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Occurrence and relevance of Gardnerella vaginalis in urine cultures of kidney transplant recipients- a retrospective cohort analysis

In brief

Gardnerella detected in urine of 38 kidney transplant patients; half show high load

In a two-year retrospective review of renal-transplant outpatients, Gardnerella vaginalis appeared in 70 urine cultures from 38 patients (86% female, median age 41). Half the isolates had at least 10⁵ CFU/ml and often co-occurred with other bacteria, but clinical infection signs were undocumented, leaving its true relevance uncertain.

Journal
BMC microbiology (Q1)
Published
1 September 2026
Study design
Retrospective cohort
Evidence level
Level 3, Low (CEBM 3b)
Authors
Sabrina Klein, Silke Deininger, Iris Schröter, Dennis Nurjadi, Claudia Sommerer
PMID
42681605
DOI
10.1186/s12866-026-05522-6

Why clinicians should know about it

  • Picked for Microbiology (medical) (paper of the day, 3 September 2026): Gardnerella urinary isolates in renal transplant recipients

Abstract

BACKGROUND: Gardnerella vaginalis is known to be associated with the development of bacterial vaginosis. In contrast, its cultivation from urine specimen in significant number is not generally regarded as causative for urinary tract infections. In a previous study, we detected G. vaginalis predominantly in urine cultures of renal transplant recipients and questioned whether this is of relevance. To address this, we conducted a retrospective cohort study over a period of two years on renal transplant recipients who presented at the outpatient clinic of the Department of Nephrology of Heidelberg University Hospital. Patient characteristics and laboratory parameters of renal transplant recipients with G. vaginalis in urine cultures were compared to those of renal transplant recipients presenting in the same outpatient clinic with urine specimen culturing other bacteria than G. vaginalis, using a multivariable logistic regression analysis. RESULTS: During the study period, G. vaginalis was detected in 70 urine samples of 38 patients. The majority of patients was female (86.8%, n = 33/38), and the age was significantly lower than in the control group (median 41 years and 51 years; OR 0.94, 95% CI 0.92-0.98, p = 0.001). a significant number of culture-forming units (CFU, ≥ 105 /ml) were detected in half of the samples containing G. vaginalis; a second microorganism was cultured in 64.3% (n = 45/70), while more than two species grew in 53.9% (n = 82/152) of the control group samples. Besides age, bacterial load of ≥ 105 CFU/ml was significantly associated the presence of G. vaginalis in urine cultures (OR 2.71, 95% CI 1.12-6.56, p = 0.003). The medical record was lacking information on clinical signs and symptoms of urinary tract infections. CONCLUSION: As clinical symptoms were not documented, the occurrence of G. vaginalis in urine samples of kidney transplant recipients cannot be finally assessed. Further studies are needed to clarify its significance, particularly in immunocompromised hosts.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.