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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

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  • BV often recurs after antibiotic treatment

  • 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,

  • 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​​

LactoGramStained.tiff
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
  • uterine infection

  • preterm birth

  • sexually transmitted infections,

  • pelvic inflammatory disease, 

  • disturbances in urinary health

BV is associated with higher risks of

Wandy Beatty
LactoGramStained.tiff

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
 

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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

1

Prevotella bivia

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

2

Group B Streptococcus

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

3

Fusobacterium nucleatum

Gardnerella sialidase enables Fusobacterium to forage on otherwise unaccessible carbohydrate sources

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