Bacterial vaginosis: modern aspects of pathogenesis, diagnosis, and treatment

Abstract

In healthy women under normal conditions, the vaginal microbiome is primarily dominated by Lactobacillus (lactobacilli), which produce a variety of antimicrobial compounds. Bacterial vaginosis (BV) is characterized by the absence or significant decrease in the total number of lactobacilli and an increase in the concentration of anaerobic microbes. It is a prevalent condition among women of reproductive age worldwide. Its influence on adverse gynecological and obstetric outcomes, such as sexually transmitted infections, pelvic inflammatory diseases, and preterm labor, has been confirmed. Gardnerella vaginalis is the most frequent microorganism identified in BV and predominant in polymicrobial biofilms, which serve as a protective barrier for G. vaginalis and other BV-associated microbes from the host organism.

This review discusses the latest research findings on the pathogenesis of BV, diagnostic approaches, treatment options, and possible strategies to reduce disease recurrence.

Although various treatment regimens for the disease are currently known, they often lack long-term effectiveness. The aim of this review is to consider the peculiarities of the vaginal microbiome, summarize the current information on the development and methods of treatment of BV, and emphasize on the latest achievements of conducted studies.

Keywords

bacterial vaginosis / biofilms / diagnosis / treatment / relapse

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