The modifications to the vaginal habitat accompanying a change to vaginal flora in bacterial vaginosis (BV) are poorly understood. In this study enzymes involved in mucin degradation were measured, including a novel glycosulfatase assay. Women attending an emergency walk-in sexually transmitted disease clinic were studied. One high vaginal swab (HVS) was used to prepare a gram-stained smear to determine BV status, using Ison and Hay's criteria, and a separate swab was used for the purposes of the assays. The median glycosulfatase activity was 8.5 (range, ؊1.2 to 31.9) nmol h ؊1 1.5 ml ؊1 of HVS suspension in patients with BV compared to 0.5 (range, ؊0.7 to 9.4) nmol h ؊1 1.5 ml ؊1 of HVS suspension in patients without BV (P ؍ <0.001). The median glycoprotein sialidase activity was 29.2 (range, ؊17 to 190) nmol h ؊1 1.5 ml ؊1 of HVS suspension in patients with BV compared to ؊1.1 (range, ؊41 to 48) nmol h ؊1 1.5 ml ؊1 of HVS suspension in patients without BV (P < 0.001). A rapid spot test for sialidase was positive in 22/24 patients with BV (sensitivity, 91.7%; 95% confidence interval [CI], 73 to 99%) and negative in 32/35 patients without BV (specificity, 91.4%; 95% CI, 76.9 to 98.2%) (P < 0.001). Glycosulfatase activity significantly correlated with both glycoprotein sialidase activity and the sialidase spot test (P ؍ 0.006 and P < 0.001, respectively). The results are consistent with the hypothesis that the consortium of bacteria present in BV requires the ability to break down mucins in order to colonize the vagina and replace the normal lactobacilli.Bacterial vaginosis (BV) is a condition in which commensal lactobacilli in the vagina are replaced by a profound overgrowth of a mixed microflora of anaerobes and Gardnerella vaginalis. It is strongly associated with preterm birth (6,7,14), endometritis, and pelvic inflammatory disease (12, 26), acquisition of Neisseria gonorrhoeae, Chlamydia trachomatis, and human immunodeficiency virus (3,21,30), and probably enhanced human immunodeficiency virus transmission (4,15,21). The causative link between BV colonization and associated pathology is not firmly established.Mucolytic enzymes (mucinases), including those which degrade terminal carbohydrate residues or those which disrupt the mucin apoprotein primary structure, are produced by some bacteria associated with BV. Previous work has shown that the presence of glycosidases, including sialidase, is frequently associated with BV (1,8,14,17,33). Certain organisms related to those found in BV have been shown to produce sialidase (reviewed in reference 32). The detection of a variety of enzymes with mucin-degrading potential from BV organisms (1,8,17,22,32,33) indicates that a complementary relationship may exist between the different types of bacteria and that synergistic-enzymatic activity is required to effect maximum control over the vaginal environment. Intensive production of hydrolytic enzymes in BV might lead to diminished mucosal barrier protection through disruption of secreted mucus viscoelasticity and d...