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Atopobium vaginae, Molecular Detection

Atopobium vaginae is one of the most common causes of bacterial vaginosis. It is found in 80% of women suffering from anaerobic vaginitis and because of its resistance to metronidazole, it is a major cause of treatment failure of vaginitis.

Bacterial vaginosis is the most common vaginal disorder in women of reproductive age. The condition is characterized by the replacement of the healthy, vaginal microbiome dominated by lactobacilli, by anaerobic and potentially anaerobic microbes (vaginal dysbiosis). Bacterial vaginosis increases the risk of sexually transmitted diseases and is associated with pregnancy complications. Although the composition of the bacteria in patients with vaginitis varies, there are some species such as Gardnerella, Atopobium, Mycoplasma, Sneathia, Megasphera, Dialister, etc., which are more common.

Atopobium vaginae was causally associated with bacterial vaginosis only in 2004. Atopobium vaginae are anaerobic, small, elongated, Gram-positive cocci and can occur singly, in pairs, or in small chains. This variable cell morphology may explain why Atopobium vaginae is extremely difficult to identify in a Gram stain. It is also extremely demanding on micronutrients while at the same time its slow growth in the culture materials, making it impossible to isolate and identify it with the classic microbiological cultures.

Atopobium vaginae is resistant to metronidazole but is sensitive to clindamycin and the newer antimicrobial, nifuratel.

Atopobium vaginae has been detected by molecular testing (PCR) in 96% of women with bacterial vaginosis and only in 12 to 20% of asymptomatic women. A. vaginae together with Gardnerella vaginalis are found in 78% to 96% of patients with anaerobic bacterial vaginosis and only in 5 to 10% of normal women.

Analysis of the composition and organization of the biofilm present in the vaginal mucosa in patients with bacterial vaginosis showed that in 70% of the samples, A. vaginae was present. The presence of A. vaginae in the biofilm in combination with its resistance to metronidazole may explain the therapeutic failures and relapses of bacterial vaginosis. In addition to vaginitis, it has occasionally been associated with gynecological-obstetric complications (including pelvic inflammatory disease, endometritis, salpingitis, and preterm birth), and is rarely reported as a cause of bacteremia and deep-seated infections.

Atopobium vaginae, like Gardnerella vaginalis and Prevotella bivia, are microbes that can trigger severe symptoms of inflammation and immune responses in the vaginal epithelium.

At Diagnostiki Athinon, the test for the presence of Atopobium vaginae in the urogenital system can be done individually or in combination with other microorganisms, both in men and women, in the following laboratory tests:


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