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Frontiers in Cellular and Infection... 2021The vaginal microbiome is a well-defined compartment of the human microbiome. It has unique conditions, characterized by the dominance of one bacterial species, the... (Review)
Review
The vaginal microbiome is a well-defined compartment of the human microbiome. It has unique conditions, characterized by the dominance of one bacterial species, the This microbiota manifests itself by a low degree of diversity and by a strong dynamic of change in its composition under the influence of various exogenous and endogenous factors. The increase in diversity may paradoxically be associated with dysbiosis, such as bacterial vaginosis (BV). BV is the result of a disturbance in the vaginal ecosystem; i.e., a sudden replacement of by anaerobic bacteria such as , and others. It is the most common cause of vaginal discharge in women of childbearing age, approximately 30% of all causes. The etiology of this dysbiosis remains unknown, but its health consequences are significant, including obstetrical complications, increased risk of sexually transmitted infections and urogenital infections. Its diagnosis is based on Amsel's clinical criteria and/or a gram stain based on the Nugent score. While both of these methods have been widely applied worldwide for approximately three decades, Nugent score are still considered the "gold standard" of BV diagnostic tools. Given the limitations of these tools, methods based on molecular biology have been developed as alternative rational strategies for the diagnosis of BV. The treatment of BV aims at restoring the balance of the vaginal flora to stop the proliferation of harmful microorganisms. Prescription of antibiotics such as metronidazole, clindamycin, etc. is recommended. Faced with the considerable uncertainty about the cause of BV, the high rate of recurrence, the unacceptable treatment options, and clinical management which is often insensitive and inconsistent, research on this topic is intensifying. Knowledge of its composition and its associated variations represents the key element in improving the therapeutic management of patients with the most suitable treatments possible.
Topics: Ecosystem; Female; Gardnerella vaginalis; Humans; Lactobacillus; Vagina; Vaginosis, Bacterial
PubMed: 35118003
DOI: 10.3389/fcimb.2021.672429 -
European Journal of Obstetrics,... Feb 2020Bacterial vaginosis (BV) affects women of reproductive age and can either be symptomatic or asymptomatic. Approximately 50 % of women are symptomatic and experience... (Review)
Review
Bacterial vaginosis (BV) affects women of reproductive age and can either be symptomatic or asymptomatic. Approximately 50 % of women are symptomatic and experience vaginal malodor, discharge, itching and increased vaginal pH. BV can increase the risk of contracting many sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV), Neisseria gonorrhea (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and herpes simplex virus-2 (HSV-2). Though effective treatment options do exist, metronidazole or clindamycin, these methods have proven not to be effective long term. The purpose of this review is to summarize current literature on the epidemiology of BV and highlight areas of deficiency in current clinical practice with respect to BV. BV recurrence rates are high, approximately 80 % three months after effective treatment. Furthermore, in some instances treatment is ineffective and BV persists. Literature also documents the relationship between BV and human papillomavirus (HPV). HPV is the most common sexually transmitted infection among young adult women while BV is the most common cause of vaginal symptoms among women of reproductive age. BV is associated with high levels of anaerobic organisms which can damage the vaginal epithelium and increase the risk of HPV infection. Recent research also highlights the role of the vaginal microbiome in BV. The results of this review warrant further exploration into the etiology of BV as well as exploration of more long-term effective treatment and the investigation of prognostic indicators. Additionally, the need for a standard definition of recurrent and persistent BV is recognized.
Topics: Female; Humans; Microbiota; Recurrence; Vagina; Vaginosis, Bacterial
PubMed: 31901667
DOI: 10.1016/j.ejogrb.2019.12.035 -
Frontiers in Cellular and Infection... 2021The vaginal microbiome is an intricate and dynamic microecosystem that constantly undergoes fluctuations during the female menstrual cycle and the woman's entire life. A... (Review)
Review
The vaginal microbiome is an intricate and dynamic microecosystem that constantly undergoes fluctuations during the female menstrual cycle and the woman's entire life. A healthy vaginal microbiome is dominated by which produce various antimicrobial compounds. Bacterial vaginosis (BV) is characterized by the loss or sharp decline in the total number of and a corresponding marked increase in the concentration of anaerobic microbes. BV is a highly prevalent disorder of the vaginal microbiota among women of reproductive age globally. BV is confirmed to be associated with adverse gynecologic and obstetric outcomes, such as sexually transmitted infections, pelvic inflammatory disease, and preterm birth. is the most common microorganism identified from BV. It is the predominant microbe in polymicrobial biofilms that could shelter and other BV-associated microbes from adverse host environments. Many efforts have been made to increase our understanding of the vaginal microbiome in health and BV. Thus, improved novel and accurate diagnosis and therapeutic strategies for BV have been developed. This review covers the features of vaginal microbiome, BV, BV-associated diseases, and various strategies of diagnosis and treatment of BV, with an emphasis on recent research progresses.
