Bacteria Associated with Bacterial Vaginosis

To the Editor: Fredricks and colleagues (Nov. 3 issue) 1 reported complex communities of bacteria and a high level of species diversity in vaginal secretions from women with bacterial vaginosis. However, the study of vaginal fluid alone provides an incomplete picture of disease pathogenesis, since infections also may affect the vaginal epithelium. Fluorescence in situ hybridization of vaginal-biopsy specimens with the use of bacteria-specific probes demonstrates that a clinical diagnosis of bacterial vaginosis is highly associated with the development of a bacterial biofilm on the epithelial surface. 2 Gardnerella and atopobium species together constitute more than 90 percent of the biofilm mass. . . .