Abstract
A healthy female genital tract harbors a microbiome dominated by lactic acid and hydrogen peroxide producing bacteria, which provide protection against infections by maintaining a low pH. Changes in the bacterial compositions of the vaginal microbiome can lead to bacterial vaginosis (BV), which is often associated with vaginal inflammation. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STIs) like human immunodeficiency virus (HIV) and affects women's reproductive health negatively. In pregnant women, BV can lead to chorioamnionitis and adverse pregnancy outcomes, including preterm premature rupture of the membranes and preterm birth. In order to manage BV effectively, good diagnostic procedures are required. Traditionally clinical and microscopic methods have been used to diagnose BV; however, these methods require skilled staff and time and suffer from reduced sensitivity and specificity. New diagnostics, including highly sensitive and specific point-of-care (POC) tests, treatment modalities and vaccines can be developed based on the identification of biomarkers from the growing pool of vaginal microbiome and vaginal metabolome data. In this review the current and future diagnostic avenues will be discussed.
Highlights
Bacterial vaginosis (BV), or vaginal dysbiosis, is one of the most common vaginal conditions associated with aberrant changes in the vaginal microbiome (VMB) (van de Wijgert et al, 2014)
The results revealed that a relatively consistent decrease in classification accuracy was observed as the random forest” (RF) classification model feature ranking decreases, while a more uneven decrease was observed for the logistic regression” (LR) model feature rankings, suggesting that the RF classification may be more useful in predicting BV (Beck and Foster, 2015)
Part of the challenge lies in determining which combination criteria are sensitive and specific enough as diagnostic criteria for BV; the other challenge is to develop cost-effective diagnostic tests, which could preferably be used at the POC
Summary
Bacterial vaginosis (BV), or vaginal dysbiosis, is one of the most common vaginal conditions associated with aberrant changes in the vaginal microbiome (VMB) (van de Wijgert et al, 2014). Diagnostic Possibilities of Vaginal Dysbiosis of the grading criteria introduced by Spiegel et al (1983), where Gram-stained vaginal smears are evaluated for the presence/absence and quantity of specific bacterial morphotypes with a scoring system ranging from 0 to 10 (Nugent et al, 1991) Both methods have been widely used worldwide for almost three decades and are considered the “gold standard” of BV diagnosis, these methods are not free of limitations. The focus of this review includes factors that complicate the diagnosis of BV, currently available diagnostic avenues and alternative approaches as potential diagnostic avenues for the diagnosis of BV
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