Trapianto di microbioma vaginale per vaginosi batterica ricorrente

In order to prevent transfer of pathogens, sperm, or antibiotic-resistant commensals we will establish a "vaginal fluid bank" in which samples from suitable donors will be kept for future use:

• Donors will be screened using a questionnaire addressing risk factors for potentially transmissible infections, undergo screening for cervico-vaginal infections, cervical cytology screening, and serology analysis for transmittable infections {see detailed screening in Lev-Sagie et al. Nat Med. 2019;25(10):1500-1504. doi: 10.1038/s41591-019-0600-6.}
• The collected samples for VMT will be examined for bacteria,viruses and sperm.

Before transplantation, patients will be treated with intravaginal antibiotics. A frozen specimen will be thawed at room temperature and will be placed in the patient's vagina.

Following VMT, patients will be evaluated every 14 days for the first month, then every month for additional 11 months.

Saline with glycerol will be used as placebo. Before transplantation, patients will be treated with intravaginal antibiotic.

Following Placebo, patients will be evaluated every 14 days for the first months, then every month for additional 2-4 months.

After 4 months, patients who initially received placebo will be offered a VMT in case they are still symptomatic and fulfill inclusion criteria, in an open-label phase.