ABSTRACT
Gene amplification studies of the vaginal bacterial microbiome of healthy asymptomatic women have demonstrated that Lactobacillus iners is the most frequently identified Lactobacillus; and this Lactobacillus does not produce H2O2. A large multitude of bacteria have been reported to be associated with bacterial vaginosis (BV) by gene amplification analyses, and not all women with BV have the same vaginal microbiota. Gardnerella vaginalis is the microbe most frequently reported to be associated with a diagnosis of BV. Microbial proteolytic enzymes have been implicated in the inhibition of cell-mediated and humoral immunity in women with BV. Epidemiologic studies of BV will have two different populations when either the R. Amsel or R. P. Nugent criteria are used alone. Symptomatic patients with BV should receive treatment to relieve their concerns about the vaginal discharge and odor. Therapeutic attempts to prevent transmission should not be solely focused upon the treatment of BV, which will reduce the risk of HIV transmission.
