Vaginal pathogenic microbiota

The vaginal pathogenic microbiota refers to a complex community of microorganisms, including anaerobic bacteria, fungi, and protozoa, that proliferate when the healthy vaginal ecosystem is disrupted. In a balanced state, the vagina is typically dominated by Lactobacillus species, which maintain an acidic environment (pH < 4.5) through the production of lactic acid and hydrogen peroxide, thereby inhibiting pathogen growth (NIH, 2021). Dysbiosis occurs when these commensals are depleted, allowing pathogens such as Gardnerella vaginalis, Atopobium vaginae, and Candida albicans to overgrow and often form protective biofilms (PubMed, 2020). This shift is associated with clinical conditions like bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis, which increase the risk of sexually transmitted infections and adverse obstetric outcomes like preterm birth (StatPearls, 2023). Pharmacological intervention typically involves antibiotics like metronidazole or clindamycin and antifungals like fluconazole to reduce the pathogen load. Emerging therapies also focus on the use of probiotics and live biotherapeutic products to restore the protective Lactobacillus population and prevent the high rates of recurrence associated with traditional antimicrobial treatments (Nature Microbiology, 2017).

Other names

Vaginal dysbiosisPathogenic vaginal floraAbnormal vaginal microbiotaVaginal pathogens

Antimicrobial agents disrupt pathogen viability through mechanisms such as DNA strand breakage (nitroimidazoles), inhibition of the 50S ribosomal subunit (lincosamides), or inhibition of lanosterol 14-alpha-demethylase (azoles). Probiotics and live biotherapeutic products function through competitive exclusion, production of antimicrobial compounds (lactic acid, H2O2, bacteriocins), and restoration of a low vaginal pH to suppress pathogenic overgrowth.