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Molecular analysis of the relationship between specific vaginal bacteria and bacterial vaginosis metronidazole therapy failure

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Abstract

Bacterial vaginosis frequently persists, even after treatment. The role of some strains of bacteria associated with bacterial vaginosis treatment failure remains poorly defined. The aim of our study was to define the risk of bacterial vaginosis treatment failure, including pre-treatment detection of specific vaginal bacteria. Bacterial vaginosis is present when the Nugent score is ≥7 and the modified Amsel criteria is positive. Women with bacterial vaginosis were treated with intravaginal metronidazole gel nightly for 5 nights. The 454 pyrosequencing method was used to detect bacteria in vaginal fluid. By univariate analysis, a history of bacterial vaginosis, intrauterine device use and the presence of Facklamia, Corynebacterium and Veillonella were significantly associated with bacterial vaginosis treatment failure. Lactobacillus crispatus, Lactobacillus pentosus and Megasphaera were significantly associated with curing bacterial vaginosis. After logistic regression analysis and detection of these bacteria for test-of-cure, we found that women who had a history of bacterial vaginosis had a higher incidence of bacterial vaginosis treatment failure, whereas women with L. crispatus had a lower incidence of treatment failure. Post-treatment sexual activity was not associated with the treatment effect. Our data suggested that treatment failure may be not caused by drug resistance. Rather, it has a closer relationship with the failed restoration of lactobacilli.

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Acknowledgements

This study was funded by a project supported by the National Natural Science Foundation of China: 81200411, 81170535. The funding sources had no role in the design and conduct of the study.

Conflict of interest

The authors declare that they have no conflict of interest in relation to this article.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China

    B. Wang, B. B. Xiao, C. G. Shang, R. S. Na, X. X. Nu & Q. Liao

  2. Xingtai Maternal and Child Health Hospital, Xingtai, China

    K. Wang

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  1. B. Wang
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Correspondence to Q. Liao.

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B. Wang and B.B. Xiao contributed equally to this study.

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Wang, B., Xiao, B.B., Shang, C.G. et al. Molecular analysis of the relationship between specific vaginal bacteria and bacterial vaginosis metronidazole therapy failure. Eur J Clin Microbiol Infect Dis 33, 1749–1756 (2014). https://doi.org/10.1007/s10096-014-2128-5

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  • DOI: https://doi.org/10.1007/s10096-014-2128-5

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