Gonorrhea: lactobacilli to the rescue?

Also known as “the clap” or “drip”, gonorrhea is a sexually transmitted infection (STI) that poses a public health problem for both sexes. In women, it can remain silent (more than 50% of women are asymptomatic) or show symptoms such as purulent discharge, lower abdominal pain or burning urination. The reasons for this difference are not known.

^{Sources (sidenote: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis) )}

Neisseria gonorrhoeae to blame

Gonorrhea is caused by Neisseria gonorrhoeae, a very discreet bacterium which, according to one recent study, represents only 0.24% of the bacteria present in the vagina and cervix of infected women (it is obviously absent in uninfected women). The presence of other bacteria in the vagina of infected women varies according to the symptoms.

Gonorrhea: a question of lactobacilli?

In asymptomatic infected women lactobacilli dominate. These rod-shaped bacteria, well known to yogurt lovers, represent more than 92% of the bacteria found in the cervix and vagina of these women. This results in the correct acidification of the vagina, which is thought to keep other microorganisms at bay.

On the other hand, in symptomatic infected women, lactobacilli are depleted, accounting for less than a quarter of the bacteria present (21.2%). Instead of being dominated by these “good” bacteria, the microbiota shows significant diversity and heterogeneity in terms of the microorganisms present. This composition is generally not a good sign for the vaginal microbiota. Unlike the body’s other microbiota (gut, skin, etc.), the vaginal microbiota is healthy when lactobacilli dominate. Furthermore, the bacteria found in the vagina of symptomatic women are not to be desired, since they are frequently associated with bacterial vaginosis.

^{Sources (sidenote: https://www.who.int/news-room/fact-sheets/detail/multi-drug-resistant-gonorrhoea )}