Amines and Bacterial Vaginosis

Sammanfattning: Bacterial Vaginosis (BY) is a common syndrome, with a prevalence of 10-30% in women of childbearing age. The decisive pathogenetic factoris thought to have a microbiological origin, but so far no specific bacteria have been implicated in causing BV. Instead, it appears that BV is accompanied by a shift in the normal lactobacilli flora to a mixed vaginal anaerobic flora. Vaginal fluid from women with BY has also been reported to contain various amines, and several techniques have been used to identify these amines.We developed a sensitive gas chromatographic and mass spectrometric (GC-MS) method to analyze amines related to BV together with quantification of the amines isobutylamine, phenethylamine, putrescine, cadaverine and tyramine. The aim of our investigation was to study if the amine content in vaginal fluids is quantitatively related to BV, diagnosed according to the Nugent scoring system. Our results show that the production of putrescine, cadaverine and tyramine is a property of BV, and that samples from healthy women do not include these amines.Using a sensitive gas chromatographic method, we also analyzed and quantified vaginal fluids with respect to trimethylamine (TMA), the amine responsible for the fishy odor in BV. In order to obtain a proper identification of BV, the vaginal fluid samples were Gram-stained and diagnosed according to two procedures. Our results show that regardless of the scoring method used for diagnosis, vaginal fluids from women with BV generally contain elevated amounts of TMA, while samples from healthy women do not.In conclusion, the presence of specific amines is clearly a prominent finding in women with BV, and these amines can thus be used as selective markers or diagnostic tools for the syndrome.