Lysozyme as a cotreatment during antibiotics use against vaginal infections: An in vitro study on Gardnerella vaginalis biofilm models

Bacterial vaginoses are frequent in women, most of them involving Gardnerella vaginalis. In more than 50% of the cases, usual antibiotic treatments are not capable of eliminating completely the infection, leading to recurrent vaginosis. In addition to the appearance of antibiotic resistance, recurrence can be due to the development of a biofilm by G. vaginalis. In vitro experiments on G. vaginalis biofilms showed that the biofilm protected bacteria from the antibiotic clindamycin. Also, recombinant human lysozyme (rhLys) was able to both degrade biofilms and prevent their formation. This degradation effect persisted whenever other vaginal commensal or pathogenic microorganisms were added to the culture and on each tested clinical biofilm-producing strain of G. vaginalis. The co-administration of rhLys and clindamycin or metronidazole improved both antibiotics’ efficiency and lysozyme-driven biofilm degradation. The comparison of both clindamycin and metronidazole antibacterial spectra showed that metronidazole was preferable to treat vaginosis. This suggests that human lysozyme could be added as an anti-biofilm cotreatment to vaginal antibiotherapy, preferably metronidazole, against Gardnerella vaginalis infection in vivo. [Int Microbiol 19(2): 101-107 (2016)]Keywords: Gardnerella vaginalis · recombinant human lysozyme · clindamycin · metronidazole · biofilms in pathogen

Lysozyme as a cotreatment during antibiotics use against vaginal infections: An in vitro study on Gardnerella vaginalis biofilm models.

Bacterial vaginoses are frequent in women, most of them involving Gardnerella vaginalis. In more than 50% of the cases, usual antibiotic treatments are not capable of eliminating completely the infection, leading to recurrent vaginosis. In addition to the appearance of antibiotic resistance, recurrence can be due to the development of a biofilm by G. vaginalis. In vitro experiments on G. vaginalis biofilms showed that the biofilm protected bacteria from the antibiotic clindamycin. Also, recombinant human lysozyme (rhLys) was able to both degrade biofilms and prevent their formation. This degradation effect persisted whenever other vaginal commensal or pathogenic microorganisms were added to the culture and on each tested clinical biofilm-producing strain of G. vaginalis. The co-administration of rhLys and clindamycin or metronidazole improved both antibiotics' efficiency and lysozyme-driven biofilm degradation. The comparison of both clindamycin and metronidazole antibacterial spectra showed that metronidazole was preferable to treat vaginosis. This suggests that human lysozyme could be added as an anti-biofilm cotreatment to vaginal antibiotherapy, preferably metronidazole, against Gardnerella vaginalis infection in vivo. [Int Microbiol 19(2): 101-107 (2016)]

Hen egg white lysozyme is less active against Gardnerella vaginalis biofilm than human lysozyme

peer reviewedBacterial vaginosis is a condition that affects millions of women worldwide. In most cases, it can be linked to the presence of Gardnerella vaginalis. Classical metronidazole treatments can lead to recurrence of bacterial vaginosis in more than 50% of cases due to its inability to fully eradicate the infection. This can be due to protective shielding of G. vaginalis by the biofilm it synthesizes. We showed previously that the co- administration of recombinant human lysozyme, as a biofilm-degrading agent, with the antibiotic greatly improves its efficiency in vitro. Lysozyme purified from egg white is less expensive than recombinant human lysozyme and is commonly produced as an additive for human consumption. Our goal was to compare the effects of recombinant human lysozyme with that of egg white lysozyme alongside a conventional antibiotic treatment for bacterial vaginosis, using in vitro vaginal biofilm models. The results obtained here show that recombinant human lysozyme is a more efficient biofilm-degrading agent than egg white lysozyme and therefore constitutes a better choice as an anti-biofilm co-treatment for current vaginal antibiotherapy against G. vaginalis infection