Laboratory of Research in Biofilms Rosário Oliveira (LIBRO), Centre of Biological Engineering (CEB), University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal.
LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
Microb Biotechnol. 2023 Jul;16(7):1423-1437. doi: 10.1111/1751-7915.14261. Epub 2023 Apr 12.
Bacterial vaginosis (BV) is the most common cause of vaginal discharge and is often associated with other health consequences mainly in pregnant women. BV is described by an imbalance in the vaginal microbiota where strictly and facultative anaerobic bacteria outgrow the lactic acid- and hydrogen peroxide-producing Lactobacillus species. The species involved in BV are capable to grow and form a polymicrobial biofilm in the vaginal epithelium. The treatment of BV is usually performed using broad-spectrum antibiotics, including metronidazole and clindamycin. However, these conventional treatments are associated with high recurrence rates. The BV polymicrobial biofilm may have an important role on the treatment outcome and is accounted as one of the factors for treatment failure. Other possible reasons for treatment failure include the presence of species resistant to antibiotics or the chance of reinfection after treatment. Therefore, novel strategies to increase the rates of treatment have been studied namely the use of probiotics and prebiotics, acidifying agents, antiseptics, plant-based products, vaginal microbiota transplantation, and phage endolysins. Although some of them are still in an initial phase of development with very preliminary results, they show great perspectives for application. In this review, we aimed to study the role of the polymicrobial nature of BV in treatment failure and explore a few alternatives for treatment.
细菌性阴道病（BV）是阴道分泌物最常见的原因，常与其他健康后果有关，主要发生在孕妇中。BV 是由阴道微生物群失衡引起的，其中严格的和兼性厌氧菌过度生长，消耗了产生乳酸和过氧化氢的乳杆菌属。参与 BV 的物种能够在阴道上皮中生长并形成多微生物生物膜。BV 的治疗通常使用广谱抗生素，包括甲硝唑和克林霉素。然而，这些传统的治疗方法与高复发率有关。BV 的多微生物生物膜可能对治疗结果有重要作用，并被认为是治疗失败的因素之一。治疗失败的其他可能原因包括存在对抗生素耐药的物种或治疗后再次感染的机会。因此，已经研究了增加治疗成功率的新策略，包括使用益生菌和益生元、酸化剂、防腐剂、植物产品、阴道微生物群移植和噬菌体内溶素。尽管其中一些仍处于开发的初始阶段，只有非常初步的结果，但它们显示出了很好的应用前景。在这篇综述中，我们旨在研究 BV 的多微生物性质在治疗失败中的作用，并探讨一些治疗的替代方法。
