ABSTRACT
As long as Lactobacillus maintains dominance, the pathogenic bacteria that constitute part of the endogenous vaginal microflora remain suppressed. Thus, the vaginal ecosystem remains in a healthy state and there is no potential threat to the health of the individual. Garner and Dukes20 were the first to report the near absence of Lactobacillus and its replacement by other endogenous vaginal bacteria. They also reported that Lactobacillus was rarely observed in women with Haemophilus vaginalis infection, now known as bacterial vaginosis. The number of lactobacilli present in a healthy vaginal microflora is ≥ 106 cfu/ml of vaginal fluid whereas other bacteria within the endogenous microflora are present in a concentration ≤ 103 cfu/ml of vaginal fluid. When viewing bacteria microscopically, the concentration required to see the bacteria is ≤ 103 cfu/ml of fluid. Therefore, it appears that lactobacilli play a key role in maintaining the vaginal ecosystem and the microflora in a healthy state. Loss of Lactobacillus dominance can result in bacterial vaginosis or bacterial vaginitis. Once the pathogenic bacteria become dominant the health of the patient becomes threatened, especially if the patient is undergoing invasive procedures that are performed through the lower genital tract.
