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Bacterial Vaginosis
Published in William J. Ledger, Steven S. Witkin, Vulvovaginal Infections, 2017
William J. Ledger, Steven S. Witkin
To further clarify, BV-associated immunity studies have investigated the immune response induced in vaginal epithelial cells in vitro following incubation with individual BV-associated bacteria.34,35Prevotella bivia was shown to induce IL-8 and TNF-α release in one study,36 but not in a second investigation.35 Strain differences and/or variations in the model systems may account for these divergent observations. Both studies were consistent in observing that A. vaginae evoked the release of a multitude of proinflammatory cytokines from vaginal epithelial cells—IL-1β, IL-6, IL-8, and TNF-α. It goes without saying that the immune-inducing properties of individual bacterial isolates in vitro might not necessarily parallel the in vivo situation where alterations in the composition of the bacterial population and quantities of bacterial metabolites and proteolytic enzymes may modify the effects of any one bacterial species.
Microbiological diagnosis: The human endometrial microbiome—Endometritis
Published in Carlos Simón, Linda C. Giudice, The Endometrial Factor, 2017
Inmaculada Moreno, Carlos Simón
AE is a polymicrobial infection of the endometrial cavity. This has been confirmed by the isolation of more than one microorganism in 80% of patients presenting with postpartum endometritis (74). Common and strictly anaerobic bacteria are mainly isolated from endometrial samples of patients with AE, including Group B Streptococcus, Enterococcus, Peptostreptococcus, Bacteroides spp., G. vaginalis, E. coli, and Prevotella bivia. Also, intracellular pathogens such as Ureaplasma urealyticum and M. hominis have been isolated from endometrial as well as blood samples from these patients (74–76).
Renal and perinephric abscesses involving Lactobacillus jensenii and Prevotella bivia in a young woman following ureteral stent procedure
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Abhinav Mohan, Jacob Rubin, Priyank Chauhan, Juan Lemos Ramirez, German Giese
Similar to Lactobacillus, Prevotella bivia is also an organism that inhabits the female genitourinary microbiota. It is a gram-negative non-pigmented anaerobe that is known to be implicated uncommonly in bacterial vaginosis, endometritis, and pelvic inflammatory disease. Rarely, cases of P. bivia paronychia, chest wall abscess, emphysematous pyelonephritis, necrotizing fasciitis, osteomyelitis, and sepsis have been published [10–13]. Lactobacillus is a known inhibitor of Prevotella in the GU system, while the pathogenicity of Prevotella increases in the presence of aerobic bacteria [10,14]. Given the rarity of P. bivia infection, there is no current consensus on the antibiotic treatment of P. bivia infections, especially for inoculations outside of the genitourinary system.
Current and emerging pharmacotherapy for recurrent bacterial vaginosis
Published in Expert Opinion on Pharmacotherapy, 2021
There is widespread agreement that BV is characterized by a shift in the vaginal microbiota lactic acid producing Lactobacillus spp. to the facultative and strict anaerobic bacilli [14–17]. There is however no consensus on pathogenesis and causation. Anaerobic species widely accepted as causing the clinical syndrome include Gardnerella vaginalis, other Gardnerella species, Atopobium vaginae, Mobiluncus spp., Bacteroides spp., Prevotella bivia, Leptotrichia/Sneathia spp., Mycoplasma hominis, and Megasphaera spp [15,16]. Epidemiological and microbiota data strongly indicate that BV is sexually transmitted, certainly with regard to the initial infection [18–21]. Current pathogenetic hypothesis has focused on G.vaginalis as the key causal pathogens in BV causation, transmitted alone or as part of a polymicrobial consortium of bacteria all transmitted sexually from a male or female partner [21–23]. Key steps in the development of BV require multiplication and proliferation of the bacterial pathogens introduced, followed by the establishment of multispecies biofilm on the luminal surface of vaginal epithelial cells [24–26]. The dominant and enabling bacterial species is G.vaginalis with lesser numbers of A.vaginaeand other bacterial species [24]. The BV biofilm containing these pathogens has been well documented within the vagina and serves as a pathogen sanctuary in that antibiotic penetration is limited, allowing microorganisms to survive and persist. As such, BV pathogens that persist have the capacity to reemerge, proliferate, and once more dominate the vaginal microbiome and play a critical role in recurring episodes of BV [22,23].
Comparison of microbial profiles and viral status along the vagina-cervix-endometrium continuum of infertile patients
Published in Systems Biology in Reproductive Medicine, 2023
Mark Jain, Elena Mladova, Anna Dobychina, Karina Kirillova, Anna Shichanina, Daniil Anokhin, Liya Scherbakova, Larisa Samokhodskaya, Olga Panina
The absence of any reliable associations of the tested microbiological parameters of the endometrium with clinical data (CE, uterine polyps and adhesions, endometriosis, history of sexually transmitted infections) could be explained by the low incidence of these conditions in our cohort. Some studies refer to a threshold value of CD138+ cells for CE diagnosis as low as a single cell in 10 high power fields (HPF) (Hirata et al. 2021). Selection of this criterion instead of 5 cells in 30 HPF in our cohort resulted in a dramatic shift of CE incidence from 11% to 83%, with Gardnerella vaginalis + Prevotella bivia + Porphyromonas spp. group as well as Atopobium vaginae being unexpectedly prevalent in non-CE patients (p = 0.002 and p = 0.026, respectively), which contradicts the results of other studies (Cicinelli et al. 2014; Tsypurdeeva et al. 2018; Liu et al. 2019; Lozano et al. 2021). Overall, there is no consensus on the microbiota composition associated with CE, mainly due to variations of the selected criteria for its diagnosis in the above-cited publications. Anyway, CE remains to be an important clinical condition, as it was shown in a recent meta-analysis (n = 4145) that patients with CE had lower ongoing pregnancy or live-birth and clinical-pregnancy rates (OR 1.97, p = 0.02 and OR 2.28, p = 0.002, respectively) (Vitagliano et al. 2022). Moreover, the same meta-analysis demonstrated that confirmed CE resolution after antibiotic therapy may improve endometrial receptivity leading to similar in vitro fertilization outcomes as compared to unaffected patients. Thus, further investigation, more methodologically uninformed, of CE aetiology and pathogenesis is needed.