The cause or causes of bacterial vaginosis are unknown. A marked decrease in vaginal lactobacilli is a constant feature, suggesting that conditions supressing lactobacilli, or promoting other flora, play a causative role. Gardnerella vaginalis, a small, aerotoler-ant bacterium with a Gram-positive type of cell wall, is commonly present in large numbers, as are strictly anaerobic bacteria of the Mobiluncus and Prevotella genera, Mycoplasma sp., and anaerobic streptococci. Pure cultures of these species do not consistently produce bacterial vaginosis when healthy people are voluntarily inoculated, although the discharge from people with the condition can produce the disease. Each of these species of bacteria can occur in vaginal secretions of women without the disease, although in much smaller numbers.
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