Biofilms: An Underappreciated Mechanism of Treatment Failure and Recurrence in Vaginal Infections

Overview

Journal Clin Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2015 May 4

PMID 25935553

Citations 69

Authors

Christina A Muzny

Jane R Schwebke

Affiliations

Soon will be listed here.

Abstract

Biofilms are microbial communities of surface-attached cells embedded in a self-produced extracellular matrix. They are of major medical significance because they decrease susceptibility to antimicrobial agents and enhance the spread of antimicrobial resistance. Biofilm-associated bacterial and fungal microorganisms have increasingly been recognized to play a role in multiple infectious diseases, particularly in their persistence and recurrence. More recently, biofilms have also been implicated in vaginal infections, notably bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC), particularly in the setting of treatment failure and recurrence. The purpose of this review is to discuss the impact of biofilms on the management and treatment of BV and recurrent VVC and highlight the need for additional research and development of novel therapeutics targeting pathogenic vaginal biofilms.

Citing Articles

[Low-intensity pulsed ultrasound combined with nystatin treatment synergistically inhibits vaginal biofilm infection in rabbits].

Xie M, Yang M, Li X, DU Y Nan Fang Yi Ke Da Xue Xue Bao. 2025; 45(2):296-303.

PMID: 40031973 PMC: 11875854. DOI: 10.12122/j.issn.1673-4254.2025.02.10.

Mechanisms of S. agalactiae promoting G. vaginalis biofilm formation leading to recurrence of BV.

Li M, Zeng Z, Wang X, Liu Y, Wei H, Liu J NPJ Biofilms Microbiomes. 2024; 10(1):138.

PMID: 39604369 PMC: 11603151. DOI: 10.1038/s41522-024-00601-w.

Candidiasis in Pregnancy: Relevant Aspects of the Pathology for the Mother and the Fetus and Therapeutic Strategies.

Messina A, Mariani A, Brandolisio R, Tavella E, Germano C, Lipari G Trop Med Infect Dis. 2024; 9(5).

PMID: 38787047 PMC: 11125970. DOI: 10.3390/tropicalmed9050114.

Untargeted metabolomics uncovers prime pathways linked to antibacterial action of citral against bacterial vaginosis-causing : An and study.

Jothi R, Kamaladevi A, Muthuramalingam P, Malligarjunan N, Pandian S, Gowrishankar S Heliyon. 2024; 10(6):e27983.

PMID: 38545203 PMC: 10966606. DOI: 10.1016/j.heliyon.2024.e27983.

A Preliminary Evaluation on the Antifungal Efficacy of VT-1161 against Persister Cells in Vulvovaginal Candidiasis.

Sinoca M, Maione A, Gambino E, Imparato M, Galdiero M, de Alteriis E Biomedicines. 2024; 12(2).

PMID: 38397991 PMC: 10887314. DOI: 10.3390/biomedicines12020389.

References

Swidsinski A, Dorffel Y, Loening-Baucke V, Schilling J, Mendling W . Response of Gardnerella vaginalis biofilm to 5 days of moxifloxacin treatment. FEMS Immunol Med Microbiol. 2010; 61(1):41-6. DOI: 10.1111/j.1574-695X.2010.00743.x. View

Watnick P, Kolter R . Biofilm, city of microbes. J Bacteriol. 2000; 182(10):2675-9. PMC: 101960. DOI: 10.1128/JB.182.10.2675-2679.2000. View

Williams D, Jordan R, Wei X, Alves C, Wise M, Wilson M . Interactions of Candida albicans with host epithelial surfaces. J Oral Microbiol. 2013; 5. PMC: 3805843. DOI: 10.3402/jom.v5i0.22434. View

Fonseca E, Silva S, Rodrigues C, Alves C, Azeredo J, Henriques M . Effects of fluconazole on Candida glabrata biofilms and its relationship with ABC transporter gene expression. Biofouling. 2014; 30(4):447-57. DOI: 10.1080/08927014.2014.886108. View

Donlan R, Costerton J . Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002; 15(2):167-93. PMC: 118068. DOI: 10.1128/CMR.15.2.167-193.2002. View

