Semiquantitative bacterial observations with group B streptococcal vulvovaginitis

Abstract

Objective: Group B streptococcal (GBS) vulvovaginitis is a poorly-delineated clinical entity. The purpose of this study is to report semiquantitative data from four cases of GBS vulvovaginitis and to comment on their significance in terms of the in vitro inhibitory capabilities of GBS.Methodology: Four patients whose clinical presentations were consistent with GBS vulvovaginitis, from whom GBS was isolated and for whom semi-quantitative as well as qualitative microbiologic data existed, were identified.Results: To produce vulvovaginitis, GBS must be at a high multiplicity (108 CFU/g of vaginal fluid). Single coisolates were identified in three of the four cases (two cases of Escherichia coli and one case of Staphylococcus aureus). Group B streptococcus does not inhibit either of these bacteria in vitro.Conclusion: When the growth requirements for the demonstration of in vitro inhibition for GBS or lack thereof are met in vivo, the in vivo observations are consistent with those projected from the in vitro data. Infect.

Influence of the Vaginal Microbiota on Toxic Shock Syndrome Toxin 1 Production by Staphylococcus aureus

“…Multiple studies have found that S. agalactiae inhibits Lactobacillus spp. and G. vaginalis without inhibiting S. aureus (34)(35)(36) and that S. aureus colonization is significantly associated with colonization by S. agalactiae in a population of pregnant women (37). Our findings thus illustrate another way in which GBS could promote the virulence of S. aureus.…”

Aerobic vaginitis: Abnormal vaginal flora entity that is distinct from bacterial vaginosis

“…The more severe the microscopic findings, the more likely these organisms will be cultured. Case studies have recently drawn attention to the possibility of vaginitis due to GBS [20], and Monif et al provide in vitro evidence that GBS inhibits growth of lactobacilli and G. vaginalis, but not S. aureus [21,22]. There is increasing evidence that some pregnant women develop mid-trimester chorioamnionitis caused by invasive GBS [23,24].…”

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

“…The more severe the microscopic findings, the more likely these organisms will be cultured. Case studies have recently drawn attention to the possibility of vaginitis due to group B streptococci 4 , and Monif et al provide in vitro evidence that group B streptococci inhibits growth of lactobacilli and G. vaginalis, but not S. aureus 22,23 . There is increasing evidence that some pregnant women develop mid-trimester chorioamnionitis caused by invasive group B streptococci 24,25 .…”