Medical research: Vaginal bacteria transplant may help women with recurrent vaginosis

The transplantation of vaginal fluid containing healthy microbes is associated with the clinical improvement of bacterial vaginosis in four out of five women who had previously not responded to antibiotic treatment. The findings are reported in an exploratory study published in Nature Medicine.

Bacterial vaginosis is a common condition in which there is a change in the natural balance of microbes in the vagina. In most cases, this change does not require treatment or can be resolved with antibiotic treatment. However, in a subset of women it can cause extreme discomfort, become disruptive to the woman’s life and increase her chances of acquiring sexually transmitted diseases or developing other genitourinary problems.

Eran Elinav and colleagues selected five patients who had a history of recurrent bacterial vaginosis symptoms and had not responded to antibiotics to receive the vaginal microbiome transplant. The vaginal fluid donors went through a rigorous screening process to exclude the presence of potential infections and were counseled to abstain from sexual activity prior to the donation of vaginal fluid. After the transplant, the authors observed no adverse effects, and four of the five patients treated showed a marked improvement of symptoms 5- 21 months after transplantation; the fifth showed incomplete remission. The team also found that the vaginal microbiomes of the four patients who showed clinical improvement were enriched with Lactobacillus microbes. These microbes have been associated with a healthy vaginal microbiome environment in previous studies.

Although all patients in this small study benefited from the microbiome therapy to some extent, the authors conclude that randomized placebo-controlled trials are required to test the therapeutic efficacy of vaginal microbiome transplant.

doi: 10.1038/s41591-019-0600-6

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