The Vaginal Microbiome: II. Vaginal Dysbiotic Conditions.
Journal
Journal of lower genital tract disease
ISSN: 1526-0976
Titre abrégé: J Low Genit Tract Dis
Pays: United States
ID NLM: 9704963
Informations de publication
Date de publication:
01 Jan 2022
01 Jan 2022
Historique:
entrez:
20
12
2021
pubmed:
21
12
2021
medline:
24
12
2021
Statut:
ppublish
Résumé
This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the recent findings and understanding of the vaginal bacterial microbiota, mainly regarding areas relevant to clinicians specializing in vulvovaginal disorders. A search of PubMed database was performed, using the search terms "vaginal microbiome" with "dysbiosis," "bacterial vaginosis," "cytolytic vaginosis," "desquamative inflammatory vaginitis," and "aerobic vaginitis." Full article texts were reviewed. Reference lists were screened for additional articles. The second article in this series focuses on vaginal dysbiotic conditions. Dysbiosis is a term describing imbalances in bacterial communities. Given that lactobacillus-dominated microbiota are thought to be the most optimal, vaginal dysbiosis is usually considered as lactobacilli-depleted VMB. Bacterial vaginosis (BV), the most common vaginal dysbiotic condition, is a polymicrobial disorder, considered the leading cause for vaginal discharge in women worldwide. In addition, we review the VMB in other vaginal conditions associated with lactobacilli depletion: desquamative inflammatory vaginitis and aerobic vaginitis. We also discuss the controversial diagnosis of cytolytic vaginosis, related with lactobacilli overgrowth. Bacterial vaginosis displays complex microbiology. The heterogeneity and diversity within the genus Gardnerella may impact the progression of BV. Bacterial biofilms may contribute to the etiology and persistence of BV, and various bacteria may affect its clinical presentation and pathogenicity. Lack of lactobacilli is not always accompanied by an overgrowth of anaerobes.
Identifiants
pubmed: 34928257
doi: 10.1097/LGT.0000000000000644
pii: 00128360-202201000-00016
pmc: PMC8719518
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-84Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.
Déclaration de conflit d'intérêts
The authors have declared they have no conflicts of interest.
Références
Dysbiosis. Definition of dysbiosis by Oxford Dictionary on Lexico.com . Available at: https://www.lexico.com/definition/dysbiosis . Accessed November 23, 2020.
Gajer P, Brotman RM, Bai G, et al. Temporal dynamics of the human vaginal microbiota. Sci Transl Med 2012;4:132ra52.
Brotman RM, Ravel J, Cone RA, et al. Rapid fluctuation of the vaginal microbiota measured by Gram stain analysis. Sex Transm Infect 2010;86:297–302.
Van De Wijgert JHHM, Jespers V. The global health impact of vaginal dysbiosis. Res Microbiol 2017;168(9–10):859–64.
Morris M, Nicoll A, Simms I, et al. Bacterial vaginosis: a public health review. BJOG 2001;108:439–50.
Schwebke JR. Gynecologic consequences of bacterial vaginosis. Obstet Gynecol Clin North Am 2003;30:685–94.
Van De Wijgert JH, Borgdorff H, Verhelst R, et al. The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS One 2014;9:e105998.
Redelinghuys MJ, Geldenhuys J, Jung H, et al. Bacterial vaginosis: current diagnostic avenues and future opportunities. Front Cell Infect Microbiol 2020;10:354.
Schellenberg JJ, Patterson MH, Hill JE. Gardnerella vaginalis diversity and ecology in relation to vaginal symptoms. Res Microbiol 2017;168(9–10):837–44.
Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 2005;353:1899–911.
Swidsinski A, Mendling W, Loening-Baucke V, et al. Adherent biofilms in bacterial vaginosis. Obstet Gynecol 2005;106(5 Pt 1):1013–23.
Muzny CA, Schwebke JR. Gardnerella vaginalis : still a prime suspect in the pathogenesis of bacterial vaginosis. Curr Infect Dis Rep 2013;15:130–5.
Sobel JD. Recurrent bacterial vaginosis, relapse or reinfection: the role of sexual transmission. BJOG 2021;128:768.
Ness RB, Hillier SL, Richter HE, et al. Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina. Obstet Gynecol 2002;100:765–72.
Bradshaw CS, Walker SM, Vodstrcil LA, et al. The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: the WOW health study. J Infect Dis 2014;209:1562–72.
Bradshaw CS, Morton AN, Hocking J, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis 2006;193:1478–86.
Amsel R, Totten PA, Spiegel CA, et al. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983;74:14–22.
Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 1991;29:297–301.
Muzny CA, Lensing SY, Aaron KJ, et al. Incubation period and risk factors support sexual transmission of bacterial vaginosis in women who have sex with women. Sex Transm Infect 2019;95:511–5.
