Prevotella is a gram-negative bacterial genus, a common microbe often part of the commensal (normal) mouth and vaginal flora. Prevotella can be involved in anaerobic infections of the respiratory tract, including the lungs, nose, throat, and ear1.
Periodontal (gum) disease and abscesses are commonly associated with Prevotella spp.
Catching vaginal Prevotella from recieving oral sex
Prevotella may be implicated in bacterial vaginosis (BV) that appears to originate from oral sex or via saliva used as lube in the vagina. This transmission route is by no means obvious since the vagina can easily contain these bacteria as a natural component. Dentists have been engaged in an ongoing battle with Prevotella species.
Where Prevotella species cause infections
Prevotella has been found in mouth wounds, bites, urinary tract infections (UTIs), brain abscesses, bone inflammation (osteomyelitis), bacterial or fungal nail infections (paronychia), and bacterial infections in the blood (bacteraemia).
Some groups of people in certain populations have Prevotella species abundant in the intestine, while others show no signs.
Diet is the presumed cause, with those eating a lot of protein and animal fats having more Bacteroides bacteria, and those with a carb-heavy diet having more Prevotella species.
Treating Prevotella in the vagina
When Prevotella is found in the vagina, it’s most likely connected to BV, and requires thorough testing and appropriate treatment. Aunt Vadge’s BV-Prevella Clear is specifically designed to target Prevotella species and other BV-related bacteria and increasing vaginal pH with abundant protective lactobacilli species.
Targets BV with Prevotella and Hoylesella, supporting restoration of a protective microbiome.
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Prevotella is an opportunist
Prevotella are present in animals and humans, with human infection being based on opportunity. If the environment is right, Prevotella can enter and start to colonise.
Prevotella strains are gram-negative, non-motile, rod-shaped single cells that operate best in anaerobic conditions. Prevotella colonises by binding to other bacteria and epithelial cells, which can exacerbate an existing infection with other bacteria.
Prevotella species take on different forms in their life cycle, and some can form biofilms, which may be of mixed species.
Prevotella are antibiotic resistant
Prevotella is naturally antibiotic-resistant (genetically), which means this species does not respond very well to antibiotic therapy, though it is known (at least at the moment)to respond to metronidazole, moxicillin/clavulanate, ureidopenicillins, carbapenems, cephalosporins, clindamycin, and chloramphenicol.
Prevotella generally uses a fermentative method of metabolism, with some species requiring vitamin K and heme (in blood) to survive. There is an association with β-Lactamase activity, with some species resistant to β-lactam antibiotics.
Some antibiotic treatments can actually make Prevotella infections worse, for example, aminoglycosides, trimethoprim/sulfamethoxazole, and quinolones. Prevotella can produce collagenase, neuraminidase, deoxyribonuclease, heparinase and proteases.
Prevotella likes mucosal surfaces
Prevotella exists on most mucosal surfaces – mouth, gut, urinary tract and vagina. Anything oxygen-deprived is a target, which is why wounds and tissue with little blood supply is a favourite.
Prevotella intermedia is a biofilm-creating species which also enjoys a higher pH, with ideal temperatures sitting at between 34 and 36˚C.
Prevotella tends to proliferate during times of increased hormone production too, particularly during pregnancy and puberty/adolescence.
Prevotella species are commonly found in healthy vaginas, with species including P. oralis, P. timonensis (now Hoylesella timonensis), P. bivia, P. disiens, P. oris and P. buccae.
Some species of Prevotella can cause respiratory problems – chronic ear infections, chronic sinusitis, pneumonia, abscesses in the lungs, and neck lymph node infections.
Prevotella species are abundant
Twenty species of Prevotella cause infection, typically presenting as periodontitis, abscesses, bacterial infections of the blood, infection of wounds, and infection in the genital tract.
Bacteroides melaninogenicus was turned into two new classified species: Prevotella melaninogenica and Prevotella intermedia.
There are 29 known species of Prevotella:
- Prevotella albensis
- Prevotella amnii
- Prevotella bergensis
- Prevotella bivia
- Prevotella brevis
- Prevotella bryantii
- Prevotella buccae
- Prevotella buccalis
- Prevotella copri
- Prevotella dentalis
- Prevotella denticola
- Prevotella disiens
- Prevotella histicola
- Prevotella intermedia
- Prevotella maculosa
- Prevotella marshii
- Prevotella melaninogenica
- Prevotella micans
- Prevotella multiformis
- Prevotella nigrescens
- Prevotella oralis
- Prevotella oris
- Prevotella oulorum
- Prevotella pallens
- Prevotella salivae
- Prevotella stercorea
- Prevotella tannerae
- Prevotella timonensis (now Hoylesella timonensis)2
- Prevotella veroralis
References
- 1.Baron S. Medical Microbiology. Published online January 1, 1996. https://www.ncbi.nlm.nih.gov/pubmed/21413252
- 2.Carella A, Carroll KC, Munson E. Update on novel validly published and included bacterial taxa derived from human clinical specimens and taxonomic revisions published in 2023. Humphries RM, ed. J Clin Microbiol. Published online December 11, 2024. doi:10.1128/jcm.01004-24
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