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Previous Volume 353:1899-1911 November 3, 2005 Number 18 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Hillier, S. L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Bacterial vaginosis affects millions of women and is associated with several serious health conditions. The cause of bacterial vaginosis remains poorly understood despite numerous studies based on cultures. Bacteria in microbial communities can be identified without cultivation by characterizing their ribosomal DNA (rDNA) sequences.

Methods We identified bacteria in samples of vaginal fluid with a combination of broad-range polymerase-chain-reaction (PCR) amplification of 16S rDNA with clone analysis, bacterium-specific PCR assay of 16S rDNA, and fluorescence in situ hybridization (FISH) performed directly on vaginal fluid from 27 subjects with bacterial vaginosis and 46 without the condition. Twenty-one subjects were studied with the use of broad-range PCR of 16S rDNA, and 73 subjects were studied with the use of bacterium-specific PCR.

Results Women without bacterial vaginosis had 1 to 6 vaginal bacterial species (phylotypes) in each sample (mean, 3.3), as detected by broad-range PCR of 16S rDNA, and lactobacillus species were the predominant bacteria noted (83 to 100 percent of clones). Women with bacterial vaginosis had greater bacterial diversity (P<0.001), with 9 to 17 phylotypes (mean, 12.6) detected per sample and newly recognized species present in 32 to 89 percent of clones per sample library (mean, 58 percent). Thirty-five unique bacterial species were detected in the women with bacterial vaginosis, including several species with no close cultivated relatives. Bacterium-specific PCR assays showed that several bacteria that had not been previously described were highly prevalent in subjects with bacterial vaginosis but rare in healthy controls. FISH confirmed that newly recognized bacteria detected by PCR corresponded to specific bacterial morphotypes visible in vaginal fluid.

Conclusions Women with bacterial vaginosis have complex vaginal infections with many newly recognized species, including three bacteria in the Clostridiales order that were highly specific for bacterial vaginosis.

Source Information

From the Program in Infectious Diseases, Fred Hutchinson Cancer Research Center (D.N.F., T.L.F.); and the Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington (D.N.F., J.M.M.) — both in Seattle.

Address reprint requests to Dr. Fredricks at the Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., D3-100, Box 19024, Seattle, WA 98109-1024, or at dfredric{at}fhcrc.org.

Full Text of this Article

Related Letters:

Bacteria Associated with Bacterial Vaginosis
Hale L. P., Swidsinski A., Mendling W., Fredricks D. N., Marrazzo J. M.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:202-203, Jan 12, 2006. Correspondence

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