Alexander Swidsinski1, Vera Loening-Baucke2, Werner Mendling3, Yvonne Dörffel4, Johannes Schilling2, Zaher Halwani5, Xue-feng Jiang6, Hans Verstraelen7, Sonja Swidsinski8. 1. Charité Hospital, CCM, Laboratory for Molecular Genetics, Polymicrobial Infections and Bacterial Biofilms and Department of Medicine, Gastroenterology, Universitätsmedizin Berlin, Germany. alexander.swidsinski@charite.de. 2. Charité Hospital, CCM, Laboratory for Molecular Genetics, Polymicrobial Infections and Bacterial Biofilms and Department of Medicine, Gastroenterology, Universitätsmedizin Berlin. 3. Vivantes Kliniken für Gynaekologie und Geburtshilfe, Am Urban and im Friedrichshain, Berlin, Germany. 4. Outpatient Clinic, Charité Universitätsmedizin Berlin, CCM, Berlin, Germany. 5. DRK Kliniken Berlin Westend, Klinik für Gynaekologie und Geburtshilfe, Berlin. 6. Department of Obstetrics and Gynecology, the first affiliated hospital of Jinan University, Guangzhou, China. 7. Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium. 8. Labor Berlin, Department of Microbiology, Berlin, Germany.
Abstract
BACKGROUND: We analysed data on bacterial vaginosis (BV) contradicting the paradigm of mono-infection. METHODOLOGY: Tissues and epithelial cells of vagina, uterus, fallopian tubes and perianal region were investigated using fluorescence in situ hybridization (FISH) in women with BV and controls. RESULTS: Healthy vagina was free of biofilms. Prolific structured polymicrobial (StPM) Gardnerella-dominated biofilm characterised BV. The intact StPM-Gardnerella-biofilm enveloped desquamated vaginal/prepuce epithelial cells and was secreted with urine and sperma. The disease involved both genders and occurred in pairs. Children born to women with BV were negative. Monotherapy with metronidazole, moxifloxacin or local antiseptics suppressed but often did not eradicate StPM-Gardnerella-biofilms. There was no BV without Gardnerella, but Gardnerella was not BV. Outside of StPM-biofilm, Gardnerella was also found in a subset of children and healthy adults, but was dispersed, temporal and did not transform into StPM-Gardnerella-biofilm. CONCLUSIONS: StPM-Gardnerella-biofilm is an infectious subject. The assembly of single players to StPM-Gardnerella-biofilm is a not trivial every day process, but probably an evolutionary event with a long history of growth, propagation and selection for viability and ability to reshape the environment. The evolutionary memory is cemented in the structural differentiation of StPM-Gardnerella-biofilms and imparts them to resist previous and emerging challenges.
BACKGROUND: We analysed data on bacterial vaginosis (BV) contradicting the paradigm of mono-infection. METHODOLOGY: Tissues and epithelial cells of vagina, uterus, fallopian tubes and perianal region were investigated using fluorescence in situ hybridization (FISH) in women with BV and controls. RESULTS: Healthy vagina was free of biofilms. Prolific structured polymicrobial (StPM) Gardnerella-dominated biofilm characterised BV. The intact StPM-Gardnerella-biofilm enveloped desquamated vaginal/prepuce epithelial cells and was secreted with urine and sperma. The disease involved both genders and occurred in pairs. Children born to women with BV were negative. Monotherapy with metronidazole, moxifloxacin or local antiseptics suppressed but often did not eradicate StPM-Gardnerella-biofilms. There was no BV without Gardnerella, but Gardnerella was not BV. Outside of StPM-biofilm, Gardnerella was also found in a subset of children and healthy adults, but was dispersed, temporal and did not transform into StPM-Gardnerella-biofilm. CONCLUSIONS: StPM-Gardnerella-biofilm is an infectious subject. The assembly of single players to StPM-Gardnerella-biofilm is a not trivial every day process, but probably an evolutionary event with a long history of growth, propagation and selection for viability and ability to reshape the environment. The evolutionary memory is cemented in the structural differentiation of StPM-Gardnerella-biofilms and imparts them to resist previous and emerging challenges.
Authors: W Mendling; K Friese; I Mylonas; E-R Weissenbacher; J Brasch; M Schaller; P Mayser; I Effendy; G Ginter-Hanselmayer; H Hof; O Cornely; M Ruhnke Journal: Geburtshilfe Frauenheilkd Date: 2015-04 Impact factor: 2.915
Authors: Richard M Weeks; Alysha Moretti; Shuang Song; Kathryn E Uhrich; Andrey V Karlyshev; Michael L Chikindas Journal: Pathog Dis Date: 2019-11-01 Impact factor: 3.951
Authors: John J Schellenberg; Teenus Paramel Jayaprakash; Niradha Withana Gamage; Mo H Patterson; Mario Vaneechoutte; Janet E Hill Journal: PLoS One Date: 2016-01-11 Impact factor: 3.240