Abstract



BACTERIAL VAGINOSIS AS AN STI

Gomberg Mikhail A., Kim Dmitry G., Guschin Alexander E.

Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology

The title itself sounds provocative, because it is well known that BV is NOT an STI.  And there are many reasons to insist it is not. Starting with clinical data (BV may be found in women who never were sexually active, treatment of partners of women with BV does not correspond with recurrences of BV, etc.) and up to the fact that males do not have vagina at all to suffer from “vaginosis” as the disease is called.

But there are many facts in favor of considering BV a disease with the same consequences that STI may cause in females, and BV may not be always safe for males in sexual contacts; it also may cause the same clinical symptoms in males that may also be caused by  STI.

We shall discuss important data that have to do with the role of BV-associated microorganisms. A lot of new data were produced with introduction of molecular diagnostic (NAAT) into clinical practice. The most common BV-associated microorganisms are Gardnerella  vaginalis, Atopobium spp., Megasphaera spp,  Leptotrichia\Sneathia, M.hominis as well as bacteria, belonging to the Clostridialis Family, and known as  BVAB-1,  BVAB-2, BVAB-3. It has been shown that BV-associated microorganisms were found in non-gonococcal urethritis in males in the absence of any other possible cause for this urethritis. BV-associated microorganisms were found in ejaculate of donors’ sperm which was associated with deterioration of sperm parameters and contamination with these microorganisms of females during their intrauterine insemination.

G.vaginalis is a key microorganism in BV, which may form biofilms on the vaginal epithelium. Very interesting data were published by A.Swidzinsky who used Fluorescence in situ hybridization, and found cohesive forms of G.vaginalis in both females with BV and their sexual partners, while there was no correlation in transmission of G.vaginalis to the partner in disperse forms of G.vaginalis. The same oligotypes of G.vaginalis in heterosexual couples were identified with NAAT.

Penile microbiota in males (community state type) may influence on the Nugent-score in their female partners. Balanopostitis is another clinical syndrome in males that may be associated with BV in their sexual partners.

If we are to add BV-associated microorganisms to the list of possible agents to cause NGU in males, why not recommend using 5-nitroimidasoles, or even better nitrofurans to treat such NGU, instead of tetracyclines which are recommended as a first choice to treat NGU now?

And if we recognize BV-associated microorganism as a possible cause of clinical problems in males, why not discuss a new name for the disease in females to make it common for both sexes?


53|magomberg@mail.ru|P1-6
34 IUSTI Congress - European Congres on Sexually transmitted Infections and HIV/AIDS
TAMING THE TIDE of STIs & HIV
Bucharest, September 3-5,