal males suggesting it is not a natural organism of the gastrointestinal tract. 32 However, the use of insensitive culture in the study would have confounded the results. 32 Testing of rectal swabs with highly sensitive and specific assays as used in this study will be essential to determine the role of G. vaginalis in healthy and inflamed rectal mucosa.…”

“…32 However, the use of insensitive culture in the study would have confounded the results. 32 Testing of rectal swabs with highly sensitive and specific assays as used in this study will be essential to determine the role of G. vaginalis in healthy and inflamed rectal mucosa. Overgrowth of G. vaginalis with other anaerobic bacteria as seen in BV 19,20 would be an important finding in the male rectum especially in males in high risk MSM populations where persistent infection may lead to HIV acquisition and transmission.…”