Abstract
Bacterial vaginosis (BV) is associated with a highly structured polymicrobial biofilm on the vaginal epithelium where Gardnerella species presumably play a pivotal role. Gardnerella vaginalis, Atopobium vaginae, and Prevotella bivia are vaginal pathogens detected during the early stages of incident BV. Herein, we aimed to analyze the impact of A. vaginae and P. bivia on a pre-established G. vaginalis biofilm using a novel in vitro triple-species biofilm model. Total biofilm biomass was determined by the crystal violet method. We also discriminated the bacterial populations in the biofilm and in its planktonic fraction by using PNA FISH. We further analyzed the influence of A. vaginae and P. bivia on the expression of key virulence genes of G. vaginalis by quantitative PCR. In our tested conditions, A. vaginae and P. bivia were able to incorporate into pre-established G. vaginalis biofilms but did not induce an increase in total biofilm biomass, when compared with 48-h G. vaginalis biofilms. However, they were able to significantly influence the expression of HMPREF0424_0821, a gene suggested to be associated with biofilm maintenance in G. vaginalis. This study suggests that microbial relationships between co-infecting bacteria can deeply affect the G. vaginalis biofilm, a crucial marker of BV.
Highlights
Bacterial vaginosis (BV) is the most-common vaginal infection affecting fertile, premenopausal, and pregnant women [1]
G. vaginalis formed a biofilm with the highest total biomass, while P. bivia formed a biofilm with the lowest total biomass
Following the hypothesis that Gardnerella is the early colonizer in BV [9], we assessed how A. vaginae and P. bivia could incorporate into a 24-h pre-formed G. vaginalis biofilm
Summary
Bacterial vaginosis (BV) is the most-common vaginal infection affecting fertile, premenopausal, and pregnant women [1]. It is associated with important adverse outcomes related to pregnancy [2] and infertility [3]. BV is a complex polymicrobial infection where beneficial vaginal bacteria, mainly hydrogen peroxide and lactic acid-producing Lactobacillus species, which are usually dominant in vaginal microbiota of healthy women, are replaced by high concentrations of facultative and strict anaerobic bacteria [1,9]. Gardnerella spp. are commonly found in asymptomatic or BV-negative women [13]. This has aroused interest in whether genetic differences among G. vaginalis isolates might differentiate pathogenic from commensal organisms [14]
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