A healthy female genital tract harbors a microbiome dominated by lactic acid and
hydrogen peroxide producing bacteria, which provide protection against infections by
maintaining a low pH. Changes in the bacterial compositions of the vaginal microbiome
can lead to bacterial vaginosis (BV), which is often associated with vaginal inflammation.
Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STIs)
like human immunodeficiency virus (HIV) and affects women’s reproductive health
negatively. In pregnant women, BV can lead to chorioamnionitis and adverse pregnancy
outcomes, including preterm premature rupture of the membranes and preterm birth. In
order to manage BV effectively, good diagnostic procedures are required. Traditionally
clinical and microscopic methods have been used to diagnose BV; however, these
methods require skilled staff and time and suffer from reduced sensitivity and specificity.
New diagnostics, including highly sensitive and specific point-of-care (POC) tests,
treatment modalities and vaccines can be developed based on the identification of
biomarkers from the growing pool of vaginal microbiome and vaginal metabolome data.
In this review the current and future diagnostic avenues will be discussed.