Srinivasan S, Hoffman NG, Morgan MT, et al. Bacterial communities in women with bacterial vaginosis: high resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria. PLoS One 2012;7:e37818.
Patterson JL, Stull-Lane A, Girerd PH, et al. Analysis of adherence, biofilm formation and cytotoxicity suggests a greater virulence potential of Gardnerella vaginalis relative to other bacterial-vaginosis-associated anaerobes. Microbiology 2010;156:392–9.
Muzny CA, Taylor CM, Swords WE, et al. An updated conceptual model on the pathogenesis of bacterial vaginosis. J Infect Dis 2019;220:1399–405.
Hickey RJ, Forney LJ. Gardnerella vaginalis does not always cause bacterial vaginosis. J Infect Dis 2014;210:1682–3.
Vaneechoutte M, Guschin A, Van Simaey L, et al. Emended description of Gardnerella vaginalis and description of gardnerella leopoldii sp. nov., gardnerella piotii sp. nov. and Gardnerella swidsinskii sp. nov., with delineation of 13 genomic species within the genus Gardnerella . Int J Syst Evol Microbiol 2019;69:679–87.
Castro J, Jefferson KK, Cerca N. Genetic heterogeneity and taxonomic diversity among Gardnerella species. Trends Microbiol 2020;28:202–11.
Plummer EL, Vodstrcil LA, Murray GL, et al. Gardnerella vaginalis clade distribution is associated with behavioral practices and Nugent score in women who have sex with women. J Infect Dis 2020;221:454–63.
Muzny CA, Blanchard E, Taylor CM, et al. Identification of key bacteria involved in the induction of incident bacterial vaginosis: a prospective study. J Infect Dis 2018;218:966–78.
Gilbert NM, Lewis WG, Li G, et al. Gardnerella vaginalis and Prevotella bivia trigger distinct and overlapping phenotypes in a mouse model of bacterial vaginosis. J Infect Dis 2019;220:1099–108.
Castro J, Machado D, Cerca N. Unveiling the role of Gardnerella vaginalis in polymicrobial bacterial vaginosis biofilms: the impact of other vaginal pathogens living as neighbors. ISME J 2019;13:1306–17.
Machado A, Cerca N. Influence of biofilm formation by Gardnerella vaginalis and other anaerobes on bacterial vaginosis. J Infect Dis 2015;212:1856–61.
Hardy L, Cerca N, Jespers V, et al. Bacterial biofilms in the vagina. Res Microbiol 2017;168(9–10):865–74.
Swidsinski A, Mendling W, Loening-Baucke V, et al. An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole. Am J Obstet Gynecol 2008;198:97.e1–6.
Swidsinski A, Doerffel Y, Loening-Baucke V, et al. Gardnerella biofilm involves females and males and is transmitted sexually. Gynecol Obstet Invest 2010;70:256–63.
Liu CM, Hungate BA, Tobian AAR, et al. Penile microbiota and female partner bacterial vaginosis in Rakai, Uganda. mBio 2015;6:e00589.
Hillier SL. Diagnostic microbiology of bacterial vaginosis. Am J Obstet Gynecol 1993;169(2 Pt 2):455–9.
Wolrath H, Forsum U, Larsson PG, et al. Analysis of bacterial vaginosis–related amines in vaginal fluid by gas chromatography and mass spectrometry. J Clin Microbiol 2001;39:4026–31.
Muzny CA, Łaniewski P, Schwebke JR, et al. Host-vaginal microbiota interactions in the pathogenesis of bacterial vaginosis. Curr Opin Infect Dis 2020;33:59–65.
Ravel J, Brotman RM, Gajer P, et al. Daily temporal dynamics of vaginal microbiota before, during and after episodes of bacterial vaginosis. Microbiome 2013;1:29.
Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am J Obstet Gynecol 2013;209:505–23.
Fettweis JM, Brooks JP, Serrano MG, et al. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology (Reading) 2014;160(Pt 10):2272–82.
Hummelen R, Fernandes AD, Macklaim JM, et al. Deep sequencing of the vaginal microbiota of women with HIV. PLoS One 2010;5:e12078.
Bayigga L, Kateete DP, Anderson DJ, et al. Diversity of vaginal microbiota in sub-Saharan Africa and its effects on HIV transmission and prevention. Am J Obstet Gynecol 2019;220:155–66.
Vieira-Baptista P, Silva AR, Costa M, et al. Clinical validation of a new molecular test (Seegene Allplex™ Vaginitis) for the diagnosis of vaginitis: a cross-sectional study. BJOG 2021;128:1344–52.
Vieira-Baptista P, Silva AR, Costa M, et al. Diagnosis of bacterial vaginosis: clinical or microscopic? A cross-sectional study. Int J Gynaecol Obstet 2021. doi:10.1002/IJGO.13792.
doi: 10.1002/IJGO.13792
Schwebke JR, Taylor SN, Ackerman R, et al. Clinical validation of the aptima bacterial vaginosis and aptima Candida/Trichomonas vaginitis assays: results from a prospective multicenter clinical study. J Clin Microbiol 2020;58:e01643–19.