Swidsinski A, Loening-Baucke V, Swidsinski S, Verstraelen H . Polymicrobial Gardnerella biofilm resists repeated intravaginal antiseptic treatment in a subset of women with bacterial vaginosis: a preliminary report. Arch Gynecol Obstet. 2014; 291(3):605-9. DOI: 10.1007/s00404-014-3484-1. View

Schwebke J, Muzny C, Josey W . Role of Gardnerella vaginalis in the pathogenesis of bacterial vaginosis: a conceptual model. J Infect Dis. 2014; 210(3):338-43. DOI: 10.1093/infdis/jiu089. View

Kolodkin-Gal I, Romero D, Cao S, Clardy J, Kolter R, Losick R . D-amino acids trigger biofilm disassembly. Science. 2010; 328(5978):627-9. PMC: 2921573. DOI: 10.1126/science.1188628. View

Anderl J, Franklin M, Stewart P . Role of antibiotic penetration limitation in Klebsiella pneumoniae biofilm resistance to ampicillin and ciprofloxacin. Antimicrob Agents Chemother. 2000; 44(7):1818-24. PMC: 89967. DOI: 10.1128/AAC.44.7.1818-1824.2000. View

10.

Reichman O, Akins R, Sobel J . Boric acid addition to suppressive antimicrobial therapy for recurrent bacterial vaginosis. Sex Transm Dis. 2009; 36(11):732-4. DOI: 10.1097/OLQ.0b013e3181b08456. View

11.

Stewart P, Costerton J . Antibiotic resistance of bacteria in biofilms. Lancet. 2001; 358(9276):135-8. DOI: 10.1016/s0140-6736(01)05321-1. View

12.

Deng Y, Lim A, Lee J, Chen S, An S, Dong Y . Diffusible signal factor (DSF) quorum sensing signal and structurally related molecules enhance the antimicrobial efficacy of antibiotics against some bacterial pathogens. BMC Microbiol. 2014; 14:51. PMC: 3941561. DOI: 10.1186/1471-2180-14-51. View

13.

Bradshaw C, Morton A, Hocking J, Garland S, Morris M, Moss L . High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006; 193(11):1478-86. DOI: 10.1086/503780. View

14.

Paiva L, Vidigal P, Donatti L, Svidzinski T, Consolaro M . Assessment of in vitro biofilm formation by Candida species isolates from vulvovaginal candidiasis and ultrastructural characteristics. Micron. 2011; 43(2-3):497-502. DOI: 10.1016/j.micron.2011.09.013. View

15.

Sobel J, Ferris D, Schwebke J, Nyirjesy P, Wiesenfeld H, Peipert J . Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006; 194(5):1283-9. DOI: 10.1016/j.ajog.2005.11.041. View

16.

Brackman G, Coenye T . Quorum sensing inhibitors as anti-biofilm agents. Curr Pharm Des. 2014; 21(1):5-11. DOI: 10.2174/1381612820666140905114627. View

17.

Costerton J, Geesey G, Cheng K . How bacteria stick. Sci Am. 1978; 238(1):86-95. DOI: 10.1038/scientificamerican0178-86. View

18.

Patterson J, Stull-Lane A, Girerd P, Jefferson K . Analysis of adherence, biofilm formation and cytotoxicity suggests a greater virulence potential of Gardnerella vaginalis relative to other bacterial-vaginosis-associated anaerobes. Microbiology (Reading). 2009; 156(Pt 2):392-399. PMC: 2890091. DOI: 10.1099/mic.0.034280-0. View

19.

Davies D, Parsek M, Pearson J, Iglewski B, Costerton J, Greenberg E . The involvement of cell-to-cell signals in the development of a bacterial biofilm. Science. 1998; 280(5361):295-8. DOI: 10.1126/science.280.5361.295. View

20.

Costerton W, Veeh R, Shirtliff M, Pasmore M, Post C, Ehrlich G . The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest. 2003; 112(10):1466-77. PMC: 259139. DOI: 10.1172/JCI20365. View