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Am J Obstet Gynecol. 2008 Jan;198(1):97.e1-6. Epub 2007 Nov 19.

An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole.

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  • 1Molekulargenetisches Labor für polymikrobielle Infektionen und bakterielle Biofilme, Berlin, Germany.

Abstract

OBJECTIVE:

The purpose of this study was to determine the efficacy of standard treatment with oral metronidazole in the eradication of the bacterial vaginosis biofilm.

STUDY DESIGN:

We conducted an interventional follow-up study in which 18 patients with bacterial vaginosis were treated with oral metronidazole during 1 week and subsequently had a single random follow-up assessment at 1-week intervals, up to 5 weeks, with 3 patients representing each point in time. Follow-up assessment included conventional scoring of the vaginal microflora and determination of bacterial biofilm characteristics on a vaginal biopsy through bacterial 16/23S recombinant DNA-based fluorescence in-situ hybridization.

RESULTS:

Although all patients recovered, we consistently observed the resurgence with treatment cessation of a dense and active bacterial biofilm on the vaginal mucosa, primarily consisting of Gardnerella vaginalis and Atopobium vaginae.

CONCLUSION:

A large reservoir of the core bacteria to bacterial vaginosis persists as a biofilm after metronidazole treatment.

PMID:
18005928
[PubMed - indexed for MEDLINE]
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