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Treatment of biofilms in bacterial vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis.
Microbiome. 2017 09 13; 5(1):119.M

Abstract

BACKGROUND

Bacterial vaginosis (BV) is the most common vaginal syndrome among women in their reproductive years. It is associated with an increased risk of acquiring sexually transmitted infections and complications like preterm labor. BV is characterized by a high recurrence rate for which biofilms frequently found on vaginal epithelial cells may be a reason.

RESULTS

Here, we report a controlled randomized clinical trial that tested the safety and effectiveness of a newly developed pessary containing an amphoteric tenside (WO3191) to disrupt biofilms after metronidazole treatment of BV. Pessaries containing lactic acid were provided to the control group, and microbial community composition was determined via Illumina sequencing of the V1-V2 region of the 16S rRNA gene. The most common community state type (CST) in healthy women was characterized by Lactobacillus crispatus. In BV, diversity was high with communities dominated by either Lactobacillus iners, Prevotella bivia, Sneathia amnii, or Prevotella amnii. Women with BV and proven biofilms had an increased abundance of Sneathia sanguinegens and a decreased abundance of Gardnerella vaginalis. Following metronidazole treatment, clinical symptoms cleared, Nugent score shifted to Lactobacillus dominance, biofilms disappeared, and diversity (Shannon index) was reduced in most women. Most of the patients responding to therapy exhibited a L. iners CST. Treatment with WO 3191 reduced biofilms but did not prevent recurrence. Women with high diversity after antibiotic treatment were more likely to develop recurrence.

CONCLUSIONS

Stabilizing the low diversity healthy flora by promoting growth of health-associated Lactobacillus sp. such as L. crispatus may be beneficial for long-term female health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02687789.

Authors+Show Affiliations

Research Group Microbial Communication, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.Research Group Microbial Communication, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.Research Group Microbial Interactions and Processes, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstrasse 56, 33611, Bielefeld, Germany.Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstrasse 56, 33611, Bielefeld, Germany.Research Group Microbial Interactions and Processes, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.Central Facility for Microscopy, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.German Center for Infections in Gynecology and Obstetrics, Wuppertal, Germany.Research Group Microbial Communication, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany. Irene.Wagner-Doebler@helmholtz-hzi.de.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28903767

Citation

Gottschick, Cornelia, et al. "Treatment of Biofilms in Bacterial Vaginosis By an Amphoteric Tenside Pessary-clinical Study and Microbiota Analysis." Microbiome, vol. 5, no. 1, 2017, p. 119.
Gottschick C, Deng ZL, Vital M, et al. Treatment of biofilms in bacterial vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis. Microbiome. 2017;5(1):119.
Gottschick, C., Deng, Z. L., Vital, M., Masur, C., Abels, C., Pieper, D. H., Rohde, M., Mendling, W., & Wagner-Döbler, I. (2017). Treatment of biofilms in bacterial vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis. Microbiome, 5(1), 119. https://doi.org/10.1186/s40168-017-0326-y
Gottschick C, et al. Treatment of Biofilms in Bacterial Vaginosis By an Amphoteric Tenside Pessary-clinical Study and Microbiota Analysis. Microbiome. 2017 09 13;5(1):119. PubMed PMID: 28903767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of biofilms in bacterial vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis. AU - Gottschick,Cornelia, AU - Deng,Zhi-Luo, AU - Vital,Marius, AU - Masur,Clarissa, AU - Abels,Christoph, AU - Pieper,Dietmar H, AU - Rohde,Manfred, AU - Mendling,Werner, AU - Wagner-Döbler,Irene, Y1 - 2017/09/13/ PY - 2017/03/06/received PY - 2017/07/18/accepted PY - 2017/9/15/entrez PY - 2017/9/15/pubmed PY - 2018/5/3/medline KW - Amphoteric tenside KW - Bacterial vaginosis KW - Biofilms KW - Vaginal microbiome KW - Vaginal microbiota SP - 119 EP - 119 JF - Microbiome JO - Microbiome VL - 5 IS - 1 N2 - BACKGROUND: Bacterial vaginosis (BV) is the most common vaginal syndrome among women in their reproductive years. It is associated with an increased risk of acquiring sexually transmitted infections and complications like preterm labor. BV is characterized by a high recurrence rate for which biofilms frequently found on vaginal epithelial cells may be a reason. RESULTS: Here, we report a controlled randomized clinical trial that tested the safety and effectiveness of a newly developed pessary containing an amphoteric tenside (WO3191) to disrupt biofilms after metronidazole treatment of BV. Pessaries containing lactic acid were provided to the control group, and microbial community composition was determined via Illumina sequencing of the V1-V2 region of the 16S rRNA gene. The most common community state type (CST) in healthy women was characterized by Lactobacillus crispatus. In BV, diversity was high with communities dominated by either Lactobacillus iners, Prevotella bivia, Sneathia amnii, or Prevotella amnii. Women with BV and proven biofilms had an increased abundance of Sneathia sanguinegens and a decreased abundance of Gardnerella vaginalis. Following metronidazole treatment, clinical symptoms cleared, Nugent score shifted to Lactobacillus dominance, biofilms disappeared, and diversity (Shannon index) was reduced in most women. Most of the patients responding to therapy exhibited a L. iners CST. Treatment with WO 3191 reduced biofilms but did not prevent recurrence. Women with high diversity after antibiotic treatment were more likely to develop recurrence. CONCLUSIONS: Stabilizing the low diversity healthy flora by promoting growth of health-associated Lactobacillus sp. such as L. crispatus may be beneficial for long-term female health. TRIAL REGISTRATION: ClinicalTrials.gov NCT02687789. SN - 2049-2618 UR - https://www.unboundmedicine.com/medline/citation/28903767/Treatment_of_biofilms_in_bacterial_vaginosis_by_an_amphoteric_tenside_pessary_clinical_study_and_microbiota_analysis_ L2 - https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-017-0326-y DB - PRIME DP - Unbound Medicine ER -