Medline ® Abstracts for References 12,24,25
of 'Bacterial vaginosis'
An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole.
Swidsinski A, Mendling W, Loening-Baucke V, Swidsinski S, Dörffel Y, Scholze J, Lochs H, Verstraelen H
Am J Obstet Gynecol. 2008 Jan;198(1):97.e1-6. Epub 2007 Nov 19.
OBJECTIVE: The purpose of this study was to determine the efficacy of standard treatment with oral metronidazole in the eradication of the bacterial vaginosis biofilm.
STUDY DESIGN: We conducted an interventional follow-up study in which 18 patients with bacterial vaginosis were treated with oral metronidazole during 1 week and subsequently had a single random follow-up assessment at 1-week intervals, up to 5 weeks, with 3 patients representing each point in time. Follow-up assessment included conventional scoring of the vaginal microflora and determination of bacterial biofilm characteristics on a vaginal biopsy through bacterial 16/23S recombinant DNA-based fluorescence in-situ hybridization.
RESULTS: Although all patients recovered, we consistently observed the resurgence with treatment cessation of a dense and active bacterial biofilm on the vaginal mucosa, primarily consisting of Gardnerella vaginalis and Atopobium vaginae.
CONCLUSION: A large reservoir of the core bacteria to bacterial vaginosis persists as a biofilm after metronidazole treatment.
Molekulargenetisches Labor für polymikrobielle Infektionen und bakterielle Biofilme, Berlin, Germany.
The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: the WOW Health Study.
Bradshaw CS, Walker SM, Vodstrcil LA, Bilardi JE, Law M, Hocking JS, Fethers KA, Fehler G, Petersen S, Tabrizi SN, Chen MY, Garland SM, Fairley CK
J Infect Dis. 2014;209(10):1562.
BACKGROUND: A community-based study of women who have sex with women (WSW) was performed to determine the burden of bacterial vaginosis (BV), and behavioral factors influencing the vaginal microbiota of women and their female sexual partners (FSPs), as measured by Nugent score (NS).
METHODS: In a cross-sectional study of 18-55-year-old WSW recruited nationally, participants completed questionnaires and self-collected vaginal swab samples weekly on 3 occasions. BV was defined as an NS of 7-10. Factors associated with BV, stability of NS category, and concordance of these categories in co-enrolled couples were examined with multivariable logistic regression analysis.
RESULTS: A total of 458 participants were recruited; 192 were co-enrolled with their FSP (96 couples). BV was detected in 125 women (27%; 95% confidence interval [CI], 23%-32%). BV was associated with≥4 lifetime FSPs (adjusted odds ratio [AOR], 1.9; 95% CI, 1.2-3.1), an FSP with BV symptoms (AOR, 2.9; 1.0-8.2) and smoking, with≥30 cigarettes per week showing greatest odds (AOR, 2.7; 1.5-5.0). Of 428 women returning≥2 swab samples, 375 (88%) had a stable NS category across all samples, predominantly reflecting normal flora. Co-enrolled WSW were less likely to have BV (31% vs 23%; P = .07), and the majority (70%) were concordant for NS category (κ= 0.47; P≤.01), with most concordant for normal flora. Concordant NS category was associated with a relationship of>6 months (AOR, 4.7; 95% CI, 1.4-16.4) and frequent sexual contact (more than once per month; AOR, 2.7; 1.0-7.1).
CONCLUSIONS: BV is associated with key behaviors and smoking practices in WSW, but longer-duration, sexually active WSW partnerships support a stable favorable vaginal microbiota.
Melbourne School of Population and Global Health.
Characterization of vaginal flora and bacterial vaginosis in women who have sex with women.
Marrazzo JM, Koutsky LA, Eschenbach DA, Agnew K, Stine K, Hillier SL
J Infect Dis. 2002;185(9):1307.
Bacterial vaginosis (BV) may be common among women who report having sex with women (WSW) and frequently occurs in both members of monogamous couples. The results of Gram staining of a vaginal smear were consistent with BV in 81 (25%) and intermediate in 37 (11%) of 326 WSW included in this study. Lactobacilli were detected in 64% of subjects, and 42% of subjects had H(2)O(2)-producing strains. BV was associated with a higher lifetime number of female sex partners, failure to always clean an insertive sex toy before use, and oral-anal sex with female partners. Neither recent douching nor sexual practices with male partners were associated with BV. Vaginal smears from each partner were concordant in 55 (95%) of 58 monogamous couples; BV was present in both partners in 16 couples (28%) (P<.001, compared with expected distribution). BV was common among subjects who did not douche, who did not have concurrent sex with male partners, or who did not have a new sex partner, which suggests that other risk factors for BV exist. These data support the hypothesis that sexual exchange of vaginal secretions is a possible mechanism for acquisition of BV.
Department of Medicine, University of Washington, Seattle, WA 98104, USA. email@example.com