Voytik M, Nyirjesy P. Cytolytic vaginosis: a critical appraisal of a controversial condition. Curr Infect Dis Rep 2020;22:1–6.
Vaneechoutte M. The human vaginal microbial community. Res Microbiol 2017;168(9–10):811–25.
Yang S, Liu Y, Wang J, et al. Variation of the vaginal Lactobacillus microbiome in cytolytic vaginosis. J Low Genit Tract Dis 2020;24:417–20.
Sanches JM, Giraldo PC, Bardin MG, et al. Laboratorial aspects of cytolytic vaginosis and vulvovaginal candidiasis as a key for accurate diagnosis: a pilot study. Rev Bras Ginecol Obstet 2020;42:634–41.
Soares R, Vieira-Baptista P, Tavares S. Vaginose citolítica: uma entidade subdiagnosticada que mimetiza a candidíase vaginal. Acta Obstétrica e Ginecológica Portuguesa . 2017;11:106–12.
Cibley LJ, Cibley LJ. Cytolytic vaginosis. Am J Obstet Gynecol 1991;165:1245–9.
Xu H, Zhang X, Yao W, et al. Characterization of the vaginal microbiome during cytolytic vaginosis using high-throughput sequencing. J Clin Lab Anal 2019;33:e22653.
Sobel JD. Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am J Obstet Gynecol 1994;171:1215–20.
Stockdale CK. Clinical spectrum of desquamative inflammatory vaginitis. Curr Infect Dis Rep 2010;12:479–83.
Murphy R. Desquamative inflammatory vaginitis. Dermatol Ther 2004;17:47–9.
Donders GGG, Bellen G, Grinceviciene S, et al. Aerobic vaginitis: no longer a stranger. Res Microbiol 2017;168(9–10):845–58.
Wang C, Fan A, Li H, et al. Vaginal bacterial profiles of aerobic vaginitis: a case-control study. Diagn Microbiol Infect Dis 2020;96:114981.
Tao Z, Zhang L, Zhang Q, et al. The pathogenesis of streptococcus anginosus in aerobic vaginitis. Infect Drug Resist 2019;12:3745–54.
Rumyantseva T, Khayrullina G, Guschin A, et al. Prevalence of Ureaplasma spp. and Mycoplasma hominis in healthy women and patients with flora alterations. Diagn Microbiol Infect Dis 2019;93:227–31.
Tang Y, Yu F, Hu Z, et al. Characterization of aerobic vaginitis in late pregnancy in a Chinese population: a STROBE-compliant study. Medicine 2020;99:e20732.
Le MT, Nguyen TLN, Le DD, et al. Is genital tract infection related to tubal diseases in infertile Vietnamese women? J Infect Dev Ctries 2019;13:906–13.
Vieira-Baptista P, Lima-Silva J, Pinto C, et al. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities. Eur J Clin Microbiol Infect Dis 2016;35:657–64.
Jahic M, Mulavdic M, Hadzimehmedovic A, et al. Association between aerobic vaginitis, bacterial vaginosis and squamous intraepithelial lesion of low grade. Med Arch 2013;67:94–6.
Donders GGG, Bellen G, Ruban KS. Abnormal vaginal microbioma is associated with severity of localized provoked vulvodynia. Role of aerobic vaginitis and Candida in the pathogenesis of vulvodynia. Eur J Clin Microbiol Infect Dis 2018;37:1679–85.
Bornstein J, Goldstein AT, Stockdale CK, et al. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. J Sex Med 2016;13:607–12.
Döderlein A. Das Scheidensekret Und Seine Bedeutung Für Das Puerperalfieber . Leipzig, Besold; 1892:12–36.
Cauci S, Driussi S, De Santo D, et al. Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women. J Clin Microbiol 2002;40:2147–52.
Larsson PG, Carlsson B, Fåhraeus L, et al. Diagnosis of bacterial vaginosis: need for validation of microscopic image area used for scoring bacterial morphotypes. Sex Transm Infect 2004;80:63–7.
Brocklehurst P, Gordon A, Heatley E, et al. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev 2013;CD000262. doi:10.1002/14651858.CD000262.pub4.
doi: 10.1002/14651858.CD000262.pub4
Lamont RF, Nhan-Chang CL, Sobel JD, et al. Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol 2011;205:177–90.
Vieira-Baptista P, Bornstein J. Candidiasis, bacterial vaginosis, trichomoniasis and other vaginal conditions affecting the vulva. In: Vulvar Disease . Cham: Springer International Publishing; 2019:167–205. doi:10.1007/978-3-319-61621-6_24.