Topics: Female; Gardnerella vaginalis; Humans; Infant, Newborn; Microbiota; Pregnancy; Premature Birth; Vagina; Vaginosis, Bacterial
PubMed: 33898328
DOI: 10.3389/fcimb.2021.631972 -
Frontiers in Cellular and Infection... 2022Probiotics have been widely used in the treatment of intestinal diseases, but the effect of probiotics on female reproductive tract health is still controversial. is... (Review)
Review
Probiotics have been widely used in the treatment of intestinal diseases, but the effect of probiotics on female reproductive tract health is still controversial. is the most abundant microorganism in the vagina, which is related to the vaginal mucosal barrier. adheres to the vaginal epithelium and can competitively antagonize the colonization of pathogens. The factors produced by , such as bacteriocin and hydrogen peroxide (HO), can inhibit the growth of pathogenic microorganisms and maintain the low pH environment of the vagina. Probiotics play an important role in maintaining the stability of vaginal microenvironment, improving immune defense and blocking the progression of cervical cancer. We review the research progress of probiotics represented by in gynecological diseases such as human papilloma virus (HPV) infection, bacterial vaginosis (BV) and Genitourinary Syndrome of Menopause (GSM), so as to provide basis for further exerting the role of probiotics in women's health.
Topics: Female; Humans; Hydrogen Peroxide; Lactobacillus; Probiotics; Vagina; Vaginosis, Bacterial
PubMed: 35967876
DOI: 10.3389/fcimb.2022.963868 -
American Journal of Obstetrics and... Mar 2021Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including... (Review)
Review
Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including infertility. Bacterial vaginosis is characterized by a lower prevalence of lactobacilli and a higher prevalence of anaerobic bacteria, including Gardnerella vaginalis, Megasphaera spp., and Atopobium vaginae. Endometritis and pelvic inflammatory disease are caused by the ascension of pathogenic bacteria to the uterus, although the mechanisms by which they do so are unclear. Bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease have been linked to infertility in retrospective and prospective trials. Similarly, the causes of bacterial vaginosis and endometritis-related infertility are likely multifactorial and stem from inflammation, immune targeting of sperm antigens, the presence of bacterial toxins, and increased risk of sexually transmitted infections. Diagnosis and treatment of bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease before attempting conception may be important components of preconceptional care for symptomatic women to improve outcomes of natural and assisted reproduction.
Topics: Endometritis; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease; Vaginosis, Bacterial
PubMed: 33091407
DOI: 10.1016/j.ajog.2020.10.019 -
Ginekologia Polska 2020The article raises important issues regarding the use of diet and probiotics in prevention and treatment of vaginitis. Vaginitis is defined as any condition with... (Review)
Review
The article raises important issues regarding the use of diet and probiotics in prevention and treatment of vaginitis. Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge. The most common causes of vaginitis are vulvovaginal candidiasis (VVC), trichomoniasis and bacterial vaginosis (BV). Vaginitis has been linked to itching, burning, pain, discharge, irritation and also adverse reproductive and obstetric health outcomes. Moreover, microorganisms that build vaginal flora in the state of bacterial vaginosis are a source of cervicitis and endometritis (often in subclinical forms) and pelvic inflammatory disease (PID) The proper diet and probiotics consumption may influence the composition of the gut microbiota, improve gut integrity, and have an impact on maintaining and recovering the normal vaginal microbiota. Future studies and reviews investigating the role of diet and probiotics in changes to gut and vaginal microbiome need to focus on deciphering the mechanismus of host bacteria interaction in vulvovaginal health.
Topics: Adolescent; Adult; Candidiasis, Vulvovaginal; Diet; Female; Humans; Probiotics; Vaginosis, Bacterial; Women's Health; Young Adult
PubMed: 32779162
DOI: 10.5603/GP.2020.0070 -
Frontiers in Reproductive Health 2023Bacterial vaginosis (BV) is a common cause of vaginitis worldwide and is associated with serious reproductive health outcomes, including increased risk of preterm birth,... (Review)
Review
Bacterial vaginosis (BV) is a common cause of vaginitis worldwide and is associated with serious reproductive health outcomes, including increased risk of preterm birth, sexually transmitted infections, and pelvic inflammatory disease. The current and only FDA-approved treatment regimens for BV are antibiotics, such as metronidazole and clindamycin. Antibiotics provide a short-term cure for bacterial vaginosis; however, fail to provide a consistent long-term cure for many women. Fifty to eighty percent of women experience a BV recurrence within a year of completing antibiotic treatment. This may be because after antibiotic treatment, beneficial strains of , such as do not recolonize the vagina. In the absence of an effective long-term cure, patients, providers, and researchers are exploring different approaches to treatment and prevention, resulting in a rapid evolution of perspectives on BV pathogenesis and approaches to management. Current areas of investigation for BV management include probiotics, vaginal microbiome transplantation, pH modulation, and biofilm disruption. Behavioral modifications that may help include smoking cessation, condom use and hormonal contraception. Additional strategies considered by many people include dietary modification, non-medical vaginally applied products, choice of lubricant, and treatments from medical practices outside of allopathic medicine. This review aims to provide a comprehensive and up to date outline of the landscape of ongoing and potential treatment and prevention strategies for BV.
