title: Presence of a polymicrobial endometrial biofilm in patients with bacterial vaginosis.
abstract: OBJECTIVE
  To assess whether the bacterial vaginosis biofilm extends into the upper female genital tract.
  
  
  METHODS
  Endometrial samples obtained during curettage and fallopian tube samples obtained during salpingectomy were collected. Endometrial and fallopian tube samples were analyzed for the presence of bacteria with fluorescence-in-situ-hybridisation (FISH) analysis with probes targeting bacterial vaginosis-associated and other bacteria.
  
  
  RESULTS
  A structured polymicrobial Gardnerella vaginalis biofilm could be detected in part of the endometrial and fallopian tube specimens. Women with bacterial vaginosis had a 50.0% (95% CI 24.0-76.0) risk of presenting with an endometrial Gardnerella vaginalis biofilm. Pregnancy (AOR  = 41.5, 95% CI 5.0-341.9, p<0.001) and the presence of bacterial vaginosis (AOR  = 23.2, 95% CI 2.6-205.9, p<0.001) were highly predictive of the presence of uterine or fallopian bacterial colonisation when compared to non-pregnant women without bacterial vaginosis.
  
  
  CONCLUSIONS
  Bacterial vaginosis is frequently associated with the presence of a structured polymicrobial Gardnerella vaginalis biofilm attached to the endometrium. This may have major implications for our understanding of the pathogenesis of adverse pregnancy outcome in association with bacterial vaginosis.
authors: Charité Hospital, CCM, Laboratory for Molecular Genetics, Polymicrobial Infections and Bacterial Biofilms and Department of Medicine, Gastroenterology, Universitätsmedizin Berlin, Berlin, Germany.
authors: Alexander
authors: A
authors: Swidsinski
authors: Hans
authors: H
authors: Verstraelen
authors: Vera
authors: V
authors: Loening-Baucke
authors: Sonja
authors: S
authors: Swidsinski
authors: Werner
authors: W
authors: Mendling
authors: Zaher
authors: Z
authors: Halwani
mesh_terms: D018441:Biofilms; D004717:Endometrium / Q000382:microbiology*; D005187:Fallopian Tubes / Q000382:microbiology; D005260:Female; D006194:Gardnerella vaginalis / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D011256:Pregnancy Outcome; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000150:complications / Q000382:microbiology* / Q000652:urine