VAGINAL MICROBIOME DYSBIOSIS AND RECURRENT BACTERIAL VAGINOSIS: BIOFILM ECOLOGY, CLINICAL EVIDENCE, REALWORLD ANALYTICS AND PRECISION PREVENTION

 Recurrent  bacterial  vaginosis  (BV)  constitutes  a  persistent  clinical  challenge  in  which  temporary  symptom  resolution  after  antimicrobial  therapy  frequently fails to produce durable microbial recovery. Its pathobiology involves loss  of  protective  lactic-acid producing  vaginal  communities,  expansion  of  diverse  anaerobic  organisms,  surface-associated  polymicrobial  structures,  host–microbe  interactions, and sexual exchange of BV-associated bacteria. Objective: To critically  synthesize  microbiological  and  clinical  conventional and emerging prevention strategies, and assess the role of real-world  evidence  (RWE)  and  computational  methods.