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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... 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 -
Annals of Clinical Microbiology and... Jan 2020Recurrent vulvovaginal infections (RVVI) has not only become an epidemiological and clinical problem but also include large social and psychological consequences.... (Review)
Review
Recurrent vulvovaginal infections (RVVI) has not only become an epidemiological and clinical problem but also include large social and psychological consequences. Understanding the mechanisms of both commensalism and pathogenesis are necessary for the development of efficient diagnosis and treatment strategies for these enigmatic vaginal infections. Through this review, an attempt has been made to analyze vaginal microbiota (VMB) from scratch and to provide an update on its current understanding in relation to health and common RVVI i.e. bacterial vaginosis, vulvovaginal candidiaisis and Trichomoniasis, making the present review first of its kind. For this, potentially relevant studies were retrieved from data sources and critical analysis of the literature was made. Though, culture-independent methods have greatly unfolded the mystery regarding vaginal bacterial microbiome, there are only a few studies regarding the composition and diversity of vaginal mycobiome and different Trichomonas vaginalis strains. This scenario suggests a need of further studies based on comparative genomics of RVVI pathogens to improve our perceptive of RVVI pathogenesis that is still not clear (Fig. 5). Besides this, the review details the rationale for Lactobacilli dominance and changes that occur in healthy VMB throughout a women's life. Moreover, the list of possible agents continues to expand and new species recognised in both health and VVI are updated in this review. The review concludes with the controversies challenging the widely accepted dogma i.e. "VMB dominated with Lactobacilli is healthier than a diverse VMB". These controversies, over the past decade, have complicated the definition of vaginal health and vaginal infections with no definite conclusion. Thus, further studies on newly recognised microbial agents may reveal answers to these controversies. Conversely, VMB of women could be an answer but it is not enough to just look at the microbiology. We have to look at the woman itself, as VMB which is fine for one woman may be troublesome for others. These differences in women's response to the same VMB may be determined by a permutation of behavioural, cultural, genetic and various other anonymous factors, exploration of which may lead to proper definition of vaginal health and disease.
Topics: Biofilms; Candida; Candida albicans; Candidiasis, Vulvovaginal; Coinfection; Female; Gardnerella vaginalis; Host Microbial Interactions; Humans; Lactobacillus; Microbial Interactions; Microbiota; Recurrence; Trichomonas Vaginitis; Trichomonas vaginalis; Vagina; Vaginosis, Bacterial; Virulence Factors
PubMed: 31992328
DOI: 10.1186/s12941-020-0347-4 -
Frontiers in Cellular and Infection... 2020Koch's postulates dictate the use of experimental models to illustrate features of human disease and provide evidence for a singular organism as the cause. The... (Review)
Review
Koch's postulates dictate the use of experimental models to illustrate features of human disease and provide evidence for a singular organism as the cause. The underlying cause(s) of bacterial vaginosis (BV) has been debated in the literature for over half a century. In 1955, it was first reported that a bacterium now known as may be the cause of a condition (BV) resulting in higher vaginal pH, thin discharge, a fishy odor, and the presence of epithelial cells covered in bacteria. Here we review contemporary and historical studies on BV with a focus on reports of experimental infections in human or animal models using . We evaluate experimental evidence for the hypothesis that is sufficient to trigger clinical features of BV or relevant health complications associated with the condition. Additionally, we evaluate models of co-infection employing together with other bacterial species to investigate evidence for the hypothesis that may encourage colonization or virulence of other potential pathogens. Together, these studies paint a complex picture in which has both direct and indirect roles in the features, health complications, and co-infections associated with BV. We briefly review the current taxonomic landscape and genetic diversity pertinent to and note the limitations of sequence-based studies using different marker genes and priming sites. Although much more study is needed to refine our understanding of how BV develops and persists within the human host, applications of the experimental aspects of Koch's postulates have provided an important glimpse into some of the causal relationships that may govern this condition .
Topics: Animals; Epithelial Cells; Female; Gardnerella; Gardnerella vaginalis; Humans; Vagina; Vaginosis, Bacterial; Virulence
PubMed: 32391287
DOI: 10.3389/fcimb.2020.00168 -
The Journal of Infectious Diseases Aug 2019
Topics: Animals; Female; Gardnerella; Gardnerella vaginalis; Humans; Mice; Phenotype; Prevotella; Vaginosis, Bacterial
PubMed: 30715397
DOI: 10.1093/infdis/jiy705 -
Microbiome Aug 2022The cervicovaginal (CV) microbiome is highly associated with vaginal health and disease in both pregnant and nonpregnant individuals. An overabundance of Gardnerella...
BACKGROUND
The cervicovaginal (CV) microbiome is highly associated with vaginal health and disease in both pregnant and nonpregnant individuals. An overabundance of Gardnerella vaginalis (G. vaginalis) in the CV space is commonly associated with adverse reproductive outcomes including bacterial vaginosis (BV), sexually transmitted diseases, and preterm birth, while the presence of Lactobacillus spp. is often associated with reproductive health. While host-microbial interactions are hypothesized to contribute to CV health and disease, the mechanisms by which these interactions regulate CV epithelial function remain largely unknown.
RESULTS
Using an in vitro co-culture model, we assessed the effects of Lactobacillus crispatus (L. crispatus) and G. vaginalis on the CV epithelial barrier, the immune mediators that could be contributing to decreased barrier integrity and the immune signaling pathways regulating the immune response. G. vaginalis, but not L. crispatus, significantly increased epithelial cell death and decreased epithelial barrier integrity in an epithelial cell-specific manner. A G. vaginalis-mediated epithelial immune response including NF-κB activation and proinflammatory cytokine release was initiated partially through TLR2-dependent signaling pathways. Additionally, investigation of the cytokine immune profile in human CV fluid showed distinctive clustering of cytokines by Gardnerella spp. abundance and birth outcome.
