Clinical Information

Specimens from genital sites are sent to the clinical microbiology laboratory for detection of microorganisms from females presenting with clinical syndromes such as cervicitis, vulvovaginitis, urethritis, bacterial vaginosis (BV), salpingitis, endometritis, or genital ulcers and from males exhibiting urethritis, epididymitis, prostatitis, or genital ulcers. The human vagina is lined with 25 layers of epithelium cells. Many indigenous microorganisms colonize these surfaces. Accurate diagnosis of genital infections from the male and female genitalia depends on the separation of microbial pathogens from the normal genital microbiota. The microorganisms colonizing the female genital tract have been studied extensively and include lactobacilli, Corynebacterium spp., Gardnerella vaginalis, coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus agalactiae, Enterococcus spp., Escherichia coli, anaerobes, and yeasts. For prepubescent females, diphtheroids and coagulase negative staphylococci predominate; lactobacilli predominate in the adult female. Postmenopausal women are generally colonized with fewer lactobacilli but have a greater number of Enterobacteriaceae than premenopausal women. They also lack the presence of yeasts and mycoplasmas. Many adult female genital tract infections arise from endogenous microorganisms, which become opportunistic pathogens when activated by host factors and other microorganisms. The male urethra normally contains relatively few skin microbiota, consisting of coagulase-negative staphylococci, micrococci, Corynebacterium spp., and viridans group streptococci.