Gardnerella vaginalis in infections of the urinary tract

During a period of 6 months, urine from 3576 patients was cultured for Gardnerella vaginalis. Specimens from 32 patients yielded this species. Eleven (0.3%) of the isolates were judged to be of clinical importance. Seven were from women and four from men. Two of these patients, both women, suffered from spontaneous cystitis. Hence G. vaginalis is very unusual as a primary pathogen in the urinary tract. More often it may cause infections related to urological abnormalities or as a complication of urological procedures. Two of the men in our series had chronic prostatitis, one an infected urinoma. All six remaining patients had either undergone a urological procedure or had had an indwelling urethral catheter for more than 6 hours. A selective medium for G. vaginalis is recommended for screening cultures before urological procedures and when this species is suspected on microscopy. The role of metronidazole in extravaginal infections is discussed and the use of an antibiotic more active against G. vaginalis is recommended.