{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:11:15Z","timestamp":1792069875663,"version":"4.4.0"},"reference-count":104,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["1R21AI111103"],"award-info":[{"award-number":["1R21AI111103"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Bacterial vaginosis (BV) is associated with a state of vaginal dysbiosis typically involving depletion of otherwise dominant populations of <jats:italic>Lactobacillus<\/jats:italic>. The causes of this microbial succession are not known; there may be multiple causes. Standard treatment includes oral metronidazole, which typically restores <jats:italic>Lactobacillus<\/jats:italic> species to dominance. However, recurrence rates are high; recurrent BV patients recur 3\u20134 times annually and are often refractory to treatment. Our previous qPCR-based study of recurrent BV patients pointed to putatively more virulent species of <jats:italic>Gardnerella<\/jats:italic> that were associated with refractory responses to oral metronidazole, and less robust recovery of <jats:italic>Lactobacillus<\/jats:italic> species associated with recurrence after an initial period of remission. However, these associations did not account for outcomes in all patients, suggesting that other bacterial species were involved. In this follow-up study, we sequenced the V4 domain of 16S rRNA sequences of 41of these same patients pre- and posttreatment. Overall compositions among pretreatment clinical outcome groups were not different, although alpha diversity significantly decreased: refractory &gt; recurrent &gt; remission. Combinations of key species were associated with and prognostic for outcome. Higher pretreatment abundance of <jats:italic>Megasphaera lornae<\/jats:italic> together with lower abundance of <jats:italic>Gardnerella Gsp07<\/jats:italic> and <jats:italic>Finegoldia magna<\/jats:italic> predicted long term remission after oral metronidazole. Furthermore, a subset of refractory patients that did not have high levels of <jats:italic>Gardnerella Gsp07<\/jats:italic>, instead had elevated levels of alternative species including <jats:italic>Atopobium vaginae<\/jats:italic>, <jats:italic>Mageeibacillus indolicus (BVAB3)<\/jats:italic>, and <jats:italic>Prevotella timonensis<\/jats:italic>. Patients who recurred after transient remission had elevated abundance of species including <jats:italic>Atopobium vaginae<\/jats:italic>, <jats:italic>Gardnerella<\/jats:italic>, and <jats:italic>Aerococcus christensenii<\/jats:italic>, compared to long-term remission patients. Core bacterial species among refractory patients did not change in abundance after metronidazole, suggesting resistance or tolerance, in contrast to the loss in abundance of the same species among recurrent or remission patients. These findings have potential prognostic and therapeutic implications.<\/jats:p>","DOI":"10.1371\/journal.pone.0272012","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T18:28:19Z","timestamp":1659032899000},"page":"e0272012","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":32,"title":["Association of key species of vaginal bacteria of recurrent bacterial vaginosis patients before and after oral metronidazole therapy with short- and long-term clinical outcomes"],"prefix":"10.1371","volume":"17","author":[{"given":"Ashomathi","family":"Mollin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounika","family":"Katta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack 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