Authors: Nuno Cerca (University of Minho, Portugal)
Take a look behind the scenes of a recent Future Microbiology review, entitled ‘Could targeting neighboring bacterial populations help to combat bacterial vaginosis?’, as we ask the authors about the challenges in treating bacterial vaginosis (BV) and the future of this field.
What inspired you to write this piece?
When I heard about the BV multi-species biofilms I became curious about the role of each species in the development of BV. Similar to other biofilm-related infections, important roles in the development of the infection are often attributed to one or a few species, while many others are simply opportunistic having no role in the development or progression of the infection.
However, we should not neglect the fact that microbial interaction might induce (or repress) virulence in key pathogens. It’s possible that by interfering with these interactions, we can prevent, or easily treat multi-species biofilm infections.
What are the main challenges in treating bacterial vaginosis?
Current therapies are effective in alleviating symptoms but often recurrence occurs. Because it’s not yet clear what key species are involved in the development and progression of BV, we really can’t find effective and accurate antibacterial targets. Furthermore, not a lot of work has been focused on the development of antimicrobial agents effective against biofilms.
Why are biofilms such a problem?
When bacteria grow as biofilms, they shift their metabolism to a more dormant state; this has implications in the activity of many antibiotics. Also, within the biofilm layers, different micro-environments allow for the development of distinct bacterial phenotypes, some more tolerant than others to external stresses. As such, while antibiotics and antiseptics might kill some of the bacteria within the more external layers of the biofilm, it fails to completely eradicate all the biofilm bacteria.
What can be done to overcome vaginosis biofilms?
There is still a lot to be elucidated regarding how bacterial species interact within the BV biofilm. We need to clarify if BV can, or can’t, occur just in the presence of G. vaginalis. If in fact more than one species is required, we need to figure out what species are involved and what the key interactions are between them that lead to BV. By interfering/inhibiting these key interactions, BV might be able to be prevented.
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