PMID- 35719334
OWN - NLM
STAT- MEDLINE
DCOM- 20220621
LR  - 20220817
IS  - 2235-2988 (Electronic)
IS  - 2235-2988 (Linking)
VI  - 12
DP  - 2022
TI  - Clue Cells and Pseudo Clue Cells in Different Morphotypes of Bacterial Vaginosis.
PG  - 905739
LID - 10.3389/fcimb.2022.905739 [doi]
LID - 905739
AB  - INTRODUCTION: Clue cells (epithelial cells heavily covered with adherent 
      bacteria) are an accepted clue to the diagnosis of bacterial vaginosis. However, 
      the exact morphologic criteria of clue cells and bacterial adherence were never 
      elaborated. MATERIALS AND METHODS: We investigated adhesive and cohesive patterns 
      of main microbiota groups in vaginal discharge using fluorescence in situ 
      hybridization (FISH). Samples from 500 women diagnosed with bacterial vaginosis 
      and positive for clue cells with classic microscopy were collected from 42 
      gynecologic practices in Berlin and reexamined in our FISH laboratory for the 
      spatial distribution of Bifidobacteriaceae, Gardnerella, Fannyhessea vaginae 
      (Atopobium); low G+C (guanine+cytosine) bacteria, lactobacilli, Lactobacillus 
      iners; Lactobacillus crispatus, Gamma-Proteobacteria; and Enterobacteriaceae, 
      Prevotella-Bacteroides, Veillonella, and Coriobacterium groups. RESULTS: 
      Bacterial taxa present in vaginal smears were not accidentally assembled 
      according to their relative abundance but were built in group-specific 
      distribution patterns, which can be well described by two features: cohesiveness 
      to each other and adherence to epithelial cells. Accordingly, four patterns can 
      be distinguished: dispersed (non-adherent bacteria), dispersed adherent bacteria, 
      cohesive (non-adherent) bacteria, and cohesive adherent bacteria. Direct cohesive 
      adherence to the epithelial cells representing true clue cells was unique for 
      Gardnerella species and observed only in 56% of the investigated samples. In the 
      remaining vaginal samples, the epithelial cells were mechanically entrapped in 
      bacterial masses, and the composition was unrelated to the epithelial cell 
      surface, building non-adherent pseudo clue cells. The proportion of women with 
      true clue cells in their samples from different gynecologic practices varied from 
      19% to 80%. DISCUSSION: Taxon indifferent imaging is inadequate for the exact 
      analysis of the microbial layer adjacent to the vaginal epithelial cells. 
      Morphologically seen bacterial vaginosis is a mix of at least two different 
      conditions: biofilm vaginosis and bacterial excess vaginosis.
CI  - Copyright (c) 2022 Swidsinski, Loening-Baucke, Swidsinski, Sobel, Dorffel and 
      Guschin.
FAU - Swidsinski, Alexander
AU  - Swidsinski A
AD  - Medizinische Klinik, Charite Charite Campus Mitte (CCM), Universitatsmedizin, 
      Berlin, Germany.
AD  - Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 
      Moscow, Russia.
FAU - Loening-Baucke, Vera
AU  - Loening-Baucke V
AD  - Medizinische Klinik, Charite Charite Campus Mitte (CCM), Universitatsmedizin, 
      Berlin, Germany.
FAU - Swidsinski, Sonja
AU  - Swidsinski S
AD  - Microbiology, MDI Limbach GmbH, Berlin, Germany.
FAU - Sobel, Jack D
AU  - Sobel JD
AD  - Wayne State University School of Medicine, Detroit, MI, United States.
FAU - Dorffel, Yvonne
AU  - Dorffel Y
AD  - Outpatient Clinic, Charite Universitatsmedizin Berlin, Charite Campus Mitte 
      (CCM), Berlin, Germany.
FAU - Guschin, Alexander
AU  - Guschin A
AD  - Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, 
      Moscow, Russia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220527
PL  - Switzerland
TA  - Front Cell Infect Microbiol
JT  - Frontiers in cellular and infection microbiology
JID - 101585359
SB  - IM
MH  - Bacteria
MH  - Female
MH  - Gardnerella
MH  - Gardnerella vaginalis
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - *Microbiota
MH  - Vagina/microbiology
MH  - *Vaginosis, Bacterial/diagnosis/microbiology
PMC - PMC9198243
OTO - NOTNLM
OT  - FISH
OT  - bacterial excess vaginosis
OT  - bacterial vaginosis
OT  - biofilm vaginosis
OT  - clue cells
OT  - dysbiosis
OT  - polymicrobials
COIS- Author SS was employed by MDI Limbach GmbH. The remaining authors declare that 
      the research was conducted in the absence of any commercial or financial 
      relationships that could be construed as a potential conflict of interest.
EDAT- 2022/06/21 06:00
MHDA- 2022/06/22 06:00
PMCR- 2022/01/01
CRDT- 2022/06/20 03:28
PHST- 2022/03/27 00:00 [received]
PHST- 2022/04/27 00:00 [accepted]
PHST- 2022/06/20 03:28 [entrez]
PHST- 2022/06/21 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcimb.2022.905739 [doi]
PST - epublish
SO  - Front Cell Infect Microbiol. 2022 May 27;12:905739. doi: 
      10.3389/fcimb.2022.905739. eCollection 2022.