Vaginal microbiome transplantation in women with intractable bacterial vaginosis

Nat Med. 2019 Oct;25(10):1500-1504. doi: 10.1038/s41591-019-0600-6. Epub 2019 Oct 7.

Abstract

We report the results of a first exploratory study testing the use of vaginal microbiome transplantation (VMT) from healthy donors as a therapeutic alternative for patients suffering from symptomatic, intractable and recurrent bacterial vaginosis (ClinicalTrials.gov NCT02236429 ). In our case series, five patients were treated, and in four of them VMT was associated with full long-term remission until the end of follow-up at 5-21 months after VMT, defined as marked improvement of symptoms, Amsel criteria, microscopic vaginal fluid appearance and reconstitution of a Lactobacillus-dominated vaginal microbiome. One patient presented with incomplete remission in clinical and laboratory features. No adverse effects were observed in any of the five women. Notably, remission in three patients necessitated repeated VMT, including a donor change in one patient, to elicit a long-standing clinical response. The therapeutic efficacy of VMT in women with intractable and recurrent bacterial vaginosis should be further determined in randomized, placebo-controlled clinical trials.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Lactobacillus / genetics
  • Lactobacillus / growth & development*
  • Microbiota* / genetics
  • Middle Aged
  • Probiotics / therapeutic use
  • Remission Induction
  • Tissue Donors
  • Vagina / microbiology*
  • Vagina / pathology
  • Vaginosis, Bacterial / microbiology
  • Vaginosis, Bacterial / pathology
  • Vaginosis, Bacterial / therapy*

Associated data

  • ClinicalTrials.gov/NCT02236429