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Antibiotics
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Biofilm-Associated Vaginal Infections
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Biofilm-Associated Vaginal Infections

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 16342

Special Issue Editors

Dr. Joana Castro

E-Mail Website
Guest Editor
I.P—National Institute for Agrarian and Veterinarian Research (INIAV), Vairão, Portugal
Interests: bacterial infections; biofilm; virulence; antimicrobial resistance; Escherichia coli; gene expression; probiotics
Special Issues, Collections and Topics in MDPI journals
Dr. José António Baptista Machado Soares

E-Mail Website
Guest Editor
Microbiology Institute, Universidad San Francisco de Quito (USFQ), Quito, Ecuador
Interests: diagnosis of pathogens; biofilms; biomedical engineering; clinical and forensic analytical toxicology; development of methodologies; virulence of microorganisms
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Christina A. Muzny

E-Mail Website
Guest Editor
Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA
Interests: pathogenesis; epidemiology; diagnosis; treatment and prevention of vaginal infections, particularly bacterial vaginosis and trichomoniasis

Special Issue Information

Dear colleagues,

Bacterial vaginosis (BV) is the most common vaginal infection worldwide in women of reproductive age. Aside from causing frequent unpleasant genital symptoms, BV can also lead to serious gynecological and obstetric complications, as well as increased risk of acquisition of HIV and other sexually transmitted infections (STIs). Despite extensive research over the past 50 years, the etiology of BV remains unclear. However, it is certain that BV involves the presence of a multi-species biofilm on vaginal epithelial cells, where Gardnerella species presumably play a pivotal role.

Similar to what happens in many other biofilm infections, traditional antimicrobial therapies are unable to fully eradicate the vaginal biofilm, and unfortunately, this often leads to high recurrence rates of BV. In an attempt to overcome antimicrobial therapy failure and recurrence, new strategies including antiseptics, biofilm-disrupting agents, probiotics, endolysins, and plant-derived products, have been proposed as emergent and valuable approaches to treat BV. This Special Issue seeks manuscript submissions that further our understanding of the role of BV-associated biofilms in antimicrobial resistance. Submissions related to the response of vaginal pathogens to novel strategies that have been proposed to treat BV are especially encouraged. Manuscripts that further our understanding of recent advances in the field of novel antimicrobial strategies against other vaginal infections are also welcome.

 

Dr. Joana Castro
Dr. José António Baptista Machado Soares
Prof. Dr. Christina A. Muzny
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaginal infections
  • bacterial vaginosis
  • biofilms
  • antimicrobial resistance
  • novel therapies

Published Papers (4 papers)

