Underlying causes of recurrent bacterial vaginosis identified by Australian scientists | Health

Australian scientists have identified two factors contributing to recurrent bacterial vaginosis infections, a common sexual health problem that affects around one in four women worldwide.

The disease, commonly known as BV, is characterized by an imbalance of bacteria naturally present in the vagina, in which there is a reduction in “good” bacteria. and an overgrowth of other mixed bacteria.

In March last year, researchers published a landmark study that found BV can be sexually transmitted to women from male partners.

They found that treating women with the disease and their male sexual partners simultaneously with antibiotics reduced BV recurrence rates by more than 60%.

In new research, the same group of scientists sought to understand why about 20% of women treated simultaneously with their partners were not cured of BV.

The study, published in The Lancet Obstetrics, Gynecology & Women’s Health, included 188 couples: women received a week’s course of oral antibiotics, while men were treated with oral and topical antimicrobials.

She identified two distinct pathways leading to recurrent BV: persistence of disease despite a one-week course of antibiotics and reinfection.

Lead study author Dr Lenka Vodstrcil, a senior researcher at Monash University and Bayside Health’s Melbourne Sexual Health Centre, said: “For about two-thirds of women, the day after finishing treatment, they return to… an optimal vaginal microbiome,” which is characterized by an abundance of healthy substances. Lactobacilli bacteria.

The other third of women had microbiomes suggesting “they may not have cleared their BV” before couples resumed sex after treatment, and were nearly three times more likely to contract the disease again within four weeks.

A better understanding of “the persistence of infection… helps us develop new strategies to cure more women of BV,” Vodstrcil said.

BV can be asymptomatic or cause vaginal itching, burning, and discomfort. Treatment is essential because this condition can increase susceptibility to other infections and is linked to complications during pregnancy and childbirth.

The study – which researchers say is the largest to date involving heterosexual couples concurrently receiving treatment for BV – found that persistence and reinfection by partners were “distinct, but not mutually exclusive, pathways.”

Of the participants, 30% used an intrauterine device, which the study said “may improve the persistence of bacterial vaginosis after treatment in some women” but noted that more research is needed.

Scientists now plan to try longer treatment durations and combinations of multiple antibiotics.

“Our goal is to prevent women from receiving two, three, four courses of antibiotics throughout the year, as happened before,” Vodstrcil said.

Lead author of the study, Professor Catriona Bradshaw, Head of Research Translation and Mentoring at Monash University and the Melbourne Sexual Health Centre, said: “By using partner treatment to mitigate reinfection and more intensive strategies targeting persistence of BV bacteria, we hope to create more effective treatment approaches that can be tailored to an individual and achieve higher levels of cure.” »

Although the ethnicities of the participants were “representative of urban Australia”, the study noted that its findings “may not be generalizable to other global populations, including those in low- and middle-income countries and in other settings where the burden of bacterial vaginosis is high”.