Bacterial vaginosis: current understanding, definition and prevention strategies

Igor A. Yatskov , Emiliya R. Zagidullina , Azizakhon J. Artikova , Ameer A. K. Alsous , Polina V. Murynina , Alide A. Resutova , Khatidzhe A. Abdurakhmanova

For citation:

Abstract

Aim. To analyze the current understanding of bacterial vaginosis, focusing on new data on the pathogenesis and evidence-based and promising strategies for its prevention.

Materials and methods. The literature review includes an analysis of scientific papers from the databases PubMed, Embase, eLibrary, CyberLeninka and Web of Science, CNKI and MEDLINE.

Results. Bacterial vaginosis (BV) remains the most common infectious non-inflammatory syndrome among women of reproductive age, with a prevalence of 15 to 50% in various populations. The modern understanding of BV has evolved from simple dysbiosis to a model of polymicrobial synergy within a structured biofilm, where Gardnerella vaginalis and Atopobium vaginae play a key role. The high recurrence rate (up to 60% within a year) after standard antibiotic therapy highlights the ineffectiveness of an exclusively eradication approach and dictates the need to shift the focus towards prevention and restoration of normocenosis.

Conclusion. Bacterial vaginosis, from a modern perspective, is a complex polymicrobial disease based on the formation of a stable biofilm and profound dysfunction of the vaginal microbiome, mediated by a complex interaction of microbial, immunological, and possibly epigenetic factors. Existing treatment methods aimed at the eradication of pathogens do not solve the problem dramatically due to the high frequency of relapses. In this regard, the development and implementation of new prevention strategies is becoming a priority.

Keywords: bacterial vaginosis, vaginal microbiome, biofilm, relapse, prevention, probiotics, postbiotics, immunomodulation, epigenetics.

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For citation:Yatskov I.A., Zagidullina E.R., Artikova A.J., Alsous A.A.K., Murynina P.V., Resutova A.A., Abdurakhmanova Kh.A. Bacterial vaginosis: current understanding, definition and prevention strategies. Clinical review for general practice. 2026; 7 (2): 89–92 (In Russ.). DOI: 10.47407/kr2026.7.04.00p4551

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Clinical review for general practice