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Research

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13 pages, 2299 KiB  
Article
Exploiting the Anti-Biofilm Effect of the Engineered Phage Endolysin PM-477 to Disrupt In Vitro Single- and Dual-Species Biofilms of Vaginal Pathogens Associated with Bacterial Vaginosis
by Joana Castro, Lúcia G. V. Sousa, Ângela França, Lenka Podpera Tisakova, Lorenzo Corsini and Nuno Cerca
Antibiotics 2022, 11(5), 558; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11050558 - 22 Apr 2022
Cited by 5 | Viewed by 2260
Abstract
Bacterial vaginosis (BV) is the most frequent vaginal infection in women of reproductive age. It is caused by the overgrowth of anaerobic vaginal pathogens, such as Gardnerella vaginalis, Fannyhessea vaginae, and Prevotella bivia, which are vaginal pathogens detected during the [...] Read more.
Bacterial vaginosis (BV) is the most frequent vaginal infection in women of reproductive age. It is caused by the overgrowth of anaerobic vaginal pathogens, such as Gardnerella vaginalis, Fannyhessea vaginae, and Prevotella bivia, which are vaginal pathogens detected during the early stages of incident BV and have been found to form multi-species biofilms. Treatment of biofilm-associated infections, such as BV, is challenging. In this study, we tested the role of an investigational engineered phage endolysin, PM-477, in the eradication of dual-species biofilms composed of G. vaginalis–F. vaginae or G. vaginalis–P. bivia. Single-species biofilms formed by these species were also analysed as controls. The effect of PM-477 on biomass and culturability of single- and dual-species biofilms was assessed in vitro using a microtiter plate assay, epifluorescence microscopy, confocal laser scanning microscopy, and quantitative PCR. The results showed that PM-477 was particularly effective in the disruption and reduction of culturability of G. vaginalis biofilms. In dual-species biofilms, PM-477 exhibited lower efficiency but was still able to selectively and significantly eliminate G. vaginalis. Since polymicrobial interactions have been shown to strongly affect the activity of various antibiotics, the activity of PM-477 in dual-species biofilms is a potentially promising result that should be further explored, aiming to completely eradicate multi-species biofilms associated with BV. Full article
(This article belongs to the Special Issue Biofilm-Associated Vaginal Infections)
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8 pages, 250 KiB  
Article
Biofilm Producing Enterococcus Isolates from Vaginal Microbiota
by Mallika Sengupta, Soma Sarkar, Manideepa SenGupta, Sougata Ghosh, Riya Sarkar and Parthajit Banerjee
Antibiotics 2021, 10(9), 1082; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10091082 - 07 Sep 2021
Cited by 6 | Viewed by 2704
Abstract
Background: Enterococcus is an important cause of infection in the hospital as well as in the community. Methods: A prospective study was done in Medical College, Kolkata for a period of 2 years (from January 2018 to December 2019). After obtaining clearance from [...] Read more.
Background: Enterococcus is an important cause of infection in the hospital as well as in the community. Methods: A prospective study was done in Medical College, Kolkata for a period of 2 years (from January 2018 to December 2019). After obtaining clearance from the Institutional Ethics Committee, Enterococcus isolates from cases of vaginitis were included in the study. Identification of Enterococcus species was done by Gram stain and conventional biochemical tests along with automated identification by VITEK 2 Compact. These isolates were tested for antimicrobial susceptibility to different antibiotics by Kirby Bauer disc diffusion method and minimum inhibitory concentration (MIC) by VITEK 2 Compact. Interpretation of susceptibility was done according to the Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines. Biofilm detection for Enterococcus species was done. Results: During the period of 2 years, 39 isolates of Enterococcus spp. were obtained from vaginitis cases. Among these, 27 were Enterococcus faecalis and 12 Enterococcus faecium. All isolates were highly susceptible to vancomycin, teicoplanin, and linezolid. Biofilm was detected in eight isolates of which five were strong biofilm producer and three moderate biofilm producers. Conclusion: Biofilm production is an important virulence factor in Enterococcus isolates from vaginitis. Full article
(This article belongs to the Special Issue Biofilm-Associated Vaginal Infections)
16 pages, 5927 KiB  
Article
Comparative Effectiveness of Treatments for Bacterial Vaginosis: A Network Meta-Analysis
by Alison Muñoz-Barreno, Fausto Cabezas-Mera, Eduardo Tejera and António Machado
Antibiotics 2021, 10(8), 978; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10080978 - 13 Aug 2021
Cited by 18 | Viewed by 4397
Abstract
Bacterial vaginosis (BV) is a common vaginal dysbiosis in women of reproductive age. However, the cure rate for BV varies considerably and many women experience a relapse after the initial treatment. The present meta-analysis aimed to evaluate the clinical cure rates (CCRs) in [...] Read more.
Bacterial vaginosis (BV) is a common vaginal dysbiosis in women of reproductive age. However, the cure rate for BV varies considerably and many women experience a relapse after the initial treatment. The present meta-analysis aimed to evaluate the clinical cure rates (CCRs) in randomized controlled trials (RCTs) through different therapies and administration routes. This meta-analysis included a final set of 25 eligible studies with a total of 57 RCTs and compared the effectiveness of BV treatments among non-pregnant and pregnant women. The initial range of CCRs varied greatly from 46.75% to 96.20% and the final pooled CCR was 75.5% (CI: 69.4–80.8) using the random model. The heterogeneity indices were Q = 418.91, I2 = 94.27%, and τ = 0.7498 (p < 0.0001). No publication bias was observed according to Funnel plot symmetry and Egger’s linear regression test (p = 0.1097). To evaluate different variables, sub-group analysis, meta-regressions, and network meta-analysis were also realized. The highest P-scores in CCR were obtained by: (1) a combined therapy with local probiotic treatment and application of antibiotics by both administration route (oral clindamycin and local 5-nitroimidazole; P-score = 0.92); (2) a combined therapy with oral administration of 5-nitroimidazole and probiotic treatment (P-score = 0.82); (3) and a combined therapy with local administration of 5-nitroimidazole and oral probiotic treatment (P-score = 0.68). A clear-cut decision of the best BV treatment was not possible due to the heterogeneity of outcomes reported in the trials, indicating the necessity for a better characterization of RCTs. Finally, combined therapies suggested the reduction of the optimal concentration of antibiotics, and double phase treatments of antibiotics indicated an increment of CCRs in BV. Full article
(This article belongs to the Special Issue Biofilm-Associated Vaginal Infections)
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Review

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12 pages, 2861 KiB  
Review
The Role of Antimicrobial Resistance in Refractory and Recurrent Bacterial Vaginosis and Current Recommendations for Treatment
by Christina A. Muzny and Jack D. Sobel
Antibiotics 2022, 11(4), 500; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11040500 - 09 Apr 2022
Cited by 14 | Viewed by 5749
Abstract
Bacterial vaginosis (BV), the most common cause of vaginal discharge, is characterized by a shift in the vaginal microbiota from Lactobacillus species dominance to a diverse array of facultative and strict anaerobic bacteria which form a multi-species biofilm on vaginal epithelial cells. The [...] Read more.
Bacterial vaginosis (BV), the most common cause of vaginal discharge, is characterized by a shift in the vaginal microbiota from Lactobacillus species dominance to a diverse array of facultative and strict anaerobic bacteria which form a multi-species biofilm on vaginal epithelial cells. The rate of BV recurrence after therapy is high, often >60%. The BV biofilm itself likely contributes to recurrent and refractory disease after treatment by reducing antimicrobial penetration. However, antimicrobial resistance in BV-associated bacteria, including those both within the biofilm and the vaginal canal, may be the result of independent, unrelated bacterial properties. In the absence of new, more potent antimicrobial agents to eradicate drug-resistant pathogenic vaginal microbiota, treatment advances in refractory and recurrent BV have employed new strategies incorporating combination therapy. Such strategies include the use of combination antimicrobial regimens as well as alternative approaches such as probiotics and vaginal fluid transfer. Our current recommendations for the treatment of refractory and recurrent BV are provided. Full article
(This article belongs to the Special Issue Biofilm-Associated Vaginal Infections)
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