Why test for Gardnerella (BV)?

Although bacterial vaginosis can often clear up without treatment, it is advised that all women with BV signs and symptoms be treated to avoid complications. Male partners do not usually require treatment. BV can spread between female sex partners.

BV treatment is especially important for pregnant women. Pregnant women who have had premature births or low weight babies should have a BV examination, even if there are no symptoms.

Some doctors say that all women undergoing a hysterectomy or abortion should be treated for BV before their procedure, regardless of symptoms. BV can be treated with antibiotics. If used correctly they are 85% to 90% effective.

Not detecting Gardnerella can lead to the following complications which have been linked to BV:

• HIV infection susceptibility – having BV may make a woman more susceptible to HIV infection if she is exposed to the virus.
• Transmitting HIV – a woman with BV has a higher risk of passing her HIV infection to her sex partner.

Other sexually transmitted infections (STIs) – a woman with BV is more susceptible to becoming infected with the herpes simplex virus, Chlamydia, gonorrhoea, and HPV (human papilloma virus).

Post-surgical infection – a woman with BV has an increased risk of developing an infection after surgery, such as an abortion or hysterectomy.

Pregnancy complications – having BV increases the risk of some pregnancy complications, such as:

• Giving birth early (preterm delivery).
• A late miscarriage.
• The amniotic sac breaking open too early.
• Chorioamnionitis – inflammation of the membranes that surround the fetus (chorion and amnion). Significantly increases the risk of preterm labour, and if the child survives, the risk of cerebral palsy.
• Postpartum endometritis – the lining of the uterus becomes irritated or inflamed after giving birth.
• Pelvic inflammatory disease (PID) – women with BV are more susceptible to developing PID; infection and inflammation of the upper female genital tract.
• Tubal factor infertility – caused by fallopian tube damage. The fallopian tubes connect the ovaries to the uterus.
• In-vitro fertilization – women with BV may have a lower success rate with IVF.

Source: Centres for Disease Control: Fact Sheet on Bacterial Vaginosis (Dec. 2007)

According to the National Health Service (NHS), UK, approximately 12% to 30% of adult women in the UK may be affected; about 20% of pregnant women in the UK are affected. The Centers for Disease Control and Prevention (CDC), USA, estimates that about 16% of US women are affected.

Bacterial vaginosis can sometimes be asymptomatic – about 50% of women with BV have no symptoms at all.

Gardnerella infection is not something that should only concern women: Gardnerella vaginalis is associated with other sexually transmittable microorganisms in the male urethra.

Source: Klinik und Poliklinik für Haut- und Geschlechtskrankheiten, Universität Würzburg. Elsner P, Hartmann AA, Wecker I