EFFECT OF UROGENITAL TRACT BIOFILMS ON THE EFFICACY OF STANDARD THERAPY OF RECURRENT BACTERIAL VAGINOSIS

Rossolovskaya K. A., Trifonova N. S., Bragina E. E., Gadaeva I. V., Polidanov M. A., Spivak L. G.

The high rate of recurrent and refractory bacterial vaginosis actualizes the need for an advanced study of the causes of this trend and calls into question the effectiveness of available monotherapeutic regimens. On the basis of Sechenov University, Moscow, and LLC “Family Polyclinic No. 4”, Korolev, a study was conducted to compare the efficacy of standard metronidazole therapy in situations of “biofilm” and “non-biofilm” bacterial vaginosis in women with a history of 3 or more recurrences. Transmission electron microscopy was used to diagnose biofilms in 36 of 58 (62.1%) patients, the presence of which was confirmed in 32 of 36 (88.9%) cases after treatment. In this group of patients the absence of microbiome normalization after metronidazole monotherapy (ineffectiveness) was significantly more often observed compared to women with “non-biofilm” bacterial vaginosis: 20 (n=36) and 3 (n=22) patients, respectively. Thus, it is legitimate to say about significantly lower susceptibility of patients with biofilm form of recurrent bacterial vaginosis to metronidazole monotherapy. This study proves the need to search for alternative approaches to treatment and introduction into clinical practice of means aimed at biofilm destruction.

Keywords:Bacterial vaginosis; biofilms; metronidazole; treatment of bacterial vaginosis; diagnosis of bacterial vaginosis; electron microscopy