Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine
Bacterial vaginosis (BV) affects 30% of women annually, but many face barriers to in-person care. Here we present real-world outcomes of remote BV diagnosis and management through self-collected vaginal microbiome (VMB) testing and telemedicine visits, focusing on symptom resolution, recurrence, and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2025-07-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/13/7/1623 |
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| author | Krystal Thomas-White Genevieve Olmschenk David Lyttle Rob Markowitz Pita Navarro Kate McLean |
| author_facet | Krystal Thomas-White Genevieve Olmschenk David Lyttle Rob Markowitz Pita Navarro Kate McLean |
| author_sort | Krystal Thomas-White |
| collection | DOAJ |
| description | Bacterial vaginosis (BV) affects 30% of women annually, but many face barriers to in-person care. Here we present real-world outcomes of remote BV diagnosis and management through self-collected vaginal microbiome (VMB) testing and telemedicine visits, focusing on symptom resolution, recurrence, and overall microbial shifts. Among the 1159 study participants, 75.5% experienced symptom resolution at four weeks when managed with our algorithm-guided treatment protocol. At a median follow-up of 4.4 months after the initial visit, 30.0% of patients experienced recurrent BV, which is lower than the typical recurrence rates seen in historical in-person cohorts. Across the entire cohort, metagenomic data demonstrated a significant increase in <i>Lactobacillus</i> abundance (mean of 32.9% to 48.4%, <i>p</i> < 0.0001) and a corresponding decrease in BV-associated taxa such as <i>Gardnerella</i>, <i>Prevotella</i>, and <i>Fannyhessea</i>. A PERMANOVA of pairwise Bray–Curtis distances showed significant separation between pre-and post-treatment samples (pseudo-F = 37.6, <i>p</i> < 0.0001), driven by an increase in <i>Lactobacillus</i>-dominated samples. Treatment adherence was high (a total of 78% reported perfect or near-perfect adherence), and adverse events were generally mild (in total, 22% reported vaginal irritation, and 13% reported abnormal discharge). These results demonstrate that Evvy’s at-home metagenomic platform, paired with telemedicine and a smart treatment algorithm, delivers robust clinical and microbial outcomes. This work offers a novel approach to managing bacterial vaginosis, a challenging condition characterized by persistently high recurrence rates. |
| format | Article |
| id | doaj-art-01cb0c8ff27341db94e3bf861a226a6e |
| institution | DOAJ |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-01cb0c8ff27341db94e3bf861a226a6e2025-08-20T03:08:06ZengMDPI AGMicroorganisms2076-26072025-07-01137162310.3390/microorganisms13071623Remote BV Management via Metagenomic Vaginal Microbiome Testing and TelemedicineKrystal Thomas-White0Genevieve Olmschenk1David Lyttle2Rob Markowitz3Pita Navarro4Kate McLean5Evvy, New York, NY 10001, USAEvvy, New York, NY 10001, USAEvvy, New York, NY 10001, USAEvvy, New York, NY 10001, USAEvvy, New York, NY 10001, USAEvvy, New York, NY 10001, USABacterial vaginosis (BV) affects 30% of women annually, but many face barriers to in-person care. Here we present real-world outcomes of remote BV diagnosis and management through self-collected vaginal microbiome (VMB) testing and telemedicine visits, focusing on symptom resolution, recurrence, and overall microbial shifts. Among the 1159 study participants, 75.5% experienced symptom resolution at four weeks when managed with our algorithm-guided treatment protocol. At a median follow-up of 4.4 months after the initial visit, 30.0% of patients experienced recurrent BV, which is lower than the typical recurrence rates seen in historical in-person cohorts. Across the entire cohort, metagenomic data demonstrated a significant increase in <i>Lactobacillus</i> abundance (mean of 32.9% to 48.4%, <i>p</i> < 0.0001) and a corresponding decrease in BV-associated taxa such as <i>Gardnerella</i>, <i>Prevotella</i>, and <i>Fannyhessea</i>. A PERMANOVA of pairwise Bray–Curtis distances showed significant separation between pre-and post-treatment samples (pseudo-F = 37.6, <i>p</i> < 0.0001), driven by an increase in <i>Lactobacillus</i>-dominated samples. Treatment adherence was high (a total of 78% reported perfect or near-perfect adherence), and adverse events were generally mild (in total, 22% reported vaginal irritation, and 13% reported abnormal discharge). These results demonstrate that Evvy’s at-home metagenomic platform, paired with telemedicine and a smart treatment algorithm, delivers robust clinical and microbial outcomes. This work offers a novel approach to managing bacterial vaginosis, a challenging condition characterized by persistently high recurrence rates.https://www.mdpi.com/2076-2607/13/7/1623bacterial vaginosistelemedicinevaginitismetagenomicsdiagnostics |
| spellingShingle | Krystal Thomas-White Genevieve Olmschenk David Lyttle Rob Markowitz Pita Navarro Kate McLean Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine Microorganisms bacterial vaginosis telemedicine vaginitis metagenomics diagnostics |
| title | Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine |
| title_full | Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine |
| title_fullStr | Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine |
| title_full_unstemmed | Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine |
| title_short | Remote BV Management via Metagenomic Vaginal Microbiome Testing and Telemedicine |
| title_sort | remote bv management via metagenomic vaginal microbiome testing and telemedicine |
| topic | bacterial vaginosis telemedicine vaginitis metagenomics diagnostics |
| url | https://www.mdpi.com/2076-2607/13/7/1623 |
| work_keys_str_mv | AT krystalthomaswhite remotebvmanagementviametagenomicvaginalmicrobiometestingandtelemedicine AT genevieveolmschenk remotebvmanagementviametagenomicvaginalmicrobiometestingandtelemedicine AT davidlyttle remotebvmanagementviametagenomicvaginalmicrobiometestingandtelemedicine AT robmarkowitz remotebvmanagementviametagenomicvaginalmicrobiometestingandtelemedicine AT pitanavarro remotebvmanagementviametagenomicvaginalmicrobiometestingandtelemedicine AT katemclean remotebvmanagementviametagenomicvaginalmicrobiometestingandtelemedicine |