An update on Gardneralla vaginalis associated bacterial vaginosis in Malaysia

Objeetive:To update the status of Gardnerella vaginalis (G.vaginalis) as a causative agent of bacterial vaginosis (BV) in Malaysia and to define its epidemiology,metronidazole resistance and virulence properties.Methods:It is a single-centre (Gynaecology clinic at the Hospital Kuala Lumpur,Malaysia) prospective study with laboratory-based microbiological follow up and analyses.Vaginal swabs collected from the patients suspected for BV were subjected to clinical BV diagnosis,isolation and identification of G.vaginalis,metronidazole susceptibility testing,vaginolysin and sialidase gene PCR,Piot's biotyping and amplified ribosomal DNA restriction analysis genotyping.Results:Among the 207 patients suspected for BV,G.vaginalis was isolated from 47 subjects.G.vaginalis coexisted with Trichomonas vaginalis and Candida albicans in 26 samples.Three G.vaginalis isolates were resistant to metronidazole.Biotyping revealed 1 and 7 as the common types.Amplified ribosomal DNA restriction analysis genotype Ⅱ was found to be more common (n =22;46％) than Ⅰ (n =12;25.53％) and Ⅲ (n =13;27.6％).All genotype Ⅰ and Ⅲ isolates carried the sialidase gene,while 91.6％ and 84.6％ contained the vaginolysin gene.Genotype Ⅰ was significantly associated with postgynaecological surgical complications and abortions (P =0.002).Conclusions:The existence of pathogenic G.vaginalis clones in Malaysia including drug resistant strains should not be taken lightly and needs to be monitored as these may bring more complications especially among women of child bearing age and pregnant women.

Matrix assisted laser desorption ionization time of flight mass spectrometry for microbial identification in clinical microbiology / 中华检验医学杂志

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) recently moved from physics laboratories into diagnostic clinical microbiology.In this capacity it is currently replacing phenotypic bacterial identification tools that were designed and developed by Pasteur and Koch.Many European microbiology laboratories now use MALDI-TOF-MS with a high degree of efficiency.In the USA this will soon become common as well since the Food and Drug Administration (FDA) has now cleared the first of the commercially available systems for in vitro diagnostic use.This will also further spark the development of mass spectrometry applications in the field of antimicrobial susceptibility testing and epidemiological typing.This review summarizes the current state of affairs with respect to MALDI-TOF-MS in clinical microbiology.Emphasis will be on clinical relevance and studies in that field and the diagnostic data obtained through comparative analyses of different MALDI-TOF-MS instrumentation and through multi-center validation studies will be reviewed.