A fruitful alliance: the synergy between and in bacterial vaginosis-associated biofilm.

OBJECTIVES

Bacterial vaginosis (BV) is characterised by a change in the microbial composition of the vagina. The BV-associated organisms outnumber the health-associated species and form a polymicrobial biofilm on the vaginal epithelium, possibly explaining the difficulties with antibiotic treatment. A better understanding of vaginal biofilm with emphasis on and may contribute to a better diagnosis and treatment of BV.

METHODS

To this purpose, we evaluated the association between the presence of both bacteria by fluorescence in situ hybridisation (FISH) and BV by Nugent scoring in 463 vaginal slides of 120 participants participating in a clinical trial in Rwanda.

RESULTS

A bacterial biofilm was detected in half of the samples using a universal bacterial probe. The biofilm contained in 54.1% and in 82.0% of the samples. was accompanied by in 99.5% of samples. The odds of having a Nugent score above 4 were increased for samples with dispersed and/or present (OR 4.5; CI 2 to 10.3). The probability of having a high Nugent score was even higher when a combination of adherent and dispersed was visualised (OR 75.6; CI 13.3 to 429.5) and highest when both bacteria were part of the biofilm (OR 119; CI 39.9 to 360.8).

CONCLUSIONS

Our study, although not comprehensive at studying the polymicrobial biofilm in BV, provided a strong indication towards the importance of and the symbiosis of and in this biofilm.

TRIAL REGISTRATION NUMBER

NCT01796613.