CONCLUSIONS
The results of this study show microbe-specific effects on CV epithelial function. Altered epithelial barrier function through cell death and immune-mediated mechanisms by G. vaginalis, but not L. crispatus, indicates that host epithelial cells respond to bacteria-associated signals, resulting in altered epithelial function and ultimately CV disease. Additionally, distinct immune signatures associated with Gardnerella spp. or birth outcome provide further evidence that host-microbial interactions may contribute significantly to the biological mechanisms regulating reproductive outcomes. Video Abstract.
Topics: Cytokines; Epithelial Cells; Female; Gardnerella vaginalis; Humans; Immunity; Infant, Newborn; Lactobacillus crispatus; Pregnancy; Premature Birth; Vagina; Vaginosis, Bacterial
PubMed: 35922830
DOI: 10.1186/s40168-022-01317-9 -
Journal of Infection in Developing... Sep 2021The aim of the study was to investigate prevalence of bacteria most frequently associated with bacterial vaginosis using Amsel's criteria as well as to quantify these...
INTRODUCTION
The aim of the study was to investigate prevalence of bacteria most frequently associated with bacterial vaginosis using Amsel's criteria as well as to quantify these bacteria by real-time PCR and to explore the difference in their quantity between healthy and bacterial vaginosis samples.
METHODOLOGY
For classification of vaginal discharge samples Amsel's criteria have been used. To detect and quantify Gardnerella vaginalis Atopobium vaginae, Lactobacillus spp. and total vaginal microbiome, real-time PCR has been applied.
RESULTS
According to results of our study Amsel's criteria matched well with real-time PCR diversification of healthy women and women with BV. Nevertheless, real-time PCR has been more sensitive in diagnosis of bacterial vaginosis. DNA quantification of bacteria demonstrated that mutual abundance of G.vaginalis and A. vaginae was good bacterial vaginosis marker . On the contrary, Lactobacillus spp. was present in high amount in both healthy and bacterial vaginosis samples, but ratio of investigated bacteria was different between them. In fact, G. vaginalis and A. vaginae comprised only 0.1% of total microbiome in healthy, whereas Lactobacillus spp. took 99.3% of it. Nonetheless, in bacterial vaginosis, G. vaginalis and A. vaginae made up 34.4% of total microbiome, while Lactobacillus spp. was 21.6%.
CONCLUSIONS
According to the results of our study real-time PCR analysis was more sensitive in diagnosis of bacterial vaginosis than Amsel's method, as well as it represented fine tool in making a difference between microbial entities in healthy and bacterial vaginosis samples.
Topics: Actinobacteria; Adult; Case-Control Studies; Female; Gardnerella vaginalis; Gram-Positive Bacterial Infections; Humans; Lactobacillus; Real-Time Polymerase Chain Reaction; Serbia; Vaginosis, Bacterial; Young Adult
PubMed: 34669599
DOI: 10.3855/jidc.13091 -
Frontiers in Cellular and Infection... 2022Bacterial vaginosis (BV) is the most common infectious disease of the reproductive tract in women of childbearing age. It often manifests as an imbalance in the vaginal... (Review)
Review
Bacterial vaginosis (BV) is the most common infectious disease of the reproductive tract in women of childbearing age. It often manifests as an imbalance in the vaginal microbiome, including a decrease in and an increase in anaerobic bacteria. While spp. are considered a major cause of BV, they are also detected in the vaginal microbiome of healthy women. was the only recognized species of until a recent study characterized three new species, , , and . This review describes the different types and genetic diversity of , as well as new findings on the correlation between different spp. and BV.
Topics: Female; Gardnerella; Gardnerella vaginalis; Humans; Microbiota; Vagina; Vaginosis, Bacterial
PubMed: 35402309
DOI: 10.3389/fcimb.2022.858155 -
Infectious Diseases & Clinical... Sep 2022This study aimed to investigate the detection rate of by multiplex PCR test in the genitourinary samples of male patients with suspected urethritis and related symptoms.
OBJECTIVE
This study aimed to investigate the detection rate of by multiplex PCR test in the genitourinary samples of male patients with suspected urethritis and related symptoms.
MATERIALS AND METHODS
A total of 144 male patients who presented to our department between February 2021 and October 2021, either with urinary symptoms or concerns following unprotected sex, were included in the study.A total of 128 (88.9%) first-void urine samples, 15 (10.4%) urethral swabs, and one (0.7%) semen sample were obtained. NeoPlex STI-14 Detection Multiplex PCR Kit (GeneMatrix Inc. Seongnam, South Korea) was used to investigate any of the following pathogens: , , , , , , , , ,herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), , , and . The patients with positive results for were retrospectively analyzed.
RESULTS
The patients' median age was 37 (range: 21 to 71 years old). was the most frequently detected microorganism (n=23; 15.9%). Other microorganisms found in order of frequency were (n=19; 13.2%), (n=15; 10.4%), (n=11; 7.6%), (n=8; 5.6%), HSV-2 (n= 7; 4.9%), (n=6; 4.2), HSV-1 (n=2; 1.4%), (n=1, 0.7%), and (n=1, 0.7%). Fifteen patients (65%) were positive for one or two microbial agents together with , while in eight patients (35%), was the only isolated agent. Six of these eight patients and 14 of the remaining 15 were symptomatic.
CONCLUSION
With the introduction of multiplex PCR tests, including those for , we can expect a higher detection rate of these species of bacteria in male genitourinary samples, which could be the cause of unexplained urinary/urethral symptoms.
PubMed: 38633399
DOI: 10.36519/idcm.2022.172