Gardnerella-associated vaginitis and anaerobic bacteria

12 patients with mild or moderate symptoms of Gardnerella-associated vaginitis were examined clinically and microbiologically on 52 different occasions, 27 of which were asymptomatic. The symptomatic state was defined by fulfilling at least three of the following criteria: (1) subjective symptoms; (2) pH above 4.5; (3) positive amine test, and (4) clue cells in wet smear. Variation of the vaginal microflora was considerable. No causative bacterial species could be identified. Microorganisms of the genus Bacteroides were significantly (p less than 0.02) more often found in the symptomatic condition. The presence of either peptococci , peptostreptococci or anaerobic streptococci was similarly related to symptoms (p less than 0.01). Lactobacilli were significantly more often present when the patient was free of symptoms (p less than 0.05). Gardnerella vaginalis was a common isolate whether the patient suffered from symptoms or not. It is concluded that the presence of this microorganism indicates a disturbed ecologic situation within the vagina, resulting in loss of predominance of lactobacilli and hence liability to develop symptoms.