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.

infertility
uterine infection
preterm birth
sexually transmitted infections,
pelvic inflammatory disease,
disturbances in urinary health

BV is associated with higher risks of

Wandy Beatty

mouse model

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

Prevotella bivia

Gardnerella enables Prevotella to cause uterine infections that contain 20-fold higher levels of bacteria in infected tissue

Group B Streptococcus

Gardnerella enables Streptococcus agalactiae to colonize the vagina and cause uterine and placental infection in pregnancy

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Fusobacterium nucleatum

Gardnerella sialidase enables Fusobacterium to forage on otherwise unaccessible carbohydrate sources