Biofilms: An Underappreciated Mechanism of Treatment Failure and Recurrence in Vaginal Infections

Clin Infect Dis. 2015 Aug 15;61(4):601-6. doi: 10.1093/cid/civ353. Epub 2015 May 1.


Biofilms are microbial communities of surface-attached cells embedded in a self-produced extracellular matrix. They are of major medical significance because they decrease susceptibility to antimicrobial agents and enhance the spread of antimicrobial resistance. Biofilm-associated bacterial and fungal microorganisms have increasingly been recognized to play a role in multiple infectious diseases, particularly in their persistence and recurrence. More recently, biofilms have also been implicated in vaginal infections, notably bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC), particularly in the setting of treatment failure and recurrence. The purpose of this review is to discuss the impact of biofilms on the management and treatment of BV and recurrent VVC and highlight the need for additional research and development of novel therapeutics targeting pathogenic vaginal biofilms.

Keywords: bacterial vaginosis; biofilms; recurrent vulvovaginal candidiasis; treatment failure.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Anti-Infective Agents / therapeutic use*
  • Biofilms / drug effects
  • Biofilms / growth & development*
  • Candidiasis, Vulvovaginal / drug therapy*
  • Candidiasis, Vulvovaginal / epidemiology*
  • Disease Models, Animal
  • Female
  • Humans
  • Recurrence
  • Treatment Failure
  • Vaginosis, Bacterial / drug therapy*
  • Vaginosis, Bacterial / epidemiology*


  • Anti-Infective Agents