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PHILADELPHIA, PA – Researchers at Drexel University have developed a groundbreaking DNA-based test that promises to revolutionize the treatment of bacterial vaginosis (BV), a common condition affecting millions of women. The test, detailed in a recent publication in the journal Genome Medicine, offers a more precise approach to diagnosing and treating BV, potentially reducing treatment failures and improving patient outcomes.
Bacterial vaginosis, characterized by unpleasant odors and potential discomfort, affects roughly one in three women aged 14-49 in the United States. Current first-line treatment often involves the antibiotic metronidazole. However, more than half of patients experience treatment failure and recurrence, highlighting the need for more targeted therapies.
The new test utilizes a simple PCR-based method to analyze the genetic makeup of Gardnerella species, the primary bacterial group associated with BV. Previous research revealed that Gardnerella is not a single species but a complex group of diverse organisms. The Drexel team’s analysis, involving genome sequencing of 129 Gardnerella genomes, identified 11 distinct genospecies within several major clades.
Crucially, the researchers discovered that two of these clades, comprising five genospecies, exhibit 100% resistance to metronidazole but remain susceptible to clindamycin. The new PCR test can differentiate between these strains, allowing clinicians to prescribe the appropriate antibiotic for each patient.
“If this test becomes available to patients, they can avoid taking the wrong antibiotic, avoiding additional potential side effects and financial costs,” explained lead author Katherine Innamorati, Ph.D., an instructor at Drexel University College of Medicine. “Faster treatment and better antibiotic stewardship is especially important for patients who may need to take multiple courses of antibiotics to fully eliminate the infection.”
BV, while not strictly a sexually transmitted infection, can be influenced by sexual activity. Untreated cases can increase the risk of sexually transmitted infections and pregnancy complications. An estimated 50% of BV cases are asymptomatic, leading to many cases going untreated.
The team is also investigating the genetic mechanisms behind metronidazole resistance, aiming to further refine the test’s capabilities. Additionally, recent findings published in the New England Journal of Medicine suggest that treating male partners of women with recurrent BV with antibiotics may reduce recurrence, adding another layer to the complex treatment landscape.
The researchers have filed for a patent on the DNA test, and they hope that commercial labs will make it widely available.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. The information provided in this article is based on the research cited and may be subject to change as new research emerges. The availability of the described test for clinical use is dependent on commercialization and regulatory approval.(
More information: Katherine A. Innamorati et al, Metronidazole response profiles of Gardnerella species are congruent with phylogenetic and comparative genomic analyses, Genome Medicine (2025). DOI: 10.1186/s13073-025-01446-4
