Abstract
Vaginal microbiota dysbiosis and bacterial vaginosis (BV) affect negatively women’s health. Understanding vaginal microbiota fluctuations in BV during and after antibiotic treatment would facilitate accurate decision-making on the treatment regimen, avoid unnecessary antibiotic use, and potentially mitigate recurrence. We investigated vaginal microbiota composition of 30 women with BV before and after 5-day metronidazole treatment and compared the results with 30 healthy women. Vaginal microbiota was assessed by Nugent score and analyzed by 16S rRNA gene sequencing in swabs on baseline Day 1, and on Day 8 and 15, after completion of antibiotic treatment by women with BV. Prior to antibiotic treatment (Day 1), BV-positive women were dominated by Lactobacillus iners (25.8%), Prevotella timonensis/bivia (18.0%), and Gardnerella vaginalis (14.6%), whereas healthy women were dominated by L. iners (37.5%) and Lactobacillus crispatus/acidophilus (19.2%). On Day 8, L. iners abundance increased in BV-treated women being significantly higher compared with healthy women (67.8% vs. 37.5%, p = 0.049). On Day 15, the relative abundance of all microbial taxa was similar between the groups. Vaginal microbiota of women with BV shifted to resemble that of healthy controls after metronidazole. Sequencing analysis provides more in-depth understanding of changes in vaginal microbiota. The role of L. iners in vaginal health and dysbiosis requires further investigations.
Highlights
Vaginal lactobacilli play a fundamental role in women’s health by interacting with host physiology and influencing pathogenic micro-organisms, positively affecting reproductive health and wellbeing
The present observational trial was designed to investigate in bacterial vaginosis (BV)‐infected women the recovery of vaginal microbiota community after oral metronidazole treatment and compare data with healthy reference women
The present observational trial was designed to investigate in BV-infected women the recovery of vaginal microbiota community after oral metronidazole treatment and compare data with healthy reference women
Summary
Vaginal lactobacilli play a fundamental role in women’s health by interacting with host physiology and influencing pathogenic micro-organisms, positively affecting reproductive health and wellbeing. Vaginal microbiota cluster at least into five major community state types (CSTs). Four of them are dominated by lactobacilli, namely CST I by Lactobacillus crispatus, CST II by Lactobacillus gasseri, CST III by Lactobacillus iners, and CST V by Lactobacillus jensenii [1]. L. crispatus, L. gasseri, and L. jensenii are most strongly associated with healthy microbiota [1]. L. iners is considered as the most prevalent species, both in healthy women and in women with vaginal dysbiosis and diseases [2]. CST IV is comprised of a mixture of strict and facultative anaerobes, including representatives of Gardnerella, Atopobium, Sneathia, and Prevotella. The bacterial composition of bacterial vaginosis (BV), one of the most common causes of vaginal discomfort in women, resembles CST IV in terms of lactobacilli depletion and the overgrowth of anaerobic bacteria such as Gardnerella, Atopobium, and Prevotella.
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