The ability of a microorganism to colonize a surface is generally proportional to the ability of the organism to adhere to that surface. This specific binding results from the interaction between the surface and specific cell receptors, and provides an ecological advantage by assuring that organisms can successfully colonize a surface that allows them to thrive. It has been suggested that fimbriae in Gram-positive bacteria and pili in Gram negatives may be involved in binding organisms to surfaces (15) and that teichoic acid is a major adhesin of S. aureus for epithelial cells (16). Human epithelial cells have been shown to bind specifically with P. aeruginosa, S. epidermidis, S. aureus, S. pyogenes, and diphtheroids, but not with viridans streptococci and Candida albicans (4). Microbial adhesion to the vulva per se has not been studied satisfactorily, in part because this environment contains several cell types and is, thus, ecologically complex. However, some microbial adherence properties of the labia majora and minora have been studied and the results demonstrate that labia majora cells generally are more amenable to microbial adherence than are labia minora cells (17).
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