Understanding the Bacterial Flora of the Female Genital Tract

  • Larsen B
  • Monif G
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Abstract

The microbiological flora of the lower female genital tract provides a dynamic, complex example of microbial colonization, the regulation of which is not fully understood. When an exogenous bacterial species, with its array of virulence factors, is introduced into the host, disease does not always occur. Conversely, under selected conditions, commensal endogenous bacteria—for example, Gardnerella vaginalis and group B strepto-cocci—can participate in disease processes. Disease caused by both exogenous and endogenous bacteria cor-relates positively with a markedly increased level of bacterial replication. The key question is what determines the quantity of a given bacterium at any given time. For disease to occur, exogenous or endogenous bacteria that possess pathogenic prerequisites must attain replicative dominance. Their ability to do so is potentially governed by inhibitory or synergistic interrelationships with other microbes. QUALITATIVE MICROBIOLOGY The microbiological flora of the lower female genital tract is a dynamic, complex example of microbial col-onization, the regulation of which is not fully under-stood. Much of what we know about the bacterial com-position of the female genital tract is derived from qualitative, descriptive studies [1–10]. The fund of in-formation that such studies have provided with regard to the microbial flora of the lower female genital tract is weakened by the intrinsic technical limitations that are inherent in the studies. Often, even the usefulness of qualitative data is negatively affected by inappro-priate or suboptimal methods of data collection, failure to use appropriate transport systems or enriched media, or a lack of stringent anaerobic technique in the pro-cessing and culture of specimens. The importance of using specialized media is illus-trated in a study of Clostridium difficile by Bramley et

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Authors

  • Bryan Larsen

  • Gilles R G Monif

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