Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions

Daniela Machado, Joana Castro, Ana Palmeira-de-Oliveira, José Martinez-de-Oliveira, Nuno Cerca*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

149 Citations (Scopus)

Abstract

Bacterial vaginosis (BV) is the most common genital tract infection in women during their reproductive years and it has been associated with serious health complications, such as preterm delivery and acquisition or transmission of several sexually transmitted agents. BV is characterized by a reduction of beneficial lactobacilli and a significant increase in number of anaerobic bacteria, including Gardnerella vaginalis, Atopobium vaginae, Mobiluncus spp., Bacteroides spp. and Prevotella spp.. Being polymicrobial in nature, BV etiology remains unclear. However, it is certain that BV involves the presence of a thick vaginal multi-species biofilm, where G. vaginalis is the predominant species. Similar to what happens in many other biofilm-related infections, standard antibiotics, like metronidazole, are unable to fully eradicate the vaginal biofilm, which can explain the high recurrence rates of BV. Furthermore, antibiotic therapy can also cause a negative impact on the healthy vaginal microflora. These issues sparked the interest in developing alternative therapeutic strategies. This review provides a quick synopsis of the currently approved and available antibiotics for BV treatment while presenting an overview of novel strategies that are being explored for the treatment of this disorder, with special focus on natural compounds that are able to overcome biofilm-associated antibiotic resistance.

Original languageEnglish
Article number1528
Number of pages13
JournalFrontiers in Microbiology
Volume6
DOIs
Publication statusPublished - 2016
Externally publishedYes

Keywords

  • Antibiotics
  • Bacterial vaginosis
  • Biofilms
  • Emerging therapies
  • Gardnerella vaginalis

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