Gardnerella vaginalis

Background

• Gram-negative or Gram-variable bacillus or coccobacillus
• Member of vaginal flora

Clinical Manifestations

• Involved in bacterial vaginosis, a dysbiosis rather than infection
• Rare cause of other infections, including urinary tract infection

Management

• Bacterial vaginosis (a dysbiosis rather than infection) is usually treated with metronidazole, which helps to normalize the overall vaginal microbiome rather than treating the Gardnerella
• Very little information about antibiotic susceptibility that would be relevant for treating infections
  • Based on one Brazilian study, ampicillin/sulbactam, clindamycin, chloramphenicol are likely reliable; ampicillin and metronidazole are not
  • A case series reports treatment with ceftriaxone, cefuroxime, aminoglycosides, metronidazole, ciprofloxacin