Bacterial vaginosis (BV), the change from a Lactobacillus-dominant vaginal microbiota to an anaerobic and facultative bacterial dominance, is associated with pathological sequelae. In many BV-positive women their microbiota is in fact normal and unrelated to pathology. Whether or not the dominance of BV-associated bacteria persists depends upon interactions between host and bacterial factors. Inconsistencies in diagnosis and erroneous associations with pathology may be due to a failure to differentiate between sub-populations of women. It is only in those women with a BV diagnosis in which the identified bacteria are atypical and persist that BV may be a clinical problem requiring intervention.
Tweetable abstract: Improved diagnosis of bacterial vaginosis is needed to accurately determine its role in pathology.
Keywords: Bacterial vaginosis; diagnosis; gene polymorphism; innate immunity; vaginal microbiota.
© 2016 Royal College of Obstetricians and Gynaecologists.