Dept of Ob/Gyn and Reproductive Sciences
Glycobiology Research and Training Center
UC San Diego
The vaginal microbiome in health and disease
What is bacterial vaginosis (BV)?
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Bacterial vaginosis (BV) is a condition of the vaginal microbiota where there are low levels of ‘healthy’ lactobacilli and overgrowth of potential pathogens
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BV often recurs after antibiotic treatment
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Little progress has been made improving pregnancy outcomes associated with BV
Clinical criteria for BV (3 of 4)
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'thin' vaginal fluid,
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fishy odor upon KOH treatment
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higher vaginal pH (>4.5) attributed to reduced lactic acid bacteria
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20% of the exfoliated epithelial cells studded with bacteria in microscopic examination​​
Long rods staining purple in a Gram-stained vaginal smear indicate Lactobacillus as a dominant feature of the microbiome
Transmission electron micrograph of Gardnerella
in association with a mouse vaginal epithelial cell.
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- infertility
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uterine infection
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preterm birth
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sexually transmitted infections,
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pelvic inflammatory disease,
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disturbances in urinary health
BV is associated with higher risks of
Wandy Beatty
Gardnerella is an enabler
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Gardnerella is one of the most abundant bacterial genera in the vagina during BV.
In multiple mouse models of co-infection, we show that Gardnerella supports colonization by other bacteria and triggers other pathogens to exhibit more virulent characteristics
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Prevotella bivia
Gardnerella enables Prevotella to cause uterine infections that contain 20-fold higher levels of bacteria in infected tissue
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Fusobacterium nucleatum
Gardnerella sialidase enables Fusobacterium to forage on otherwise unaccessible carbohydrate sources