PubMed: 37325243
DOI: 10.3389/frph.2023.1100029 -
Deutsches Arzteblatt International May 2023Bacterial vaginosis (BV) is the most common genital disease worldwide in women of sexually active age, with a prevalence of 23-29%. Its traditional definition as... (Review)
Review
BACKGROUND
Bacterial vaginosis (BV) is the most common genital disease worldwide in women of sexually active age, with a prevalence of 23-29%. Its traditional definition as dysbiosis, i.e., a disruption of the normal balance of the vaginal microbiota, with a massive increase of facultative and obligate anaerobic bacteria (mainly Gardnerella spp.) and a loss of lactobacilli, accurately describes the change in the vaginal microbiota, but does not explain the underlying pathophysiology.
METHODS
This review is based on information in pertinent articles retrieved by a selective literature search and on the authors' own research findings.
RESULTS
Fluorescent in situ hybridization (FISH) has revealed Gardnerella spp.-dominated polymicrobial vaginal biofilm as a cause of ascending gynecologic and pregnancy-related infections, preterm birth, and infertility in patients with BV. The biofilm-induced disturbance of epithelial homeostasis favors co-infection with pathogens of sexually transmitted infection (STI). Standard antibiotic therapy is ineffective against biofilms, and there is thus a recurrence rate above 50%. The characteristic biofilm can be followed as a diagnostic marker and is considered evidence of sexual transmission when heterosexual couples and ejaculate samples are examined. FISH studies have shown that, in addition to biofilm-related vaginosis, there are other dysbiotic changes in the vaginal microbiota that have not yet been characterized in detail. It is therefore justified to speak of a "bacterial vaginosis syndrome."
CONCLUSION
The simplistic view of BV as dysbiosis, characterizable by microscopic reference methods, has so far led to inadequate therapeutic success. An evaluation of molecular genetic testing methods that would be suitable for routine use and the development of therapeutic agents that are effective against biofilms are urgently needed if the "bacterial vaginosis syndrome" is to be effectively treated.
Topics: Infant, Newborn; Pregnancy; Humans; Female; Vaginosis, Bacterial; Dysbiosis; In Situ Hybridization, Fluorescence; Premature Birth; Gardnerella; Biofilms
PubMed: 37097068
DOI: 10.3238/arztebl.m2023.0090 -
Frontiers in Cellular and Infection... 2020A healthy female genital tract harbors a microbiome dominated by lactic acid and hydrogen peroxide producing bacteria, which provide protection against infections by... (Review)
Review
A healthy female genital tract harbors a microbiome dominated by lactic acid and hydrogen peroxide producing bacteria, which provide protection against infections by maintaining a low pH. Changes in the bacterial compositions of the vaginal microbiome can lead to bacterial vaginosis (BV), which is often associated with vaginal inflammation. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STIs) like human immunodeficiency virus (HIV) and affects women's reproductive health negatively. In pregnant women, BV can lead to chorioamnionitis and adverse pregnancy outcomes, including preterm premature rupture of the membranes and preterm birth. In order to manage BV effectively, good diagnostic procedures are required. Traditionally clinical and microscopic methods have been used to diagnose BV; however, these methods require skilled staff and time and suffer from reduced sensitivity and specificity. New diagnostics, including highly sensitive and specific point-of-care (POC) tests, treatment modalities and vaccines can be developed based on the identification of biomarkers from the growing pool of vaginal microbiome and vaginal metabolome data. In this review the current and future diagnostic avenues will be discussed.
Topics: Female; Humans; Infant, Newborn; Microbiota; Pregnancy; Premature Birth; Sexually Transmitted Diseases; Vagina; Vaginosis, Bacterial
PubMed: 32850469
DOI: 10.3389/fcimb.2020.00354 -
Current Opinion in Pharmacology Dec 2021The different Lactobacillus strains of probiotics have been applied to the treatment and prevention of bacterial vaginosis and vulvovaginal candidiasis. The... (Review)
Review
The different Lactobacillus strains of probiotics have been applied to the treatment and prevention of bacterial vaginosis and vulvovaginal candidiasis. The experimental data demonstrated that it works well via reducing the number of harmful bacteria, maintaining the acidic microenvironment, inhibiting the immune response, and so on, to restore the vaginal microecology. However, the clinical data indicated that it is not sufficient to support the use of probiotics in the intervention of vulvovaginal candidiasis rather than bacterial vaginosis. Hunting for novel probiotic strains and uncovering the precise mechanism of probiotics, especially with the new concept gut-vagina axis, to maintain the homeostasis of vaginal microbiota should be a great challenge in the future.
Topics: Candidiasis, Vulvovaginal; Female; Humans; Lactobacillus; Probiotics; Vaginosis, Bacterial
PubMed: 34649216
DOI: 10.1016/j.coph.2021.09.004