Impact of Periodic Presumptive Treatment for Bacterial Vaginosis on the Vaginal Microbiome among Women Participating in the Preventing Vaginal Infections Trial.
Open Access
- 22 December 2016
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 215 (5), 723-731
- https://doi.org/10.1093/infdis/jiw622
Abstract
Evidence suggests that specific vaginal bacteria associated with bacterial vaginosis (BV) may increase the risk of adverse health outcomes in women. Among women participating in a randomized, double-blinded trial, we assessed the effect of periodic presumptive treatment (PPT) on detection of select vaginal bacteria. High-risk women from the United States and Kenya with a recent vaginal infection received intravaginal metronidazole 750 mg plus miconazole 200 mg or placebo for 5 consecutive nights each month for 12 months. Vaginal fluid specimens were collected via polyester/polyethylene terephthalate swabs every other month and tested for bacteria, using quantitative polymerase chain reaction (PCR) assays targeting the 16S ribosomal RNA gene. The effect of PPT on bacterium detection was assessed among all participants and stratified by country. Of 234 women enrolled, 221 had specimens available for analysis. The proportion of follow-up visits with detectable quantities was lower in the PPT arm versus the placebo arm for the following bacteria: BVAB1, BVAB2, Atopobium vaginae, Leptotrichia/Sneathia, and Megasphaera. The magnitude of reductions was greater among Kenyan participants as compared to US participants. Use of monthly PPT for 1 year reduced colonization with several bacteria strongly associated with BV. The role of PPT to improve vaginal health should be considered, and efforts to improve the impact of PPT regimens are warranted.Keywords
This publication has 31 references indexed in Scilit:
- Relationship of Specific Bacteria in the Cervical and Vaginal Microbiotas With CervicitisSexually Transmitted Diseases, 2015
- The significance of Lactobacillus crispatus and L. vaginalis for vaginal health and the negative effect of recent sex: a cross-sectional descriptive study across groups of African womenBMC Infectious Diseases, 2015
- Differences in vaginal microbiome in African American women versus women of European ancestryMicrobiology, 2014
- Temporal Variability of Human Vaginal Bacteria and Relationship with Bacterial VaginosisPLOS ONE, 2010
- Improvement of Vaginal Health for Kenyan Women at Risk for Acquisition of Human Immunodeficiency Virus Type 1: Results of a Randomized TrialThe Journal of Infectious Diseases, 2008
- The International Infections in Pregnancy (IIP) study: Variations in the prevalence of bacterial vaginosis and distribution of morphotypes in vaginal smears among pregnant womenAmerican Journal of Obstetrics and Gynecology, 2006
- High Recurrence Rates of Bacterial Vaginosis over the Course of 12 Months after Oral Metronidazole Therapy and Factors Associated with RecurrenceThe Journal of Infectious Diseases, 2006
- Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosisAmerican Journal of Obstetrics and Gynecology, 2006
- Association of Atopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosisBMC Infectious Diseases, 2004
- Bacterial Vaginosis Is a Strong Predictor ofNeisseria gonorrhoeaeandChlamydiatrachomatisInfectionClinical Infectious Diseases, 2003