The vaginal microbiome in health and disease
What is bacterial vaginosis (BV)?
Bacterial vaginosis (BV) is a condition of the vaginal microbiota where there are low levels of ‘healthy’ lactobacilli and overgrowth of potential pathogens
BV often recurs after antibiotic treatment
Little progress has been made improving pregnancy outcomes associated with BV
Clinical criteria for BV (3 of 4)
'thin' vaginal fluid,
fishy odor upon KOH treatment
higher vaginal pH (>4.5) attributed to reduced lactic acid bacteria
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.
sexually transmitted infections,
pelvic inflammatory disease,
disturbances in urinary health
BV is associated with higher risks of
This field that has suffered from a lack of in vivo model systems.
We have built the first small animal models of BV, providing evidence for a causal role played by pathogenic Gardnerella in some of the features and health complications associated with BV.
Gardnerella is an enabler
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
Gardnerella enables Prevotella to cause uterine infections that contain 20-fold higher levels of bacteria in infected tissue
Gardnerella sialidase enables Fusobacterium to forage on otherwise unaccessible carbohydrate sources